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Vol. 13
JUNE 2022
ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL
14 24 60
Company Showcase Elite Biomedical Solutions
Company Showcase The InterMed Group
Roundtable Training/Education
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PITTSBURGH • TULSA • DENVER
CONTENTS
FEATURED COVER STORY
60
THE ROUNDTABLE: TRAINING/EDUCATION Insiders share insights regarding HTM education and training.
I 68
ext month’s Feature article: N CMMS
68
n an age of graying biomeds, the resources to replace the exodus of talent are few. A wealth of experience is exiting a profession that most people have never heard of, so replenishment is a challenge. AAMI estimates that half of all biomeds are over age 50. TECHNATION
JUNE 2022
For employers, the question is; how do you onboard new biomeds who have technical training and hands-on experience? For a student, who has an interest in the profession, or someone who is trained who seeks hand-on experience, how do you garner experience or prove your worth to an employer?
There are vehicles to accomplish all of these objectives and they come in different stripes, ranging from “shadowing” to a formal internship to a paid apprenticeship. Within each, there is a commitment by both the student, career-changer or trainee and the employer or supervisor. There are expectations of each party, and
GETTING OFF ON THE RIGHT FOOT: BMET APPRENTICESHIP & INTERNSHIPS BMET apprenticeships and internships can provide qualified applicants for vacant HTM jobs. WWW.1TECHNATION.COM
ext month’s Feature article: N How IT Security Impacts HTM
TechNation (Vol. 13, Issue #6) June 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
JUNE 2022
TECHNATION
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CONTENTS
INSIDE Departments
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
webinar@mdpublishing.com
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
P.12 SPOTLIGHT p.12 Department of the Month: McLaren Greater Lansing Hospital Clinical Engineering Department p.14 Company Showcase: Elite Biomedical Solutions p.18 Professional of the Month: Elvin Velez p.20 Shifting Gears: Biomed Children’s Book Writer p.24 Company Showcase: The InterMed Group P.28 p.28 p.33 p.40 p.42 p.44 p.46
INDUSTRY UPDATES MD Expo Recap News & Notes Ribbon Cutting: Voytek Medical ECRI Update AAMI Update Welcome to TechNation
P.48 p.48 p.52 p.55 p.56
THE BENCH Biomed 101 Shop Talk Tools of the Trade Webinar Wednesday
P.74 EXPERT ADVICE p.74 Career Center p.76 Sponsored Content: Avante Health Solutions p.78 The Future p.80 Sponsored Content: SPBS p.82 Cybersecurity p.84 Sponsored Content: 20/20 Imaging Insights Innovatus Imaging p.88 Sponsored Content: Althea p.91 The Other Side p.92 Sponsored Content: ReNew Biomedical P.96 BREAKROOM p.96 Did You Know? p.98 The Vault p.100 Where in the World is Ben C.? p.102 HTM Jobs p.106 MD Expo Scrapbook p.114 HTM Strong p.110 Service Index p.113 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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SPOTLIGHT
DEPARTMENT OF THE MONTH: McLaren Greater Lansing Hospital Clinical Engineering Department BY K. RICHARD DOUGLAS
D
uring the mid-1960s, license plates in Michigan bore the slogan: “Water-Winter Wonderland.” The plates were available through 1967. In 2021, the Michigan Secretary of State revived the historic plate. Most license plates today have the “Pure Michigan” slogan.
The old slogan may be the most appropriate one for many people, reflecting Michigan’s four seasons and the outdoor attractions that bring many to the state, along with favorite activities of residents who enjoy skiing or the Great Lakes. While the outdoor activities can be an enjoyable part of the state, there are times when residents need health care. McLaren Health Care, which is headquartered in Grand Blanc, Michigan, is a $6 billion health care system serving the needs of Michigan and Ohio residents. One of the systems 14 hospitals is located in Michigan’s capital city of Lansing. McLaren Greater Lansing is a tertiary teaching facility located on the edge of the Michigan State University
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campus. The hospital’s clinical engineering (CE) team manages the facility’s medical equipment. The facility recently opened thanks to an enormous effort from the CE team. “Greater Lansing originally had two campuses/hospitals—Penn and Greenlawn—which are part of the larger McLaren Health Care system. This project was to build a single replacement hospital for both sites next to the campus of (and in conjunction with) Michigan State University,” says Samantha Jacques, Ph.D., FACHE, AAMIF, vice president of McLaren Clinical Engineering Services (MCES). Jacques says at the Greater Lansing location eight staff members in Zak Fitch, Karl Ervin, Spencer Cottrell, Ronald “Rip” Kinne, Mitchell Roach, David Webber, Steve Bucsi and Brian Carver. Rick McCloy, who recently retired, served as the project lead and is a former CE manager. Gary Woods and Nate Thayer, members of the corporate team, were
brought in to help with medical device integration and cybersecurity along with clinical engineer Pam Shuck. Among the core team of techs, Ervin specializes in ventilators. Fitch specializes in anesthesia. Carver specializes in imaging. Each team member is crosstrained on a variety of monitors and devices. “Gary Woods does all the biomedical device integration (BMDI) for anesthesia, ventilators, fetal monitors and patient monitors. Nate Thayer is responsible for medical device cybersecurity and aided Gary in the BMDI work. Pam Shuck managed the implementation of the new EKG management system and the vital signs (Welch Allyn) integration,” Jacques says. Most work on the system’s medical equipment is handled in-house by CE team members. “We have a centralized contract management team at corporate that handles renewals and negotiations. We have very few contracts on equipment as most repairs are
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SPOTLIGHT The McLaren Greater Lansing Hospital Clinical Engineering Department recently completed a hospital-consolidation project in addition to its regular duties.
handled in house,” Jacques explains. Data collection is handled through a centralized CMMS system that serves the entire system. “For this project, we also had to employ an equipment planning software to track and manage all the net new purchases as well as track what was moving from which campus to the new campus,” Jacques says.
COMPLETING A MEGA-PROJECT The hospital-consolidation project tested the skills of the entire biomed team. Leadership for the project was imperative for getting the medical equipment portion accomplished. “This project started in December of 2017 when the announcement was made that McLaren was going to consolidate its two Lansing hospitals into a new $600 million campus adjacent to Michigan State University. We broke ground in 2018. The replacement hospital is a 39-acre, 240-bed, state-of-the-art hospital, Karmanos Cancer Center and an ambulatory care center,” Jacques says. She says that with over 750,000 square feet, the new hospital’s spaces were designed with patients and clinical workflow in mind. “It includes an expanded emergency department, ICU and patient care areas. It also includes the Orthopedic and Sports Medicine Institute, Heart and Vascular Institute and Karmanos Cancer Institute,
which provides expanded health care services to the region,” Jacques adds. The CE team pulled off an inspiring feat through hard work and confident leadership. “Building a new hospital, during a pandemic, while still maintaining the current two hospitals was more than challenging. The team on site spent endless hours working between multiple sites, ensuring operations continued flawlessly, while unpacking, installing and deploying a bevy of new technology at a new site. Coordination of vendor installs, integration of technology with IT platforms, and testing of technology newly implemented also had to be coordinated,” Jacques says. The efforts of the entire team remained focused under the direction of the manager. “Rick McCloy, who started his 45-year career as a BMET assistant at the site, rose up through the ranks to lead the department as it’s manager when this project was first conceived. In late 2020, he transferred full time over to the project to manage and coordinate all the CE work for the project,” Jacques says. She says that McCloy retired on April 1, 2022, having led all the equipment management for one of the most complex projects in McLaren history. His endless hours and remarkable dedication to getting the details right have made all the difference in the project, she says.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
“Patient move day was probably the most challenging as two teams had to be deployed to different locations to uninstall equipment that was moving, as the patients were moving. As the patients were transported to the new hospital, teams had to remove the equipment from the departments, transport them to the new hospital and re-install them,” Jacques says. She says that the amount of coordination to ensure same day moves happened, with no impact to patient care, was astonishing. The team worked long hours and did what it took to make the opening incredibly successful. Jacques says that it was a wonderful team effort. “This department does have two AAMI BMET apprentices in the program developed by AAMI (Mitchell and Spencer). This was an awesome opportunity for both of them to learn about technology and gain valuable experience on their way to CBET certification,” Jacques says. Michigan’s capital city is served by an impressive new medical facility completed during the COVID-19 pandemic. A competent team of HTM professionals, led by a knowledgeable and experienced manager, were able to successfully complete the mega-project, with flawless medical device installation and integration.
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SPOTLIGHT
SPECIAL ADVERTISING SECTION
COMPANY SHOWCASE Elite Biomedical Solutions Why Made in the USA Counts
T
hird-party biomedical NOEM parts manufacturers play an essential role in keeping hospital assets up and running. Health systems and service organizations benefit by seeking strategic partnerships with 3rd-party NOEM parts manufacturers based on a shared commitment to patient-centered care.
In the medical device industry, patient safety is directly connected to the supply chain. Dynamic socioeconomic and regulatory factors influence domestic and international supply networks. The global supply chain holds impressive economic power, but it also carries a complex burden of risk. Some U.S. biomedical companies import and sell internationally sourced replacement parts, while others obtain components from overseas manufacturers, then assemble parts stateside. Many of them are responsible businesses, but they can never eliminate the complicated risks associated with the global supply chain.
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For this reason, starting with U.S. manufacturers when searching for a strategic 3rd-party biomedical device partner makes sense. Here’s why:
U.S. MANUFACTURERS CONTROL PRODUCT DECISIONS A product legally falls under the “Made in the USA” description when “all, or virtually all” parts, processing, and labor originate in the United States. Most Americans associate “Made in the USA” with secure U.S. job creation and good quality due to American manufacturing standards that exceed those in other parts of the world. Starting with “Made in the USA” means that a potential 3rd-party partner knows all of the specifics about production processes, materials, suppliers, and controls than companies who source parts or components globally. However, in the 3rd-party biomedical space, the level of quality isn’t necessarily the same with every U.S. 3rd party company. PATIENT SAFETY OVER CUTTING CORNERS The FDA subjects OEMs to rigorous
quality control standards in manufacturing. However, the FDA does not currently regulate 3rd-party repair services, which includes U.S. 3rd-party companies who sell replacement parts for FDA-approved OEM devices. The FDA’s 2018 review of 3rd-party repair safety and subsequent 2021 guidance may pave the way for future regulatory changes. At this time, however, nothing prevents 3rd-party companies from using inferior materials and cutting corners in production-the same issue that compromises overseas manufacturing in some parts of the world. A values-driven U.S. manufacturer understands that human lives depend on the reliability and safety of their products. Their business model prioritizes patient-centered values, and sees ROI and cost-savings as supportive of, but secondary to, the goal of exceptional patient care.
“THE VALUE OF THOROUGH REVERSE ENGINEERING” Most overseas companies do well at replicating OEM products, quickly
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SPOTLIGHT fabricating and shipping parts that will fit properly and do what they’re supposed to do. However, the materials and construction of these parts might not match the quality of the OEM devices. Rather than copying, a quality-focused 3rd-party company approaches design with the same care and attention to detail as the OEM. A multistep reverse engineering process ensures that the part not only functions but is also structurally sound.
ROBUST SUPPLY-CHAIN VETTING Third-party companies who source entirely in the U.S. can thoroughly vet all suppliers, allowing them to make targeted decisions throughout the production cycle. This includes choosing design tools, selecting types of steel for molds, contracting an independent testing lab, and purchasing the machinery involved in full-scale production. VOLUNTARY CERTIFICATIONS AND PRECISION QUALITY CONTROL The most important hallmark of a values-driven U.S. medical device manufacturer is participation in voluntary quality standards programs. Look for the following voluntary programs: • FDA facility registration: Third-party parts manufacturers who voluntarily register must maintain all FDA safety and quality manufacturing standards. The FDA may inspect the facility at any time. Although 3rd-party parts aren’t subject to FDA clearance, the agency may initiate a facility inspection in response to consumer complaints, product failure, or if the facility didn’t pass a previous inspection. • ISO 13485 Certification: The International Organization for Standardization offers this quality management system certification. It requires rigorous documentation of quality controls based on internationally recognized standards for medical devices.
Some U.S. companies integrate additional quality controls to add extra insurance against product anomalies and human error. A quality-focused manufacturer will allow potential and current healthcare partners to observe the quality management system as well as full production runs. A trusted strategic partner also commits to standing by the health system in product failures or adverse patient events.
PARTNERING TO UPHOLD PATIENT SAFETY Biomedical equipment will continue to evolve with the changing health needs of the American population. At the same time, increasingly complex data streams will power intricately connected biomedical solutions. Equipment procurers need partners who can help them navigate the expanding world of medical technology. An experienced, dedicated U.S. manufacturing partner has a comprehensive understanding of leading-edge biomedical innovation. From digital design to minor hardware changes, a 3rd-party strategic partner will help you upgrade your asset inventory to deliver state-of-the-art, patient-centered care.
Elite now has clean room capabilities. (seen above)
INTRODUCING ELITE PRECISION PLASTICS When low stockpiles and export bans tied overseas suppliers’ hands, U.S. device production continued virtually uninterrupted, with minimal cost increases. U.S.-built parts kept devices running, so thousands of COVID-19 patients and other hospitalized individuals stayed safe in the worst months of the crisis. A strategic partner should have a clear strategy for future global emergencies that affect the supply chain. This is the exact reason our sister company, Elite Precision Plastics, was created. EPP partners with health systems to contract manufacture their parts to design and produce high quality USA made products. Our goal is to provide supply chain peace of mind. For more information, visit elitebiomedicalsolutions.com
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
EPP is Elite’s new sister company that provides USA contract manufacturing.
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SPOTLIGHT
PROFESSIONAL OF THE MONTH: ELVIN VELEZ Sunshine State Biomed
BY K. RICHARD DOUGLAS
F
or years, vacationers and snowbirds have enjoyed traveling to the Tampa Bay area on the West Coast of Florida. The city of Tampa is the largest city in the area of the bay. Other cities include St. Petersburg and Clearwater. Old Tampa Bay and Hillsborough Bay form Tampa Bay.
There are water sports, beaches and entertainment for visitors. The area is also home to several professional sport teams and boasts good areas for raising families along with a mild climate. BayCare is the leading not-for-profit health care system serving the health care needs of those in the Tampa Bay and West Central Florida regions. The system includes 15 hospitals. One HTM professional who works at the system’s main St. Joseph hospital campus in Tampa is Elvin Velez, BMET II.
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Velez knew early on that he wanted to work in a technical or electronics role, but it was a move to Florida that really put him on the path. “I moved to Tampa in 1997 from Staten Island and was having difficulty finding a decent job and my wife suggested I go to ITT Tech where I had some family attending,” Velez says. He says that he was always interested in electronics and started studying and received a degree soon after. “I was looking for a career after moving to Florida from New York. A family member enrolled in ITT Technical Institute and suggested I attend. I enrolled in the electronics engineering program and earned a bachelor’s degree. I’m grateful for the education that I received from ITT Tech. The skills I learned from ITT Technical Institute led me to a wonderful career as a biomed,” Velez says. Even with a degree in electronics, Velez
didn’t immediately enter the biomed field. “Once I graduated, I started repairing thermal printers at Ticketmaster. After a few years, I got my first opportunity in the HTM field repairing respiratory devices for Mercury Medical. After about seven years, I had a great opportunity to work as an in-house biomed at St. Joseph’s Hospital/ Baycare,” Velez says Since earning his degree, he has worked as a bench technician repairing respiratory devices such as blenders, ventilators and anesthesia machines at Mercury Medical and worked in biomedical engineering as a BMET I and II at St. Joseph’s Hospital. His areas of specialty include central supply, telemetry, EKG and Philips V60 ventilators.
GRATEFUL FOR HTM As every biomed knows, the job isn’t limited to PMs, repairs and calibrations. There is often new construction or
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SPOTLIGHT equipment change-overs that depend on the HTM department for specialized skills. Velez has been a part of these challenges as well. “Having been at St. Joseph’s Hospital for over 13 years, I have been involved in many projects. One of the major projects I have been involved in was a complete transition of our telemetry system from Philips to GE. We spent several weeks setting up the new monitoring equipment, testing and deinstalling the old equipment while minimizing the impact to patient care,” he says. He says that when the health care system built a new hospital in 2010, the CES team was responsible for setting up all the new equipment prior to the grand opening. “This was a major undertaking and took over a month to complete. During construction of the new hospital, we were responsible for unboxing and setting up the new patient care equipment. This entailed adding the equipment into the database, performing electrical safety tests and ensuring the equipment was functioning properly and was patient
safe,” Velez says. When not engaging in these special projects or performing other biomed duties, Velez uses his technical skills off the job. “I like working on cars, reading comics and Manga and watching Korean TV shows. I enjoy auto mechanics, working on engines and transmissions. I like building bicycles, model cars and planes. I like to be outdoors around nature and going to the beach,” he says. Velez is happy to work in the HTM field and would like to give back to the profession by passing his knowledge and experience on to those newer to the field. “I just want to help mentor the younger generation of HTM professionals and share my knowledge with others. I moved to the United States from Puerto Rico in 1983 and am grateful to work in the United States and the opportunities that I have had. I love the HTM field and working for a great organization,” he says. With that kind of mindset, the biomed trainees and medical equipment at BayCare are in good hands.
BIOMETRICS FAVORITE BOOK: “Manga”
FAVORITE MOVIE: All Korean dramas
FAVORITE FOOD: Sushi, pizza, Puerto Rican food, I like everything!
WHAT’S ON MY BENCH? My BayCare thermal coffee mug, tea bags, mini arcade game, Milwaukee cordless drill, and my laptop computer.
HIDDEN TALENT? Building model cars
FAVORITE PART OF BEING A BIOMED? Coming to work and staying busy all the time. Being a biomed is rewarding and challenging at the same time. Every day is different and I enjoy helping to keep patients safe and my departments happy.
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SPOTLIGHT
SHIFTING GEARS
Biomed Children’s Book Writer BY K. RICHARD DOUGLAS
I
nvariably, around New Year’s Day every year, a TV reporter will ask a random person on the street about their goals or resolutions for the year. Occasionally, the answer will include a response about a dream of writing a book. That dream of many people can be found in personal blogs, literary forums and on social media.
The dream of applying one’s creative skills and abilities to the pages of a book, along with the potential for a modicum of fame, has been a goal for many. Whether fiction or non-fiction, writing a book is often a way to increase social capital. For some, it’s a way to achieve some degree of immortality. It is not only an endeavor that benefits the author, but the resulting product can provide benefits to the readers. That fact is particularly true when the book is aimed at the youth market and provides educational benefits. One recent example of this idea is a book called: “Meet the STEAM TEAM: Coloring & Activity Book.” The book’s author is Douglas Redwine, operations manager of
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healthcare technology management at Texas Health Resources. Amazon describes the book as: “The STEAM TEAM is a group of ordinary teenagers who discover the superpower of Science, Technology, Engineering, Art and Math and use it in magical ways to solve problems and create fun adventure.” The website goes on to say: “‘Meet the STEAM TEAM’ is loaded with action-packed mazes, word searches, things to draw, pages to color and more.” What prompted an HTM professional to delve into the world of children’s activity books? “I’ve had the idea of writing a book for many years and always knew I would one day,” Redwine says. “I’ve made several attempts in the past, but just never completed the task. Once the COVID-19 pandemic struck, it limited my opportunities to work with my students in the after-school program, but gave me more free time to think, and I took advantage by returning to the idea of creating books,” he adds. Redwine is referring to a media arts class for the Fort Worth After
School Program at Dunbar High School that was part of the focus of a 2017 TechNation article. The focus of the after-school class is STEM education. That has been a passion of Redwine’s and he clearly believes in its importance in preparing kids for the future. “My original idea for writing books was to produce books in the self-help/motivation genre, but one day I was struck with the idea that I should work in my area of expertise; science, technology, engineering and math and arts activities for kids. Once I came to the conclusion to create books for kids the idea of the STEAM TEAM suddenly came to me about a week later during a morning drive to work,” he says. Redwine says that before arriving to work that day, he had the names of the characters and knew he was now ready to begin researching and learning how to publish books. The science, technology, engineering and math advocate didn’t jump into the author role head-first; he initially did some research. “As a result of my many years working with students and creating theme-based lessons, I knew exactly
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SPOTLIGHT
what the content of The STEAM TEAM books should be, but I had to spend a lot of time researching about publishing, illustrations, copyright rules and the resources available to create things for the manuscript that I could not do myself. Udemy and YouTube has been my friend in the research department,” Redwine says.
ILLUSTRATION AND PUBLICATION Children’s books are usually a combination of words and illustrations so a children’s book author needs to find a qualified artist to bring the story to life. “When it was time to have my books illustrated, I called on one of my former students; Arius Ball. I’ve known Arius since he was in grade school and I took early notice that he was an extremely talented artist,” Redwine says. Redwine tells a funny story about when Ball was in junior high. Redwine used to always ask him to see what he was working on and jokingly tell him he was going to write a comic strip and have him do the illustrations. “Long story short, or fast forward, he went on to Texas A&M and graduated with a bachelor’s degree in visualization. At a ceremony for recent college graduates at Greater Saint Stephen First Church, I approached him about my idea of The STEAM TEAM by saying, “Remember when I used to say we would do a comic strip? Well; and the rest is history,” Redwine jokes. Writing a book is half the battle. An author has two choices; to self-publish or to go through a literary agent and a publishing house. When a publishing house is involved, they handle most of the marketing of the book. When an author self-publishes, this task is mostly left to the author. “To get the word out about my books I will utilize all of the traditional chains for marketing and distribution, such as website, social
media, book ads, podcast interviews, magazine reviews, book clubs, and public events for book sellers and vendors. I’ve learned that in order to market books successfully, you have to constantly network, plan, strategically promote the product and make every effort to connect with the intended audience,” Redwine says. His vocation as an HTM professional involves science, technology, engineering and math as well. “In my role as the operations manager of healthcare technology management (HTM), I oversee the daily operations of the biomedical engineering departments of seven wholly owned and joint venture hospitals in my region. In summary of my day to day, I am responsible for the biomed department contractual and operations budget management, risk management, operations management and personnel management,” he says.
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
“Outside of corporate work and my passion for teaching youth, I am a member and on the executive board of the National Society of Black Engineers (NSBE) DFW Professionals Chapter, a board member of Book Angels Nonprofit, I enjoy running with the ZFT Run Club and enjoy spending quality time with my partner, Keelia, my family and friends,” Redwine adds. He says that he wants young readers to have fun while learning and hopes the book will spark their imagination. “Under The STEAM TEAM moniker, I will be publishing kid’s journals, early learning, science, technology, engineering and math careers, at home projects and The STEAM TEAM adventure series. I’m super excited about the upcoming projects and believe they will inspire kids to dream, explore and create,” Redwine says.
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COMPANY SHOWCASE The InterMed Group
T
he InterMed Group is a dynamic provider of comprehensive healthcare technology management services covering a broad range of client needs. InterMed’s deep-rooted partnership philosophy drives all of its offerings, helping to ensure everything it does moves clients closer to achieving their goals. The diverse service offerings include fully outsourced programs covering all medical devices from the linear accelerators, MRIs and CTs through anesthesia, dialysis, and respiratory therapy, to the patient monitors, infusion pumps and beds and everything in between. A rather unique attribute of InterMed is its willingness to fill in the gaps for any existing program. If a client has a solid in-house program, InterMed is more than happy to take care of the areas they do not have the staff or the expertise to handle.
Expanding on this, InterMed also provides field service-based contracts on medical equipment. Roughly 50% of its technical team members are specialized in diagnostic imaging where it provides service contracts for specific devices in hospitals, imaging centers and veterinary hospitals. To add value, InterMed is also able to offer new and pre-owned equipment to clients. InterMed provides clients with capital planning reports along with assessments of existing equipment to identify capital replacements that will best
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benefit the client. InterMed then also provides the clients with options to consider if they choose to move forward with a replacement. Many years ago, InterMed established the JumpTeamsTM program as it saw the demand for temporary skilled technical talent. Whether a facility is trying to fill in for vacation time, adding skills for a recall or supplementing staff until a full-time technician is hired, the InterMed JumpTeamsTM can provide partners with qualified staff.
PANDEMIC (COVID-19) Like many, InterMed’s ongoing challenge during the COVID-19 pandemic is to keep all team members safe and healthy. That includes mental health as well as physical health. InterMed is still dealing with the toll COVID is having on the nation’s health care and front-line workers. Through all the challenges and unknowns InterMed has faced, the company found that a positive mindset is key to overcoming any obstacle. Working its way through the pandemic actually made InterMed stronger as a team, as an organization and, most importantly, for its customers, as a partner. InterMed embraced the challenges and turned them into opportunities to improve. The dedication to the safety of the InterMed team, its partners and patients is part of InterMed and continues to inspire everyone within the company to bring the best every day in every way.
MEDICAL DEVICE SECURITY ENVIRONMENT There is not a day that goes by without the industry hearing about another health care cyber security attack. In today’s environment, hackers see health care as an easy target. The FDA issued a warning that other countries have made it clear that they are targeting health care. The three main areas of concern are: • IT – The facilities network infrastructure (servers, computes, switches, routers and Wi-Fi) • IoT – Internet of Things, the other devices that communicate on the network (phone systems, video camera systems, cellphones, tables, etc.) • IoMT – Internet of Medical Things. This is a subset of IOT and includes medical devices such as imaging devices, patient monitors, infusion pumps and lab devices. Most larger facilities have IT and IS departments and they mainly focus on the IT/IoT devices. This approach often leaves the IoMT devices at risk to vulnerabilities. Smaller facilities may not have an IT/IS team, leaving their entire network at risk. The biggest risk to IoMT is that there are still many facilities, regardless of size, that do not have a plan in place to evaluate currently known vulnerabilities, mitigate the risk, thus reducing their
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SPOTLIGHT
Left photo: InterMed employees stay current with hands-on field training both internally and with OEMs to provide the best service to clients. Right photo: InterMed’s headquarters in Alachua, FL houses administrative offices, warehouse, and training space.
risk score. The first step is training your biomed teams and a good inventory connected and connectable devices. InterMed has solutions to fit the needs of its clients no matter size or where they are in their cybersecurity journey, a journey that begins at procurement and lasts through the life cycle of the device.
STAFFING CONCERNS AND SOLUTIONS The industry has been facing a shortage of qualified technical talent for many years, with a large population approaching retirement age and a shortage of new technicians joining the workforce. Over the past couple of years, COVID has amplified the issue, with many highly experienced technicians choosing to retire. With an increased focus on addressing staffing challenges, InterMed continues to successfully recruit and maintain the most qualified individ-
uals as part of the InterMed team. InterMed’s internal philosophy of constant and never-ending improvement is really highlighted by its training and educating all employees to be the best at what they do.
THE INTERMED GROUP’S GROWTH InterMed continues to grow rapidly as customers feel the impact a real partnership approach can bring to them. There has always been a strong dedication to finding solutions to customers’ problems, at all levels of the organization. InterMed’s flexible programs ensure its teams are focused on what makes a difference for each partner. The goal is to become the number one independent service organization in the market and in the industry for healthcare technology management services. InterMed has all the services and technical skill sets to provide each element of service needed, from infusion pumps to MRI.
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Over the past 10 years InterMed has grown, expanding from its headquarters in Florida, throughout the East Coast, midwestern and southwestern United States. InterMed looks to its relationships with customers as partnerships and becomes involved in the community. InterMed’s official charity is Tyler’s Hope for a Dystonia Cure. Dystonia is a neurological movement disorder with over one third of dystonia patients being children. InterMed and Tyler’s Hope are committed to finding a cure for dystonia. InterMed won’t stop until a cure is found. The company carries this focus into all that it does, working to bring hope to healthcare. At The InterMed Group, the team knows the industry will continue to evolve, so InterMed will continue to create solutions for tomorrow’s challenges. For more information, visit intermed1.com.
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MD EXPO CELEBRATES 20TH ANNIVERSARY HTM Conference Delivers Education, Exhibit Hall, Networking BY JOHN WALLACE
M
D Expo 2022 in Atlanta was a home run! The twice a year healthcare technology management (HTM) conference celebrated its 20th anniversary in style in the city where it all began. More than 800 HTM professionals – including students, biomeds, managers, business owners and more – came together for first-rate educational sessions, signature networking events and a packed exhibit hall featuring the latest and greatest from throughout the industry.
MD Publishing President and Founder John Krieg reflected on the past 20 years of the conference. He is proud of the work the MD Publishing team has done to help elevate the HTM industry. From the very first MD Expo in Callaway Gardens, Georgia, the philosophy has always remained true; provide the latest in HTM education, use the best presenters, have a worldclass exhibit hall and sprinkle in some exciting and fun networking opportunites ... and, last but not least, never charge a hospital employee, military member or student to attend.
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“After more than two years of dealing with the COVID-19 pandemic, things are getting close to normal in regard to conferences,” Krieg said. “It is fantastic to come ‘home’ after 20 years, and see so many people attend MD Expo Atlanta, including many who were at the very first one 20 years ago. It is exciting to see the next generation of biomeds and their excitement to participate in the educational sessions, networking events and walk the exhibit hall.” “It is also nice to visit longtime attendees and exhibitors who have supported MD Expo over the years,” he added. “There is good energy at this MD Expo and I can’t wait for the next one in Southern California.” Chace Torres, a.k.a. The Bearded Biomed, said this was his very first MD Expo. He recorded several podcasts with attendees while at the conference and met a man who became inspired to become a biomed because of the podcast series. “For me, (my favorite part) was setting up my booth and interviewing folks helping the HTM industry in their own unique way. Doing a live show at the MD
Expo was a surreal validating experience I’ll never forget,” Torres said. “The MD Expo is an opportunity to network with someone from a broad spectrum within our field. An event like no other – filled with technology, solutions and people that just might make your job as a biomed more effective.” When asked to describe MD Expo in three words he said, “networking, educational and fun.” His experience included many connections. “I made several connections with biomeds and vendors doing wonderful things that will be showcased in upcoming podcast episodes. Companies that provide third-party solutions to allow biomeds to continue taking care of our EOL medical devices. I made connections with longtime supporters of the show that I got to bring on the show and give them much deserved limelight for their work,” he explained. Allison Woolford, CBET, who works at UNC REX Healthcare said her first MD Expo was a blast. “I absolutely had a marvelous time,” Woolford said. She said the education portion of the
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MD Expo was her favorite part, but that it was all great. “I made numerous connections at MD Expo Atlanta. I also teach at Durham Technical Community College in the biomedical program. I was able to connect with Dr. Monty Gonzales with the College of Biomedical Equipment Technology as well as with Danielle McGeary from AAMI who are both willing to provide assistance for me to help improve the biomedical program at Durham Tech,” she added. “I also spoke with Rigel Medical. They offered to come to the college and demonstrate their various test equipment to the students.” “The education that was offered at MD Expo Atlanta was sensational,” she continued. “There were so many good topics that were discussed and ideas shared. Learning about HTM in a Box was fundamental. That presentation makes it so easy to go out into the public sector and explain what HTM is. Also, learning tips of the trade, how to help improve workplace relations, and how to fill vacancies are all essential facts that will help me down the road as I grow and advance in the field.” “I would give the exhibit hall a 5-star review. I enjoyed walking around and talking to all of the vendors. All of
the goodies they handed out is also a plus,” Woolford said. “The Young Professionals social was also great. It provided me an opportunity to interact with adults within my age group. I am excited for the next MD Expo in California.” Integrity Biomedical Services Owner Michele Shahbandeh said this was her first conference since the COVID-19 pandemic began. She did not appear to be the only one based on the high number of people in attendance at the conference. However, it was not the high number of attendees that impressed her the most. Shahbandeh said the quality of the attendees was outstanding because the people in attendance were the people she needed to connect with as a business owner with lots of managers and decision makers in classes and the exhibit hall. AIV Inc. Vice President of Sales and Product Development Jeff Taltavull said this MD Expo included a “walk down memory lane.” “It was great to see the history and all the old photos. I’ve been in the industry for 23 years and have only missed three MD Expos that I remember. Lots of history,” he said. “I made multiple connections and was able to
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see people we haven’t seen in years. It was great to reconnect with the Atlanta community. On top of that, as we start to get back to some resemblance of normality, it was great to see the more familiar faces back out.” More people seem willing to gather as the COVID-19 pandemic lingers and that was evident at this MD Expo. “The traffic wasn’t at the volumes it has been in the past, however the contacts were fresh and seemed to be more meaningful. It was great to see some C-level decision makers walking the floor,” he added. “MD Publishing is a great partner in our industry. We appreciate the effort that goes into helping vendors support the industry and keeping those connections available.” When asked to describe MD Expo in three words, Taltavull said “Opportunity, Relationships, Education.” Samuel Hill, director of product marketing for Medigate by Claroty, presented at MD Expo Atlanta. As a first-time attendee, Hill said the conference exceeded his expectations. “It was my first MD Expo – I have thoroughly enjoyed meeting and interacting with this community, mostly through the MD Publishing family of publications, but seeing the group live
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ABOVE: A group of HTM professionals pose for a photo at MD Expo. The event serves as a reunion of sorts for some HTM professionals. LEFT: Posters featuring photos from MD Expos over the years were on display at MD Expo Atlanta as part of the 20-year celebration.
and in person was special! What I liked about the show was the overall lack of pretense. Sometimes, at other health care trade shows, there is an air of self-importance. I found it refreshing to interact in real ways with real people, without some of the normal ‘preening’ of other shows,” Hill said. “I think the quality of attendees was good. Most everyone came ready to learn, hear new ideas and find ways to improve their day-to-day operations,” Hill added. “We left the show having begun lots of great conversations with existing clients, potential clients and industry partners.” Steve Santos, executive director of clinical engineering at Broward Health, participated in the Leadership Summit and the MD Expo. “I thought it was good with a great group of vendors there considering all that we have been going through the past couple of years,” he said. “I was in the leadership summit and I think the keynote speaker was great. A great group of vendors. I met some good people out there from a leadership standpoint. The location was great. It was good a venue.”
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Greg Goll, manager of projects and medical imaging services department at WellStar, has attended several MD Expos. He said this one reminded him of “pretty much the old days.” “I thought it was back to the one in Florida I did right before COVID. I was surprised there were this many people. It felt like a throwback to 2017,” Goll said. “It was almost like Stone Mountain.” He said the MD Expo does a tremendous job of helping like-minded people connect and share solutions. “When people are going to the MD Expo they are looking to connect with people who provide them with a service they need,” Goll said. When asked to describe MD Expo in three words, Goll thought about the question for several seconds before answering “Very informative networking.” Matin Kondori from SakoMed also attended his first MD Expo and was blown away. “Yes, it was our first time to be at MD Expo and it was a great experience, everything was well organized and super easy for exhibitors,” he said. “I was surprised of seeing top
biomeds of the big facilities and hospitals at the show.” He said MD Expo is a great conference to exhibit or attend to get familiar with the trusted companies and new items and technology they can offer to make a biomed’s life easier. University of Colorado Hospital Senior Biomedical Technician David Scott has attended several MD Expos. He estimates that he has attended 20 over the years. “I thought it was really good. I liked it,” Scott said. “It seemed more back to normal with lots of people there. The trade show was pretty full. The education was really good. I really enjoyed every session that I went to.” He added that a “return to normal” is something that he was looking forward to. When asked to describe this MD Expo in three words he said, “Best one ever!” The next MD Expo is set for Southern California this October. For more information, including a Call for Presenters, visit MDExpoShow.com.
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Visit Us at AAMI Exchange Come meet with us June 3-6 in San Antonio, Texas and see how Connected Workplace can benefit your organization. Set up a private discussion with us, and learn more: Connectedworkplace.nuvolo.com/aami-exchange-2022 Nuvolo also will be co-presenting: Creative Ways Vendors Can Support the HTM Community
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NEWS & NOTES Updates from the HTM Industry
ADVANCED DEFIB TESTING DEVICE NOW AVAILABLE Rapid and accurate performance testing of critical biomedical lifesaving equipment is provided by the advanced and portable UniPulse 400 defibrillator analyzer now available from Rigel Medical. The compact UniPulse 400 incorporates all the common features needed to perform full preventative maintenance on all types of defibrillators to deliver accurate and time-efficient testing. The lightweight, battery-powered and portable unit, which is equipped with a pacer function for comprehensive testing of defibrillator functionality, can easily be carried around facilities by busy technicians for rapidly analyzing all monophasic, biphasic, standard and pulsating waveforms. Incorporating advanced measurement technology, including dedicated fast keys and to enable biomed test engineers to select the relevant test function in seconds, the
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tester’s large internal memory and on-board results storage also helps to reduce test time and supports hospital and health care teams working towards automated database record keeping systems. The crisp LCD color displays clear and detailed results while simplicity of use ensures the tester is easy to operate with intuitive navigation and dedicated fast keys to ensure a seamless user experience. The UniPulse 400 can be linked to Rigel’s Med-eBase software to enable test results to be downloaded quickly to a USB or direct to a computer-based records storage system. The UniPulse 400 forms part of the comprehensive Rigel Medical range of biomedical testing solutions for health care environments.
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INDUSTRY UPDATES COX EXPANDS PROSIGHT PLATFORM Cox Communications recently announced the addition of hand hygiene monitoring capabilities to its real-time location services (RTLS) platform Cox Prosight. Hand hygiene is just one way Cox Prosight is improving hospital operations. Leveraging RTLS and Cox’s Prosight Core Internet of Things (IoT) platform, Cox Prosight provides hospital administrators and staff with advanced asset tracking, environmental monitoring, staff safety alerts and patient/visitor experience solutions. Cox Prosight is already at work in the field with impactful results. Cox’s longtime health care partner Ochsner Lafayette
General has been using Cox Prosight for over six months, tracking 5,400 pieces of equipment, multiple staff members to ensure efficient operations. Attendees of HIMSS22 from March 14-18 in Orlando were able to witness a demo of the Cox Prosight’s new hand hygiene monitoring capabilities, and explore Cox’s growing health care portfolio of hospital to home including Cox Edge, Cox Business Cloud Solutions and Trapollo. For more information, visit www.coxprosight.com.
ECRI OPENS NEW GLOBAL HEADQUARTERS ECRI, a global, independent authority on healthcare technology and safety, recently celebrated the opening of its new state-of-theart global headquarters and medical device evaluation laboratory on a 24-acre campus near Philadelphia. “The opening marks an historic opportunity for the nation’s largest patient safety organization to fulfil its mission to advance effective, evidence-based health care globally,” according to a news release. “The new building symbolizes the transformation that ECRI has been undergoing over the past few years,” says Marcus Schabacker, MD, Ph.D., president and CEO of ECRI. The independent nonprofit organization, founded more than 50 years ago, has evolved the scope of its capabilities with data-rich, cloud-based patient safety and technology solutions, partnering with hospitals and health systems in every state in the U.S. With offices in the United Kingdom, the Netherlands, United Arab Emirates and Malaysia, ECRI works internationally with clients in more than 150 countries. In 2020, ECRI’s acquisition of the Institute of Safe Medication Practices (ISMP) created the largest health care quality and safety entity in the world, driving greater value to health care across all care settings, including community, specialty and hospital pharmacies. “As we expanded our global footprint and forged new solutions for a rapidly changing health care market, we also reshaped our business structure to support a virtual hybrid workforce. For these reasons and more, we designed a global headquarters that reflects our core values and engages our diverse and talented employees in helping us achieve our
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strategic vision,” explained Schabacker. The overarching goal of the headquarters transformation was envisioning a new workspace for a new virtual hybrid workforce for ECRI and its affiliate ISMP. The building pays tribute to the legacy the organization’s founder, Joel Nobel, MD, and his invention of the Max Cart, the first medical crash cart. “The pandemic posed an incredible opportunity for ECRI to completely reimagine how to transform our existing space to meet the changing needs of the health care community. For us, creating collaboration spaces for our mainly virtual workforce was the unifying element and we accomplished this with a design centered on transparency, flexibility and smart technology,” says Pete Catalano, chief financial officer of ECRI, and executive project manager of the headquarters renovation. ECRI’s new headquarters features an independent medical device evaluation laboratory, an environmental lab, and accident and forensic investigation lab, multi-use, high-tech meeting rooms, open collaboration areas and flexible workstations. The building’s third level, which has yet to be built out, is being envisioned as a hub for health care innovation, a place where local health care organizations with similar goals can collaborate on health care advancements. Philadelphia-based Irwin & Leighton were the contractors on the building project that was designed by Meyer Architecture+Interiors. The building officially opened on April 19, 2022, with a formal ribbon cutting ceremony. For more information about ECRI, visit www.ecri.org.
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NEW HTM PROGRAM FOCUSES ON DEVICE DESIGN What if healthcare technology management (HTM) professionals could go beyond maintaining and repairing medical devices, and reach into the design of those devices themselves? At the University of Windsor in Ontario, Canada, a newly launched stream of courses is designed to do just that – to teach HTM students how to design new, innovative biomedical equipment. HTM educator and professor James Linton, a biomedical engineer and member of AAMI’s Technology Management Council, helped introduce the new biomedical engineering technology stream of courses, which is beginning its second cohort in the fall. According to Linton, students attending the new University of Windsor course stream will not only cover design theory, but also explore the practical aspects of creating medical devices and even prosthetic limbs. Interestingly, the new courses are designed to take on students with experience in device repair and maintenance from programs such as the nearby biomedical engineering technology program at St. Clair College, also in Windsor, Ontario, for which Linton is a coordinator and professor. By first learning HTM training and then device development, these students may prove a boon for medical device manufacturers, Linton explained. The reasoning is that engineers who understand how complex medical devices and prostheses are maintained also make for good designers. “When something gets built, in theory, it’s never going to break, it’s perfect. But then when rubber hits the road, there will need to be repairs,” he said. “With a biomed engineer who knows how to make repairs and knows how important it is to worry about things like maintenance and easy access, they have that extra little insight when designing machines.” Students wrap up their time in the new Windsor program by earning a bachelor’s degree in engineering technology. There is also the possibility of earning a professional engineer (PEng) certification through additional courses. Additionally, the program relies on students taking already established courses in an effort to expose students to not just experts in their fields but also to help them understand the different fields they can expect to work with on a daily basis such as mechatronics and kinesiology. “The students are also working on creating a biomed club to further their professional development and to help raise funds for professional development opportunities, like attending AAMI eXchange this June,” Linton said.
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PROSPECTIVE HTM STUDENTS ATTEND OPEN HOUSE Northeast Wisconsin Technical College (NWTC) Biomedical Electronics Program Instructor Don Cormier reports that close to 200 prospective students recently attended an open house hosted by the college’s engineering and technology department. Cormier was impressed by the turnout, especially considering Wisconsin’s predictably unpredictable weather deciding to make things difficult. The event was designed to give future students the opportunity to meet with hospital staff from the area who could be the very organizations that hire them after they earn a two-year associate
degree. Current students were also on hand to answer questions from the prospective students and their parents. The open house is just one way that many within the HTM community are recruiting future biomeds as a work force shortage continues to grow. The retirement of many experienced baby boomer biomeds is among the challenges the industry faces now and in the coming years. For more information about the college, visit nwtc.edu.
INNOVATUS IMAGING ADDS TO COMMERCIAL TEAM Innovatus Imaging has added Shawn Lease to the Innovatus commercial team. A seasoned sales executive in the healthcare technology management (HTM) industry, Lease will serve as the director of national accounts. Lease’s 20-plus years of experience spans organizations such as Imaging Associates, Global Medical Imaging (now Avante Health Solutions), Trimedx and, most recently, Agilti. He earned his Bachelor of Science in Business Adminis-
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tration and Marketing from the University of North Carolina. “Shawn brings not only years of experience in clinical and imaging device management, but also great depth of knowledge of the HTM industry and a demonstrated record of developing quality cost-saving initiatives for health care systems nationwide,” says Matt Tomory, vice president of sales and marketing. For more information, visit innovatusimaging.com.
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TRI-IMAGING, MAULL BIOMEDICAL TRAINING TEAM UP Tri-Imaging and Maull Biomedical Training announced a new collaboration that will provide contrast injector training in Music City. This is not a merger nor an acquisition, it is teamwork among industry leaders to provide training in the increasingly in-demand field of contrast injector maintenance and repair. The training will be offered at the Tri-Imaging facility in the Nashville area. Maull Biomedical Training, LLC Owner Steve Maull is among the top contrast injector trainers in the nation. He presented a session at the 2022 Imaging Conference and Expo (ICE) in Napa, California. Maull’s course in Napa was titled “Introduction to Contrast Injectors.” He taught the purpose of contrast injectors, the principles of why the different parameters are selected when performing an injection and the general components of contrast injectors. The presentation also
covered general operation and items of interest when performing preventative maintenance. A recording of the presentation is available at tinyurl.com/2t9db34y. Tri-Imaging is an independently owned, highly experienced team with an unparalleled quality assurance record, according to the company’s website. “We have 328 years of combined experience across our employee roster. Our combined years of industry experience averages over 10 years per employee,” it reads. Tri-Imaging’s reputation for its training is outstanding. It offers many different imaging service courses including an apprentice program. For more information about all the Tri-Imaging training opportunities, visit triimaging.com and click on the “Training” tab. For more information about Maull Biomedical, visit maullbiomedical.com.
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COGNOSOS LAUNCHES PROPAR Cognosos has announced the availability of ProPAR (Proactive Periodic Automated Replenishment) a suite of features and dashboards that supports central supply and biomedical engineering teams in turning reactive work into proactive processes by providing instant visibility to asset counts and PAR level thresholds throughout hospitals and health care facilities. ProPAR leverages Cognosos’ indoor location engine, LocationAI, to provide room-level visibility to asset location, eliminating the need to search for equipment for maintenance, cleaning or re-circulation, and helping to ensure PAR levels are consistently met. With ProPAR, central supply and biomed users have a flexible framework that offers notifications, tile view action boards, and picklists that can be used to prioritize each day’s activities and allows the team to optimize and improve its asset management practices based on best practices workflows. Not only can users determine the utilization of equipment on all floors in hospitals in designated storage areas like clean and soiled storage, but they can also easily generate new zones to track asset movement patterns in areas where mobile assets are often placed for easy access for the clinical staff, like alcoves or hallways. Cognosos ProPAR supports health care organizations’ need for continuous and accurate real-time visibility of all equipment in a health care organization. For more information, visit cognosos.com/hospitals.
ALPHA SOURCE GROUP HIRES SENIOR VICE PRESIDENT OF SALES Alpha Source Group (ASG), a health care services partner that delivers service and solutions for biomedical, surgical and diagnostic imaging (DI) under three brands – Alpha Source, Medical Optics and BC Technical – recently announced the hiring of Senior Vice President of Sales Thomas Vorpahl. In his role, Vorpahl will lead and direct the commercial team and strategic initiatives to achieve the company’s sales goals and profitability margins. He will also serve as a member of the ASG executive leadership team. “We’re extremely excited to add someone like Tom to the team,” said ASG CEO Al Klotsche. “His extensive experience in the industry along with his customer-first mentality and leadership approach that elicits peak performance is a true asset to our company.” Vorpahl joins ASG after spending more than a decade as the principal consultant at Northstar Healthcare Partners LLC. His
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experience includes leading sales and marketing teams for medical technology and imaging firms as well as spearheading market-leading sales teams. Vorpahl has more than three decades of experience in the health care industry. “It’s an honor to lead such a diverse and talented group of professionals and bring my own experiences to help maximize their process,” Vorpahl said. “Ultimately, I’m thrilled to be a part of such a progressive, exceptional team and look forward to our continued growth and success.” Vorpahl holds a BA in health sciences from the University of Wisconsin-Milwaukee and is a Tenured Fellow in the American Academy of Physicians Assistants. In addition, he completed the executive program at UCLA Anderson School of Management. For more information, visit alphasourcegroup.com.
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from wire lengths, to clasp colors all the way down to the choice of security screws can be customized to fit your facility’s individual cable management and security needs.” TechNation learned even more about Voytek Medical in an interview with Senior Administrative Support Coordinator Krista Jaworski.
T
he concept behind Voytek Medical has always been a simple one: to save time and money. It started with a clinical engineer’s irk at squandering hours searching for cables and transformed into a full-fledged business to fill a gap in the market.
The job of a clinical engineer is complex. Between completing preventative maintenance to repairing and servicing broken equipment, the days are fast-paced and require an immense amount of skill and hard work. Some days are productive and skillful while others are spent tracking down cables. And a lot of time and money was being wasted on continually searching for and replacing patient monitoring cables. But this was not out of the ordinary. Spending hours a day searching for various missing cables that had been removed, misplaced and sometimes discarded altogether was just another part of the job. But did it have to be? What if there was a way to secure those cables to not only prevent loss but to provide cost savings? That’s where Voytek Medical comes in. Voytek Medical specializes in securing these assets to not only help clinical workflow be more efficient but to provide substantial cost savings for health care systems. 40
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Krista Jaworski Senior Adminstrative Support Coordinator “Our products are designed by clinical engineers for clinical engineers. The days of scrounging through drawers for loose and missing cables are gone thanks to the BEAR TRAP cable management and security systems,” Voytek Medical Senior Administrative Support Coordinator Krista Jaworski says. “Our BEAR TRAP clasps are designed with multiple distinct grooves that separates each cable for superior organization and cable management. Our patented design prevents the messy bundling of cables and allows for each cable to be easily identified as well as promotes effortless cleaning and decontamination. At Voytek Medical, every aspect of our products
Q. WHAT ARE SOME OF THE SERVICES AND PRODUCTS YOU OFFER? A. At Voytek Medical we specialize in cost-savings products, more specifically in the design and manufacturing of cable management and security systems for medical devices. Our BEAR TRAP product line is designed to protect invasive blood pressure cables, non-invasive blood pressure hoses, EKG/ECG cables, SpO2 cables, temperature cables, cardiac output cables and any other item that needs to be secured without voiding warranties or modifying equipment. Q. IS THERE A SPECIFIC OR NEW ONE YOU ARE EXCITED ABOUT RIGHT NOW? A. We recently developed three new products for our BEAR TRAP product line that we are very excited about! Our newest clasp design, the 1-hole clasp, is designed to secure ultrasound probes and patient bed speakers/ remotes but can also be used to secure a wide variety of other accessories that require a single hole clasp. Our newest
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mounting option, the Wall Block Mount, allows Voytek Medical configurations to be affixed to any desired wall or surface in a facility. Lastly, our new Looping Color ID Tag is a colored clasp that is perfect for any device that moves around often such as aspirators, bair huggers or work stations on wheels. It is designed to be secured to any piece of equipment that does not have accessories to protect and provides a colorful visual indicator of which department each device belongs to. Q. HOW DOES YOUR COMPANY STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A. At Voytek Medical, we pride ourselves on creating products that are exceptional in quality and durability, as well as in customer satisfaction. Our BEAR TRAP line of products are fully
customizable, to better fulfill each of our customers unique needs. An integral design component across our line of products is that they exclusively protect the trunk cables for bedside monitoring, leaving the accessories that have direct patient contact and infection risk to be easily replaced. We also provide a one-year limited warranty against manufacturer defects on a majority of Voytek Medical products. Q. WHAT GOALS WOULD YOU LIKE TO ACHIEVE IN THE NEAR FUTURE? A. Our goals for the future are to continue to expand our partnerships and for our products to be integrated and utilized into all medical facilities. Our team looks forward to continuing to provide innovative, affordable solutions
to help our customers protect their assets and attain cost savings. Q. IS THERE ANYTHING ELSE YOU WOULD LIKE OUR READERS TO KNOW? A. At Voytek Medical, we are always cultivating new designs and expanding our product line to further benefit our customers and accommodate their needs. While we offer a wide variety of configurations, if our standard designs don’t currently meet the specifications for an asset you need secured, please reach out and our team can create a custom design to address your facility’s specific needs and protect your medical devices. For more information, visit voytekmedical.com or email kjaworski@voytekmedical.com
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ECRI UPDATE
Spotting Infusion Pump Damage Before Patient Care is Affected
I
nfusion pumps are a common fixture in many care settings – a facility could have hundreds of pumps in near-constant use. Not surprisingly, these devices can become damaged; and if the damage is not identified and remediated, medication errors and patient harm can result. ECRI addressed this issue as Hazard No. 3 in its 2022 Top 10 Health Technology Hazards report. Keys to preventing harm include recognizing the signs of damage and responding appropriately.
It’s not controversial to suggest that a damaged infusion pump should be removed from service rather than remaining in clinical use. Infusion pumps are expected to deliver fluids or medications – potentially life-sustaining ones – with high accuracy over a specified time interval; damage to the pump could hinder its ability to perform that function reliably. But what’s simple in theory – removing damaged infusion pumps from service – is not always simple in practice. ECRI continues to receive reports of damaged infusion pumps being used during patient care, sometimes with tragic consequences. Several factors could explain such incidents. One is that users may not appreciate the risks posed by seemingly minor damage. The risks are real, however: ECRI has investigated several incidents in which damage to an infusion pump prevented the pump from regulating the flow of medication. As a result, too much medication was delivered to the patient (overinfusion), leading to patient harm. The reverse is also a concern: Damage to the pump may result in too little medication being delivered to the patient
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(underinfusion), or even cessation of the infusion altogether. Patient care could be impacted in those situations as well, particularly if a critical medication was to be delivered. Another explanation is that pump damage can be hard to identify. “Damage may not be visibly apparent,” explains Juuso Leinonen, a principal project engineer in ECRI’s Device Evaluation group. A small crack or a corroded connector may be hard to spot or in a location that it is obscured from view. “Also, and this is important to note: the damage may not result in an alarm condition,” adds Leinonen. In either case, BMETs and health technology managers can play a vital role in preventing dangerous, and possibly fatal, medication administration errors. Key actions include helping users recognize the signs of infusion pump damage and educating them about what to do if damage is suspected. RECOGNIZING SIGNS OF DAMAGE Infusion pumps can be used in many patient care areas and for a variety of infusion applications, from relatively low-risk fluid delivery to the high-risk delivery of critical medications. The manner and frequency of use can lead to pump damage, whether through wear and tear, mishandling, misuse, poor device design, or the use of improper cleaning agents or methods. Not all forms of damage will impact the operation of the pump; but distinguishing between a cosmetic crack, for instance, and a dangerous flaw can be difficult. “That’s why any signs of damage should be investigated,” advises Leinonen. Adverse
events related to infusion pumps are the most common type of incident investigated by ECRI’s accident and forensic investigation team. Often, the use of a damaged pump is found to have played a role in such incidents. Following are a few commonly reported areas of damage and the potential consequences for device operation: • A door that doesn’t seat correctly when closed could impact the flow control mechanism. (Excessive resistance when closing the door could be a sign of trouble.) • Broken or cracked door hinges could alter the door positioning, affecting its ability to compress the administration set (see Figure 1). • Broken door latches could interfere with the activation of the pump’s free-flow protection mechanism. • The integrity of plastic pump components could be compromised by environmental stress cracking. This type of cracking can be caused by the repeated use of incompatible cleaning agents. (ECRI has worked with several facilities where the failure to follow manufacturer cleaning guidance led to frequent pump issues.) • Corrosion of battery pack contacts (see Figure 2) or other electrical connectors – such as those used to connect pump modules to the control unit or for data communication – can interrupt the pump connection with the battery or with the brains of the module. This could cause the infusion system to shut down, delaying infusion
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Figure 1. Cracked platen door hinge inside the pumping module
Figure 2. Corroded battery pack connectors therapy. (ECRI recommends inspecting external connectors for damage during a periodic performance verification and stressing the importance of following manufacturer cleaning and disinfection instructions.) KNOWING HOW TO RESPOND Clinical staff are the last line of defense when it comes to spotting infusion pump damage. Instruct staff not to use an infusion pump if: • Visible damage is identified during initial setup – for example, if the user notices a crack in the door or door hinge. • Any part of the setup seems abnormal, such as a door that is hard to close or unexplained air in the chamber. • An unexpected malfunction alarm condition occurs.
If damage is suspected, staff should: • Tag the pump as faulty, with a short description of the problem, and take it out of clinical use. • Notify the unit manager and clinical engineering. Other staff play a role as well. Clinical engineering departments can track pump-related damage, identify potential failure patterns, and be on the lookout for unseen or previously unobserved damage when investigating pump-related incidents. Nurse educators can train staff on common failure modes and how to recognize signs of damage. Central equipment distribution staff should carefully follow manufacturer instructions for cleaning and disinfection, and should visually inspect pumps for signs of damage before distributing them for use. Even pump manufacturers can do more, designing devices that are less prone to damage given their environment of use. The bottom line, according to ECRI’s
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Leinonen: “Failure to remove a damaged pump from clinical use can lead to patient harm, or even death. It takes a team effort to keep patients safe.” TO LEARN MORE . . . This article is adapted from ECRI’s Top 10 Health Technology Hazards for 2022—Hazard No. 3: “Damaged Infusion Pumps Can Cause Medication Errors.” 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.or
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AAMI UPDATE Medical Device Work Order Types Standardized by CMMS Collaborative
F
ollowing an early first success with the standardization of healthcare technology management (HTM) failure codes, a new white paper from the AAMI-sponsored CMMS Collaborative project has been published to create a standard categorization for all work activities carried out by HTM personnel.
Up until now, there has not been a standard approach for using the “work order type” field that is found in most computerized maintenance management system (CMMS) software. “The HTM community has been rather inconsistent in how they configure them, what data they associate with them, and what is done with the data,” the white paper reads. “It was agreed that the types and data associated with them could not readily drive management decision-making because of these inconsistencies.” The team was initially hesitant to invest time and resources into standardizing something as seemingly straightforward as labeling different types of work orders for HTM
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departments, according to Matt Baretich of Baretich Engineering and Vancouver Coastal Health, co-facilitator of the new white paper. However, as the CMMS Collaborative team worked to consolidate key data from the HTM community, they kept running into issues concerning how departments categorized their work. “It’s not quite as easy as defining planned maintenance (PM) and repair. Of course, we do lots more and we need to capture that somehow,” Baretich said. “For example, there’s the cybersecurity and networking work that we do. That’s not really PM; it’s not really repair, but it’s very important.” On a high level, the new white paper outlines best practices for differentiating between maintenance and non-maintenance activities in most CMMS databases. This can help managers optimize their maintenance schedules or craft Alternative Equipment Maintenance (AEM) programs as needed. “What makes this effort different is that we’ve got the suppliers who build the tools that use these codes agreeing to this standardization,” said Baretich. “Their customers are
looking for best practice for using these deeply customizable management systems, and now there is one.” Standardizing the data that HTM departments collect “also opens the door for CMMS data to be of value to the larger organization as well,” added Carol Davis-Smith, vice chair of clinical engineering of the AAMI Board of Directors and principal of Carol Davis-Smith & Associates. Davis-Smith, who worked with Baretich to make this second white paper a reality, explained that consistent data from HTM departments will enable the setting of benchmarks for comparing program success between health system locations and service providers. Additionally, a long-term goal for the project team is better informed policy. With robust data, the HTM community and CMMS suppliers can work with regulators in a more proactive manner than is currently possible. But first, HTM departments must adapt the failure code and new work order type standards. To facilitate a speedy adoption, the CMMS Collaborative members have already committed to working with
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their existing clients to transition from current platform configurations to ones that leverage the team’s evolving standards. “When we started this project, we were worried that CMMS suppliers wouldn’t want to collaborate with their competitors,” Baretich said. “However, that worry was really off base. By standardizing things that are common to all CMMS packages, suppliers can remain very competitive on how they implement it and the extra features they offer, even while enabling clear applications of data, and ultimately, better ways to ensure patient safety.” The new white paper Optimizing the CMMS Work Order Type Field was sponsored by the Association for the Advancement of Medical Instrumentation (AAMI) and represents the insights of a CMMS Collaborative made up of experts from Accruent, EQ2, MediMizer, Nuvolo, Phoenix Data Systems, and TMA Systems. It can be downloaded at aami.org
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Q: TELL US WHAT DIFFERENTIATES YOUR COMPANY FROM THE COMPETITION. Clinical Technology Solutions was started in 2006. The company was created at the request of many hospitals that needed better support options at reasonable prices. We believe that Jeff Ledford integrity and honesty are important for any President business, but we do not stop there. Listening to what customers need, charging a fair price, doing what you say you are going to do, and delivering exceptional value leads to long term business relationships that prosper. For more information, visit ctsbiomedical.com.
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BIOMED 101 Telehealth, Telemedicine and Hospital at Home BY PERRY KIRWAN
O
n April 30, 2020, the Centers for Medicare and Medicaid Services (CMS) published an interim final rule (IFR) that made regulatory changes and clarified certain policies in response to the novel coronavirus (COVID-19) public health emergency (PHE). The IFR’s changes include increased flexibilities for hospitals to provide and receive Medicare payment for hospital outpatient services to patients in their homes. This put a giant spotlight on topics like telehealth, telemedicine and hospital at home as health care organizations looked for alternative ways to deliver care during the pandemic.
This prompted many healthcare delivery organizations (HDO) to quickly pivot strategy to implement a technology-forward approach to care delivery with some the following goals: • Facilitate early hospital discharge for COVID-19 patients (in addition to other conditions) • Monitor lower-acuity COVID-19 patients at home • Avoid hospital admissions for patients needing acute hospital care that could be treated in the home. What is telehealth, telemedicine and hospital at home? Telehealth refers broadly to electronic and telecommunications technologies and services used to provide care and services at-a-distance. Telemedicine is the practice of medicine using technology to deliver care at a distance. A physician in one location uses a telecommunications infrastructure to deliver care to a patient at a distant site. Hospital at home (H@H) is the practice of providing care to a patient in their home when the hospital considers the home to be a relocated outpatient
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location of the hospital. Every health system has a unique workflow for staff, patients, caregivers and the system as a whole. Banner Health has deployed models of hospital at home since the mid-2000s and healthcare technology management (HTM) played a vital role in planning and implementing those models. As is typical, there are always lessons learned and the following are five important ones before implementing H@H programs. (1) Set Clear H@H Program Goals: In order for a program to be successful, health systems must establish clear goals from the beginning. Goals can evolve and change once the program kicks off (and metrics start to accumulate) but launching the program with a clear set of goals is the best way to set up the program for success. Some example goals might be: • Decrease length of stay • Decrease total cost of care • Reduce admissions/readmissions • Increase patient satisfaction • Divert patients from the emergency department or urgent care In addition to program goals, it is also crucial to determine which disease states a patient might benefit from the most. See the following table of potential uses cases along with potential exclusion from a program. (2) Determine Patient Eligibility, Select Patients for the Program and Prioritize Patient Safety: Once goals are established, the next step is building the H@H program framework. Keeping patients at the center, health systems can build eligibility criteria based on the needs of unique patient populations and available resources. The goal is to offer the program to patients who are sick enough to require emergency departmentlevel care, but stable enough to be cared for at home Common eligibility criteria include:
•
Patient must have one or more specified conditions that can be safely treated in a home environment (and that meet criteria for a hospital admission) • Patient lives in a geographic area that is a reasonable distance from the hospital – in case they need to be admitted • Patient has insurance coverage (e.g., covered by a commercial carrier, the hospital’s health plan or Medicare) • Patient has a caregiver at home to help the patient, if needed • Patient’s home is suitable for home-based care delivery (self-reported by the patient) Once eligibility criteria are established, there are some operational considerations. • How/where do patients get enrolled in a program? • Emergency department? Discharge from a care unit? • When the patient no longer needs inpatient clinical interventions (IV antibiotics, fluids, treatment) and daily visits • Should these patients be in your revenue cycle? • Should these patients be in the charting application? (depends on what care delivery and workflow looks like) And lastly, it takes technology to help enable the clinical care delivery. The following are some considerations from that perspective: • What devices will be necessary to collect and deliver data to your organization in the home? • Medical devices • PCs, tablets – patient user interface devices
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THE BENCH Potential Program Use Case
Potential Program Exclusions
Acute Asthma
Clinically Unstable
Chronic Obstructive Pulmonary Disease (COPD)
Requiring cardiac monitoring or ICU care
Decompensated Congestive Heart Failure
Living in an unsafe environment (consider fall hazards, accessibility needs, connectivity)
Urinary Tract Infections
Reside outside of the service area
Community Acquired Pneumonia Cellulitis of the Lower Extremities Deep Vein Thrombosis (DVT) Patient transfer during their hospitalization to complete their hospitalization at home COVID-19 Patients who are stable enough to be managed at home
•
Connectivity enabling technology – cable modem, router, etc. • How will the patient’s assigned device connect and deliver data? • ED enrollment • During hospitalization discharge process • Other • Where will the data generated by the home devices go (receive location) and how is that supported? • ED environment • ICU environment • Dedicated H@H environment • Telehealth environment Avoid the trap of technology for the sake of technology. High-tech doesn’t always rule the day. Consider instead: • What clinical programs require what data to deliver hospital at home services? • Think in terms of technology required for what disease state. • Technology needs to be right-sized and resource matched to what is required for the specific care requirements. Not every situation requires sophisticated monitoring with a large number of clinical parameters. • How is the technology sourced? • Developed in-house • Out of the box solution • Hybrid (3) Consider who the H@H Program Team Consists of and Provide Continuous Internal Education: Oftentimes, there are multiple interdisciplinary teams involved in managing H@H programs. Coordinating
across teams is essential for success – and can also present challenges. The health system must consider (and plan for) all teams that are involved in the H@H program and ensure buy-in at every level. Gaining program buy-in is key and that starts with demonstrating to internal stakeholders that the program works, that it’s beneficial and (most importantly) that it’s safe for patients who qualify and enroll. Buy-in for a H@H program starts at the very top of the health system leadership chain, and includes key leaders within each department, such as operational and front-line staff. Every H@H same umbrella, highlighting the program benefits and providing transparency into how the Hospital at Home program can help improve outcomes. Clinicians involved in a H@H program must be: • Comfortable with the H@H model, understanding why (and how) the program can benefit patients • Knowledgeable about technology, with the ability to use technology hardware and software to administer at-home care independently • Are there areas that make sense to engage partners? Technology? Call Center? Staffing? Home Health? (4) Ask the Right Questions – and Plan Ahead for Challenges. In order to successfully launch a H@H program, health system leadership must ask fundamental questions about how the program will work: • Will the health system work with an affiliated home health agency or
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a third party to ensure care is delivered properly into the home? • Day-to-day, who is responsible for monitoring patients? • Who is in charge of overseeing the remote patient monitoring clinical dashboard? Think on how to overcome logistical challenges for the H@H team. Some examples might be: • Arranging medication delivery • Ensuring a nurse or another clinician will be at the home at the right time, aligning with the patient’s schedule • How to manage and respond to abnormal test results • How will technology be delivered, supported, returned and reprocessed such as nebulizers, oxygen, X-ray machines or assisted devices (5) The Do’s of a Telehealth/H@H Program: For patients enrolled in a H@H program, telehealth and remote patient monitoring is essential – and required, per the acute care at home waiver. Although every health system might leverage telehealth technology differently, there are a few common telehealth themes to improve care delivered across the continuum. Some examples include: • Daily check-ins with patients • Remote monitoring to track symptoms and vitals • Help with medication adherence and activity tracking • Promotion of patient education, helping patients become more involved in their own care • Direct contact with their provider should a patient have concerns about their health or condition Looking ahead to the next pandemic – and to the future care of patients, all the time – there’s a need for health systems across the country to embrace these changes and explore H@H programs. The patient’s home should be considered an extension of the hospital, serving as a place for high-quality care to be delivered (for those patients that qualify), acting as an integral part of the larger health system. – Perry Kirwan is the vice president of technology management at Banner Health.
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SHOP TALK POWERED BY
TOSHIBA APLIO XG
KONICA MINOLTA AERODR
Q:
When I press the start button of my Aplio XG, the fan of the motherboard starts spinning then stops after 2 or 3 seconds and the startup process cannot go any further. In addition, the start button doesn’t even respond after that and I have to completely cut the power off with the switch at the back of the machine. The same thing happens all over again when the system is powered on. Hopefully someone encountered the same problem and will be able to help.
A:
Sounds like you have a high draw on a power supply. Most switchers will “chirp,” that is you can hear the chopper frequency on the line side as a brief chirp as the line tries to chop the incoming line and because of the load on the output, it will pretty much shutdown immediately. Hence the chirp sound, sometimes obvious, sometimes very hard to hear. Some supplies will shutdown and not allow repower until line voltage is removed for a short period. If the supply is a PC style, you can get power supply testers for these. If this is more like the ones in the older Accuson (or yours judging by the picture) you can start by unloading the supply. This thing looks suspiciously like an Accuson 512X. So, pull all the boards back from the back plane and see if power will come up and stay up. If so, put half the boards back in. If it stays on, put half the remaining boards back in and so on until it won’t power on. If it does not power up with all boards out, the PS may have an issue. If this is an Accuson clone, there is a suitcase-sized power supply that likely has the problem.
Q: A:
What type of an access point is used to configure AeroDR?
The systems I have use a Moxa AWK-3121 access point. I believe the newer systems use a different one, but I am not sure what type.
A:
Aruba IAP-205 I believe is the most current.
PHILIPS SURESIGNS VS3
Q:
I have a Philips SureSigns vs3 and the power button is not working anymore. It was working yesterday and today it’s not working. Anyone have any ideas or how to fix it? I appreciate your help.
A:
Philips had a big issue with those VS3 power switches a long time ago. They had a program that if you contacted Philips with the model and serial number, they’d send a box of 5 of the rubber switch sets to you. The power switch is part of the other buttons except for the knob encoder. So, you end up replacing all the membrane switches at the same time. It looks like Philips has a FCO on this part. You *might be able to get it replaced for free if you mention Field Change Order: FCO86201022A. Philips pn: 4535 641 01891 latest pn: 4535 642 42221
A:
There is a problem that I found with an extremely low battery. The watchdog feature will “lock out” the power button, until you remove the battery and unplug the power cord. Then, re-insert the battery and plug into AC power. The device will restart, and the power button will work. You will then have to reset the date and time. The battery will be very low so plan to plug it into AC power for 2 to 4 hours to recharge.
A:
1) Unplug the device from AC power 2) Open the battery compartment door 3) Remove the battery 4) Re-insert the battery 5) Plug back into AC power 6) Unit is now active and the date and time will need to be set correctly. SYNERON-CANDELA GENTLELASE PRO
Q:
The screen does not work when the device is turned on. Can someone please help?
A:
The display and the touchscreen are two different things. The display is how the CPU communicates to you, and the touchscreen is how you communicate with the CPU. So, the screen may not come on, but it can still be possible that the touchscreen is still functional. You typically know because of the sounds emitted to indicate touch. If the screen works, then you probably have a bad LCD display. If nothing works, then either you are missing power or the display assembly needs replacing.
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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THE BENCH
WEBINAR WEDNESDAY Presentations Deliver Helpful Tips STAFF REPORT
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he recent Webinar Wednesday session “Top-5 Benefits of Improved Device Effectiveness” presented by Medigate Director of Product Marketing Samuel Hill was eligible for 1 credit from the ACI. It was sponsored by Medigate.
In the webinar, Hill shared five of the most common outcomes for improving device effectiveness. Every hospital has thousands of devices that cost thousands of dollars. When one factors in the workflows needed to keep them operational and available for patient care, there is incredible pressure on getting the most from each one. Organizations can uncover critical benefits by incorporating up-to-date inventory with dynamic location and utilization metrics. Hill provided additional insights during a question-and-answer session. One question was, “Can you specify what is medical device data?” Hill explained that “what we’re looking at is the data that the medical device communicates about itself on the network. So, it does include some of the pieces of what it is doing, like the specific work that it is performing. But, what we’re mostly interested in is, what does the device say about itself?” He explained that the data can be used to track equipment and that information can be used to update systems, namely the CMS, specifically in the biomed use case, with accurate data
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about the device itself. He also spoke about MAC addresses and how they serve as unique device identifiers for every piece of equipment. The webinar, including the complete Q&A session, is available for on-demand viewing at WebinarWednesday.live. The webinar was popular. Attendees provided positive feedback in a post-webinar survey that included the question, “What do you like best about the Webinar Wednesday webinar series?” “Getting the perspective and some best practices of different vendors, etc. on several topics,” CE Manager William D. said. “Quick and short topics on things that help us in our jobs,” Program Manager Chad N. said. INCREASE TRANSDUCER LIFE The recent Webinar Wednesday session “Basic Tips and Tricks: How to Increase an Ultrasound Transducers Useful Life” was presented by Larry Nguyen, CEO and CTO of Summit Imaging. The session was sponsored by Summit Imaging and eligible for 1 credit from the ACI. In this 60-minute webinar, Nguyen provided a demonstration and analysis to educate clinical engineers on common ultrasound transducer handling mistakes as a means to increase the life of their equipment and better serve patients. As health care facilities are catching up on elective procedures, the utilization of
ultrasound equipment is significantly increasing. This is a leading indicator of increased ultrasound transducer use and failures. There is good news, a significant amount of failures can be prevented with education and awareness of common accidental handling issues. Attendees gained additional knowledge from Nguyen during a question-and-answer session toward the end of his presentation. One question was, “Does your technical support team help diagnose probe issues?” He explained that Summit Imaging provides that and added that a large portion of the support is focused on identifying if it’s a machine issue or a transducer issue. He answered another question by explaining the importance of the early detection of the issues. The complete question-and-answer session is available via the on-demand recording of the webinar at WebinarWednesday.live. Attendees provided feedback regarding the webinar via a survey that included the question, “What did you like most about today’s webinar?” “The presenter was prepared, well-informed and provided practical suggestions,” Biomed Manager P. Phillips said. “All the good information about the differences between the OEM and the generic transducers,” Biomedical Specialist H. Matos said. “Examples, practical descriptions,” Diagnostic Imaging Physicist A. Browne said.
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THE BENCH CONNECTED MEDICAL DEVICE SECURITY The recent Webinar Wednesday presentation “See. Know. Secure: Simplifying Connected Medical Device Security” by Ordr Director of Healthcare Product Management Ben Stock was eligible for 1 credit from the ACI. The session was sponsored by Ordr. In this 60-minute webinar, Stock explored simplifying the overwhelming task of keeping connected medical devices protected. Securing connected medical devices can be a daunting task. Stock spent 17 years managing connected medical devices at SSM Health before transitioning to developing products that could address his challenges. In his presentation, he was able to break down the process into three steps and outlined techniques and tools that can be used to identify high-risk devices, understand how they are being used, and implement measures to protect them without interfering with patient care. He explained that there is no one-size-fits-all solution, but there are tools and best practices that can make a seemingly impossible task manageable regardless of the organization’s size. Stock also answered questions as part of the webinar. One question was, “You mentioned retrospectives, security on one of your slides. What can be done to determine the extent of an event?” “So, we’re gathering stuff, whether we know that it is malicious or not, and we’re keeping metadata around those flows. So, if an event is determined to have happen, either a known event or a zero-day event, where we don’t necessarily know, it’s going on until a certain point in time,” Stock said. “I mean, you can actually take this data and look at it, and analyze it over time, and see what devices are communicating with, what other devices and, watch the east west traffic and the external traffic to determine how an event took place, where it started, what machines were affected. And basically, build a timeline around the event, and how and what occurred, the things that are captured. You, know, when the first and last team, the communication. What’s talking to what. So, all give you a picture retrospectively of what happened during that event.”
“It gives us a couple things that we can do, we can look at and probably can prevent it in the future, for one,” he added. “And additionally, we can look at what devices were affected, and what we need to focus on to remediate the issue at hand without having to go around and look at every single device that may have been a potential victim.” The other questions and answers are included in the on-demand recording of the webinar at WebinarWednesday.live. Attendees provided positive feedback via a post-webinar survey that included the question, “What did you like most about today’s webinar?” “I really enjoyed the information that was presented and the clarity of the presentation,” said C. Brown, BMET II. “The simplified explanation of identifying high-risk devices,” said K. Wheeler, BMET III. “Learning how cybersecurity benefits the hospital in terms of protecting PHI,” Biomed Supervisor A. Bia said. RTLS & STAFF SAFETY The session “RTLS & Staff Safety within Behavioral Health Settings” was presented by Stephanie Andersen, managing partner of ZulaFly, and Sandra Rasmussen, senior vice president sales and marketing of Sonitor. It was co-sponsored by Sonitor and ZulaFly and eligible for 1 credit from the ACI. Andersen and Rasmussen discussed the value add of an RTLS system within behavioral health facilities with a focus on staff safety. Details on the importance of location accuracy, analytics and how alerts are administered were covered during the webinar. The duo provided additional insights via a question-and-answer session. One question was, “Can staff alerts be sent to any device?” Anderson said, “Yes, so out of the box, alerts can be sent via text, email at the mobile app pop up. … So, any communication device that you are already using, we can tie into and send those alerts to.” Another question was, “How easy is it to add on additional applications?” Rasmussen replied, “So, from an infrastructure standpoint, if the use case,
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for example, that we talked about, is staff safety then the technology that is deployed is the same technology that would be used to support additional use cases.” She said that from an infrastructure standpoint, if the facility is looking to ensure room-level coverage for staff safety, there would not be any, or I would say insignificant additional infrastructure, that would be required. If additional use cases, such as patient safety or patient locating or asset locating or asset management, are the use cases to be added on then there would be additional tags that would be required, but from an infrastructure standpoint, little, if any, new infrastructure would be required. Exactly 100 individuals registered for the webinar and a recording of the session is available for on-demand viewing at WebinarWednesday.live. Attendees provided valuable feedback via a survey that included the prompt, “Give us 3 words to describe today’s webinar.” “Insightful new technology,” Biomedical Engineer V. Mendoza said. “Informative, interesting, thought-provoking,” M. Mortensen, CBET, said. “Interesting, new technology, forward-thinking,” Clinical Engineering Director K. Hoellein said. For more information, visit WebinarWednesday.live.
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echNation recently invited several industry leaders to comment and share insights regarding education and training in the healthcare technology management and/ or biomedical realm. Participating in the roundtable discussion are Injector Support and Service (ISS) Director of Procurement and Training Bruce Clarke, College of Biomedical Equipment Technology (CBET) President Dr. Richard L. “Monty” Gonzales, Innovatus Imaging Clinical, Technical and Commercial Specialist Ted Lucidi, Maull Biomedical Training LLC President Steve Maull, Probo Medical Senior Territory Manager Hobie Sears, Elite Biomedical Solutions CBET/Service Specialist Jake Walters and ReNew Biomedical Instructor and Field Service Tech Richard Woods.
Q: WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR WHEN SEEKING TRAINING? CLARKE: Beyond the obvious of applicability of the training to the career path of the attendee, I would say presentation type. Is the training a straight lecture (snore)? Does the training include any dialogue between the presenter and other attendees? Are there any hands-on aspects to the training? The training presented by Injector Support and Service integrates the concept by Confucius of “Tell me, and I will forget. Show me, and I may remember. Involve me and I will understand.” into our training sessions. By implementing both the “show me” and “involve me” precepts into our training sessions, the attendees are far
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Bruce Clarke Injector Support and Service (ISS) better prepared to work on injectors than those that sit in an audience, slipping in and out of lecture coma as the speaker rambles on and on. GONZALES: Technicians seeking advanced education and training should carefully consider career objectives and return on investment. Purposely aligning one’s career path, education and training is an important first step. Considering the source of the training is also important – accreditation, flexibility, alignment with the industry, costs and outcomes are important factors. Today’s students should expect a partner in education that is willing to work as hard as they are to reach their academic and professional goals. LUCIDI: As we look at the right to repair movement, facilities need the right types of
training as well as the proper tools to effectively service today’s complex medical devices. Two important criteria are overall cost and value to the organization. A successful strategy would have service training be negotiated into the purchase cost of any capital equipment. The purchase cost is only a fraction of the total cost of ownership across a device’s lifecycle. An individual who has attended an OEM training course should also have access to tools, such as diagnostics, similar to those used by the factory service reps. The cost of tools, such as diagnostics, is another factor that should be integral to the negotiations. If the responsibility of supporting a medical device will fall upon the HTM department, then the HTM staff needs support from the C-suite to effectively control costs though quality training initiatives. MAULL: The primary thing you need to ask yourself is “Will this training save us money?” When the training is finished, will my BMET be able to perform the tasks needed to take over the maintenance of the piece of equipment they are getting trained on? Or, is this just an overview course. Overview courses are fine, but you need to manage your expectations if you’re sending BMETs to an intro course or overview course. Also, you want to know something about the training company. How long have they been in business? Who is the instructor? Are they a professional instructor, truly an expert in the field or just some former BMET who knows how to do a task and he’s offering to show you how to do it. There’s a big difference between the two.
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ROUNDTABLE SEARS: First, it’s important to ensure the instructor and company providing the training have the competency to educate on that subject. At Probo Medical, we use several of our experienced senior territory managers to provide our training. They each bring current field knowledge and experiences into the classroom, augmenting the normal course theory and hands-on time. Second, you need to be sure there is enough equipment to provide adequate access during lab/hands-on time. I have heard some sad stories over the years about folks who got little-to-no physical time on the unit being taught. Third, you should consider having a conversation with the instructor before signing up for the class. Even from a conversation, you’ll know if they’re a good trainer for you. It’s OK to be picky about finding the right instructor. WALTERS: In my opinion, one of the more important things to consider is the technical knowledge of the facility that is providing the training. If leading a clinical engineering department, I would want to be sure that the technicians I sent to training would come back knowing considerably more than when they left. Another important thing to consider is if the training benefits your department/facility as a whole. One of the main goals of training (other than the personal development of the technician) should be to help the department run more efficiently. WOODS: Training is vital to career success and job performance. OEM instruction can influence your skill set, making you more credible and reliable among peers in your industry. It is important to consider the quality of training and whether it is valuable instruction to advance your performance or improve your field expertise. Pay close attention to what types of equipment PMs and repairs are most profitable for your organization and plan your calendar a year ahead to avoid missing valuable opportunities. Q: HOW OFTEN SHOULD BIOMEDS UPDATE THEIR TRAINING ON SPECIFIC TYPES OF MEDICAL EQUIPMENT? CLARKE: Depending upon the type of
training every year or two. The equipment doesn’t change that much that often that they need to pay a company again to get updated training on a piece of medical equipment. Software training, maybe. But if you’re getting trained on the specifics of how to maintain a certain type of medical equipment, if the training is covering what it’s supposed to cover and it comes with good documentation, having to pay for a refresher course every year sounds like a money grab to me.
Dr. Richard L. “Monty” Gonzales College of Biomedical Equipment Technology (CBET) equipment, an update may never be required. Sort of like learning how to use Velcro shoelaces. However, if the equipment is complicated and their contact with the equipment is infrequent, once or twice a year, then a refresher course of some kind should be required/offered every two or three years or if modifications are made to the equipment. GONZALES: We live in an exponential era propelled by rapid technological change. Staying ahead of the curve demands constant upskilling, training and education. The most obvious example of the changes we are seeing involve medical device integration and issues associated with cybersecurity. The short answer to this question is continuously and frequently.
SEARS: This will vary based on the type of equipment that is being considered. When manufacturers release new products, sometimes they don’t upgrade much, and new training probably isn’t necessary. However, if a new version of a product is released that significantly changes the product or structure, then training is advisable. Certainly, any new product would require training. Having a conversation with a prospective trainer should provide you with the answers you need. WALTERS: That depends on how often the device has changes made to it, whether it be functional changes or otherwise. In my experience, devices such as infusion pumps do not change very often. I believe if you continue to work on these types of equipment on a semi-regular basis, further training is often not necessary. However, devices such as radiology or some telemetry equipment most likely will require training every few years as the OEM makes changes or improvements to the device.
LUCIDI: No matter one’s current workload, individuals should be open to additional trainings as often as they become available. Technology changes too rapidly for HTM professionals to remain status quo. By continually investing in oneself, individuals will always be of value to their customers, their employer or a potential new employer willing to invest in their employees. Most importantly, continued training projects engagement, investment and value in one’s own future.
WOODS: It is essential to keep up with industry trends. We try to stay connected through email newsletters and notifications from all our equipment manufacturers. Our techs check quarterly with our biomed partners to ensure that there are no training updates that we inadvertently missed. Things like product warnings, recalls or software updates. The medical field is very competitive, introducing new equipment models frequently. There are always new features requiring a different PM than prior models.
MAULL: I can only speak to the devices we provide training on, but in general a BMET should not have to get refresher
Q: HOW IMPORTANT ARE CERTIFICATIONS? CLARKE: Having a certification is great.
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However, certifications are sort of like toilet paper. Anybody can get one, it’s what you do with the certification after you receive it that’s important. If you never apply or use the training garnished from the certification process, what good is it? It ends up being a footnote on a resume or an ego booster thrown out in conversation. The same is true for college degrees. Just because you have a degree, doesn’t mean you know what you’re doing.
healthcare technology management.
GONZALES: Certifications like those offered through AAMI, the DNV and other organizations, are an important component of the HTM and imaging career path. At the College of Biomedical Equipment Technology and the Imaging Academy, we purposely aligned the learning objectives and program outcomes with industry certifications in mind. Technicians and engineers should purposely map their career paths, seek advanced education and training, and obtain advanced industry certifications. Certifications are an excellent way to validate skills and expertise.
SEARS: Certifications are important in the HTM field as a whole and I have great respect for those that have acquired those certifications. These certifications are yours to hang onto for your entire career. Simply put, more doors will open with them than without them.
LUCIDI: Only a portion of employers require certification as a condition for employment, and even fewer offer increased pay for achieving certification. I see certification as a commitment to oneself and to the HTM industry. When I sat for my certification, I did so for personal reasons only. I viewed it as a challenge, but also as something that might provide me an advantage. To that end, I value certifications. When considering choosing between two individuals with similar experience, interpersonal skills and personal recommendations, the certified individual would be my choice.
WALTERS: While not required for employment in the biomedical engineering field, I think all BMETs should strive to obtain their certification. I will say that technicians who specialize in areas such as radiology or lab-equipment may find it necessary to get their certifications to find more employment opportunities. In my personal experience, studying for and obtaining my CBET not only expanded my career opportunities, but made me a better technician in all areas. This includes my technical skills, hospital knowledge, organization and my effectiveness in troubleshooting.
MAULL: I believe that a BMET can professionally flourish without any certifications. There are plenty of outstanding BMETs out there who do not have their CBET or CRES. But, what certification does provide, along with the knowledge acquired to get certified, is that the BMET is serious about their own upward mobility. Having a certification is almost a requirement to land a managerial role. Without some sort of professional certification you stand very little chance of moving up the managerial chain in the HTM world.
WOODS: I believe certifications are very important to career path growth and product expertise. Biomed departments across the nation classify clinical technicians in different ways. BMETs are typically classified in three ways: BMET 1, BMET 2 and BMET 3, all subjectively based on experience. AAMI certifications are recognized nationwide and provide testing that supports consistent training expectations. Having been tested and certified through this association helps to ensure that all certification holders have been exposed and are knowledgeable in all levels of
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Ted Lucidi Innovatus Imaging
Q: HOW DOES HTM TRAINING PROVIDE COST SAVINGS TO HEALTH CARE FACILITIES? CLARKE: Health care facilities with welltrained biomeds, save their facilities thousands of dollars simply by not calling in the OEM, and relying on their own staff of in-house professionals. This is especially true when the facility is not near a densely populated area or city. Just the travel time charged by the OEM can sometimes be nothing short of highway robbery. One should also consider the downtime of the equipment and what impact the downtime has on patients and patient health. A well-trained biomed with the proper tools and parts can greatly limit lab downtime, which in turn has a direct impact on patient throughput, hence patient care and ultimately provides the facility with monetary gains. GONZALES: I will answer this question from the perspective of the technician. The first challenge health care organizations must consider is attracting talented technicians and embracing what our colleague Al Gresch refers to as the “Maturity Curve.” Investing early in professional development and education aligned with the organization’s mission is critically important to building a strong workforce. The second challenge is maintaining a strong workforce through a period of unprecedented opportunity and demand for skilled technicians. Again, investing in their continued education and training can be a powerful tool that ultimately saves organizations money and time. LUCIDI: Investing in HTM personnel is one of the keys to success with reducing service spend. Training enables facilities to reduce their dependence upon costly service contracts. The true value of a service contract is very seldom realized. Contracts are insurance policies, and service providers are betting on the facility not needing service and possibly not having to deliver upon certain commitments. Studies have shown that, with the right types of investments in training and staffing, and proper management, in-house service (including asset managers) can be much more cost-effective than outsourcing or WWW.1TECHNATION.COM
ROUNDTABLE supporting through service contracts. Investing in employee training shows team members that they are valued. In turn, this leads to greater job satisfaction, quicker advancement and, ultimately, lower employee turnover.
transitioned to virtual sessions. This would enable maximized focus on the hands-on portion for a reduced amount of time. The result would be more effective use of the trainer’s time, reduced out-of-office time for the learner and lower travel costs for the facility.
MAULL: The most obvious answer to that question is the ability to take in-house equipment off outside contracts (whether it’s OEM or third-party). You know the old saying; give a man a fish and he eats for a day but teach a man to fish and he can save hundreds of thousands of dollars on service contracts. SEARS: It mostly provides labor cost savings. With proper training, many facilities can bring labor costs down by bringing services in-house. However, something that must be factored into this is the amount of time it will take the in-house person to service this new equipment. If you are training an already over-committed engineer, then the cost savings may not be as significant since you may still turn to outside labor to offset your labor demand. There will also be the modest cost savings that come from ordering the right part more often considering the engineer has more knowledge. These savings will grow with experience. WALTERS: The cost savings can be huge when a clinical engineering team is appropriately trained. Rather than constantly sending devices in for repair or having an OEM technician come to your location, the technicians can perform repairs and/or evaluations at less of a cost. It may also save on future training costs if you have someone on your team who has previously been trained and can then train new and existing employees as a result. WOODS: To the biomed department, training provides cost savings to a hospital by reducing errors, maintenance time and third-party repair costs. Q: HOW HAS COVID-19 IMPACTED TRAINING PREFERENCES AND EXPECTATIONS? CLARKE: Although many of the restrictions applied over the past year and a half are lifted or found to be knee-jerk reactions, some organizations are still placing travel restrictions on their staff. Limiting access to
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Steve Maull Maull Biomedical Training LLC
MAULL: Luckily Maull Biomedical implemented a remote learning option back in 2015. It was popular pre-COVID, but during COVID our demand for distance learning skyrocketed, as you can imagine. The expectations of the training did not change with COVID, but how the training was delivered was impacted. Pre-COVID, probably 10% of our training was done remotely. Since 2020 that has gone up to about 30%.
educational seminars offered at trade shows and access to off-site training provided by various vendors. Some training organizations chose to offer an online solution to this problem, while others have offered to take the training to the student and set up classes in the city of the facility in question. GONZALES: Fortunately, we are seeing the effects of COVID-19 diminish. However, the pandemic added rocket fuel to many changes we were already seeing in education and training, and frankly, that genie cannot be put back in the bottle. Industrial era thinking associated with traditional fixed-site learning will never return to the prominent position it once maintained. We are going to see continued investment in online learning, mixed reality, short-term training programs, with high ROI for students. I do not believe we need to sacrifice quality for value. The technicians and engineers seeking continuing education and training should expect both. LUCIDI: Although hands-on, in-person trainings are much preferred and quite necessary depending upon the device, the COVID-19 pandemic has shown that virtual trainings can be effective and can provide similar value. Virtual trainings, and the technology that supports them, have taken a quantum leap since preCOVID. Don’t get me wrong, there’s no substitute for a several-week hands-on training course for a CT or MRI. However, segments of the coursework could be
Hobie Sears Probo Medical
SEARS: It depends on who you talk to. Personally, I don’t think it has impacted preferences. Most individuals know the best training is in-person with devices to work on during lab time. Therefore, I believe the preference is to train in-person for most products. However, there are some expectational differences since, in the COVID era, we must find ways to work differently provided we can create an equal experience. This, of course, is some type of virtual or remote class. As trainers, we must be able to deliver a class that is as equal as possible to live training. Otherwise, we are just providing training that checks a box for someone, which is often not beneficial.
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ROUNDTABLE Arterion injectors. The training is offered in Orlando/Winter Garden, Florida the third week of each month.
Jake Walters Elite Biomedical Solutions
WALTERS: COVID-19 has led some facilities to seek out virtual training rather than the traditional in-person training. I believe one of the few good things to come from the pandemic is the realization that learning does not have to exclusively be a face-to-face event, it can be accomplished from almost anywhere with an Internet connection. I think this has made training more accessible to people that may not have had the opportunity in the past. WOODS: At this time, some equipment manufacturers are only allowed to offer online training. Others allow hands-on training but only accept vaccinated students. Opting to host a trainer in your facility lowers travel costs and allows the possibility of training more technicians. Of course, the disadvantage is the missed opportunity to visit the manufacturer’s facility and see all models of their equipment, eliminating live hands-on time with various models. Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT TRAINING OPPORTUNITIES? CLARKE: Injector Support and Service offers a Level-II, troubleshooting, component replacement and repair training on the Medrad Stellant, Solaris, Provis and Mark 7
GONZALES: A convergence across several domains, including healthcare, technology, and education, is ushering in unprecedented change and limitless possibility. These changes were accelerated because of COVID-19. We must create education and training models that meet the demands of the HTM workforce of tomorrow. Such an approach includes mixed reality content, including artificial intelligence, virtual and augmented reality, and other advanced technologies that will allow the HTM community to effectively address the education and training demands through a period of accelerated change. LUCIDI: Seek out partners that provide free training opportunities. Innovatus customers have access to in-the-can as well as custom training sessions relative to ultrasound technology. Our latest program, SafeTEE, has sessions designed for the clinical and support staff (Echo-techs and central processing techs), as well as service engineers. The focus of SafeTEE is on helping facilities reduce their overall service spend supporting TEE probes through quality, sustainable repairs as well as limiting the need for future repairs through customer education and preventive services. SEARS: First and foremost, training is necessary! When I hear stories about engineers that haven’t been to a training class in years and years it makes me wonder why. We all need to keep our skill levels up and make sure we are getting updated training as hospitals move on to new products. Second, as I mentioned earlier, talk with the person who will be teaching the class. Sometimes there are folks you just know you won’t learn from. If that is the case, find another avenue. I have had two situations like this early in my career and I still talk about how bad those experiences were to this day. In these cases, I didn’t have much control, but it goes to show how an instructor who
Richard Woods ReNew Biomedical you don’t connect with can make or generally break the training experience. WALTERS: The only other thing I would say is to keep your eyes and ears open. There are many training and learning opportunities out there than you probably think there are, whether it be in-person, virtual, product specific or general technical knowledge. There is seldom an excuse to stop learning while in the health care field. Elite now offers a customized training program to BMETs so call or email to learn more. You can send an email to bhester@elitebiomedicalsolutions.com WOODS: Never, never, never pass up an opportunity for free training! Even if the training is less relevant to your current job, it could be useful later. These experiences could expose you to an area of interest you had not previously considered. Keep a lookout for Webinar Wednesdays; they are a great resource. For anyone interested in building a firm foundation in the HTM industry, look into an AAMI-recognized apprenticeship program. These apprenticeship programs are an excellent opportunity to be compensated while mentored by experienced Journeyman. Certifications are highly encouraged and rewarded by the program.
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COVER STORY
. BY K
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n an age of graying biomeds, the resources to replace the exodus of talent are few. A wealth of experience is exiting a profession that most people have never heard of, so replenishment is a challenge. AAMI estimates that half of all biomeds are over age 50. 68
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For employers, the question is; how do you onboard new biomeds who have technical training and hands-on experience? For a student, who has an interest in the profession, or someone who is trained who seeks hand-on experience, how do you garner experience or prove your worth to an employer?
There are vehicles to accomplish all of these objectives and they come in different stripes, ranging from “shadowing” to a formal internship to a paid apprenticeship. Within each, there is a commitment by both the student, career-changer or trainee and the employer or supervisor. There are expectations of each party, and WWW.1TECHNATION.COM
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the roles and responsibilities need to be well-defined. Historically, within the trades and many other professions, there have been programs to familiarize a new trainee with a job. In some cases, such as with an academic or technical program, an internship is a component of the program. These programs most often allow a student to become actively involved in a profession they are training for or an opportunity to test the waters in a profession they are considering. The intern is usually not paid. An apprenticeship program is somewhat different than an internship. With an apprenticeship, the employer is not simply a host or participant in a short-term learning experience; the employer may be using the apprenticeship to onboard a new employee with the skills that they need. Apprenticeships are paid and there is usually a minimum rate attached to the apprenticeship. Both types of programs can combine classroom training with hands-on training. Each of these types of programs are also fundamental to the HTM profession. The apprenticeship program recently had a more standardized structure added to it in order that it might be more inviting. The hope is that it can stimulate more growth and replacement within the ranks of biomeds. The term “journeyman” has been used throughout the trades to indicate a person who has officially completed an apprenticeship qualification and has the competency to work in a chosen trade. The title indicates that they can work without supervision and can take on higher level responsibilities. Historically, in medieval trade guilds where the term was derived, the three ranks of workers were apprentices, journeymen and masters. An apprentice is a trainee; a journeyman is not. APPRENTICESHIP BY DESIGN On the apprenticeship side, any discussion would have to include AAMI’s new apprenticeship program, launched in 2021. The program starts with the apprenticeship concept and gives it more
structure, guidelines and career-enhancing credentials. The program was the brainchild of Maggie Berkey, CBET, senior BMET with CommonSpirit Health and was developed through the work of Berkey and AAMI Vice President of HTM Danielle McGeary. Berkey is also a member of AAMI’s Technology Management Council and a former AAMI and GE Healthcare BMET of the year. The pair had to earn approval from the Department of Labor (DOL) to fulfill the five requirements for creating a registered apprenticeship. The two-year hybrid program pairs education with up to 6,000 hours of paid, on-the-job experience and learning. The program brings some standardization to the process, providing consistency to a defined process that ends with a nationally recognized certification from AAMI and the U.S. Department of Labor. Best of all, as Berkey points out, the apprentice does not acquire any student debt. AAMI apprentice program college courses can be taken online. The program is national. Applicants should go through AAMI. As of March 2022, there were 15 employer partners who have partnered with AAMI and the DOL and 15 apprentices. Entry-level BMETs can earn $25/hour as an average entry-level income. That income can increase substantially with specialization. The program is not only open to students, but available to career changers or persons from any technical backgrounds. Not only does a national BMET apprentice program provide standardization, but it provides a starting point, a user’s manual and a checklist for employer-sought skills. “Our main consideration was feasibility. We wanted the apprenticeship to be available to anyone, anywhere, at any time so there was a simple framework to training strong entry-level BMETs while benefiting local communities,” Berkey says. “The bonus is that we made great efforts to avoid barriers. In fact, much of the education that is required can be accessed by learners at no cost to
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anyone thanks to our collaborative work and the numerous free resources our industry already offers (such as WebinarWednesday.live). We have also acquired lots of industry support including offers of 20 percent discount for the two required college-level courses (at CBET.edu) or covering the cost of required certifications (by Nuvolo),” Berkey adds while offering thanks to those participants. In designing the program, several considerations had to be contemplated for participants – apprentices and mentors/employers. Berkey says that for the apprentices, they built the program as a hybrid program to benefit the majority of learners.
“We wanted the apprenticeship to be available to anyone, anywhere, at any time so there was a simple framework to training strong entry-level BMETs while benefiting local communities.” - Maggie Berkey “It was designed to be attained by most apprentices within two years, however, someone from a military BMET background could potentially meet all program requirements within one year and those who need an extra year of studying to achieve CBET certification have it built in using this model,” she says. She says that the goal was to lay a strong foundation by writing competencies that the majority of the field could agree upon.
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“Before finalizing Appendix A, we had over 100 industry professionals from various career levels and organizations agree that all competencies included were needed to build exceptional entry-level BMETs from scratch. I truly believe the apprenticeship sets a high bar for the entire HTM community,” Berkey says. For those sharing their expertise with the apprentices, the focus was on the mentor’s real-life experience.
“Our intern could work alongside our experienced technicians to gain knowledge not available in the classroom settings.” - Rich Reamer “We know that there are no two shops alike so the primary consideration for mentors was to not put a bunch of language in requiring X, Y and Z to be a mentor. Ideally, mentors will have a few years of solid BMET field experience and be passionate about shaping the future of HTM,” Berkey explains. She says that there are many benefits for apprentices and mentors. She points out that there is paid for training from day one for the apprentice and they have credentials and skills which are portable, stackable and transferable. For mentors, Berkey points to the personal reward that employers get from mentoring and how it is worth the investment. She says that you get to pass along your pride in work and teach apprentices the “right way” to get the job done. Several early adopters entered the AAMI BMET apprenticeship program as participating partners. The participants
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on both sides of the equation benefit. “Our system has five apprentices currently within a two-year structured process,” says Rich Reamer, CHTM, regional manager of clinical engineering with McLaren Health Care in Michigan. He says that each of the apprentice candidates have varying levels of experience in the clinical engineering field. “We are able to guide our employees through the process and invest into the future of them and our department teams. Having the opportunity to see firsthand the education and training of our apprentices allows us to find the special skills that may build our overall talent in areas of the greatest need for our organization,” Reamer says. He points out that they also see growth within their other employees during the process. “Our more senior technicians and mentors get to hone their skills and share their knowledge. This entire process drives value in our team, and shows our willingness to invest into their careers, building an environment of engagement and culture of personal, and team value,” Reamer says. He says that having these options/ tools available is critical toward HTM’s success in the future. INTERNSHIP INSIGHTS A survey provided to BMET students and supervising professionals was conducted through Penn State New Kensington (PSNK) in 2020. Part of the focus of the survey was to identify challenges for internships. The survey was conducted by Joie N. Marhefka, Ph.D., biomedical engineering technology program coordinator at Penn State New Kensington in New Kensington, Pennsylvania, and CTL Scholar Assistant Researcher Dalynn Park. The results provided valuable insights into the BMET internship. “I think a big challenge for the supervisors is finding the resources to train the
students, especially when things get busy. For the students, one challenge is learning a lot in a short time period (likely devices they haven’t seen, a new workplace, etcetera). Another challenge for students is communication during the internship. Also, money is a challenge for many students as they are typically at their internship for approximately 40 hours a week and most are unpaid,” Marhefka says. What did the researchers learn about what can cause an internship to be unsuccessful or to fail from the student’s perspective? “From the student’s perspective, the complaint I hear most often is that they either spent too much of their time doing things to help the department and weren’t able to see and experience enough different devices/departments, etcetera. We have designed the requirements for our internship to try and prevent this, but in a few rare instances, students have not been satisfied,” Marhefka says. She says that from the employer’s perspective, the biggest complaint she gets is that students aren’t engaged/ eager to learn. “The employers really want the students to ask questions and try to see and do as much as they can. Many students do, but I sometimes get complaints that a student spends all of their downtime on their phone or something along those lines,” Marhefka adds Internships can pair the right future biomed with the right employer. “We have had the opportunity to work with a local college to have an intern. My experience with internships is very positive,” Reamer says. “Our intern could work alongside our experienced technicians to gain knowledge not available in the classroom settings. At the same time, we were able to assess the basic skills and overall fit with our team and environment,” he adds.
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Well-structured and thought-out internships and apprenticeships are KEY COMPONENTS to replenishing the ranks of biomeds with those who already understand the profession. Reamer believes that this is a benefit for the student and employer. “At the end of the internship, we extended an offer, and now employ this person,” Reamer says. Internships are often an important component of many degree programs and the up-close, hands-on benefits they offer to biomeds in training make them invaluable. At Indiana University-Purdue University Indianapolis, better known as IUPUI, biomed students can complete the healthcare engineering technology management (HETM) program with degrees issued by Purdue University. The program has two degrees, a Bachelor of Science (BS) degree which is ABET accredited, and an Associate of Science (AS) degree. “A significant component of the AS degree is a semester long 200-hour internship at a hospital of the student’s choice,” says Phillip E. Pash, M.S., lecturer of healthcare engineering technology management in the department of engineering technology, within the Purdue School of Engineering and Technology. He says that the HETM program has partnered with numerous central Indiana hospitals to support the internship program. “The students work side-by-side with an HETM professional mentor to learn aspects of the profession that will better prepare the student for entry into an HETM career. The internship program has been very successful in producing workready HETM graduates and provides a potential employer for the student once they have graduated,” Pash says. Pash says that when he has visited hospitals where one of the HETM
students is conducting an internship, he typically finds the student at a bench working on a piece of equipment, next to their mentor who is providing guidance. “Or, the student will be somewhere in the hospital working on, helping to repair or maintaining a piece of medical equipment. IUPUI is very proud of our internship program and our partners and will continue to help support the HETM industry by preparing high-quality graduates for this rewarding career path,” he says. OTHER ROLES FOR INTERNSHIPS The focus of most HTM internships and apprenticeships are to train or educate those new to the profession. The concept can also be used for someone with experience as a biomed who is interested in transitioning into management or completing an advanced degree. “In the fall of 2020, I had onboarded an intern who was working on his capstone internship report for his Master’s in Health Care Administration. This individual was a working BMET for Kaiser Permanente at the time, and I admired his ambitions to seek higher educational goals. So, I was more than willing to help him in achieving his aspirations,” says Darwin Fontanares, MBA, CHTM, CBET, BSBMET, senior manager of IT/biomedical engineering at Stanford Health Care – ValleyCare in Pleasanton, California. Fontanares says that the internship required 100 working hours of shadowing
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him and how he managed the biomedical engineering department. “We would meet for one-hour a day for about five months, and basically followed a lesson plan for each session. I broke down each month into five key pillars in managing a biomed department: operations, finance, risk, human resources and education/training,” Fontanares says. “He was able to complete the 100 hours and composed a 12-page internship report; he completed all the requirements of the program and eventually earned his master’s degree,” Fontanares adds. Regardless of the approach, well-structured and thought-out internships and apprenticeships are key components to replenishing the ranks of biomeds with those who already understand the profession. They offer a great tool for employers and interns/apprentices. With the addition of the AAMI BMET Apprenticeship program, a new era of well-trained rookie biomeds will keep departments staffed.
Employers can become AAMI BMET apprenticeship partners by following the steps outlined at this link: https://www.aami.org/HTM/bmet-apprenticeship
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CAREER CENTER Advice for Dealing with Sexism in the Workplace
Kathleen Furore
BY KATHLEEN FURORE
W
hile women have come a long way, there is still a lot of prejudice against them in the workplace as they try to move up the career ladder. Stories abound about women having to deal with comments on the job and during job interviews that clearly would not be directed at men. What can a woman do when confronted by comments and questions that are clearly sexist in nature.
Board-certified behavior analyst Gianna Biscontini can relate. When she learned her dream job was available, she threw her hat in the ring. It was the same job she’d been doing for years but involved twice monthly travel. The male interviewer’s response? He told her the travel was not as glamorous as she may think and asked how being married and traveling away from her then-husband would impact her job. “In that moment I wasn’t even aware I was being stereotyped, I just knew that I was deeply uncomfortable and confused,” Biscontini recalls. “I’d traveled through dozens of countries; why did I feel like I had to justify my ability to withstand a one-hour flight? Why did I let someone ask me how my marriage and job would be affected, in a tone that absolutely stated I should clear it with him first, when I knew that question never would have been asked of a man? “I think that happens a lot to women; we find ourselves in the middle of an outrageously discrimi-
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natory situation and either play it off in the moment or don’t realize it until later, when our brains catch up with our intuition,” she continues. “There is still a fearful, embedded message we hear as our bodies clam up in an awkward retreat: ‘Don’t say anything.’ We need to stop this cycle.” What should you do if you find yourself in that position? • K now the law. “Brush up on what employers can ask you and what they can’t,” Biscontini suggests. • Take a minute. “If you feel uncomfortable, buy time by saying, ‘That’s a great question, and I’d like some time to consider it. Let’s come back to that one,’ “ Biscontini says. • U nderstand your power. “It is important to understand that you have something they want, or you likely would not be there in the first place,” Biscontini stresses. “You can say, ‘I hear what you are asking/saying, but I don’t see the professional relevance in that question.’ This will force them to reconsider their question, realizing it is inappropriate or illegal, or it will force them to explain how the stereotype placed upon you is relevant to the job (hint: it’s not). You are now in a place of power.” • R edirect the conversation. “If I feel like it’s possible to give the interviewer a bit of grace, I would redirect the question to how they’re measuring success
in the role, share how I’d meet the outcomes, and circle back to the question for a coaching moment to help them understand how they’re coming across and validate if that was their intention,” says Robin Lykins, chief people officer at Branch. Biscontini agrees and gives this example: “If a hiring manager is poking around to gauge whether you want to have children, you can say, ‘Do you have children?’ and then ask another question that relates to the job. This gets them talking about themselves and then allows you to swoop in with a job-related question to retain control over the direction of the conversation.” • R eframe the question. “Nothing allows us to see our own biases like someone repeating our words back to us,” Biscontini says. “It is well within acceptable social standards to reframe the question and ask a question of your own. In my scenario it would have gone something like, ‘So what I hear you asking is whether my being married will affect my ability to perform this job (pause a second or two). Is that what you’re asking?’” • G ive it to them straight. It might take more nerve that some of your other options. But if nothing else is working, Biscontini suggests this saying something like this: “I’m curious here, would that question be asked of a man?” She says, “People aren’t used to
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women being so straightforward, and at the very least this will signal that you understand what’s going on in that moment.” • Evaluate the company culture. Are inappropriate comments and questions a sign of a toxic culture? Not necessarily, but it might be, experts say. “If you are being stereotyped or downright discriminated against, this is a demonstration of at least one person’s values within the company,” Biscontini says. “It is perfectly alright to connect with someone else at the company and let them know what happened by saying, ‘I’m so disappointed, I felt very uncomfortable when [explain the situation], and it has me wondering if this is representative of company culture.’ ” Lykins, who has experienced those situations as a working mom with a husband who is the primary caregiver,
agrees. “While it’s tempting to go on the defensive, it’s usually not productive,” she says. “When presented with this situation, my first thought is to strongly consider if the company is the right place for me.” • Alert HR. “At Branch, we request candidate experience feedback from every interviewee and ensure that our culture of inclusion is being represented by each person at the company,” Lykins says. • Stay calm and confident. Bonnie Low-Kramen, TEDx speaker and author of “Be the Ultimate Assistant,” says everyone brings their personal biases and beliefs to the interview no matter their gender. “The male interviewer is revealing his beliefs, and not in a good way, with this response,” says Low-Kramen, who recommends looking the interviewer in the eye
while delivering this retort: “I know you don’t know me that well, and while I can understand your comment, you need to know it does not apply to me. I am very excited for this challenge and my family is totally supportive of me, as I hope yours is of you. In my last job, I traveled on a regular basis, so I know what to expect; but I appreciate your concern. I’m not sure travel was ever very glamorous. Has that been your experience? The work I am doing is very important to me, and I know that I have much to contribute with this next challenge. What are the next steps?” 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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Avoiding Helium Loss in MRI Matt Talley
BY MATT TALLEY
B
iomedical service technicians know that expectations for expertise across multiple forms of equipment can easily become overwhelming. Hospital staff expect you to have the answers to the problems they are experiencing. Whether you service general medical equipment, or specialize in some form of imaging modality, hospital staff are calling your department for help. In the case of MRI, round the clock coverage is required. If responses to certain MRI problems are not addressed immediately, it can result in extremely costly or extensive repairs. Imagine being on call and you get an urgent service request from the MRI department. You know that certain MRI failures require immediate attention, but you don’t really know MRI systems very well. What should you do? Who should you call? The first step in managing the situation is to familiarize yourself with some basics before there is an emergency, so let’s talk about it.
Safety: The most important consideration when dealing with MRI is … safety! I know we have all heard the safety mantra a million times so it’s easy for some of us to just tune out when we hear the word, but MRI is unlike any other machine you will be exposed to in a hospital. Don’t gloss over the very real danger of this machine. The scan room has a high-powered magnet that
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is always on. Do no enter the scan room without first having specialized training or unless you are under the supervision of an MRI technician/engineer. A major concern for any hospital/MRI department is the loss of liquid helium. Many urgent calls for MRI will be the result of a failure in one of the components necessary for preventing the loss of liquid helium. Usually the service request will state, “coldhead is off” or “not chirping.” The coldhead should be running 24 hours a day, 7 days a week. If it is off – or “not chirping” – time is of the essence. The components necessary for maintaining liquid helium levels are: 1. Coldhead 2. Coldhead compressor 3. Chilled water supply (Chiller) Before you ever get a service call for an MRI, you should try to identify these components and any associated gauges and service indicators. There are many variations of coldhead compressors, chillers, plumbing line, etc. Therefore, it’s best practice to observe them when operating normally. In most equipment rooms you will find supply and return chilled water pressure gauges, and sometimes temperature sensors with visible readouts. Mark any pressure gauge or temperature reading with the system operating normally so you know what it should be. Most chillers will have
run and fault indicator lights. The coldhead is located at the top of the magnet vessel inside the scan room (refer to previous safety note). It is not important to physically see this component, but it is important to hear it. It should not be necessary to enter the scan room to hear if the coldhead is running. The distinct coldhead “chirping” sound is typically audible from the control and equipment rooms. If the coldhead is off (no audible chirping sound) the problem will be one of the above components. Check the following: 1. Check pressure gauges for chilled water. If normal move to step 2. Check the chiller, if no indicator lights are on, and the fans are not spinning, check if the main breaker for the chiller is on. Reset the main breaker. Try pressing the RUN or ON button at the chiller. If unresponsive and incoming power is available call a HVAC service company. If no incoming power, call facility electrician. 2. Check coldhead compressor Error on compressor display? Try resetting compressor. Check incoming power. If incoming power and chilled water are OK, call MRI service engineer. Avante has remote MRI monitoring available to help prevent these issues. Call us today. Matthew Talley is an MRI support specialist.
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THE FUTURE
Importance of Mentors Joie N. Marhefka
BY JOIE N. MARHEFKA, PH.D.
I
have been thinking about the importance of mentoring, both in my own career and for my students. In my own career, I value both having good mentors and being a good mentor. I also think it is important for my students to have good mentors as they transition from students to professionals. Therefore, I recently paired each of my incoming students with an alumni mentor, which really seemed to benefit the students. Digging a bit deeper into mentoring, I asked some of our recent graduates to share their insights on how mentors have helped them as they have started their career and on how they’ve mentored students and others entering the field.
Q: THINK OF SOMEONE WHO HAS BEEN A MENTOR TO YOU. HOW HAS THAT PERSON HELPED YOU IN YOUR CAREER? Some answered that their mentor provided information on career pathways as well as tips for doing the job right. Others answered that their mentors provided them with opportunities. Eian Shurina, a 2017 graduate and current senior clinical engineering technician at Rochester Regional Health Care, added that his mentor
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“taught me if someone is willing to take the time to show you how to do something the right way it’s my responsibility to pay it forward and help people that are willing to learn.” Q: HOW HAVE YOU MENTORED OTHERS, INCLUDING STUDENTS AND NEW EMPLOYEES, IN YOUR CAREER? All of the graduates who I spoke with said that they have mentored students and/or new employees, and they mentioned showing students and new employees how things work. Jack DelloStritto, a 2017 graduate and current radiology engineering tech at WakeMed Health & Hospitals, added a few specifics, including demonstrating good troubleshooting skills, people skills and documentation tips. Nathan French, a 2016 graduate and current biomedical equipment technician at UPMC Children’s Hospital of Pittsburgh, also highlighted the importance of being available to answer questions as a mentor. Q: WHY IS IT IMPORTANT TO HAVE A GOOD MENTOR AND TO BE A GOOD MENTOR? Several answers to this question focused on modelling quality work. If a mentor demonstrates good work practices, the mentee will likely follow
in their mentor’s footsteps. Other answers focused on the importance of mentoring relationships in helping the field to evolve and thrive. Q: HOW WOULD YOU GO ABOUT FINDING A MENTOR? I asked this question because it can be challenging to find a mentor, especially outside of school. DelloStritto suggested “look for the ones that are ‘doing it right.’ That doesn’t mean that you or a mentor need to be a slave to the job by any means, just that you find someone in your career path that takes their job seriously, does their best, and treats equipment as if your family member were going to be placed on it, all while accepting that we cannot ‘do it all’ and are sometimes going to make mistakes.” Shurina added. “I take any opportunity to learn from anyone that is willing to teach.” Q: DO YOU HAVE ANY RECOMMENDATIONS ON BEING A GOOD MENTOR? Several people stressed the importance of communication to being a good mentor. DelloStritto added, “Let your mentee know when you are available and through what means you are available.” Dalynn Park, a 2020
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graduate and current clinical engineering generalist at UPMC Children’s Hospital of Pittsburgh, stressed the importance of being open to discussing all questions and to being open and honest. Shurina suggested letting the mentee take the lead on service calls when possible and providing guidance as a mentor. French emphasized being a good communicator. Q: WHAT ARE SOME SPECIFIC THINGS YOU HAVE DONE TO HELP SOMEONE THAT YOU ARE MENTORING? Park said that she allows mentees to shadow her. She added that she “assisted on service calls while allowing them to take charge but offered suggestions/tips when needed.” DelloStritto said, “I think giving personal experience stories have been the best. That is where you really get a feel of what the field is like. One could say ‘sometimes you encounter a difficult doctor/nurse’ but that is far
less helpful than giving an actual example of when you personally encountered that situation and what you did to resolve it.” Shurina added, “since we have our intern three times a week, I will look at the work order queue and see what tasks would be suitable. We run though about 5-10 work orders a day to get him more familiar with how to interact with staff along with troubleshooting the device in question. Last week we also went through how to order parts by contacting the manufacturer to get price points and part numbers.” Q: DO YOU HAVE ANY RECOMMENDATIONS ON BEING A GOOD MENTEE? Common recommendations included keeping an open mind, showing interest and asking questions. DelloStritto suggested, “Do not be afraid to ask questions! That is why the mentor is there! There are no stupid questions!” Park also recommended that a
mentee take the reins in order to get what they want out of the experience. When asked for some final thoughts on mentoring, DelloStritto stated, “Just that you’re never too old or too far in your career to have a mentor. There is always someone you can learn from! The great thing about this field is that it is ever-changing, there will always be more to learn!” French felt that pairing current students with alumni mentors provided a very good opportunity for current students. He added, “the more resources to students or technicians, the better.” I could not agree more. Many thanks to Dalynn, Eian, Jack and Nathan for their contributions to this column and for being excellent mentors to our students. Joie N. Marhefka, Ph.D., is the biomedical engineering technology program coordinator at Penn State New Kensington.
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HTM Talent Pool is Shrinking W
hether eating at a restaurant, buying parts, ordering tools or refilling a coffee with your monthly subscription, these business models share a common problem. The current challenge facing nearly every industry, as the signs are plastered over business windows and walls, is the one that reads, Help Wanted! As companies and business models transform, the health care industry is at the forefront of this talent and technological paradigm shift. This shift has heightened and potentially exposed the challenges that health care systems and biomedical equipment technicians (BMETs) encounter to improve outcomes and career progression of a clinical engineer or healthcare technology management (HTM) associate.
The HTM talent pool is shrinking every day with skilled technicians retiring and the lack of formal technological education for new talent to enter the market ready to handle the advancing technology and the health care environment. The talent pool may be shrinking, but the need and quantity of medical devices in most health care systems are
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growing. The challenge is not just recruiting from a dwindling talent pool. It is also the lack of training venues (I mean insightful holistic medical device training), finding the time to get additional training, hospital budgeting allowances and the changing environment of regulations and OEM requirements. The medical device maintenance and repair business sector (or HTM) is a small group, and even the OEMs struggle with talent as their pricing fluctuates higher to overcome this hurdle. You need a partner that understands your overall situation. A partner that has the skills to navigate all technology challenges, timing and the health care environment. Finding talent or the right partnering company can be challeng-
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ing, considering cost, timing, trust, quality and the essential but almost vanishing art of client interactions skills. These crucial characteristics in our trade are critical for trust, communication and client satisfaction. These skills, or the lack of them, will make your team the hero of your hospital or the heel. SPBS has been servicing and evolving with health care for over 40 years. We understand your hurdles, environment and struggles. We can help in-house or third-party programs during this challenging period in our industry. SPBS is your onestop shop solution. For more information, go to spbs.com.
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IPv6 Is Here: Thoughts for Migrating Your Health Care Organization BY MICHAEL JOHNSON AND JOSH GARVIN
F
or so long we’ve been accustomed to the IPv4 protocol. We’ve spent countless hours understanding the ins and outs of networking, subnetting and more based on IPv4 addressing. With the everchanging needs of our society, including more and more devices that require a connection to a network, the world is running out of available IPv4 addresses. Enter IPv6, the solution to IPv4 address exhaustion.
One of the main exciting differences between IPv4 and IPv6 is the available IP space. Where IPv4 had approximately 4 billion IP addresses, IPv6 has more IP addresses available than stars in the universe. The total amount of available IP Addresses in IPv6 is so large that it is hard to comprehend, it is best shown as 2128. That equals 340 undecillion IP addresses. A number that virtually guarantees that there will never be a shortage of available IP addresses. The reason IPv6 has more available IP addresses is due to bit size. With IPv4, the IP address contains 32 bits, broken into four 8-bit blocks separated by a period. IPv6 IP addresses contain 128 bits, made up of eight 16-bit blocks that are represented by hexadecimal (alphanumeric characters represented by A-F and 0-9) separated by colons. IPv6 packets have been updated to include a more streamlined header compared to IPv4. The header is designed to only
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Michael Johnson include the minimal amount of information needed to decrease the processing time a router needs to send your packets across the network. IPv6 no longer utilizes Address Resolution Protocol (ARP). ARP is replaced with an ICMP based Neighbor Discovery Protocol (NDP). NDP uses special IPv6 ICMP messages to find and resolve Layer 2 neighbor’s IPv6 addresses. NDP provides a simple way for hosts to learn the IPv6 addresses of neighboring devices within the same subnet as itself. This includes other hosts as well as routers in the local network. Subnetting in IPv4 is used to save IP space and segment your network. In IPv6, subnetting is configured and implemented within the network portion of the IP address itself. The last 16 bits of the 64-bit network address denote the subnet, this allows the use of 65,535
unique subnets. With 64 bits left for the host portion, variable limit subnet masking should no longer be required. In fact, using VLSM is not recommended and would cause failures in some built-in IPv6 features. There is no exact date when every network must be migrated to IPv6. However, some government and private organizations are setting their own deadlines to implement the newer protocol. In some rare cases, an organization may decide to never make the change to IPv6, using NAT protocols to publicly route the devices in their private network. When your organization migrates from IPv4 to IPv6, ensure your budget includes room for upgrading network appliances if necessary (e.g., routers, switches, firewalls, etc.). Make sure you’re considering IPv6 function as part of your internal equipment lifecycle planning reviews. When your organization begins to migrate; it will take time and a phased approached will likely be required. Dual stack, tunneling and translation are methods used to help provide that transition period. Dual stack environments use IPv4 and IPv6 protocols concurrently. With dual stack, every capable device on the network will have one of each type of IP address. The stack used for communication is determined by the protocol version returned with the DNS query responses. Tunneling provides IPv4 encapsulation on IPv6
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packets. It allows separated IPv6 locations to connect over IPv4 infrastructure, using similar methods we use with VPNs. Translation uses an intermediary system to convert from one IP stack to the other. One of the downsides of these transition strategies is that they rely on the continued use of IPv4. Depending on the scale and complexity of your organization, you may still not have a lot of time to confront IPv4 address exhaustion. There are also concerns with higher overhead using these methods, due to increased processing requirements and potential latency. When planning for IPv6, you need to consider the addressing method that will be used to configure your network, there are a few options available. While some have familiar terminology, the functions can be different. • Static – Functions the same as it does with IPv4. You manually enter the IP, the subnet prefix length, default gateway and DNS details. This method removes some of automatic features provided with IPv6. This is still the recommended configuration for your servers. • Stateless Auto Address Configuration (SLAAC) – Provides a device the default gateway and network prefix when connected to a network, no other information is sent. The end device can use a technique called EUI-64 to create a 64-bit identifier based on its MAC address. The EUI-64, when combined with the SLAAC provided prefix, allows a device to create its own unique IP address. EUI-64 is considered a security risk, as it can expose your MAC address to external networks. Privacy extensions have been incorporated to compensate. However, privacy extensions cause your device IP to change at predefined intervals, making network inventory and auditing much more difficult. Auto-addressing and privacy extensions, if any, are determined by the device
Joshua Garvin operating system. Identifying how this will play out for each device may require extra research. • Stateless DHCPv6 – Uses the SLAAC process. Once the address is assigned, stateless DHCPv6 can provide details regarding domain name and DNS. It does not assign addresses or manage lease time. • Stateful DHCPv6 – Functions like DHCPv4. Assigns IPs, gateways, DNS and manages leases. Converting and expanding your existing network security is a significant obstacle during your migration. During the transition phase, dual stack will be doubling your attack surface. You have spent a lot of effort over many years building policy designed to protect your medical device systems in an IPv4 environment. Now those policies need to be converted to IPv6, or in some cases created from the ground up. IP based rules will need to have the IPv4 addresses translated to their IPv6 addresses. Policies will need to be written to cover the new IPv6 subnets. New access control lists (ACLS) and firewalls will need to be applied to the appropriate interfaces, ports and/or VLANs. It would be very easy to miss a single rule or forget to apply a ruleset to a specific interface. Creating and managing these policies could be further complicated if privacy addressing is in use. Attention to detail and careful testing will be required. If systems are using IPv6 and
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network security policies have not transitioned correctly, you could be allowing unrestricted traffic on segments of your network. If your organization is not already moving towards a zero-trust architecture, it should be considered with your IPv6 conversion. A zero-trust framework can prevent unnecessary lateral (internal) access, which will help keep medical device systems isolated and protected from inside threats. It isn’t possible to cover all the aspects of the required changes in this column. Network infrastructure and cybersecurity are deep and complex areas. Hopefully this information can provide a basic understand, and kickstart some self-learning. The RFC and NIST documents in the sources listed below have a lot of depth. For those that don’t enjoy reading technical documents, reach out to your IT office, they may be able to fill in a lot of the blanks. They are probably already addressing network hardware compatibility, new routing protocols and a myriad of other items. The larger your organization is, the more likely this process has already begun in some capacity. The changeover won’t be simple, and it will take time. Don’t be intimidated by the complexity of the process, dig in and collaborate. Delaying the process will only make it more difficult, while being part of the transition will provide you invaluable experience and knowledge for the future. Michael Johnson works for the Dayton Veterans Affairs Medical Center as the Team Lead for Biomedical Equipment Support - Information Systems. Joshua Garvin is the VISN 10 Cybersecurity Lead/Information Systems Biomedical Equipment Support Specialist (IS-BESS) at the Department of Veterans Affairs. REFERENCES: RFC 8200 - Internet Protocol, Version 6 (IPv6) Specification (ietf.org) RFC 7381 - Enterprise IPv6 Deployment Guidelines (ietf.org) NIST SP 800-119, Guidelines for the Secure Deployment of IPv6
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20/20 IMAGING INSIGHTS SafeTEE Process Analysis Program = Proven Cost Savings
Matt Tomory
BY MATT TOMORY
W
hen it comes to imaging devices, little things go a long way. And not always in the right direction.
A little slip of the hands could cause trauma to a TEE probe, and according to years of data from first-hand experience and researching common failures, trauma is one of the leading reasons for costly repair services. In fact, many believe that “biting” is one of the primary causes of traumatic damage, yet research conducted by our Centers of Excellence show that poor transportation practices and poor set-up practices are a much higher cause. Additionally, the process of disinfecting a transducer with traumatic damage, such as a hole in the bending rubber or crack in the distal tip, is one of the primary causes of
irreparable catastrophic damage. Research also shows that many of the little things that lead to big repairs are easily avoidable by training staff in key processes for handling, cleaning and storing. Repairs and replacements can add up fast. Consider the following typical costs you could incur: • Exchange through an OEM may range from $12,000 to $50,000 • Exchange through the third-party market may range from $5,000 to $40,000 • Cost of repair may range from less than $500 to about $10,000 By implementing the SafeTEE Process Analysis Program, facilities of all sizes can drastically reduce their cost of operations and ownership for TEE and other types of probes. For example, our clinical experts pioneered TEE care and handling
Crushed Insertion Tube
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assessments as a means to assist customers with failure prevention.
Annual TEE probe failure rate from Innovatus pilot customer. Our pilot customer “owned 10-TEE transducers, yet experienced 28 catastrophic failures stemming from trauma and gross fluid invasion in a single year.” By modifying key steps in cross-functional processes, this customer achieved the following results: • 50% failure rate reduction in year 1 • Additional 31% failure rate reduction in year 2 • Translated into a 44% cost reduction for a 3-year trend • Resulted in increased customer satisfaction
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Here are a few of the steps that have helped cut costs and failures in half. Determine a Benchmark and Starting Point: • Compare existing processes with industry best practices • Monitor and observe how staff behavior aligns with these best practices • Partner with Innovatus Imaging, the pioneer in TEE process analysis, to “observe” (as sometimes insiders don’t see what others see). • Review observations to determine weaknesses, strengths and resources needed to achieve goals Develop a Plan: • Define what processes should be modified and the managers able to implement change
•
Determine who is responsible for assuring staff compliance • Establish goals and how to measure team success Act, Monitor and Repeat: • Educate end-users regarding best practices • Integrate as many best practices as possible • Monitor compliance frequently • Perform preventative maintenance on all TEE probes Report and Analyze: • Use worksheets, controls and other tools to empower employees to self-report or suggest improvements • Capture photographic evidence • Highlight good practices and identify areas for improvement The money saved by eliminating several catastrophic failures with the above steps
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can often justify the expense of one employee to fully manage this process. With over 20 plus years, we’ve proven that following these tips can potentially save facilities 50% or more in TEE probe maintenance costs, regardless of size and patient volume. The Process Analysis Program is just one of the segments in our comprehensive SafeTEE program. Our experts provide your teams with the tools and training needed to become the TEE experts in your facility. To learn more about the SafeTEE Program, go to innovatusimaging.com/safetee or contact us at safetee@innovatusimaging.com. Matt Tomory is the vice president of sales and marketing at Innovatus Imaging.
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Althea US Offers HTM Solutions
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he Althea Group is a privately held organization backed by Permira Funds. Its Centers of Excellence, workshops, and laboratories span the globe, leveraging the expertise of more than 3,000 engineers, technicians, administrators and customer service specialists.
Althea has an established global presence to the market space, managing more than 1.4 million medical devices in over 2,700 health care facilities across 17 countries. This presence allows it to maximize skill sets and supply chains to improve customer outcomes. The U.S. Center of Excellence located just outside of Nashville, Tennessee, specializes in CT, MRI, X-ray, and injectors. The programs consist of replacement parts, new and preowned equipment and contrast injector training and service. All the U.S. team knows how challenging and complex the tasks technicians face can be, that is the reason why the services are designed to support technicians and engineers as well as provide consultancy to anticipate future needs. This, coupled with Althea’s competitive pricing and quality initiative, allows the company to show customers they have selected a great HTM partner. “We supply parts for CT, MRI and X-ray and have recently begun a
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significant reinvestment in each of these modalities. The modality leaders of Althea US have a combined experience level of over 100 years servicing diagnostic imaging equipment,” CEO Dan Siler said. “Our newest modality was launched in 2020 and features a comprehensive program for injectors,” he adds. “This program offers free onsite training, technical support, parts and PM kits for a capitated price. This is our fastest growing program and we have partnerships with some of the largest in-house and ISO organizations in the country.” Althea also offers turnkey solutions for equipment replacements. This includes planning, construction, refurbishment, installation and service. The company has completed 16 projects nationwide over the past 12 months. TechNation found out more about Althea US via a Q&A with Siler. Q: HOW DOES YOUR COMPANY STAND OUT IN THE MEDICAL EQUIPMENT FIELD? Siler: Althea was founded to break those technological barriers. With Althea, customers are free to choose service solutions that work seamlessly, increasing the efficiency of patient care by integrating the management of the technologies that care relies upon. Althea is a global organization which gives us the ability to utilize our global supply chain to bring quality and savings to our customers.
Dan Siler CEO, Althea Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY? DO YOU HAVE ANY GOALS YOU WOULD LIKE TO ACHIEVE IN THE NEAR FUTURE? Siler: Althea continues to innovate everyday by creating programs that support the success of in-house and ISOs. Based on the success of our comprehensive injector program, we have launched a capitated DI parts program. This program improves the technician knowledge base with built-in free training, ensures supply chain efficiency by guaranteeing parts delivery and drives predictability of cost. It does not matter how large or small the install base is, Althea is here to support every customer’s success. For more information, visit althea-group.com.
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THE OTHER SIDE
COVID-19 and the Right to Repair BY JIM FEDELE
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t least the COVID-19 pandemic has stoked the right to repair movement. I am encouraged that we may actually see some positive change on this front. One side of this issue that I slightly overlooked is the impact this will have on our options for getting equipment serviced outside of the OEM. I would l like to share a story about a situation I experienced lately. It involves a CT scanner, the OEM and a third-party servicing company. Without the expertise of the company that I used we likely would not have gotten our problem solved. Luckily, the third-party servicer had the proprietary knowledge needed to solve our issue.
The CT scanner involved in this situation was only 11 years old. At the time of purchase, it was one of the first dual tube units. The promise was that it would take our cardiology program to a new level. However, we didn’t utilize the feature till almost five years later. The unit was very expensive, and the service contract was over $160,000 per year. When the unit was purchased, a point-of-sale agreement for 6 years (warranty year plus 5 post-warranty) was signed that locked in the OEM service. I would argue we probably never realized the ROI and benefits that we were promised. Unfortunately, that isn’t too uncommon in our industry. By the time the service agreement expired we had enough history on the unit that it made fiscal sense to renew the service
Jim Fedele contract. The unit would go through a tube every 12 months and the tube costs exceeded $200,000. When the CT scanner was around 8 or 9 years old we got notice from the OEM that it was going to be declared end of life by 2022. I get these notices all the time and did not think too much about it as we have had CT scanners in use that were well over 15 to 20 years old. The OEM still sold us a full-service agreement in 2021 and in 2022 they lowered the cost and changed the wording to include as long as parts were available. In February of 2022, after a full day of being down, it was determined that the unit needed a tube. This was almost exactly one month past the warranty of the tube that was replaced in January of 2021. I got the call from my technician giving me the news, which was followed by a call from the OEM service manager telling me they did not have any tubes for the unit. Then, he sent me the letter again that stated the unit was end of life and support. I managed to suspend the level of frustration I was feeling to maintain a level of professionalism. I composed my thoughts and my tech, and I got to work to find a tube. As luck would have it, the tube was not common. We struggled to find a replacement and a company that would install it. The installation required a special tool to measure and set oil pressure. Our regular sources were not able to help us. I escalated this to my management team and soon got some
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
suggestions. One of the suggestions was to check with GE who is a pretty good partner to our organization. I called my local service manager, and he pointed me to a company that could help. I called Avante Health Solutions per my GE rep’s recommendation. I was not disappointed; they were able and willing to help us. Because of the uniqueness of the tube, it did take a little time for us to get one and get the system back up. However, what impressed me was their technician had the knowledge and the tools to take care of our unit. I was so impressed with their abilities; we signed an agreement with them and canceled the agreement with the OEM. As I reflect on this situation, it occurred to me that if we had laws in place that guaranteed the right to repair equipment, I may have had an easier time finding someone to help us. For editing purposes, I shortened the story, but we worked on this problem for a full week before we had a solution. I believe that if we can get the legislation needed to ensure we have everything we need to repair equipment efficiently it will create a lot of opportunities for third-party repair companies. Not to mention the local in-house biomed teams. Jim Fedele, CBET, is the senior director of clinical engineering for UPMC. He manages six Susquehanna Health hospitals. He has 30 years of HTM experience and has worked for multiple service organizations.
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What does ISO 13485 Certification Mean to a Biomedical Service Company? BY STEVEN LUTZ
I
SO certification is a valuable asset for many companies. It is a way to prove to customers that you place a strong emphasis on customer satisfaction. The ISO 13485 certification intended for medical device suppliers also ensures that your quality management system (QMS) conforms to and exceeds regulatory requirements such as the FDA 21 CFR 820.
ISO certification can sometimes look like a daunting process, but the idea of ISO is simple. Document and standardize what your company does, then ensure that you follow your documentation and standard operating procedures. When you find areas where the processes don’t conform to the documentation, you find ways to make the documentation and the processes align. In other words, you write what you do, do what you write, and verify that the actions match the documentation. ISO certification ensures that your company properly tracks and documents every aspect that could impact product quality and customer satisfaction. This certification involves external factors such as supplier quality and performance and internal factors such as quality inspection and documentation of
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defective products received from either a supplier or internal upstream process. It includes addressing infrastructure needs to provide employees with the tools required to perform their duties properly. This certification also requires the support of management to address concerns and ensure that our quality objectives align with industry and customer expectations. This is critical given that our business is repairing and servicing life-saving medical equipment. A failure on our part to ensure product conformance can result in the loss of human life. One of the essential aspects of ISO 13485 certification is risk-based analysis and decision-making. As someone who loves numbers, I find data critical to a proper risk evaluation. Our QMS requires that we document both internal and external complaints and take appropriate actions to resolve the issues. Ensuring that we track these complaints allows our company to quickly sort and identify recurring problems, whether these issues are a product issue coming from a supplier or a missed process coming from a department within our organization. This allows us to focus our corrective efforts on the most significant impact on our company and helps us increase
efficiency and effectiveness. This streamlining process enables us to offer our customers faster turnaround times, more efficient paperwork and increased transparency. ISO also emphasizes training employees to make each team member an expert in the processes they’re involved in. ISO helps management empower the technicians to become process owners and subject matter experts. It allows each employee to understand better their role in the company and how their work impacts product quality, customer satisfaction and, most importantly, the effectiveness of the life-saving equipment we provide. Partnering with an ISO 13485 certified equipment service company gives hospital and EMS purchasing agents peace of mind. It ensures a high level of quality repairs, service and company relations. This ISO 13485 certification verifies the company’s commitment to the quality of its work, constant self-evaluation, and striving for excellence. Steven Lutz is an analytics manager with ReNew Biomedical. For more information, go to ReNewBiomedical.com.
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DID YOU KNOW? Science Matters
Grown with modified immunity cells
Unlike conventional chemically synthesized drugs, monoclonal antibodies are produced by specifically programmed germ-killing cells
Mouse is infected with virus Immune cells from spleen (1) are fused with cancer (lymphoma) cells (2) and they grow rapidly
1
2
Immune cells that produce desired antibody (3) are grown in a cell culture (4)
Antibodies from those cells are purified, used as a medicine against the virus (5)
TECHNATION
JUNE 2022
A COVID treatment Bebtelovimab attacks the outer protein spikes of the COVID-19 virus
COVID virus
Some of the -mab drug family
4
Monoclonal antibody
Source: US Food and Drug Administration; Cancer Research UK; Sanford Burnham Prebys Medical Discovery Institute Graphic: Helen Lee McComas, © 2022 TNS Tribune News Service
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“Monoclonal antibodies” are a new generation of drugs more effective for treating some serious conditions than standard medications.
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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 stems Garci numb , internal nearly tro-Tucso clin e ; Guille a, n are er medic and family ics a IGHT SPOTL BMET BMET II; engine of specia rmina the Un million peo a is po ine as lty ser pulat Da eri well “Mina iversit ple ng ed vic . The Lynn III; Jaye Joh rell Hend as a well suppo Natio y ” , BM as city is with rts all es. Clinic nal Pa of Arizo ET III; nson, BM rickson, al na an home III; Jim TMC: the follow U.S. of the rk. It d Sag Scott ET II; borde ing to is 60 se are hospi uaro Ma r with John mi Roon Pangrac, as geriat ce, am facilities larges BMET cLachlan ey, BM ric psy Mexic les north affiliat as t city bulat , of ser in gym ory o ch ET ed and is the Arizo vices servic with Hand I; Joe III; Rebec BMET surger ,” she na. the sec e and ling ca Sm imagi engineer those an em y center, Clinic says. ond I; and ith, imagi ng ser people the medic plo al ng Mark al nee engine Direc yee (TM Brish vices eng C), wh is the Tu ds of tor of Weltz, ering ineer. cson all of centra says ser IT Inf report tions ich is ty-ba senior Me vic ras Su sed ho a stand s to TM lly ma dical each up of san Sneda tructure Ce naged e contracts -alon S “Hosp spital lice 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 Ca Ro ed I; TECHN medic depart to the clin eement engine ssell, senior Dirk Call, berto ATION al ment er; Bri ical eng s were BMET imagi APRIL to be an Da ng ser ineeri III; “This 2018 ma rr, bio vices ng na move ged. 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.
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TEC
HNATI ISSUES .COMIMAGING YONAND NETWORK SECURIT job es come with the Projects and challeng network has worked on and Martoglio and imaging issues. security projects care of be challenging taking o says. can “It Martogli night,” y when there are a manager at multiple sites, especiall time at different “I met David Booker, only Not s. same the hospital 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 are multiple causes someone who there adds. that he because then, well the change,” It’s no surprise have access to or auto technician on automobiles that I do not always Going from the hips is trained to work n relations some good HTM meant skill set to transitio control of. Having profession into ions, would have the ed training. Martoprofession. ing, clinical applicat HTM specializ network the al to with key addition those skills 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 ing services departm locations an A.S.,” he out of with vascular d based is and graduate which three heart College and Health System, . This involved migrate to our network applications, says. Clearwater, Florida. n for clinical 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 wanted to do. One ed e PM tech we have been very landed a part-tim ry therapist mention security, and care respirato a meeting, is who equipment. My opportunities were I would be a good securing our medical position there. These locking out that he thought while I ce included ers. have experien rememb io 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 current position I found and joined and then to my I was looking for. nd,” he says. ing group, the Bay service, ultrasou local biomed network InstrumentaMedical of ion Area Associat CHNATION.COM
BY K. RICHARD
DOUGLAS
W
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 with both; to make same the is always as the manufacturer that machine work intended it to.
to went to a meeting tion (BAAMI), and as it seemed. I was see if it was as good that the support I received overwhelmed by
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9. Chace Torres, a.k.a. The Bearded Biomed, recorded several podcasts with attendees while at MD Expo Atlanta. One podcast included MD Publishing’s John Krieg, Kristin Leavoy and Jayme McKelvey.
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23
P P
Diagnostic Imaging International X-Ray Brokers internationalxraybrokers.com/ • 508-559-9441
Lexicon lexiconmedparts.com • 615-545-8587
Mammo.com mammo.com •
Probo Medical www.probomedical.com • 3174947872
Siella Medical
104
Cardiology
47
93
pd1medical.com •
93
Cardiac Monitoring
Nuvolo
75
smarttanktester.com •
pd1medical.com •
50
Biomedical ALCO Sales & Service Co.
PD1 Medical
CMMS
Beds/Stretchers
TECHNATION
SERVICE
Cables
Life Spark Medical
110
PARTS
Anesthesia
Company Info
AD PAGE
TRAINING
SERVICE
PARTS
AD PAGE
Company Info
108 94 86
P P
4
P P
27
P
Endoscopy Cadmet www.cadmet.com • 800-543-7282
Healthmark Industries hmark.com • 800-521-6224
90 WWW.1TECHNATION.COM
SERVICE INDEX CONTINUED
www.multimedicalsystems.com • 888-532-8056
P
General ALCO Sales & Service Co. www.alcosales.com • 800-323-4282
Eagle Medical www.eaglemedgsm.com • 805.238.7401
Lexicon lexiconmedparts.com • 615-545-8587
PD1 Medical pd1medical.com •
SalesMaker Carts salesmakercarts.com • 800-821-4140
Voytek Medical www.voytekmedical.com • (800) 282-1670
www.HealthTechTM.com • 757-563-0448
94 89
P
94 93 104 79
hmark.com • 800-521-6224
41
aiv-inc.com • 888-656-0755
Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701
Infusion Pump Repair www.infusionpumprepair.com • 855-477-8866
Multimedical Systems www.multimedicalsystems.com • 888-532-8056
Siella Medical siellamedical.com • 888.688.6822
90
aiv-inc.com • 888-656-0755
Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6702
FOBI www.FOBI.us • 888-231-3624
Infusion Pump Repair www.infusionpumprepair.com • 855-477-8866
RepairMED www.repairmed.net • 855-813-8100
Siella Medical siellamedical.com • 888.688.6822
Soma Technology, Inc www.somatechnology.com • 1-800-438-7662
USOC Bio-Medical Services www.usocmedical.com • 855-888-8762
94
www.spbs.com/ • (800) 713-2396
Ozark Biomedical www.ozarkbiomedical.com • 800-457-7576
SPBS, Inc
105 39
P P P P
17 54
P
65
P
International X-Ray Brokers internationalxraybrokers.com/ • 508-559-9441
Mammo.com mammo.com •
53
Clinical Technology Solutions ctsbiomedical.com • (877) 643-6134
Soma Technology, Inc
USOC Bio-Medical Services
37 3
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
P P P
77
P P
37
3
Innovatus Imaging www.innovatusimaging.com • 844-687-5100
P P
8
Nuclear Medicine InterMed Group
67
www.intermed1.com • 386-462-5220
P P P
Online Resource HTM Jobs
102
www.htmjobs.com •
Oxygen Blender
65
P P
MRI
P P
54
86
Monitors/CRTs
Webinar Wednesday
17
108
65
siellamedical.com • 888.688.6822
P P P P
P
Monitors
26
www.MedWrench.com • 866-989-7057
39
P P
Mammography
MedWrench 105
50
94
www.spbs.com/ • (800) 713-2396
www.usocmedical.com • 855-888-8762
Infusion Therapy AIV
SPBS, Inc
www.somatechnology.com • 1-800-438-7662
Infusion Pumps AIV
65
Siella Medical
Infection Control Healthmark Industries
Siella Medical
Labratory
Imaging Health Tech Talent Management, Inc.
IV Pumps siellamedical.com • 888.688.6822
54
TRAINING
Multimedical Systems
SERVICE
Fetal Monitoring
Company Info
PARTS
P
AD PAGE
TRAINING
54
SERVICE
www.multimedicalsystems.com • 888-532-8056
PARTS
Multimedical Systems
AD PAGE
Company Info
www.1technation.com/webinars • 800-906-3373
FOBI www.FOBI.us • 888-231-3624
95
53
P P
105
P P
81
P P
77
P P
104
P P
P
Patient Monitoring AIV aiv-inc.com • 888-656-0755
BETA Biomed Services www.betabiomed.com/ • 800-315-7551
Clinical Technology Solutions ctsbiomedical.com • (877) 643-6134
Jet Medical Electronics Inc www.jetmedical.com • 714-937-0809
JUNE 2022
TECHNATION
111
SERVICE INDEX CONTINUED
sebiomedical.com • 828-396-6010
Southwestern Biomedical Electronics, Inc. swbiomed.com • 800-880-7231
USOC Bio-Medical Services www.usocmedical.com • 855-888-8762
Siella Medical siellamedical.com • 888.688.6822
www.interpower.com • 800-662-2290
www.ambickford.com • 800-795-3062
FOBI www.FOBI.us • 888-231-3624
66
P P
Vizzia Technologies
3
P P
Software
https://vizziatech.com • 855-849-9421
Medigate Nuvolo nuvolo.com • 844-468-8656
TruAsset, LLC 115
P
Radiology
www.truasset.com • 214-276-1280
Vizzia Technologies https://vizziatech.com • 855-849-9421
Cure Biomedical www.cure-us.com • 775.750.7070
Soma Technology, Inc www.somatechnology.com • 1-800-438-7662
59 37
P
P
Recruiting www.cure-us.com • 775.750.7070
Health Tech Talent Management, Inc. www.HealthTechTM.com • 757-563-0448
HERO herobiz.com • 800-834-1122
HTM Jobs www.htmjobs.com •
59 41
SPBS, Inc www.spbs.com/ • (800) 713-2396
www.cure-us.com • 775.750.7070
Healthmark Industries hmark.com • 800-521-6224
aiv-inc.com • 888-656-0755
AIV
102
Clinical Technology Solutions
105
Rental/Leasing
aiv-inc.com • 888-656-0755 ctsbiomedical.com • (877) 643-6134 elitebiomedicalsolutions.com • 855-291-6701
MedEquip medequipusa.com • 305-470-8013
Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6703
39
P
Multimedical Systems www.multimedicalsystems.com • 888-532-8056
Repair
RepairMED
ALCO Sales & Service Co.
www.repairmed.net • 855-813-8100
www.alcosales.com • 800-323-4282
Eagle Medical www.eaglemedgsm.com • 805.238.7401
Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701
Jet Medical Electronics Inc www.jetmedical.com • 714-937-0809
94 89 39 104
P
P P P P
Siella Medical siellamedical.com • 888.688.6822
Southwestern Biomedical Electronics, Inc. swbiomed.com • 800-880-7231
USOC Bio-Medical Services www.usocmedical.com • 855-888-8762
A.M. Bickford
Clinical Technology Solutions
www.ambickford.com • 800-795-3062
Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701 112
TECHNATION
JUNE 2022
77 39
P P P
P P
47
5 31 35 47
94
P
59
P
90
105
P P
77
P P
39
P P
19
P
54
P
54
P P
65 66
P P
3
P P
Test Equipment
Replacement Parts ctsbiomedical.com • (877) 643-6134
53
Telemetry
Elite Biomedical Solutions
AIV
P
Surgical
51
Refurbish
73
Sterilizers
Cure Biomedical
Cure Biomedical
P
RTLS
www.medigate.io •
Power System Components Interpower
A.M. Bickford
P P
65
6
Respiratory
32
Patient Monitors
TRAINING
Southeastern Biomedical, Inc
P P
www.eng-services.com • 888-364-7782x11
SERVICE
sakomed.com • (844) 433-7256
23
P P
Engineering Services, KCS Inc
PARTS
SakoMED
54
P P
Company Info
AD PAGE
www.repairmed.net • 855-813-8100
TRAINING
RepairMED
19
SERVICE
medequipusa.com • 305-470-8013
PARTS
MedEquip
AD PAGE
Company Info
BC Group International, Inc www.BCGroupStore.com • 314-638-3800
73 BC
P P
WWW.1TECHNATION.COM
SERVICE INDEX CONTINUED
sebiomedical.com • 828-396-6010
Ultrasound
75
Innovatus Imaging MW Imaging www.mwimaging.com • 877-889-8223
99
Probo Medical www.probomedical.com • 3174947872
P P
Summit Imaging
Training Althea https://www.althea-group.com/ • 888-652-5974
College of Biomedical Equipment Technology www.cbet.edu • 866-866-9027
ECRI Institute www.ecri.org • 1-610-825-6000.
Medical Technology Management Institute https://www.mtmi.net • 800-765-6864
Probo Medical www.probomedical.com • 3174947872
Tri-Imaging Solutions www.triimaging.com • 855-401-4888
www.mysummitimaging.com • 866-586-3744
P
11
P
sakomed.com • (844) 433-7256
72
P
www.spbs.com/ • (800) 713-2396
99
P
Engineering Services, KCS Inc
97
www.cadmet.com • 800-543-7282
Tri-Imaging Solutions www.triimaging.com • 855-401-4888
SakoMED SPBS, Inc
97
P P
7
P P P
23
P P
6
www.eng-services.com • 888-364-7782x11
P
67
www.intermed1.com • 386-462-5220
P
internationalxraybrokers.com/ • 508-559-9441
P P
www.rtigroup.com • 800-222-7537
P
8
InterMed Group International X-Ray Brokers
27
4
X-Ray
www.innovatusimaging.com • 844-687-5100
P
P P
94
Innovatus Imaging
4
16
Ventilators
45
Tubes/Bulbs Cadmet
8
www.innovatusimaging.com • 844-687-5100
2,108
32
TRAINING
Southeastern Biomedical, Inc
SERVICE
www.rtigroup.com • 800-222-7537
PARTS
RTI Electronics
Company Info
AD PAGE
www.pronktech.com • 800-609-9802
TRAINING
Pronk Technologies, Inc.
SERVICE
smarttanktester.com •
PARTS
Life Spark Medical
AD PAGE
Company Info
P P P
108
RTI Electronics
99
Tri-Imaging Solutions
97
www.triimaging.com • 855-401-4888
P P P
ALPHABETICAL INDEX A.M. Bickford………………………… 73 AIV…………………………………… 105 ALCO Sales & Service Co.…………… 94 Althea………………………………… 45 Asset Services………………………… 50 BC Group International, Inc………… BC BETA Biomed Services……………… 81 Cadmet……………………………… 27 Clinical Technology Solutions………… 77 College of Biomedical Equipment Technology…………………………… 11 Cure Biomedical……………………… 59 Eagle Medical………………………… 89 ECRI Institute………………………… 72 Elite Biomedical Solutions…………… 39 Engineering Services, KCS Inc………… 6 FOBI………………………………… 53 Health Tech Talent Management, Inc.… 41 Healthmark Industries……………… 90 HERO………………………………… 51
HTM Jobs…………………………… 102 Infusion Pump Repair………………… 17 Injector Support and Service………… 87 Innovatus Imaging……………………… 8 InterMed Group……………………… 67 International X-Ray Brokers………… 108 Interpower…………………………… 115 Jet Medical Electronics Inc………… 104 Lexicon……………………………… 94 Life Spark Medical…………………… 75 Mammo.com………………………… 86 Maull Biomedical Training…………… 27 Medical Equipment Doctor, INC.…… 22 Medical Technology Management Institute… 99 Medigate………………………………… 5 MedWrench………………………… 26 MedEquip…………………………… 19 Multimedical Systems……………… 54 MW Imaging………………………… 16 Nuvolo………………………………… 31
EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL
Ozark Biomedical…………………… 50 PD1 Medical………………………… 93 Probo Medical…………………………… 4 Pronk Technologies, Inc. ………… 2,108 RepairMED…………………………… 54 RTI Electronics……………………… 99 SakoMED…………………………… 23 SalesMaker Carts…………………… 104 Siella Medical………………………… 65 Soma Technology, Inc……………… 37 Southeastern Biomedical, Inc……… 32 Southwestern Biomedical Electronics, Inc.…66 SPBS, Inc…………………………… 94 Summit Imaging………………………… 7 Tri-Imaging Solutions………………… 97 TruAsset, LLC………………………… 35 USOC Bio-Medical Services…………… 3 Vizzia Technologies………………… 47 Voytek Medical……………………… 79 Webinar Wednesday………………… 95 JUNE 2022
TECHNATION
113
BREAKROOM
E
ach month, TechNation magazine will feature photos from throughout the industry on this page. Be sure to tag your posts with #HTMStrong and check the magazine each month to see which photos are included and what is happening in the HTM community.
Hamidsha Shahudeen, BTech, DBME, CBET, MBA
Biomedical Engineering Consultant
Leon Ge lking Field Servi ce Enginee r
Security rmation f the fo In A ital o t, MB Kersain at the Hosp Martine gineering Manager . PAMIA President l En idate Sr. Clinica h.D. Cand of Penn, P y it rs e iv n U
“Don’t be a Biomedical Engineer only for the salary. No salary is worth leaving your family at 1 AM to fix broken down critical care medical equipment.”
“As an FSE , yo electrician u are not only an , you need to be muc more. You h sho mechanic uld be good at plum s, SW, netw bing, ork the most c ommon th , electric. But ing missed is y ou should that is often be also a c leaner.”
of HTM e women luding th g in e e s We love ment, inc g on equip out workin Martine!
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TECHNATION
JUNE 2022
sary of #MDExpo in Atlanta, Photos from the 20th anniver
GA!
WWW.1TECHNATION.COM
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