SEPTEMBER 2022 | VOLUME 6 | ISSUE 9 MAGAZINE ADVANCING IMAGING PROFESSIONALS THEICECOMMUNITY.COM PRODUCT FOCUS Surgical Imaging PAGE 29 NEW TECH NEW ISSUES PAGE 34 SHOWCASECOMPANYPAGE20
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RISING STAR Courtney L. Trindade has always been interested in health care and upon earning an associate degree she set her sights on a career in diagnostic imaging.
FEATURES CHEW ON THIS Medical errors are now the third leading cause of death in the United States. This is not a statistic the medical community is proud of, nor is it one that can be ignored.
COVER STORY When the latest and greatest technologies don’t solve all your problems on their own, what’s necessary to manage them making.kindsgroundedbecomesindifferentofdecision144434 ADVANCING THE IMAGING PROFESSIONAL6 ICEMAGAZINE | SEPTEMBER 2022
SEPTEMBER 2022 PRODUCT FOCUS The global surgical imaging market is projected to reach $2.4 billion by 2025. IMAGING NEWS Catch up on the latest news from around the diagnostic imaging world. EMOTIONAL2329INTELLIGENCE How to create a clearly understood vision and mission statement.48ICEMAGAZINE 7WWW.THEICECOMMUNITY.COM
CONTENTS 10SPOTLIGHT In Focus Michelle Nocera, MBA, CRA, CIIP, RT (R)(CT)(M) 12 Rad Idea Putting Patients First Program 14 Rising Star Courtney L. Trindade, R.T. (R)(CT)(M) (ARRT) 16 Off the Clock Elena Danilova, BS, R.T. (MR) (ARRT) 20 Company Showcase Advanced Health Education Center 23NEWS Imaging News A Look at What’s Changing in the Imaging Industry 28PRODUCTS Market Report 29 Product Focus Surgical Imaging 38INSIGHTS Director’s Cut Jump-starting DE&I Initiatives in Imaging 40 AHRA Q&A Q&A with AHRA President Brenda DeBastiani 42 PACS/IT FDA Sends AI Warning Letter 44 Chew On This What Healthcare Can Learn From the Energy Industry 46 Diversity DE&I with Empathy, Intent and Integrity 48 Emotional Intelligence Getting More Powerful With a Common Mission 50 Roman Review Don’t Be That Guy 51 ICE Break 52 AMSP Member Directory 54 Index MD Publishing 1015 Tyrone Rd. Ste. 120 Tyrone, GA 30290 Phone: 800-906-3373 President John M. john@mdpublishing.comKrieg Vice President Kristin kristin@mdpublishing.comLeavoy Group Publisher Megan megan@mdpublishing.comStrand Account Executives Jayme McKelvey Emily Hise Editorial John Wallace Art Department Karlee Gower Taylor KamerynPowersJohnson Events Kristin Leavoy Webinars Linda Hasluem Digital Department Cindy KennedyGalindoKrieg Accounting Diane Costea Editorial Board Manny SeptemberICENicoleJasonJoshJefChristopherRomanNowakWilliamsLabereeTheadoreWalton-TrujilloMagazine(Vol.6,Issue#9)2022ispublishedby MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to ICE Magazine at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. For subscription information visit www. theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2022 ADVANCING THE IMAGING PROFESSIONAL8 ICEMAGAZINE | SEPTEMBER 2022
WHAT’S INSIDE MATTERS We deliver an inside advantage you can’t get elsewhere: • Int er nal su ppl y c hai n su ppo rti n g hund re ds of ul tras ound pro b es a nd MRI c oil s • Engi n eer in g ex pe r tise in cl ud es tra nsd u cer ar r ay s, pl as ti c m oldin g, 3 D pri n ti n g, ca bl e harne ss fabrica ti on , a nd pr ec ision len s es • Repair proc e sses info rme d by ou r le ga cy in FD A reg is tere d ma nuf act uri n g MORE R EAS ONS THAN E VER T O EVER T O INSIST ON INNOV A TUS IMAGING IN SIDE! Visit us at the CEAI and CMIA in September and get the Inside Advantage PI TTS BU R GH • TU LSA • DE NV ER X-ray of GE C3-10-D customercare@innovatusimaging.com 844.687.5100 innovatusimaging.com @ WHAT’S INSIDE MATTERS We deliver an inside advantage you can’t get elsewhere: Int er nal su ppl y c hai n su ppo rti n g hund re ds of ul tras ound pro b es a nd MRI c oil s Engi n eer in g ex pe r tise in cl ud es tra nsd u cer ar r ay s, pl as ti c m oldin g, 3 D pri n ti n g, ca bl e harne ss fabrica ti on , a nd pr ec ision len s es Repair proc e sses info rme d by ou r le ga cy in FD A reg is tere d ma nuf act uri n g MORE R EAS ONS THAN E VER T O EVER T O INSIST ON INNOV A TUS IMAGING IN SIDE! Visit us at the CEAI and CMIA in September and get the Inside Advantage PI TTS BU R GH • TU LSA • DE NV ER X-ray of GE C3-10-D customercare@innovatusimaging.com 844.687.5100 innovatusimaging.com @ WHAT’S INSIDE MATTERS We deliver an inside advantage you can’t get elsewhere: • Int er nal su ppl y c hai n su ppo rti n g hund re ds of ul tras ound pro b es a nd MRI c oil s • Engi n eer in g ex pe r tise in cl ud es tra nsd u cer ar r ay s, pl as ti c m oldin g, 3 D pri n ti n g, ca bl e harne ss fabrica ti on , a nd pr ec ision len s es • Repair proc e sses info rme d by ou r le ga cy in FD A reg is tere d ma nuf act uri n g MORE R EAS ONS THAN E VER T O EVER T O INSIST ON INNOV A TUS IMAGING IN SIDE! Visit us at the CEAI and CMIA in September and get the Inside Advantage PI TTS BU R GH • TU LSA • DE NV ER X-ray of GE C3-10-D customercare@innovatusimaging.com 844.687.5100 innovatusimaging.com @
Her imaging career began when a couple of great friends in the nursing field guided Nocera to radiology.“When I began radiology school and started my clinical rotations, is the moment I fell in love with the field,” she explains. “Radiolo gy offered many opportunities to grow and expand my knowledge. I started studying and achieving certifications in different modali ties. Those accomplishments be gan my career path in radiology.”
Nocera continues to enjoy a successful career in imaging, but her greatest achievement is of a more personal nature.
“My greatest accomplishment is becoming a parent of two love ly children. My children changed my world. You cannot even imag ine how much your heart can be filled with love,” she said. “I have an 11-and 15-year-old who keep me busy, and we have a lot of fun together.”Sheloves her children and her job.“Almost all patients have some type of imaging test in the course of their medical care. Radiology employees touch many lives and the results will impact the pa tient’s experience. Being able to be a part of that is very special and rewarding,” Nocera explained when asked why she loves her job. “Patient care and patient experience is one of the reasons I went into the field. I also love that the technology in radiolo gy is continually changing and advancing. I love the challenge of
MICHELLE NOCERA
SPOTLIGHT
INFOCUS ADVANCING THE IMAGING PROFESSIONAL10 ICEMAGAZINE | SEPTEMBER 2022
Michelle Nocera, MBA, CRA, CIIP, RT (R)(CT)(M), is the director of radiology academic market for University Hospitals in Cleveland, Ohio.
U niversity leader.inthetentialSheservesCRA,MichelleAcademicRadiologyHospitalsDirector,MarketNocera,MBA,CIIP,RT(R)(CT)(M)inCleveland,Ohio.seesa“limitlesspo-fordiagnostics”inimagingfield.Afieldwhichsheexcelsasa
3. What is something most of your coworkers don’t know about you? I played the saxophone in grade school and have not touched it since then.
8. What would your superpower be? The ability to connect with people, be a good listener, create positivity and be open and transparent are my superpowers. Being in leadership, I make sure everyone that works for me knows I am still just a normal person like them who wants them to be successful.
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7. Who has had the biggest influence on your life? My mother has a large influence in my life. She has taught me to be independent yet open to the views of others and to think outside the box. She is one of my biggest supporters.
MICHELLE NOCERA MBA, CRA, CIIP, RT (R)(CT)(M)
5. What is one thing you do every morning to start your day? Every morning I have a relaxing cup of tea that helps me mentally plan my day.
9. What are your hobbies? I like to color and draw cartoon characters. I have done this since I was in high school.
“When I started in the radiology field, I realized imaging is truly the eyes of medicine – the different modalities, the ability to make a positive impact in a patient’s life, and the growth potential,” she added. “Now that I am in leader ship, I can use my skills to help lead my employees to be the best they can be for our patients and themselves – I cannot imagine a more rewarding job.”
4. Who is your mentor? While I have had many mentors in my career, my latest mentor is Jason Theadore. His knowledge in business and vast experience in radiology will benefit me in my current and future positions.
“My daughter loves gymnastics and has been involved in the sport since she was 3. My son plays football and is currently a defensive end on the high school team. Sports keep us extremely busy,” Nocera said. “As with any family involved in sports, our schedules (both work and school) are always busy. Our weekends are focused on family time. We like to go to the movies, family game night and out to dinner. Doing things with our extended family is enjoyable and we get together often.”
1. What is the last book you read? The book I am reading (again) is “Harry Potter and the Sorcerer’s Stone”. I enjoy the magic and mystery.
2. Favorite movie? “Practical Magic”
10. What is your perfect meal? My perfect meal would be a salad and steak with a loaded baked potato. constantly learning something new.”
“Helping cultivate people to support their learning, development and growth fosters a sense of belonging, open communication and engagement not only with the leadership team but with all employees,” Nocera said. “I enjoy working with teams to create methods to improve their processes. Getting our employees involved and having them engaged and take ownership in effective and efficient end results is satisfying.” Her leadership style is no doubt influenced by the men tors who have motivated, empowered and stimulated her growth over the years.
“I have had many mentors throughout my career. In my first full-time radiology job, my manager, Keith March and, pushed me to do my best in all areas, learn multiple modalities, have an understanding of what is involved with state inspections and ACR. He inspired me to always learn and grow and that I had the capability and possibility to excel in the field of radiology,” Nocera explained. It was the belief others had in her along with shared wisdom that propelled her career.
Nocera thrives at work and at home with a support ive cast, but she seems to enjoy helping others just as much as her colleagues and family members enjoy assisting her. •
She describes her approach as “servant leadership.”
“His encouragement led me to my next job and the growth opportunities my leaders in that organization offered me. The support I received from the leaders and radiologists was priceless. I learned how to become a better leader, listen to people and engage others to be better,” she said. “Because of all the support and guidance from my multiple mentors, I was able to help mentor a few people to further their careers in either leadership or informaticAnotherroles.”exciting aspect of her career is “looking for challenges.” She said she is excited about the future of the field of radiology. She is also excited about her “amazing husband and two wonderful children.”
6. Best advice you ever received? The best advice I have been given was, “Never give up.” And, “Find solutions to difficult problems.”
PUTTING PATIENTS
Rad idea
PROGRAM SPOTLIGHT 12 ICEMAGAZINE | SEPTEMBER 2022 ADVANCING THE IMAGING PROFESSIONAL
The Putting Patients First program applies to USA residents only and the submission deadline is November 7, 2022. • To apply, Sharehttps://form.jotform.com/52925201729960.visityour RAD IDEA via an email to editor@mdpublishing.com. FIRST
F or the past 13 years Canon Medical Systems USA Inc. has partnered with AHRA in support of the Putting Patients First program, awarding more than 70 grants dedicated to improving patient care and developing best imaging practices in the areas of CT, MR, ultrasound, X-ray and vascular. This collaboration seeks to improve patient care, safety and cybersecurity in imaging through grants that fund programs, trainings and seminars at IDN/hospital systems, local hospitals and imaging centers. This year, five grants will be awarded according to the following categories: Three grants of up to $10,000 each will be awarded to single-site hospitals and imaging centers. The three grants will include one focusing on diagnostic imaging, one focusing on pediatric imaging and one focusing on oncology imaging. There will be one grant up to $4,250 for a single-site hospital or imaging center on sonography imaging. One grant up to $20,000 will be awarded for projects that improve overall patient care and safety in imaging implemented across the IDN/hospital system.Intotal, the AHRA website states that more than $50,000 in grant money will be awarded “which we think is a marvelous way to honor AHRA’s 50th year of helping to put patientsBeyondfirst!”receiving funds, the grant recipients will publish an article in an AHRA publication about their innovative program to improve patient care and safety in diagnostic imaging.
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SPOTLIGHT RISING STAR
rowing up in Mansfield, Louisiana, Courtney L. Trindade, R.T. (R)(CT)(M) (ARRT), knew she would one day help others. She was interested in health care and upon earning an a ssociate degree of a pplied s cience she set her sights on a career in diagnostic imaging. She is currently the a ssistant c enter d irector for Solis Mammography.
ICE magazine Editor John Wallace met Trindade at the 2022 AHRA Annual Meeting in Phoenix, Arizona. He found out more about her via a question-and-answer session.
Q: WHERE DID YOU RECEIVE YOUR IMAGING TRAINING/EDUCATION? WHAT DEGREES/CERTIFICATIONS DO YOU HAVE?
2022 Courtney L. Trindade, R.T. (R)(CT)(M) (ARRT), plans to pursue a master’s degree in health care administration. ADVANCING THE IMAGING PROFESSIONAL
COURTNEY L. TRINDADE
G
A: I received my imaging/training at Southern University at Shreveport, Louisiana. I have an associate degree in applied science and my certifications are radiologic technologist with focuses in diagnostic imaging, computed tomography and mammography under the ARRT. I also have a certifica tion in basic life support.
14 ICEMAGAZINE | SEPTEMBER
Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?
FUN FACTS FAVORITE HOBBY: Going to concerts FAVORITE SHOW: “Power” TV series on Starz FAVORITE FOOD: Brazilian Cuisine FAVORITE VACATION SPOT: Brazil 1 THING ON YOUR BUCKET LIST: Visit Fiji Islands SOMETHING YOUR CO-WORKERS DON’T KNOW ABOUT YOU: I’m musically talented. I play clarinet/alto saxophone and piano. ICEMAGAZINE 15WWW.THEICECOMMUNITY.COM
Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR?
A: My mother knew that I was interested in working in the health care field but wasn’t quite sure which area I would want to be in. She saw an article in the newspa per stating how there was a shortage in the radiology field for technologists and asked me to read it to see if it would be something that would interest me. I read the article and it went up from there. I was very inter ested in the things that they were explaining about what the field could offer. It gave me the opportunity that I was looking for because I would get the chance to do exactly what I was looking for – giving great care to patients and being apart of the treatment pro cess. I started my career as a staff technologist in di agnostic imaging and from there I pursued computed tomography. After working in those areas for 13 years, I went into the mammography field as a staff tech nologist. I’ve always possessed leadership skills and moved quickly into the lead technologist role after 9 months and from there was promoted to assistant center director within the next 18 months.
A: My greatest accomplishment has been being recog nized by my senior leadership and given the opportu nity to thrive as a fellow leader within my company.
A: I always knew that I wanted to be in the health care field because I love to help others and I wanted to make a difference in their care. I wanted to be that person of assurance so that they would feel confident that they were receiving the best care possible.
Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD?
Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS?
Q: HOW DID YOU FIRST DECIDE TO START WORKING IN IMAGING?
A: What interests me the most is that I get to see a side of the human body that can only be visualized by using special equipment. I have the opportunity to work alongside radiologists/technologists who are knowledgeable and passionate about what they do for this field.
A: I enjoy being able to help guide my team to suc cess. I love seeing others thrive and grow within their scope and help build them up to be able to grow further if they desire. I love the respect that is given to me from my team because they believe and know that I will always be there to help where I am needed. I also love that I get to grow and learn more so that I can continue to achieve more success.
A: My goal is to work towards my bachelor’s degree and pursue a master’s degree in health care administration. •
Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD?
ELENA DANILOVA, BS, R.T. (MR) (ARRT)
THE
BY MATT SKOUFALOS W hen she arrived in the United States in 2001, Elena Danilova began seeking to continue the medical career she had begun in her native Russia. There, Danilova had worked as a physician’s assistant, but the professional burnout she experienced left her interested in a career in MRI. In 2004, Danilova arrived in California, and enrolled at Sonoma College with the intention of becoming an MRI technologist.
Three years later, she graduated cum laude, with a diplo ma in applied science, an MRI certificate and $24,000 of debt. But none of that was enough to secure employment in her chosen field. Danilova was told that despite having earned an advanced medical imaging certificate — and despite her schooling as a physician’s assistant — she had unknowing ly completed her coursework at a school that was not accredited. She could not work as an MRI technolo gist without first earning a radiologic technologist (RT) certificate. She would not be able to enter her cho sen career field.
Danilova vowed to her classmates that when she be came program director, she’d make changes to prevent the same thing from happening to another student. They started laughing, she said, but five years after graduation, Danilova made good on her vow. In 2010, she joined the Gurnick Academy of Medical Arts, a vocational school headquartered in San Mateo, California, as an interim clin ical instructor. By 2012, Danilova was offered a position as MRI program director there.
“I was furious,” Danilova said. “I was so disgusted. Yes, it was my mistake, but I didn’t know I needed to be an RT first in order to become an MRI technologist. I was very upset because a lot of people, especially recent immigrants like me, could make the same mistake. I started thinking about what I could do. I always wanted to make changes.”
Danilova worked to help her program continue to grow, and eventually saw it accredited by the American Bureau of Health Education Schools. In 2014, the American Registry of Radiolog ic Technologists (ARRT) recognized the MRI technologist certificate as suitable for work in the field regardless of wheth er the certificate holder had previously earned their radiologic technologist (RT) degree as well. The next hurdle, however, was finding clinical placements for her students. Danilova recalled how one of her former MRI program classmates had waited six months for such a placement, and finally came to Danilova for training. To help overcome that deficit in opportunity, Danilova began working with outpatient
ADVANCING THE IMAGING PROFESSIONAL16 ICEMAGAZINE | SEPTEMBER 2022
Elena Danilova overcame obstacles to make a positive impact on the next generation of imaging professionals.
OffClock
“I was scared to death,” she said. “I had never been a director. I wasn’t confident if my English language skills were good enough to be understood by students. But I realized it was my chance to start making a difference.”
SPOTLIGHT
“I responsiblefeel for those people who look at me as a leader, who trust me, and I want to use my own experience to help those who need it.”
ICEMAGAZINE 17
“The situation is changing slowly but surely,” Danilova said. “We need to cooperate, educators and clini cians, because we fall short of tech nologists so quickly and so thorough ly that it becomes a crisis. Clinicians don’t want to train their own replace ments, and they don’t want to open their doors for student training.”
•
“I feel responsible for those people who look at me as a leader, who trust me, and I want to use my own experi ence to help those who need it,” Dani lova said. “I have a goal and a vision to train a team of champions, because those champions will be the ones who make positive changes in the medical imaging world and life beyond it.”
Although it’s neither the career path she could have anticipated, nor the one she might have chosen, Danilova said the challenges she met along the way helped shape her resolve and reveal the depths of her own character to herself.
In 2021, Gurnick extended its MRI program into Florida, Arizona, and Nevada, and into several other states by 2022. Danilova has since been promoted to executive director of clinical development, working to pro mote medical imaging programs in different states, and establish and maintain relationships to grow“Ithem.feltthat bringing new, fresh people to the program opens more advantages for the Danilovaprogram,”said,“so I moved into a new position within Gurnick to apply all my knowledge and skills in cooperation with new clinical sites.”
“We need to train people,” Dani lova said. “Imaging departments spend so much money and so much time training new hires. We can train the person according to your needs. You have a student who comes to your facility and already has all the training under his belt; you have time to see who this person is. You will really know if that particular person really fits the culture of your organiza tion.”Itstarted working. Manag ers and technologists shifted their mindsets, from viewing student training as a burden, to seeing an opportunity to clear a path for the next gen eration of front-line technol ogists. After Gurnick opened its MRI program in Modesto, California in 2014, it opened a second location in Sacramen to in 2017. Today, the school offers MRI programs on three campuses — San Mateo, Modesto, and Sacramento — with two rotations at each, and every student is guaran teed a clinical placement.
“I very much appreciate that my life gave me so many obstacles, and because I had to deal with all those issues and challenges, I learned about myself,” she said. “I’m a fighter; I didn’t know. I also learned that I’m a servant-leader: I like to help people, encourage them, and when they grow, give them all support and assistance.”
Executive Director of Clinical Development Elena Danilova is passionate about imaging and helping others succeed. and freestanding clinics to place her students in settings where their skills would develop; as she continued to grow her program, hospitals opened their doors soon after. Her pitch? “Just let us try.”
“When I was in high school and thinking about who I would like to be when I graduated, I didn’t know,” Danilova said. “But I knew who I didn’t want to be. I never wanted to be a teacher. I considered that profes sion very boring and monotonous.”
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“MEDRelief Staffing was developed in 1995 at the request of the facilities using our educational services,” Cantu said. “AHEC had an extensive network of radiology profession als from which to recruit top quality staff to provide on a temporary basis for clients. MEDRelief expanded services beyond diagnostic imaging by acquiring two small indepen dent staffing companies specializing in nursing, respiratory and laboratory professionals. Current staffing services in local per diem shifts, local and travel contracts, and permanent placements are provided for clients. MEDRelief Staffing has been nationally recognized with various awards for customer service.Following the pioneering spirit of the company, MEDRelief was one of the first staffing companies in the United States to attain Joint Commission accreditation which celebrates the 16th anniversary this year. Cantu is the co-facilitator for the Joint Commission’s Healthcare Staffing Advisory Counsel and has served in this position for the past six years
ADVANCED HEALTH EDUCATION CENTER SPOTLIGHT ADVANCING THE IMAGING PROFESSIONAL20 ICEMAGAZINE | SEPTEMBER 2022
A dvanced Health Education Center Ltd (AHEC)., charted in 1988, was created to fulfill continuing education in imaging technology that was unavailable by conventional academic routes. It was a pioneering effort to provide health care facilities lacking trained professionals’ methods to sponsor staff training.
The company has multiple advantages over the competi tion. The company’s leadership is knowledgeable in areas of imaging that enable the correct response to the client’s pain points.“We put the customer’s needs first,” Cantu explained. “We have a long history of partnerships with some of the nation’s leading medical providers and academic leaders. Being led by former radiology directors and managers, we offer a dif ferent perspective because we understand the pressures for facility management and front-line staff. Therefore, we offer a variety of training options and platforms that are custom izable for each client. We don’t believe that one size fits all when it comes to skills training in areas such as ultrasound and mammography.”
COMPANY SHOWCASE
Founders Marilyn Sackett, M Ed, RT(R), FASRT, and Brenda Arnett, RT(R), started the company in Houston, Texas. Sack ett acquired the company in 1998 and Jence Cantu, MHA, RT(R), the company’s CEO, became a partner in 2022. Initially the company served rural hospitals with cross training for staff in short-term corporate style training for basic ultra sound procedures. The training style to acquire skills was suc cessful and the company expanded into skills training such as CT, MRI, bone density and mammography initial training. The company grew quickly when it began to offer courses throughout the state and nationwide. This positioned AHEC to become the premier provider of continuing education and skills training in the United States.
“We have trained students from over 30 countries in the Houston Training Center. Custom designed curriculum and expert faculty have made consulting an important part of the training platform,” Cantu said.
AHEC can provide customized educational content for clients through an assessment of needs and shared goals to achieve with training, consulting and expertise. The client can access training in regularly scheduled programming, private tutorials, onsite training, contract training or through interac tive Zoom training.
AHEC is accredited to provide continuing education coursework by approvals for physicians, nurses, radiologic technologists and social workers. The training coursework has traveled the world and had foreign guests training in the cor porate office. Educational programs have traveled to Japan, Egypt, multiple countries in the Middle East, Guatemala and Caribbean Island countries.
Working hard to resolve problems through both the educational offerings and our staffing company, results are usually successful and immediate.”
“Our central focus is our customers’ needs, we offer variable solutions, cus tomized for their facility. Be it education, skills training, consulting or staffing, we are here to help,” she added. •
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“The AHEC/MEDRelief Staffing core competencies are based in assisting our clients, whether facilities or individ uals, in providing better patient care and high-quality health care,” Cantu explained. “We understand the pain points, and the desire for improving patient care results. We also ‘speak reg ulatory’ and can answer many questions pertaining to regulatory requirements.
“The biggest challenge for AHEC was to remain flexible and to think outside the box in how to assist our clients,” Cantu said. “Education slowed as facilities became overwhelmed and it traded down the list of priorities. This was matched with a huge increase in the request for health care staffing. Inhouse staff were redirected to jobs for recruitment, credentialing and com munications for supplemental staffing jobs. Senior leadership rolled up their sleeves and everybody joined the effort to find and supply qualified health care workers.”Thepivot during the pandemic was not by chance as the mission and goal is to provide solutions for clients.
“Continuously evaluating our prod ucts means they have the most current information and standards of care. Providing educational products to the professional in a COVID environment means continually making changes in delivery, scheduling and clinical compo nents. Increasing communication to our clients by newsletters, emails, blogs and podcasts has provided vital informa tion on certificate renewal, regulatory requirements and compliance,” Cantu said. “Clients using staffing services can earn educational tuition credit to use for staff through the rewards program. Clients can earn free educational tuition credits with every hour filled during an hourly shift at MEDRelief Staffing.”
Just as it has done throughout it’s nearly 35-year history, AHEC is agile and adapts to meet the needs of clients.
She added that restarting ultrasound training post-COVID, using live mod els for lab instruction has allowed the reality “hands-on” scanning program to resume. “This is the fastest and most efficient method of acquiring an ultra sound skill,” Cantu said.
“The faculty network is compre hensive and is always increasing. The coursework is cutting edge. Our faculty are content experts, working not only in an academic capacity, but as con sultants or contractors for government agencies such as NASA and NIH, or in law enforcement,” she added. The recent pandemic brought chal lenges to all industries. Being an indus try pioneer, AHEC’s transformation to digital education had begun three years prior, but their efforts were accelerated for the addition of more coursework via webinar and staff who were trained in Internet-delivery and Zoom platforms. The expansion included continuing education, on-demand home studies, structured education, CQR prescribed education, contracted courses and initial trainings such as mammography and bone density.
The future is bright for the company as well as for the facilities and individu als that it serves.
“We have updated our ultrasound scan lab and there is new coursework on the horizon. Some programs have already been placed on the sched ule and are available such as the new nuclear cardiology program that meets the CME accreditation requirements for physicians,” Cantu said. “A leadership academy with specialized courses for those aspiring to management posi tions is available as of September 2022.”
AHEC also continues to add to its webinar content “with industry legends and new Programsfaculty.”about diversity and in clusion, as well as artificial intelligence advancements have been incorporated into courses. New programs for technol ogists’ CQR and structured education, expanding the ultrasound training, and accreditation or licensure CE require ments such as those for human traf ficking and nuclear medicine are in the works for next year.
“Our mission statement: Our vision is to provide high-quality education to health care professionals. Our education promotes the learning or improvement of skills which impact the delivery of pa tient care. We believe that professional development can best be achieved through training for the future. The future is now,” Cantu said.
SOLUTIONS The Total Package FOR EMPOWERING THE ENGINEER PARTSREPLACEMENT Quality Imaging parts for CT, Mammography, MRI, Cath labs, and general X-Ray TRAININGTECHNICAL Hands-on technical training for all imaging modalities in Nashville, TN. Now offering an Apprentice program! SUPPORTSERVICE Service support for all major imaging manufacturers including GE, Philips, Siemens, Hologic and Toshiba/Canon. EQUIPMENTPRE-OWNED Inspected, tested, and certified by our team in our 60k square foot facility in Nashville, TN. 1 32 4 Call: 855.401.4888 | Visit: triimaging.com | Email: sales@triimaging.com Located in Nashville, TN • ISO 13485:2016 certified
VIZ.AI RECEIVES FDA 510(K) CLEARANCE FOR VIZ SDH
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“Viz SDH allows us to detect both acute and chronic subdural hemorrhages to better identify early treatment pathways. Acute subdurals require urgent intervention. Therefore, prompt notification will allow us to improve outcomes in emergent cases. Chronic subdurals have a very different pathway and having an algorithm that identifies both can allow us to take better care of our patients,” said Jason Davies, MD, Ph.D., associate professor of neurosur gery and biomedical informatics at the State University of New York (SUNY) at Buffalo. “The Viz.ai algorithm ensures that patients are quickly identified and routed to the appro priate therapy.”
NEWS ICEMAGAZINE 23WWW.THEICECOMMUNITY.COM
Viz.ai has received U.S. Food and Drug Administration (FDA) 510(k) clearance for Viz Subdural (SDH). The Viz SDH algorithm uses artificial intelligence to automatically detect subdural hemorrhage, enabling physicians to triage patients effectively and deliver optimal care. Subdural hematoma (SDH) is projected to become the most common neurosurgical diagnosis by 2030, and multiple global clinical trials are investigating promising new treatments for this disease. However, acute and chronic subdural hemorrhages require different types of interven tion via different clinical pathways, with some requiring quick attention from the care team. Viz SDH is the only SDH-specific AI-powered detection and care coordination platform with the ability to identify acute and chronic sub dural bleeds, then quickly notify the care team to mobilize in case an immediate intervention is necessary.
A multi-center trial of over 500 patients demonstrated the high degree of accuracy, with the AI achieving a 94% sensitivity and 92% specificity.
A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY ImagingNews
“With the ARTIS icono ceiling, Siemens Health ineers combines excellent image quality and a pre viously unseen level of design flexibility to be the angiography system of choice for an unprecedented number of interventional radiology and cardiovas cular procedures,” said Kris McVey, vice president of interventional radiology and cardiology at Siemens Healthineers North America.
ARTIS ICONO CEILING ANGIOGRAPHY SYSTEM EARNS FDA CLEARANCE
ADVANCING• THE IMAGING PROFESSIONAL24 ICEMAGAZINE | SEPTEMBER 2022
NEWS
Siemens Healthineers has announced Food and Drug Administration (FDA) clearance of the AR TIS icono ceiling, a ceiling-mounted angiography system designed for a wide range of routine and advanced procedures in interventional radiology (IR) and cardiology. The system’s high degree of mechanical flexibility also makes it suitable for many surgical procedures. The ARTIS icono ceiling combines design flex ibility with advanced positioning accuracy and intelligent workflows. The new rotational capabili ties and simplified cabling of its C-arm permit cone beam CT data acquisitions in just 2.5 seconds at the patient’s head and 4 seconds at the left and right sides of the body. This extremely short 3D spin time reduces motion artifacts and requires less contrast media. Predefined Case Flows settings enable pre cise intraoperative guidance and excellent clinical outcomes with minimal user interaction, faster system positioning and reduced patient radiation dose. In this manner, Case Flows help drive stan dardization and consistency across a health care organization. Tools such as Embolization Guidance and myNeedle Companion help simplify the naviga tion of complex procedures. The OPTIQ image chain allows the user to reduce patient dose while maintaining consistent image quality. After the user determines the desired image quality, OPTIQ sets the exposure parameters to meet these criteria. Also, the ARTIS icono ceiling can instantly acquire and display images live with out any loss in quality. The system was designed to enhance the cus tomer experience. Its open architectural design allows vendor-neutral third-party integration so the healthcare provider can maintain an up-to-date system, regardless of vendor.
Exo recently launched Exo Works, an intuitive point-ofcare ultrasound workflow solution that streamlines documen tation, billing and quality assurance all from one platform, and will be commercializing a handheld ultrasound device that uses radically new technology to deliver powerful imaging at a fraction of the cost of a cart-based system.
The Carestream Lux 35 Detector, a lightweight, glass-free wireless detector ergonomically designed with the comfort of patients and radiographers in mind, has earned the 2022 Frost & Sullivan Global New Product Innovation Award in the digital radiography detector industry. Frost & Sullivan noted that the Lux 35 Detector “encompasses all of the attractive features of different digital radiography (DR) detectors in a single solution, making it the industry’s best DR“Thedetector.”Frost & Sullivan Award is another validation of our research and development team’s continued success at developing solutions that incorporate cutting-edge tech nology to improve radiology workflow and enhance patient care,” said Dharmendu Damany, chief technology officer at Carestream. “With our first cesium iodide, glass-free Lux 35 Detector for the medical space, we provide a solution that is lightweight and provides superb resolution and better de tail, and a reduced exposure as compared with gadolinium detectors.”TheLux 35 Detector supports a variety of image-pro cessing options to assist radiologists, including Tube and Line Visualization, Pneumothorax Visualization, EVP Plus, Bone Suppression and many more. It uses Carestream’s ImageView Software powered by Eclipse for high image quality and also features the X-Factor, so the detector can be shared with other compatible DRX equipment. Addi tionally, the Lux 35 Detector battery is backwards compat ible – it works with DRX Plus Detectors and uses the same battery charger.
CARESTREAM’S LUX 35 DETECTOR WINS AWARD
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Exo is acquiring Medo, a Canadian developer of artificial intel ligence (AI) technology. By integrating Medo’s proprietary Sweep AI technology into its ultrasound platform, Exo will make ultrasound imag ing more accessible to a wider range of caregivers, according to a news Ultrasoundrelease.imaging is complex and requires specialized education and training. This limits the number of caregiv ers who can use point-of-care ultrasound to significantly improve patient care.
“This acquisition is about bringing unprecedented ease of use to ultrasound imaging – allowing caregivers to easily obtain and interpret ultrasound images,” said Sandeep Ak karaju, CEO and founder of Exo. “Medo has built a robust AI pipeline to go from acquiring medical images to FDA-cleared software. We are excited about joining forces with an inno vative team that shares our vision of taking medical imaging everywhere.”“Exo’spowerful hardware and workflow technologies and Medo’s AI will dramatically reduce the challenges that have long held back the widespread adoption of point-of-care ultrasound,” said Dornoosh Zonoobi, CEO of Medo. “The ease of imaging and immediacy of diagnostic information we provide will radically transform medical care, creating a world where caregivers can image the body as easily as snapping a photo on a smartphone.”
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EXO ACQUIRES MEDO AI
THE IMAGING PROFESSIONAL26 ICEMAGAZINE | SEPTEMBER 2022
Iodixanol and other contrast media agents are in shortage across the U.S. because of COVID-19 related supply-chain disruptions. Fresenius Kabi is committed to preventing and mitigating shortages by working closely with its customers, suppliers, and the FDA, and by making long-term investments that support the supply chain of care in the United States. Contrast media agents are essential to patient diagnosis. An estimated 50 million examinations with contrast agents are performed each year in the United States, and as many as half the nation’s hospitals have been affected by this shortage.Iodixanol Injection, USP is bioequivalent and therapeuti cally equivalent to Visipaque, rendering it fully substitutable to the brand, and is the first generic iodinated contrast me dia agent available exclusively from Fresenius Kabi, a global health care company that specializes in medicines and technologies for infusion, transfusion and clinical nutrition.
GENERIC IODIXANOL CONTRAST MEDIA AGENT INTRODUCED
NEWS
“Fresenius Kabi is pleased to help expand access to affordable, high-quality contrast media agents for the radiology community,” said John Ducker, president and CEO of Fresenius Kabi USA. “The approval and U.S. availability of Fresenius Kabi Iodixanol Injection, USP is expected to provide immediate relief to the current shortage. As a company committed to the purpose of ‘caring for life,’ we’re honored to help patients receive the timely care they ADVANCINGneed.”•
Fresenius Kabi announced that it will introduce a portfolio of generic contrast media agents in the United States, start ing immediately with the launch of Iodixanol Injection, USP, a product the U.S. Food and Drug Administration (FDA) lists as being in shortage nationwide. Iodixanol Injection, USP is the first U.S. FDA-approved generic iso-osmolar, dimeric iodinated contrast media agent, which is used during diagnostic X-ray-based imaging such as computed tomography (CT) scans.
GE intends to execute the tax-free spin-off of GE HealthCare in early 2023, creating an independent compa ny driving innovation in precision health to improve patient outcomes and address critical patient and clinical chal lenges. Building on a more than 100-year history, the GE HealthCare name and Monogram will serve as an enduring badge of safety, quality, trust, and innovation, the release added. The new brand color for GE HealthCare is called “compassion purple” to reflect more humanity and warmth and achieve greater distinction. The company will continue to be at the forefront of provider and patient care with more than four million product installations and over two billion patient exams a year.
GE recently announced the brand names of the future com panies it will create through its planned separation into three global, investment-grade public companies focused on the growth sectors of health care, energy, and aviation.
GE HealthCare will be the name of GE’s healthcare busi ness. GE’s existing energy portfolio of businesses, including Renewable Energy, Power, Digital, and Energy Financial Services, will sit together under the brand name GE Vernova. GE Aerospace will be the name of GE’s aviation business.
GE ANNOUNCES 3 BRAND NAMES
All three planned companies will continue to benefit from GE’s heritage and global brand valued at nearly $20 billion, according to a news release.
In other news, GE Healthcare has unveiled its most ad vanced ultrasound yet, the next-generation Voluson Expert 22. This latest addition to GE Healthcare’s award-winning women’s health portfolio utilizes graphic-based beam former technology, which produces higher quality images and offers greater flexibility in imaging functions. Cutting-edge tools powered by artificial intelligence (AI) ensure greater consis tency in exams and decreased number of tasks. Customiz able touch panels, color and lighting options provide for a revolutionary user experience.
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Market Report
The COVID-19 outbreak has upended many lives and businesses on an unprecedented scale. The pandemic is going to negatively impact the surgical imaging market. The pandemic has put significant strain on the health care systems of the world. During the height of the pandemic, health care institutions and providers have been instructed to stop performing elective surgical procedures and medical examinations to slow the spread of the disease and conserve health care resources for COVID-19Accordingpatients.toareport
The number of persons aged 60 and older has consis tently increased over time due to rising life expectancy. The worldwide geriatric population will grow from 727 million in 2020 to 1.5 billion by 2050, according to the United Nations Database on World Population Ageing 2020. Geriatric people have the highest risk of suffering from chronic diseases, increasing the demand for the surgical imaging market.
published by researchers, approx imately 28 million surgeries were canceled across the globe during 12 weeks of peak disruption during the COVID-19 pandemic. The American Hospital Association estimated an average loss of revenues to U.S. hospitals of $50.7 billion per month from March 1 to June 30, 2020 because of can celled elective procedures (as these procedures typically constitute a substantial part of hospital revenue).
Moreover, the rising adoption rate of advanced tech nologies will provide beneficial opportunities for the surgical imaging market growth. •
Data Bridge Market Research reported that factors driving market growth include an increasing prevalence of chronic diseases. The rising prevalence of chronic diseases such as diabetes, high blood pressure, cancer, high cholesterol and osteoporosis will propel the market’s growth rate during the forecast period of 2022-2029.
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SURGICAL IMAGING MARKET GROWTH EXPECTED ADVANCING THE IMAGING PROFESSIONAL28 ICEMAGAZINE | SEPTEMBER PRODUCTS2022
STAFF REPORT
Capital markets and economies worldwide have been negatively impacted by the COVID-19 pandemic, and it may cause an extended regional or global economic recession. Such economic disruption could have a negative impact on surgical imaging manufacturers. Most hospitals have deferred their ongoing purchase of capital equipment. Furthermore, as economic pressures increase, customers will seek leasing or alternative financing arrangements instead of outright purchases, leading to deferred revenues for surgical imaging system manufacturers.DataBridgeMarket Research reported that the surgical imaging market was valued at $1.91 billion in 2021 and is expected to reach $3.14 billion by 2029, registering a CAGR of 6.37% during the forecast period.
Furthermore, the rising demand for minimally inva sive procedures will act as a major factor influencing the growth of the surgical imaging market. Along with this, increasing urbanization and the rising level of dispos able income are factors accelerating the growth of the surgical imaging market. Also, increasing expenditure on health care infrastructure and the continuously changing lifestyle of people are major market drivers that will fur ther escalate the growth of surgical imaging market.
he global surgical imaging market is projected to reach $2.4 billion by 2025 from an estimated $1.8 billion in 2020, according to MarketsandMarkets. This would be a compound annual growth rate (CAGR) of 6.3% during the forecast period. The major factors driving the growth of this market include the advantages of FPDs over image intensifiers, technological advancements, reimbursement cuts for analog radiography systems and the increasing demand for minimally invasive procedures. However, the high cost of systems is estimated to restrain the growth of this market during the forecast period.
KONICA HEALTHCAREMINOLTA mKDR Xpress Mobile X-ray System
ProductFocus
Konica Minolta Healthcare Americas Inc. (KMHA) re cently announced the launch of the mKDR Xpress Mo bile X-ray System and the AeroDR Carbon Flat Panel Detector. The mKDR Xpress Mobile X- ray System is KMHA’s smallest and lightest portable X-ray system available today. Its slim design and collapsible column facilitates moving the system wherever needed, including tight spaces in the ICU, CCU and OR. Ease of use is assured with a customizable mobile-specif ic user interface, remote control and front and back collimator controls with laser alignment. The mKDR Xpress Mobile X-ray System is ready for the most de manding mobile X-ray imaging needs with on-board charging for two panels and front and back storage for panels and consumables. An industry-unique, tube-mounted graphical user interface and image preview function help ensure clear images are visible quickly. The new AeroDR Carbon Flat Panel Detector is Konica Minolta’s most advanced digital detector.
Surgical Imaging 1 ICEMAGAZINE 29WWW.THEICECOMMUNITY.COM
Fujifilm introduces ELUXEO Vision: the only in-market solution to enable physicians with real-time visualization of hemoglobin oxygen saturation (StO2) levels in tissue us ing laparoscopic and/or endoscopic imaging without the need for fluorescent dyes, allow ing physicians to circumvent inherent dye limitations such as time restrictions or the need for consumables. Being able to detect StO2 levels helps endoluminal and laparo scopic surgeons identify potentially ischemic tissue, better positioning them to prevent tissue necrosis. The technology is uniquely engineered with 5-LED Multi-light technology when used in conjunction with the Fujifilm ELUXEO Endoscopic Imaging System.
The OEC 3D is a surgical imaging C-arm that provides precise 3D and 2D imaging to surgical suites while enabling efficient imaging every day.
FUJIFILM ELUXEO
GE HEALTHCARE OEC 3D Surgical Imaging C-arm 3
PRODUCTS ADVANCING THE IMAGING PROFESSIONAL30 ICEMAGAZINE | SEPTEMBER 2022
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Based on GE Healthcare’s proven AW image fab ric technology, the OEC 3D C-arm now enables surgeons to quickly capture and analyze 2D as well as precise 3D volumetric images with a C-arm, bringing CT-like images into the operat ing room. OEC 3D also includes the recognizable OEC C-arm 2D imaging experience and versatil ity for all types of procedures from general sur gery to interventional cardiovascular procedures for everyday procedures. Vision
HEALTHINEERSSIEMENS ARTIS pheno 45 ICEMAGAZINE 31WWW.THEICECOMMUNITY.COM
ZIEHMCARESTREAM’S Vision RFD C-arm System
Carestream’s Ziehm Vision RFD C-arm Sys tem is a mobile, fluoroscopic surgical imaging system that allows for broad procedural work including vascular, cardiac, spine ortho-trau ma and pain management, in addition to many general surgical applications. The system’s Advanced Active Cooling enables extended case times beyond traditional aircooled systems. It also provides an intuitive graphical interface that benefits technolo gists with reduced training time as well as improved productivity. The Ziehm Vision RFD C-arm — offered in partnership with Ziehm Imaging — is available through Carestream in the U.S. and Canada.
The ARTIS pheno floor-mounted robotic C-arm angi ography system from Siemens Healthineers is designed to maximize capabilities and efficiency for a wide range of minimally invasive interventional procedures in the hybrid OR. Its flat panel detector and GIGALIX X-ray tube produce outstanding image quality and it can deliver 2D imaging resolution that is four times higher than its predecessor. The system can regulate acquisi tion parameters to automatically achieve optimal image contrast at low dose levels. The syngo DynaCT clinical software application produces 3D images that use less contrast media. Other applications include real-time verification of stent positioning during implantation and automatic segmentation of coronary computed tomog raphy angiograms. The Artis pheno has a maximum 3D volume of 16.9 feet (diameter) by 9.3 feet (height) for excellent anatomical coverage, and a patient coverage of 13 feet. Its free inner diameter of 37.6 inches enables staff to remain at the patient‘s side.
Imaging Jobs NOW AVAILABLE htmjobs.com REGISTER FOR FREE AT HTMJOBS.COM Contact us at htmjobs@mdpublishing.com to learn more about our various posting options! Companies like ours have such a difficult time finding qualified candidates for field service roles that it just made sense to publish our opening with HTMJobs. – K. White, HR/Compliance Manager “ ” LOOKING TO FILL A POSITION? Visit htmjobs.com/start-posting/ to post a job. Companies that post with us: MXR Imaging, OSF Healthcare, First Call Parts, Associated Imaging Services, Medical Imaging Solutions, Renovo Solutions, TRIMEDX, Canon Medical Systems, Cal-Ray, Banner Health, Agiliti and many more!
The Imaging Engineer II installs, inspects, troubleshoots, repairs, calibrates, and verifies the performance of complex medical imaging equipment including, but not limited to, general radiographic rooms, R/F, C-arms, mammography, Nuclear Medicine, CR, DR, ultrasound, bone density, and all supporting equipment.
An Imaging Service Engineer (ISE) performs and documents planned maintenance and repair of medical diagnostic imaging equipment and associated systems with under the supervision from service management to perform the required duties. The ISE must demonstrate a working knowledgeof and ability to use the required test equipment and have the electronic and mechanical knowledge and skills.
Universal Medical Resources, a leader in Nuclear Medicine Sales, Service, and Parts has openings for experienced Field Service Engineers throughout the United States. Field Service Engineers are assigned a territory where they are responsible for main taining nuclear medicine equipment atcustomer’s sites. The position requires frequent travel within the territory as well as occasional travel outside the assigned territory.
Field Service Engineer
This position is responsible for customer relationship management through the effective use of technical knowledge to service and maintain the site. As a primary service engineer for assigned accounts, incumbents’ diagnoses & resolves most equipment problems working independently and provides required preventative maintenance and service on all assigned equipm
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The Field Service Engineer is responsible for main taining the customer’s high end medical imaging equipment, including systems applications, quality control, calibration, operating system support, applications support, software support, technical support, and troubleshooting.
The Radiology Equipment Technician II (RADT II) performs scheduled maintenance and repairs of a wide variety of medical imaging devices & systems at multiple locations. Examples of these imaging devices & systems are; Portable radio graphic, portable fluoroscopic, radiographic unit digital and conventional, radiographic/fluoroscopic digital & conventional Ultrasound, mammography, molecular imaging systems, bone density, etc.
First Call Parts has been providing customers with quality replacement imaging parts since 2009. We pride ourselves in developing a top-notch reputation in the imaging industry as delivering the best in diagnostic imaging replacement parts. We specialize in the sale of refurbished/tested and used, Philips, Siemens, and GE in the Cath/Angio, R/F, and RAD modalities.
Field Service/Cust Eng III-CT/XR/UL
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Company vehicle or Car allowance, tools, uni form, relocation assistance, training (on the job, online & classroom technical instruction at our training facility in Irvine, CA), benefits on day one of employment, 401K with match ing, collaborative team environment, growth, work life balance, strong company culture of excellence... and so much more!
Field service on medical imaging equipment. Growth opportunities include Diagnostic Imaging field service engineer servicing multi-vendor/multi-modality equipment in hospital and other environments. Focus is toward c-arms, Digital Mobiles, x-ray systems and digital capture both DR and CR. Additional modalities to include CT, MRI, Ultrasound, and others. Position advancement possibilities will be available when appropriate.
ADVANCING THE IMAGING PROFESSIONAL34 ICEMAGAZINE | SEPTEMBER 2022
NEW TECH NEW
W hen the latest and greatest technologies don’t solve all your problems on their own, what’s necessary to manage them becomes grounded in different kinds of decision-making.
ISSUES
Dr. Ryan Gibbons, an emergency med icine physician and associate professor at the Lewis Katz School of Medicine in the Temple University Health System of Philadelphia, Pennsylvania, learned first-hand how disruptive the scope of innovation can become when Temple concluded its 2021 whitecoat ceremo ny for new medical students with a show-stopping moment. At the direc tion of Katz School Interim Dean Dr. Amy J. Goldberg, all 220 students of the Class of 2025 reached underneath their seats, and pulled out a Butterfly iQ+ point-of-care ultrasound (POCUS) device. The gift, made possible by an alumni donation, put the technology in the hands of every incoming medical student for use throughout the next chapter of their education, and beyond.
COVER STORY By Matt Skoufalos
Gibbons directs ultrasound in med ical education and the emergency ultra sound fellowship at the Katz School of Medicine, as well as being the associate director of the hospital’s emergen cy ultrasound division. Not only had nothing like the Butterfly been available when he began his residency at Temple 10 years ago, but Gibbons described himself as among the least likely early adopters of any technology.
“People make fun of me for talking on my iPhone 4,” he said. “When I started my residency back in 2012, I had no idea what ultrasound was, and now it’s expanded across multiple specialties. But we’re supposed to be lifelong learners, and this is one of those examples where you’ve got to adapt to what’s happening.”
Another of the challenges to intro ducing this skill set to students, Gib bons said, is that they must use POCUS routinely to use it well, obtaining and reviewing images over and over again to hone their proficiency. Previous to acquiring the hand-held devices, the school had relied on a handful of cartbased traditional ultrasound devices that cost tens of thousands of dollars a piece and could only be used by one student at a time. The handheld roll-out has meant that Temple can expand and develop its ultrasound curriculum. “That’s what’s going to be able to change people’s practices,” Gibbons said. “The biggest advantage of what we’ve been able to do is to improve the access our students have to ultrasound to learn it. When you have so many students trying to get their hands on a probe, it limits the time they have to use it. Now they can practice at home, they can practice with their friends, and they can bring it to the hospital in their clinicalWithyears.”morethan 200 medical students per class now commanding POCUS technology at the point of care, that still doesn’t assure its smooth inte gration into the practice environment. Instead, it puts the students ahead of the majority of veteran physicians who aren’t very familiar with POCUS, its use, and its interpretation, which can be another integration challenge, Gibbons said. “Most physicians are accustomed to ordering an ultrasound,” he said. “The patient goes down to the suite, someone performs the exam, someone interprets the exam, and then you get the answer. When you have 200-some students come into the hospital with only a hand ful of physicians who are familiar with POCUS, it does come with some issues. Are we going to let them practice on each patient? Are they making clinical decisions based on this? We’re trying to figure out the best way and the safest way for students to bring this technolo gy to the bedside appropriately.”
COVER STORY
“The technology really has changed the way we can practice medicine. Not only is it augmenting your physical exam, but it’s allowing you to narrow your differ ential diagnosis or potentially diagnose at the bedside. You can scan, interpret and make decisions in real time.”
“One of the biggest challenges of any new technology is whether people can adopt it, learn it and understand it,” Gibbons said. “The earlier you introduce it, the more easily people are going to adapt to what’s going on. We’re on our third year, and we’ll have 600 students with these in their hands. How do we develop a curriculum that can meet the needs of the students, and how do we train 200 students per class? That has been a big challenge to say the least.”
That benefit is particularly trenchant in Gibbons’ work as an ER physician, a practice environment in which he might be the only doctor in-house under certain circumstances. Now, without any other emergency physician on call, or even in the absence of any radiolo gist or technician who can perform an ultrasound, his familiarity with POCUS has helped him deliver improved bed side care that also has benefited other specialties. He believes that by intro ducing the next generation of medical students to POCUS as early as possible in their schooling, it will cut down the knowledge gap that they might have to overcome later in their careers anyway.
“You need a large cohort of oth er supportive faculty,” Gibbons said. “Some have practice with POCUS, and others are just learning it and willing to help out. Some people truly buy into lifelong learning, and sometimes they don’t. Whether it’s at an academ ic or a community hospital, you need someone who understands the benefit to doing this, and you need to start small. You’re going to meet resistance because there’s a lack of understand ing, legacy issues with training, cre dentialing; there’s a lot of things that go on behind the scenes from a whole
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Dr. Ryan Gibbons uses a handheld ultrasound device on a patient during the COVID-19 pandemic.
Gibbons also said that he’s encoun tered some resistance from physicians who adhere to what he described as a more traditional mindset, and who were not eager to learn about the program. That underscored his observation that faculty support for the ultrasound program isn’t just a challenge from an educational perspective, but from the standpoint of building buy-in among faculty; finding those who are willing to be trained on the systems and become champions for the technology within the system. Most of the support he’s found has come from faculty who are giving their time freely, which isn’t guar anteed in all practice environments.
Completing a POCUS fellowship at Temple gave Gibbons a leg up on the ultrasound training that emergency room (ER) doctors typically might receive throughout the course of their education, and as he came to appreci ate the value of ultrasound in practice, Gibbons became more outspoken in stumping for its broader adoption throughout the clinical and educational environments at Temple. The curricu lum had been slowly building prior to the donation of the Butterfly devices, and the infusion of capital that spurred the purchase “kind of coincided at a perfect time when I was pushing to expand the curriculum,” he said. “It really is a small world, POCUS, and it’s something at Temple that I wanted to contribute, and one of the main reasons I wanted to get this [pro gram] up and running,” Gibbons said.
COVER STORY
Doctors Ryan Gibbons, Thomas Costantino and Mark Magee teach Temple University medical students pointof-care ultrasound techniques. Gibbons directs ultrasound in medical education and the emergency ultrasound fellowship at the Katz School of Medicine.
Conwell also discovered the creeping challenges associated with integrating legacy PACS systems with in a vendor-neutral archive (VNA). At one point, Sentara was trying unsuc cessfully to tie together six different legacy PACS systems into a third-party VNA really well. After installing a Mach7 enterprise PACS system, however, the health network managed to resolve its system integration issues, but was left with new challenges — balancing increasing storage costs with high-per formance demands — that required policy solutions as much as technolog ical“Manyones. organizations like mine are sitting here with studies that are 20 to 25 years old, and what’s the purpose of keeping those?” Conwell asked. “What are we doing with all these studies? Legal, financial, technology [departments] — they say ‘Get rid of it for performance, liability, or financial reasons.’ Clinical says, ‘Keep it all.’ In many organizations, clinical is winning out because they’re playing the patient safety or regulatory cards. So every body gets confused by it, and when budget cycle comes around, they don’t have time to untangle it. We just budget more money for storage and go about ourForbusiness.”aspleased as he was with the technical ability of the Mach7 to manage image life cycles, Conwell felt frustrated at having his hands tied by business rules that didn’t allow for his department to make the best use of its functionality, and in turn, save time, money and effort. Determining the relevance of which studies to preserve, for how long to preserve them and how to manage the costs of doing either became a challenge to be negotiated inter-departmentally.“Organizationsare dealing with performance issues because modalities are growing, solutions are growing, and vendors are designing tiered hard
ADVANCING THE IMAGING PROFESSIONAL36 ICEMAGAZINE | SEPTEMBER 2022
“We didn’t feel as if we had a true standard, or that we could support it over a wide-area network with proper performance,” Conwell said. “Modality vendors’ file sizes just continue to grow and grow and grow. Now we’ve got a factor in here that is making us re-ex amine having these siloed data storage solutions. They’re just not cost-effective.”
While Gibbons has the added re sponsibility of integrating POCUS into the clinical and academic environments at Temple, he remains free from being tasked with managing the back-end aspects of the technology. Those, how ever, are the specific challenges that Trent Conwell, IT director for Sentara Healthcare of Virginia Beach, Virginia, has been juggling since tackling the work of standardizing and storing reliable access to medical images at Sentara’s 13 hospitals across some 300 miles of Virginia and North Carolina.
system-wide perspective. Start small, be patient and have an advocate.”
ware and tiered storage, driving up the costs,” Conwell said. “So what can we do? Where do we see this going? If I could save $X million year-over-year in storage costs because I went from an average of 6.5 copies of studies to two, could I invest that into my network?” “We did, and it’s been a one-time capital cost,” he said. “When you take a look at it over five years, the savings were still substantial. We could dump money into our network infrastructure and still have three years of storage sav ings on the outside. Let’s go ahead and cut our storage volume by somewhere between 40 and 50 percent. That’s just image life cycle management.”
Finding” a way to blend seamlessly the demands of cutting-edge and legacy imaging technologies may require some fundamental underlying work to create uniformity of experience throughout clinical environments, said Rekha Ranga nathan, GE Healthcare interim chief dig ital officer, and senior vice president and general manager of imaging solutions.
One aspect to the GE Healthcare approach to improving imaging opera tions is the Edison Imaging and Imag ing Protocol Manager, a cloud-based solution for editing, monitoring, and managing imaging protocols, which are some of the most time-consuming tasks for technologists to get a handle on, specifically because they keep evolving.
Edison offers physicians a chance to use the same protocols across all devices, while also updating and managing them with authorship so it’s known who made theAnotherchanges. solution, Digital Expert Ac cess, enables senior technologists to see the consoles of their junior technologists, Ranganathan said, offering protocol guidance, and fielding questions across multiple sites remotely.
“While everyone wants the hardware to last longer, they also want the func tionality to be the latest and greatest,” Ranganathan said. “Your PC can be old, but all the applications have to be new.
A lot of our customers have multiple CT, MRI, X-ray machines, and because of this drive to standardization, they want fleet management solutions – software man agement applications that have reduced variability between different systems.”
“The number one topic we hear about from our customers, especial ly imaging, is operational efficiency, which has different flavors for different customers,” Ranganathan said. “A lot of the work that we do is really not about real-time stuff; however, if it is touching the raw scanner, and the raw data, making it vendor-neutral requires a lot of work.” “Ithink we have a long way to go for the industry as a consortium to improve interoperability in a critical care or emergency room environ ment,” she said. “We do have part nerships to try to move the industry, but if we are all as an industry able to come up with the right standards, I think interoperability will come. Some of this is really about the industry coming together to move ahead.”
•
Conwell said he’s been amazed to discover that all 13 hospitals can manage their digital image archives from one central database and provide appropri ate performance at each by managing the archival issue and reinvesting in the network.“Theclinical side is physician-led, and that’s the way it should be,” he said. “I’m here as the IT director saying, ‘Once you figure out which way to go, I’m here to deliver it.’
“We call it a remote collaboration tool; that’s been a big part of our fleet and workflow management,” Rangana than said. “It increases the leverage of what a senior technologist can do at any point in time without having to be at a single location. They can counsel up to eight junior technologists at the same time.”Additionally, Ranganathan said, the company is also working to increase the modularity and standardization of the devices it retails, the better to improve operational efficiency and integration.
A Temple University medical student uses a handheld ultrasound device to scan her arm.
- Trent Conwell
COVER STORY ICEMAGAZINE 37WWW.THEICECOMMUNITY.COM
growing,are“Organizationsdealingwithperformanceissuesbecausemodalitiesaresolutionsaregrowing,andvendorsaredesigningtieredhardwareandtieredstorage,drivingupthecosts.”
INCREASE STORYTELLING IN YOUR DEPARTMENTS. Carve out time where employees can share their stories with you and each other. This sharing can be in staff meetings, daily hud dles or department events. Storytelling not only helps us to connect with our team, but it is an opportunity for staff to release their assumptions and biases. Without engaging in deep conversation, we are left with our own stories about people. This singular one-sided story is what creates stereo types, and without engaging with others, we are left with this story, the story we make up about others. Having others share their story, whether it be their life journey, their path into radiology, or a significant life event, stories create connections and help remove biases. BE AWARE OF YOUR OWN BIAS. UNCONSCIOUS BIAS WILL GRIP YOU. Our minds are busy, but the unconscious mind help preserve energy by processing information based on prior experience and assumptions. The brain is so efficient that it prefers not to spend time understanding all information in depth. Therefore we don’t spend enough time accurately interpreting what is happening around us. This uncon scious bias can negatively influence our thoughts and perception, impacting our leadership.• Nicole Dhanraj, Ph.D., SHRM-SCP, PMP, GPHR, CPSS, CRA, R.T(R)(CT)(MR), is an experienced imaging director.
INDE&IJUMP-STARTINGINITIATIVESIMAGING
Health care leaders know the significant benefits of diversity and inclusivity in a workplace. Yet, despite these benefits, we remain lagging in implementing these initiatives; not that we don’t want to focus on them, but in these trying times, we find ourselves consumed with staffing and supply chain challenges while navigating the turmoil of the pandemic.
As you come up for air and settle into whatever this new normal is, we as leaders must recommit to executing DEI initiatives.
As you get started remember that diver sity does not have to be just about color, we can be of the same color and be very diverse in education, experience, socioeco nomic status, culture and so much more! It would help if you considered foster ing DEI-safe spaces whether your team is colorful or homogeneous. If you have not started, here are some recommendations.
BY NICOLE DHANRAJ
INSIGHTS ADVANCING THE IMAGING PROFESSIONAL38 ICEMAGAZINE | SEPTEMBER 2022
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A: Staffing continues to be the biggest challenge for many imaging leaders. Leaders are struggling to identify how to keep positive morale and how to properly address technol ogists’ needs.
A: I have been an AHRA member since 2004. Since I “worked up through the ranks,” my leadership training actually came from AHRA. I learned from “the best of the best,” which are AHRA leaders whom I have met over the years. The AHRA forum has been a huge help to me, as I can ask a question and get almost immediate answers from across the country. I personally have grown as a person and as a leader because of the volunteer opportunities within the AHRA. I have pushed myself outside of my comfort zone all just to “give back” to other AHRA members.
Q&A AHRAWITHPRESIDENT BRENDA DEBASTIANI AHRA ADVANCING
Q: WHERE DO YOU SEE THE FUTURE OF IMAGING IN 5 YEARS? 10 YEARS?
Q: WHAT ARE SOME OF THE BIGGEST CHANGES/ADVANCEMENTS IN IMAGING DURING YOUR CAREER?
Q: WHAT ARE THE TOP CHALLENGES YOU AND OTHER IMAGING DIRECTORS/LEADERS FACE NOW AND IN THE NEAR FUTURE?
Q: HOW LONG HAVE YOU WORKED IN THE IMAGING FIELD?
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A: I have been working in the imaging field for 36 years. I started as a radio logic technologist, cross-trained into CT, was promoted to supervisor in 2001, and then promoted to director in 2013.
BRENDA DEBASTIANI AHRA PRESIDENT B renda DeBastiani, MBA, CRA, FAHRA, RT(R), is experiencing a lot of change in her life. The longtime AHRA member began her tenure as president of the organization in July. She and her husband also recently moved to Florida where she is now the director of imaging at Bravera Health Spring Hill. ICE magazine caught up with her recently and asked her some questions regarding her new post as AHRA president.
Q: HOW LONG HAVE YOU BEEN AN AHRA MEMBER AND WHY?
Q: WHAT ARE SOME KEY OBJECTIVES YOU WANT TO ACHIEVE DURING YOUR TENURE AS AHRA PRESIDENT?
A: I have watched imaging move from “analog” to “digital.” That “technolo gy change” away from film improved techs’ efficiencies tremendously.
A: We just completed our AHRA member survey, and that data is be ing evaluated. The qualitative data gained from the in-person focus groups at the 2022 AHRA Annual Meeting in Phoenix (to wrap up our THE IMAGING PROFESSIONAL
A: I believe that we will continue seeing staffing struggles in the next 5-10 years, as there will be more pa tients requiring care and less health care providers available. I also believe that there will be a challenge find ing imaging leaders in the next 5-10 years. Many current employees want better work-life balance. They want to work their set hours and go home to be with their loved ones. This means that we are going to have to re-think how health care leaders are expect ed to do their jobs and allow greater flexibility in order to draw people into leadership careers. There are several opportunities for us to learn from our employees!
AHRA member survey) was instrumental in helping us with our on-site strategic planning meeting (held on Thursday after the annual meeting). The AHRA strategic planning task force has been meeting to develop our new mission and vision, as well as the strategies that we are going to use to move us forward for the next 5-plus years. Representation from the AHRA Board of Directors, AHRA staff and AHRA members were all included on the strategic planning task force to have compre hensive representation. We have one final meeting coming up next week to nail down the final version of our strategic plan.
AHRA Diag nos t ic Solut ion s i s a c u s tome r se r v ice ba se d pa r t s pr ov ide r t hat s pe c ia l i ze s i n a l l i mag i ng mod a l it ie s a nd manufacturers Created to offer hos pita l s a nd I SO’s a cos t ef fe c t i ve a nd t i me sav i ng solut ion for or de r i ng i mag i ng r e place me nt pa r t s , e qu ipme nt move s , u lt r a sou nd pr obe r e pa i r a nd on site se r v ice. Contac t u s today, we a re conf ident you w i l l see u s a s T H E Pa r t s Solut ion! diagnostic-solutions.com 330.296.9729 LE N DING A H E LP ING HAN D AT E V E RY S T E P. ICEMAGAZINE 41WWW.THEICECOMMUNITY.COM
The textbook task force has been working hard to revise two of our oldest textbooks. Those books will be available soon.AHRA members need to help encourage other imaging providers move into leadership roles. We are telling our own personal stories without ever saying a word. Our technolo gists are watching our every move. Our current leaders need to share positive stories and help others to want to actually become imaging leaders. Imaging leaders need to take better care of themselves to be the best that they can be. Imaging leaders cannot help others if their “cups are empty,” so we all need to learn how to take great care of ourselves so that we can better take care of others. Resiliency is key for leadership survival and success.
Q: IS THERE ANYTHING ELSE YOU WANT TO ADD?
A: I just relocated from West Virginia to Florida on Friday. After 33 years at the same facility, I decided it was time to go. It is time for me to reinvent myself. (It just so happens that it is in the Sunshine State.) While I was nervous and sad about leaving my home and my family, I am very excited to meet new people, learn from different cultures and begin this new adven ture in a new hospital. I have always said that I am a life-long learner, and here I am opening myself up to learn from my new employees and new employer. •
Based on feedback from our members, the radiology man agement journal is very important; so, we need to focus on including robust education to meet their needs. We know that we need to meet our members “where they are” to provide what they need. That will be a focus this year, as health care is constantly changing, and the AHRA needs to respond appropriately.
Iam of the option that artificial intelligence (AI) in imaging can improve accuracy, productivity and safety if used correctly.
• Recognize that the device does not remove any radiolog ical exams from the queue for interpretation by an imag ing physician. When used as intended, exams that are not flagged by the device are still interpreted by an imaging physician according to the standard of care.
Health care providers may not be fully aware that LVO CADt devices are intended for prioritization and triage
BACKGROUND Acute ischemic stroke caused by LVO contributes to stroke-related disability and death. Timely intervention may improve health outcomes. Many CADt devices are based on artificial intelligence and machine learning (AI/ ML) technology. LVO CADt devices are classified under 21 CFR 892.2080 Radiological computer-assisted triage and notification software (eCFR :: 21 CFR 892.2080 -- Radio logical computer aided triage and notification software).
• Recognize that when the device is used as intended (as a prioritization and triage tool and not a diagnostic device), it can improve workflow by prioritizing suspected cases.
RECOMMENDATIONS
INSIGHTS ADVANCING THE IMAGING PROFESSIONAL42 ICEMAGAZINE | SEPTEMBER 2022
• Recognize that LVO CADt devices cannot rule out the presence of an LVO. If a radiological exam is not flagged by a LVO CADt device, an LVO may still be present.
“The U.S. Food and Drug Administration (FDA) is reminding health care providers about the intended use of radiological computer-aided triage and notification (CADt) devices for in tracranial large vessel occlusion (LVO). LVO is an obstruction of one of the large arteries in the brain and is a common cause of acute ischemic strokes. LVO CADt devices are software devices intended to aid in prioritization and triage of time-sensitive suspected findings of LVO based on the analysis of radiological exams of the brain. LVO CADt devices do not provide diagnos tic information or remove any cases from the imaging physi cian’s reading queue. Information from real-world use suggests that providers may not be aware of the intended use of these devices. If LVO CADt devices are not used as intended, there is the potential for misdiagnosis resulting in patient injury or death. The FDA is bringing this information to your attention as a reminder and to ensure that providers are aware of the intended use of the software as a triage and prioritization tool.”
• Be aware of the design of LVO CADt devices. This includes an understanding of the vessels (arteries) for which the device was designed and tested to detect LVO. LVO CADt devices may not be designed and tested to evaluate all intracranial vessels. If you have questions about which vessels the LVO CADt device is designed to evaluate, or are unsure, review the most recent product labeling or contact the device manufacturer for further information or questions on device performance.
The use of radiation for treatment and diagnosis was voted by the American Medical Association as one of the top 10 most useful innovations in health care. As radiology technologists, we are charged with the safe use of this potentially dangerous tool. First do no harm. The industry has set up stringent limits and complex monitoring systems to insure safe best practices in radiation use. A vendor of a radiation-generating device cannot insure the safe administration of the proper dose. This is why, as an open advocate of medical imaging AI, I feel obligated to share with you this letter from the U.S. Food and Drug Administration.
The FDA recommends that health care providers:
• Be aware that LVO CADt devices only flag radiologi cal exams with suspected findings and should never be used as a replacement for informed interpretation by an imaging physician.
FDA SENDS AI WARNING LETTER BY MARK WATTS PACS/IT
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only. These devices should not be relied on when making any diagnostic decisions. In addition, health care provid ers should ensure that they understand which vessels the device was designed and tested to evaluate. If the device is used for diagnostic decisions or to evaluate vessels for which it was not designed, delayed or missed diagnoses may occur and result in worsened outcomes for patients.
• Device manufacturers and user facilities must comply with the applicable Medical Device Reporting (MDR) regulations.
When used as intended, CADt devices can improve the workflow by prioritizing suspected exams. The device does not remove any radiological exams from the queue for interpretation by an imaging physician. When used as intended, exams that are not flagged by the device are still interpreted by an imaging physician according to the standard of care. FDA ACTIONS
Mark Watts is an experienced imaging professional who found ed an AI company called Zenlike.ai.INSIGHTS
The FDA is working with LVO CADt device manufacturers to ensure that health care providers are informed about the intended use and design of these devices. More generally, because postmarket performance in clinical practice may not match the premarket data, the FDA is also engaged in continuing efforts to evaluate the real-world performance of AI/ML imaging devices, including CADt devices. The FDA will continue to keep health care providers and the public informed if new or additional information becomes available.
REPORTING PROBLEMS TO THE FDA
• Voluntary reports can be submitted through MedWatch, the FDA Safety Information and Adverse Event Report ing program.
•
• Health care personnel employed by facilities that are subject to the FDA’s user facility reporting require ments should follow the reporting procedures estab lished by their facilities.
The FDA encourages health care providers to report any adverse events or suspected adverse events experienced with imaging software for LVO.
Prompt reporting of adverse events can help the FDA iden tify and better understand the risks associated with medical devices.”Thevendors will tell you their product “can” do this, “over 100Itfinding.”isourobligation to the patient and our health care orga nizations to understand and apply AI in imaging in a safe and compliant manner.
CATCH THE ISSUE BEFORE IT BECOMES A MELTDOWN Nuclear infrastructure safety is all about de fense-in-depth, a strategy that leverages mul tiple levels of security measures to protect or prevent errors. This approach works to limit the chance that any small or even large issue results in a dangerous nuclear meltdown. At a nuclear power plant, depth is the physical distance between radioactive materials and civilians as well as the depth of the contin gency/backup plan. Nuclear meltdowns are avoided by the rods that mitigate the radio active power of the reactor’s uranium fuel, the massive steel reactor vessels and cooling systems that hold and cool the rods, and the several feet of steel-reinforced concrete that houses the reactor vessels. If standard equip ment malfunctions, multiple redundant safety equipment options are in place. Within health care, there are not nearly as many double checks or backup security options applied in clinical practice for patient safety.
after treatment • Inadequate
To
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results My
include: • Medication errors • Anesthesia errors • Hospital-acquired infections • Missed or delayed diagnosis • Avoidable
SECOND
While safeguards are critical for limiting
in treatment • Inadequate
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• Failure to act
BY KEITH CHEW CHEW ON THIS ADVANCING THE IMAGING PROFESSIONAL44 ICEMAGAZINE | SEPTEMBER 2022
WHAT HEALTH CARE CAN LEARN FROM THE ENERGY INDUSTRY errors are now the third leading cause of death in the United States. If this was an Olympic event, that would be a bronze medal. This is not a statistic the medical community is proud of, nor is it one that can be ignored. Medical error reduction and prevention is a challenge being addressed across all aspects of health care. address the issue, it’s essential to un derstand the problem and what constitutes a medical error; a few of the most common errors delay follow-up monitoring after a procedure on test final column in this series on cross-in dustry learnings has us focusing on the ener gy industry – specifically the nuclear energy industry. By carefully studying these errors, as well as how similar industries manage mistakes, we can learn to prevent them in the future.Like health care, nuclear energy compa nies need to be highly reliable organizations. Atomic reactors are some of the earth’s most sophisticated and complex energy systems. However, any complex system, no matter how well designed and engineered, cannot be deemed failure-proof. Given the high human, environmental and financial cost of a radioactive leak, these companies go to great lengths to bring errors theoretically to zero. Here are some approaches from the nuclear energy sector that the health care industry can learn from and apply to address medical errors.
incidents, errors do occur and their root cause must be understood to prevent those errors in the future. As one nuclear energy researcher stated, “the problem with new reactors and accidents is twofold: scenarios arise that are impossible to plan for in sim ulations, and humans make mistakes.” To address this, the nuclear power industry has gone to great lengths to understand these human mistakes and learn from them. For example, multiple stakeholders review each reactor plan to ensure safety. First, the U.S. Nuclear Regulato ry Commission (NRC) oversees plant safety and security for commercial U.S. nuclear reactors. One oversight initiative is the Resident Inspectors Program, where two individuals are stationed at each plant, daily auditing people, processes and technology to prevent errors. Furthermore, the nuclear power industry conducts peer reviews of plant operations through the Institute of Nuclear Power Opera tions, the International Atomic Energy Agency, and the World Association of Nuclear Operators to identify and miti gate possible errors whenever feasible.
Unfortunately, only 3 to 5% of the total imaging volume of a hospital receives this safety net peer review, leaving over 90% of all radiology images with only a singleAnotherreview.factor in the medical error cycle is that hospitals haven’t fully bought into a streamlined incident reporting process or a blame-free just culture. At a result, 40% of U.S. hospi tals are not leveraging the numerous benefits of patient safety organizations (PSOs). PSOs allow for the safe iden tification of errors that lead to quality and safety issues and enable the next step of developing interventions to prevent and mediate errors in a true peer learning
• Does your health system have a radiology second read program in place that assesses the vast majori ty of images or just the routine 3 to 5% that fall within the credentialing required peer review process? Is your hospital a member of multiple PSOs with each focusing on a differ ent aspect of quality improvement? If yes, how is your hospital using those programs to learn and change behavior moving forward? If no, is joining multiple PSOs something your hospital should consider and research? Join us next month as we do a series re-cap!
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Health care has the radiology peer review process in which providers randomly double-check their work to ensure diagnostic medical errors are identified, utilized as learning expe riences and are ultimately resolved.
Pioneeringatmosphere.healthcareleaders can learn from the nuclear energy indus try and work within their hospitals to implement redundant checks across the entire patient journey. In addition, the use of technology, such as AI for a second read across all imaging scans, and adopting a true peer learning philosophy will be critical in positively impacting medical error. Health systems can leverage these cross-industry learnings by asking a few•questions:Whatisyour health system’s de fense-in-depth strategy for limiting medical errors?
• Keith E. Chew, MHA, CMPE, FRB MA, is a principal with Consulting with Integrity.
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• Diversity – the practice or quality of including or involv ing people from a range of different social and ethnic backgrounds and of different genders, sexual orienta tions, etc.
Verlon E. Salley is the Vice President of Community Health Equity at UAB Health System.
DE&I WITH EMPATHY, INTENT AND INTEGRITY BY VERLON E. SALLEY
DIVERSITY ADVANCING THE IMAGING PROFESSIONAL46 ICEMAGAZINE | SEPTEMBER 2022
A health care organization that has the courage to recog nize that its workforce does not represent the community at its highest level of leadership; and remedies this disparity by recruiting underrepresented persons and placing them in positions where they have a voice, is a company that is serious about DE&I. Which would also mean the represent ed minorities would have to feel comfortable to share their voice. A delicate and intent-filled dance that I one day look forward to seeing play out in many organizations. •
• Equity – the quality of being fair and impartial.
• Inclusion – the practice or policy of providing equal access to opportunities and resources for people who might otherwise be excluded or marginalized, such as those who have physical or mental disabilities and mem bers of other minority groups.
iversity, equity and inclusion are some of the most notorious buzzwords in the workplace today. My charge is that these terms have to be implemented with empathy, intent and integrity. First, I shall define these words separately.
Diversity should be at the foundation of preparing for culture change within your organization’s DE&I strategy. A health care organization’s workforce should represent the community it serves. Therefore, the strategy should rec ognize the demographics of the community as well as the workplace. The focus should not be on race alone. Gender, sexual orientations and ethnic backgrounds could also be minority groups that may deserve a recruitment initiative within a DE&I strategy. Though, having one represented should not come without the next level buzzword, equity. For me, equity cannot exist without empathy. It is not the simple act of treating everyone equally, but it is an organization’s leadership recognizing it may have to do something intently different for a group of people that is underserved, marginalized and/or underrepresented. I was the senior director of radiology when the George Floyd murder happen. In the hospital’s first executive-level meet ing after the murder, I told my peers (directors, associate vice presidents and C-level) that it was OK to ask their Black staff members in their departments, “Are you OK to work today because of what has happen in Minnesota?” I encouraged my peers to use this as an opportunity to engage employees and show compassion. I remember one of my peers thinking they did not have the tools to engage their staff. I said, “Sure you do. What would you say to me if it told you a family member of mine passed away?” With out hesitating she said all the right things because she has empathy. I then explained to her to use that same energy when approaching her staff that day. Once again, equity cannot exist without empathy. Lastly, the pentacle of a DE&I strategy must be inclusion. Inclusion is the most resisted initiative within a DE&I strat egy because it requires honesty, vulnerability and intent. I will compare and contrast diversity and inclusion with two infamous sentences. Diversity is someone asking you to a party. Inclusion is someone asking you to dance at a party.
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THE NUTS AND BOLTS OF VISION AND MISSION I cannot blame people for not know ing the difference between vision and mission statements, because the concept isn’t even taught well in business schools. So, with the intention of making your team more focused and effective, allow me to offer an easy way to remember how to create a BY DANIEL BOBINSKI
A few years ago, a Gallup survey found that only about half of employees know what’s truly expected of them. Most people just show up and follow the day’s “to-do” list, but when people know how their job fits into a bigger picture, they are more likely to be en gaged and more productive. Oh, and happier, too.
if you’re on a team, I challenge you to ask each team member the following question: “What would you say is our team’s purpose?”
EMOTIONAL INTELLIGENCE GETTING APOWERFULMOREWITHCOMMONMISSION INSIGHTS ADVANCING THE IMAGING PROFESSIONAL48 ICEMAGAZINE | SEPTEMBER 2022
It’s another way to ask what your team is trying to achieve. Take note of the answers you get. Chances are you will hear different responses, and perhaps you will hear the ever popular, “I don’t know.” Some people may even laugh.
Do you think anyone in that company could recite that mission statement? Do you think anyone could explain how their job helped the com pany achieve it? Do you think anyone cared?Ifyou answered, “no” to any of those questions you are not alone. It’s a direc tionless statement full of buzz words. In case you’re wondering, that company closed its doors six years ago. As in the example above, mission statements are often paragraphs-long, making them almost impossible to be recalled by anybody. Therefore, such statements are largely useless. This problem is compounded when vision and mission statements are intermixed, further clouding their practicality. In fact, if you’re still in the mode of asking questions of your team members, ask people to define the difference between vision and mission. Chances are you’ll get a wide range of responses.
Consider the following statement, which I found hanging on the wall of a company I visited about 10 years ago: “[XYZ Company] is committed to complying with the standards of its quality management system to provide total customer satisfaction through continual improvement of its products and processes. The objective of the quality manage ment system is to drive and review programs and initiatives to provide customers with quality products and superior value.”
If a question about your team’s purpose elicits shoulder shrugs or inconsistent answers, it’s almost always because of a missing or under-com municated vision and mission state ment. If a company or a team has a mission statement, a common problem it’s an overly vague generalization that could apply to almost any company.
In other words, if managers have several options for actions on the table, looking at them in light of the organization’s mission statement helps when choosing a course of action.
Notecustomerthatthe vision statement is not what the company will do but where they want to be. Furthermore, note that the mission statement outlines what the company will do. The differences are quite clear. Most of the time a company keeps its vision statement to itself, since where a company sees itself being is nobody else’s business. Besides, if the competition knew where you wanted to be, they could create a strategy to get in your way. The purpose of a vision statement is to guide top leadership in making strategic decisions.
• Research and integrate the latest, most reliable widget technology
It’s common for strife to exist in companies when no shared focus exists. When a company lacks a vision to which all subscribe, individual vision missions tend to rise up and com pete with each other. The result is conflict, delays, and lost revenues, all because of unnecessary turf wars consuming time and Creatingenergy.aclear corporate vision minimizes pet projects and helps point everyone in the same direction.
Vision: Widget Manufacturing will be recognized nation wide for producing the highest quality widgets.
• Daniel Bobinski, who has a doctorate in theology, is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach him by email at DanielBobinski@ protonmail.com or 208-375-7606.
Mission: Widget Manufacturing strives to:
Aligning a team’s efforts with an agreed-upon focus saves time and frustration, and it makes a company much more effective and productive.
First, remember that your vision and mission statements must be short and sweet, otherwise people can’t memorize them. Second, your mission statement should be posted on the company website and also published on company literature. It should also be posted throughout the workplace so people can see it, and be reminded to use it as a guideline for oper ations. Everyone from the top down should be able to recite your company’s mission statement from memory. Managers, supervisors and leaders should talk about the bullet points in the statement in casual conversation. If top management eats, drinks and breathes the mission statement, everyone else will too. If management ignores your mission statement, so will everyone else.
The key to successful and useful statements is to keep them short, specific and memorable. Here’s a simple example:
Does a company need a vision and mission statement to function? Obviously not. The mere fact that many companies survive without them answers that question. So, what is the benefit of having them? Simply stated, the answer is focus and flow, plus a founda tion for decisions. In other words, thriving instead of surviving.
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• Mission statement: What you do to get there
HOW TO PROMOTE YOUR MISSION STATEMENT
THE CONSEQUENCES OF NO SHARED VISION
• Use the most reliable widget manufacturing process, and
On the other hand, a mission statement clarifies what your company does. If you want your company or team to remain focused, people need to know what they’re supposed to do, both internally and externally. Internally, a mission statement keeps employees focused, because what’s listed in the mis sion statement forms a basis for making tactical decisions.
• Vision statement: Where you see your organization being; or you want to go
Whatever a team does should be guided by the mission to move the company in the direction of the vision. Externally, publishing your mission statement tells your clients what they can expect from you. Knowing that provides customers a sense of stability and security, and they can be more comfortable doing business with you. That leads to longevity and profitability.
clearly understood vision and mission statement.
• Provide unparalleled customer service to every widget
Think of the last time that you were in a restaurant and had a loud, boisterous and annoying individual near you. Did it not hinder your enjoyment of the meal and your companions? Were you “That Guy?”
uring a recent trip to visit friends in Wisconsin, Ruth and I encountered the normal hassles of getting to the airport, parking, dragging suitcases, checking luggage and the long walk that accompanies all these. Finally, arriving at the gate brought some relief, or so we thought. The gate area was very crowded since apparently people are conducting what is called “revenge travel.” People are making up for vacations lost during the lockdowns and are traveling in droves. People may be making up for lost vacations, and leav ing the lockdowns behind, but they are not leaving their rudeness behind. We were feeling the anxiety of finding a place for us to sit to wait for the boarding time. So many people place their backside in one chair and their back pack in the seats next to them. They totally ignore that many people are standing because of the many seats holding luggage and other items. Many elderly people were standing while many young occupied two or more seats with their stuff. I was especially surprised that a flight attendant had her luggage in one seat and her lunch in another.Aswesurveyed the room we found two seats nearly empty. Their only occupants were a charging cell phone in each. I asked the nearest human if the seats could be released. A person in the opposite isle said they would move their phones and one even offered to move to another seat so we old people could sit. There is hope for the young after all. The flight was, of course, delayed and we were re lieved that we had seats for the next 45 minutes. Other old people were not so lucky as they searched for two adjacent seats. I wondered if people are just uncaring of others. Maybe they are just not very aware of their surroundings. Maybe they are just plain rude. The benefit of the doubt causes me to believe that the circumstances surrounding travel ers may heavily influence this behavior. We are in very close proximity to complete strangers. We have in our possession items which are valuable to us – luggage, computers, purses, etc. We must protect them. The safest place would be on the seat right next to us. We also want to keep the isle clear. We also are influenced by the consistency trigger when we see others acting the same way. Those who are standing must want to be standing or they would ask for the seat. Who would want to sit so close to a stranger who may be contagious or a talker. Ruth is a magnet for talkers.
D
DON’T BE THAT GUY
MANNY ROMAN THE ROMAN REVIEW INSIGHTS ADVANCING THE IMAGING PROFESSIONAL50 ICEMAGAZINE | SEPTEMBER 2022
Whoever sits next to her takes one look and immediate ly begins to divulge their family secrets. Sometimes the pictures are brought out. It is uncanny to watch and listen. I stopped asking what happened to cause this. She does notSo,know.why am I boring you with this stuff? I am asking that we all be constantly aware of our surroundings. Pay attention to how your actions or inactions may affect others – especially in crowded situations such as airports, restaurants, etc. I know that some of you will say that we are not responsible for the comfort of others, especially strangers.People can be passively annoying as in the case of a seat snatcher. Active annoyance is even more disturbing.
What about the diners who are finished, yet retain possession of the table for quite a while even knowing that there are many others waiting for their turn? The staff provides many hints that they should leave – clearing the plates, bringing the check, asking if there is anything else needed, hostile looks, etc. Yet they remain thus keeping others hungry and depriving the wait staff of possible tips. I know that in the end, everyone is in it mostly for them selves. I am asking that you attempt to not be “That Guy.” •
Manny Roman, CRES, is association business operations man ager at Association of Medical Service Providers.
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