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CONTENTS

P.12 SPOTLIGHT

p.12 Professional of the Month: Jesse A. Glasco, CBET

p.14 Department of the Month: The TRIMEDX Vanderbilt Clinical Engineering Department

p.17 Next Gen: Connor Walsh

p.18 Shifting Gears: Maulapalooza

P.22 INDUSTRY UPDATES

p.22 News & Notes

p.28 Company Showcase: Datrend

p.32 Welcome to TechNation

p.34 AAMI Update

p.36 Ribbon Cutting: Isikel CET

p.38 ECRI Update

P.42 THE BENCH p.42 Biomed 101

p.45 Tools of the Trade p.47 Webinar Wednesday

50

60 FEATURE ARTICLES

p.50 Roundtable - Employment

p.54 Corporate Profile: Tri-Imaging Solutions

p.60 Cover Story - Right to Repair: What is New & What You Can Do

P.67 EXPERT ADVICE

p.67 Career Center

p.68 [Sponsored Content] Maintenance to a TEE

p.70 The Future

p.72 [Sponsored Content] What Is The Cost of Good Enough?

p.76 [Sponsored Content] Efficient Ventilator Service and Repair with Renew Biomedical

P.80 CONNECTED

p.80 Cybersecurity

p.82 HIMSS23

p.84 HEALTH-ISAC

PUBLISHER John M. Krieg

VICE PRESIDENT Kristin Leavoy

VICE PRESIDENT Jayme McKelvey OF SALES

ACCOUNT Megan Cabot

EXECUTIVES

ART DEPARTMENT

Emily Hise

Karlee Gower

Taylor Hayes

Kameryn Johnson

EDITORIAL

CONTRIBUTORS

John Wallace

Roger Bowles

K. Richard Douglas

Jim Fedele

Joie Marhefka

Manny Roman

Connor Walsh

David Witt

Steven J. Yelton

DIGITAL SERVICES Cindy Galindo

Kennedy Krieg

EVENTS Kristin Leavoy

WEBINARS

HTMJOBS.COM

ACCOUNTING

CIRCULATION

Linda Hasluem

Kristen Register

Sydney Krieg

Diane Costea

Joanna Manjarrez

EDITORIAL BOARD

Rob Bundick, Director HTM & Biomedical Engineering, ProHealth Care

Carol Davis-Smith, CCE, FACCE, AAMIF, Owner/ President of Carol Davis-Smith & Associates, LLC

Jim Fedele, CBET, Senior Director of Clinical Engineering, UPMC

Bryant Hawkins Sr., Site Manager, Children’s Hospital of New Orleans

Benjamin Scoggin, MBA, MMCi, Director, Clinical Engineering | Biomedical Operations, Equipment Distribution, Clinical IT, DHTS, Duke Health Technology Solutions

Allison Woollford, Biomedical Equipment Specialist at Duke University Health System

PROFESSIONAL OF THE MONTH Jesse A. Glasco, CBET

Keeping Patients Safe

BY K. RICHARD DOUGLAS

n introduction to electronics in the military is often the catalyst for a career in biomed. It provides a useful skill set that many HTM professionals can depend on as a foundation.

That was the case for one experienced biomed in Texas.

“I’ve always enjoyed keeping up with electronics and the advancement of technology growing up. It all started when I joined the Illinois Army National Guard in 2007 – discharged as an E5 in 2013 – as a Multichannel Transmission Systems Operator-Maintainer. I was always working on radios, satellite terminals and setting up encryptions for said radios so I always had a niche for troubleshooting and problem solving,” says Jesse A. Glasco, CBET, senior biomedical equipment technician in the healthcare technology management department at Baylor Scott & White Medical Center in Waxahachie, Texas.

He says that during this time, he was going to college and trying to decide his career path.

“I wanted something that made me feel like I was making a difference, something that made me feel accomplished and made me proud of what I do at the end of the day. I spent a year studying electronic engineering technology, but then heard from my best friend about the biomed classes he was taking,” Glasco says.

He reasoned that there is always a need for health

care professionals and researched biomed and decided it was the right career path.

“I graduated from Southern Illinois University in 2015 with a bachelor’s of electronics systems technology and with a full-time job in HTM,” Glasco says.

Glasco says that he studied electronics management research, troubleshooting and maintenance, solid state electronics, LAN/WAN networking physics and many other electronics application studies.

“Near the end of my studies, I attended an internship program with a local regional hospital where I was hired before my internship was even finished,” he says.

After his National Guard service, Glasco was a BMET I at Heartland Regional Medical Center in Southern Illinois in a shop with just two techs.

“Within my first year after getting my bachelors, I continued studies toward my CBET and passed it my first attempt in 2015. This led me to obtaining an advancement to BMET II at the same hospital. After five years of working there, I was offered the biggest opportunity to date of moving 650 miles to become a senior BMET with Baylor Scott and White in Texas, where I’ve been since April 2021,” Glasco says.

On the job, Glasco deals with everything from nurse call, IV pumps, ESUs, vents, bipaps, patient monitoring, telemetry, defibrillators and OR tables, although his primary focus is on patient safety. He continues to receive specialty training on devices at his facility.

“I have attended training on the Puritan Bennett 840 ventilator and I’m currently scheduled to attend the training for the Baxter PrisMax CRRT machine at the end of February 2023,” he says.

PATIENT SAFETY FOCUS

A keen eye and resourceful thinking are often helpful attributes for those working in the health care field. Glasco saw an opportunity to improve patient safety at his facility and took steps to initiate an improvement.

“Upon coming here to my current facility, I took on a portion of responsibility for HTM’s Environment of Care role. I attend EOC rounding every month and attend the quarterly meetings. While becoming familiar with my facility, I noticed that the lavatory pull station cords were a white color. These cords were the same color as the grout in the tiling for the walls and it caused the cords to blend in,” Glasco says.

He tallied up the number of pull cords in the facility and their lengths to order spools of red pull cord.

“I decided to make it my facility’s performance improvement for the year as patient safety is our number-one priority in HTM. We are currently changing hundreds of pull cords throughout the facility to better protect our patients,” Glasco says.

He has also started mentoring the next generation of HTM through his employer’s partnership with Texas State Technical College.

“I’ve always loved teaching others, and this partnership has been a blessing for me as, again, it gives me a sense of accomplishment and belonging. Due to the continually changing advancements and integrations of medical equipment, it is important to show these new members of our HTM field that our duties go further than just repairing and checking equipment,” Glasco says.

Away from work, Glasco enjoys video gaming, and in particular, Star Wars/Lord of the Rings, and likes to listen to Audible books on his commutes instead of the radio.

As for family, he says he has “a beautiful wife of almost nine years and two wonderful kids.”

Glasco characterizes himself as just a small-town guy from Southern Illinois who strives to continue learning and advancing with the world around him.

“I never settle for anything less than perfect in anything that I do. My first boss’s biomed ethos has always stuck with me; ‘If I’m not comfortable with using the device on my family, then it isn’t good enough to put back in to service.’”

With that focus on patient safety, Glasco is the kind of HTM professional you want around.

BIOMETRICS

FAVORITE BOOK:

Star Wars Thrawn Trilogy

FAVORITE MOVIE:

“Lord of the Rings: Return of the King”

HIDDEN TALENT:

If you were to ask my kids; I’m magic.

FAVORITE FOOD:

Pad Kee Mao from Thai D in Marion, Illinois. It is a special place: the owner has a cameo in the movie “Thirteen Lives” as he was one of the people that traveled to Thailand to aide in the rescue efforts. Not important to my interview but I like to brag on the place since it’s from my home.

WHAT’S ON MY BENCH?

I must have my Black Rifle Coffee, my Yoda bobblehead perched on my monitor, pictures of my family, my Fluke QA-ESIII, and my Sharpie ink pens.

FAVORITE PART OF BEING A BIOMED?

“Being the reason that our medical professionals have working equipment at their disposal to save lives in our community. Being the face that when you show up people say ‘We’re so glad that you are here.’ when things just aren’t going right for others.”

SPOTLIGHT

DEPARTMENT OF THE MONTH

The TRIMEDX Vanderbilt Clinical Engineering Department

BY K. RICHARD DOUGLAS

Tennessee is often best known for being the location of Nashville; the home of country music and the Grand Ole Opry. It is also known for Elvis Presley’s Graceland in Memphis.

The state has much more to offer, including beautiful landscapes and state parks, the Great Smoky Mountains and good barbeque.

One of the health care providers in the state has a national reputation for its children’s hospital, cancer center and diabetes center. Vanderbilt University Medical Center is based in Nashville and has a focus on research and teaching, in addition to patient care. The health system is the largest non-government employer in Middle Tennessee. It serves more than 3 million patients annually.

Handling medical equipment management for this respected institution is the TRIMEDX Vanderbilt Clinical Engineering Department.

The team includes Site Director Mark Speckmann; Senior Site Manager of Imaging Larry Cunningham; Senior Site Manager of Biomed Derrick Cole; Biomed Supervisor Deb McGraw; Biomed Supervisor Rick Clark; CEIT Supervisor James Bryan; nine imaging engineers, three CEIT specialists and 22 biomeds.

Clinical engineering oversees an inventory of 43,000 pieces of equipment at two main hospitals, consisting of 1,400 adult beds and 400 children’s beds, 370 offsite clinics, including three large

surgery centers and two large clinics.

“We provide a full-service clinical engineering shop and also are asked to support Vanderbilt in numerous capacities,” Cole says.

Those capacities include a trained in-house staff, contract management, CE/IT support, project management and capital requests.

The department manages all equipment contracts and works in conjunction with TRIMEDX corporate to determine if a contract is more beneficial than T and M.

The team integrates clinical engineering and IT internally with its specialists.

“We have a dedicated team that’s responsible for managing all the CE/IT integrations within all our facilities. Those include accounting for all network configurations, software patches and server upgrades,” Cole says.

ADDRESSING PROJECTS AND TROUBLESHOOTING

With such a large health system, the probability that special projects will arise is increased proportionately. The CE team is poised to handle these projects.

“We are oftentimes asked to participate in special projects and those vary in all areas,” Cole says.

He says that working with Philips to perform house-wide software updates on all monitors is one example.

“This required working with Philips’ project managers to determine an implementation schedule for both hospitals. Coordinating with hospital leadership to approve the implantation schedules and sending those notification out to department leaders. Accommodating a large Philips’ team to assist with the work and providing them the proper

credentials,” Cole adds.

He says that the project also required identifying a specific number of loaner monitors to keep and new revisions, that would allow for replacements if one failed.

He adds that participating in weekly communications to review completion status and escalating equipment failures was also a part of the project.

The team has also been involved in deinstalling and re-installing equipment during renovation projects.

“During the high COVID-19 periods, we were often asked to help convert patient areas to accommodate an influx of patients. Sometimes those included the adding or removal of patient monitors and updating the profiles to match the patient populations,” Cole says.

He says that this involved reprograming servers to increase the patient visibility to the appropriate monitoring rooms, checking and tracking rental equipment for proposed areas and returning areas back to their previous configurations once patient volumes decreased.

“Collecting hardware and software data from all equipment and working with Health IT to address unsupported equipment. Our entire team is required to enter the appropriate CDI information on any new devices that enter our facilities,” Cole says.

He says that after transferring to the new database, they had to collect or confirm the CDI data on over 8,000 devices.

“That information includes network configurations, software revisions and operating systems,” Cole says.

He adds that the team meets monthly with Vanderbilt Health IT to help identify unsafe operating platforms and follow up with those vendors for solutions. They also are required to perform routine patches on servers and

address any virus-related issues.

In addition to these many projects, the CE team put on their problem-solving caps to troubleshoot a variety of problems.

“We have over 100 sterilizers and numerous cart washers in our facilities. Occasionally those experience electrical, plumbing and gas related failures, that are not directly an equipment failure. Our technicians would troubleshoot to determine the root cause and work with the facilities team to help repair utility failure,” Cole says.

He says that most sterilizer or washer failures are isolated issues and require in-depth troubleshooting to resolve.

“All these systems – along with imaging rooms – are fed by various hospital-supplied utilities and we are responsible for the systems up until those connections. We had issues when the high-pressure alarms sounded on a sterilizer and we had to determine if it was an internal or supply line failure. Of course, these get a lot of attention and our response and turnaround time is critical,” Cole says.

He explains that if the failure is deemed a supply issue, the department will coordinate with the appropriate facilities team to address it.

“After their repair is completed, we perform a full operational check to make sure the systems are functioning properly,” Cole adds.

The TRIMEDX Vanderbilt CE team brings their A-game to work every day to match the reputation of the health system they support.

The TRIMEDX Vanderbilt CE team brings their A-game to work every day to match the reputation of the health system they support.

The TRIMEDX Vanderbilt Clinical Engineering Department oversees an inventory of 43,000 pieces of equipment.

NEXT GEN POWERED BY YP AT MD

Connor Walsh

onnor Walsh, CISSP, CCNA, Network+, holds a Bachelor of Science in Biomedical Engineering from the University of Rhode Island. He is a biomedical engineer specializing in medical device cybersecurity at the VHA Office of Healthcare Technology Management, 10NA9.

TechNation recently learned more about this up-and-coming HTM professional.

Q: WHERE DID YOU GROW UP?

A: Cranston, Rhode Island

Q: WHERE DID YOU RECEIVE YOUR HTM TRAINING/ EDUCATION?

A: Began my HTM journey working as a technical career field (TCF) biomedical engineer at the Indianapolis VA medical center.

Q: HOW DID YOU FIRST DISCOVER HTM?

A: Through a Department of Veteran Affairs technical career field (TCF) flier.

Q: HOW DID YOU CHOOSE TO GET INTO THIS FIELD?

A: My grandfather was a World War II veteran and received most of his care through the VA – I wanted to give back to this organization.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?

A: The unique challenges of navigating where cybersecurity meets medical device integration.

Q: WHAT INTERESTS YOU THE MOST ABOUT HTM?

A: I enjoy working in a field with a wide range of co-workers and colleagues across the country that have similar roles in their respective facilities/organizations that can be engaged for guidance and second opinions.

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

A: Obtaining my CISSP was a big achievement for me, also elevating my role to the national VHA HTM program office is something I am proud of.

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

A: Continue down the path of cybersecurity certifications to help bridge the gap between traditional IT cybersecurity and healthcare cybersecurity.

FUN FACTS

FAVORITE HOBBY: Working out

FAVORITE SHOW OR MOVIE: “Anchorman”

FAVORITE MEAL: Cheeseburger Sliders

WHAT WOULD YOUR SUPERPOWER BE? To fly

1 THING ON YOUR BUCKET LIST: Skydiving

SOMETHING YOUR CO-WORKERS DON’T KNOW ABOUT YOU:

I have my Rhode Island real estate license and flip investment properties in my free time.

SHIFTING GEARS

BY K. RICHARD DOUGLAS

ome people don’t need an excuse to throw a party; they find an excuse. In other cases, a landmark birthday, whether it be a 16th, 21st, 50th or 100th, will demand extra attention and provide a good reason for extra celebration.

There is work that has to go into the party planning, purchasing of supplies and implementation of a good get-together. The effort can result in a memorable occasion.

One very special party that occurs annually is the Maullapalooza. The event, thrown every September, is the work of Steve Maull and his family. Maull is the owner of Maull Biomedical Training LLC.

The origins of the event go back to 2016 when it originated as a milestone birthday party.

“It’s true origin was in 2016 when my wife threw me my 50th birthday party. We had roughly 30-40 people over to the house for it and my wife went all out. Lots of decorations and she ordered a food truck; it was actually an old fire engine that someone converted into a mobile pizza oven; it was very cool. There was lots of booze and revelry, and at the end of the night, the party moved inside,” Maull remembers.

He says that the next summer was his daughter’s high school graduation, so they basically did the same thing, just on a slightly bigger scale.

“That was when we also purchased a large party tent with tables and chairs, because we invited more people — I’d say around 60-70 — and also rented a booze truck (like a food truck, but with booze). Again, everybody had a blast. It was our daughter Megan’s idea to make it an annual thing. She was going into

the music industry and got the idea to call it Maullapalooza, an ode to Lalapalooza, and we’ve been doing it bigger and bigger and bigger each year since. So, 2018 was the inaugural Maullapalooza. Originally, we had around 100 people attend that first year; Maullapalooza 2022 had over 150 people show up,” Maull says.

PRE-PLANNING AND GOOD JELL-O

Successful parties don’t just grow out of good intentions. There is a great deal of planning and coordination ahead of time. The planning for the Maullapalooza event is no exception.

“Throwing the party is on our mind’s kind of the whole year. What can we do next year that’s new or different? We’re always texting each other ideas we see that might be fun to do at the party, but the serious planning starts roughly four months before the party. A few years ago, we decided the first Saturday of September was the best day to have it for many reasons; summer vacations are over, as is the summer heat, it’s a holiday weekend but not the kind of holiday people travel for, so most everyone is home yet in a holiday mood,” Maul says.

He says that it is around May/June that he and his family start making real plans such as booking the food truck, booze truck, party tent, tables/chairs and anything else that they think of.

“The food and booze trucks are a staple each year; we always use the same ones. We also have a massive quantity of Jell-O shots each year; this past year we made 200. We have five or six different flavors of Jell-O shots and we mix it up a little each year; not the same ones every time. But we always run out of them. Each year we also have giant yard pong, beer pong, flip cup and whatever other drinking games our two college graduate kids and their friends come up with. We also have a 10-foot-

Maullapalooza

tall beach ball bouncing around the party. We’re never sure what to do with it, but we got one,” Maull says.

He says that the week of the party, friends and relatives come in from Florida, New York and Virginia to stay with the family and help get it ready.

“They help setup the party area with decorations, tables and chairs, getting all of the drinks and ice, party snacks, ice cream, popcorn maker, bubble blowing machine, smoke machine, moving yard furniture, setting up the DJ booth — I forgot to mention we have a DJ — and just 100 other little things you don’t even think of until the day of. Our son’s girlfriend is a high school art teacher, so she always does a great job writing the booze menu on the door of the booze truck, all colorful and artistic like. It always looks fantastic,” Maull says.

He says that the absolute best part of throwing Maullapalooza is the 8-10 hours of non-stop comradery.

“We literally have dozens and dozens and dozens of people that we don’t get to see very often; some of these folks we haven’t seen since last year’s party; you know how life is. And all of the attendees are experiencing the same thing; catching up with friends they haven’t seen in a while. So, catching up with all these folks is just never

ending all night. Everybody is in a great mood. It just has the atmosphere of a reunion of sorts. This is going to be a thing we do for the rest of our lives. I mean, how often do you get to just have a blow-out party with pretty much everybody you know and like? It’s not just a lot of fun, but it’s sort of spiritually uplifting. Everybody looks forward to it each year,” Maull says.

He says that ax throwing has been one of the most popular attractions at the event.

“We found a company that rents a mobile ax throwing cage; they bring it to you and man it for you during the party. We did it for the first time in 2021 and it was by far the most popular thing we’ve ever done at Maullapalooza,” Maull says.

His advice for anyone considering throwing a similar event may be surprising.

“Unless you’re willing to let a party you are about to throw consume your life for weeks before the event, don’t do it. It’s like planning a wedding once a year,” he says.

Whether you party like its 1999 or 2023, Steve Maull and family know a thing or two about getting a party right. The trick is getting on the invite list.

Have a safe, healthy and lucrative 2022 It's the Doctor's Orders...

Have a safe, healthy and lucrative 2022 It's the Doctor's Orders...

Day and Night - All Year Long

The Doctor is Here to Help

Medical Equipment Doctor is all settled into our new company-owned offices, warehouse, and service center in Tustin, California. We are here for all your medical equipment needs: Buying - Selling - Renting - Servicing - Connecting.

Medical Equipment Doctor is all settled into our new company-owned offices, warehouse, and service center in Tustin, California. We are here for all your medical equipment needs: Buying - Selling - Renting - Servicing - Connecting.

Medical Equipment Doctor is all settled into our new company-owned offices, warehouse, and service center in Tustin, California. We are here for all your medical equipment needs: Buying - Selling - Renting - Servicing - Connecting.

The Doctor is in... and ready to make this the best year ever.

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NEWS & NOTES Updates from the HTM Industry

INNOVATUS IMAGING ADDS TO COMMERCIAL TEAM

Innovatus Imaging recently announced Laci Yocum as a key addition to the Innovatus commercial team. A seasoned sales executive in the healthcare technology management (HTM) industry, Yocum will serve as director of national accounts.

In her new role, Yocum will be responsible for serving key strategic accounts that entrust their repair and maintenance of MRI coils and ultrasound probes to Innovatus Imaging. Yocum’s 20-plus years of experience spans organizations such as Legendary Supply Chain, Conquest Imaging, Bayer Healthcare and MEDRAD. She will be operating out of Innovatus Imaging’s headquarters in Pittsburgh, Pennsylvania.

“Laci brings years of industry expertise and a proven track record of maximizing results for her clients. An aggressive customer advocate, Laci works with facilities and organizations of all sizes to drive bottom-line results,” said Matt Tomory, vice president of sales and marketing.

“Innovatus Imaging is the ISO-13485:2016 certified preferred provider for best-in-class repair services for medical imaging products. Expertise spans the entire device life cycle – from design, development, and manufacturing, to sales, distribution, and repair. With a legacy spanning 35-plus years and having repaired more than 175,000 ultrasound probes and 40,000 MRI coils, Innovatus has accumulated tremendous amounts of data which serves as a massive knowledge base for continual improvement. The company operates an FDA-registered site for the design and manufacturing of ultrasound transducers and related products,” according to a news release.

Headquartered in Pittsburgh, Innovatus Imaging also maintains Centers of Excellence in Tulsa, Oklahoma and Denver, Colorado.

TENACORE ANNOUNCES LEADERSHIP PROMOTIONS

Tenacore LLC, an ISO-certified healthcare technology management company, has announced the promotion of senior leaders James Willett and Riley Van Hofwegen.

Willett, Tenacore’s CEO for the past three years, will become executive chairman of the board. Van Hofwegen will become president and will execute the company’s strategic growth plan.

“Riley’s 10 years of experience, valuable mix of skills, longstanding relationships across the industry and core expertise in clinical asset management will be instrumental in continuing to position Tenacore LLC as the undisputed industry leader,” Willett said.

Van Hofwegen most recently served as Tenacore’s chief commercial officer.

As executive chairman of the board, Willett will actively engage with Van Hofwegen and the leadership team to ensure continuity and continued focus on the strategic growth plan.

“It has been a tremendous honor to lead Tenacore since the acquisition of the business by The Courtney Group and Centerfield Capital Partners,” Willett said.

Under Willett’s leadership, Tenacore has redesigned its quality management system, expanded technician training and moved into a new facility incorporating a newly designed repair lab.

“The Tenacore Board of Directors are very appreciative of Jim’s leadership in the chief executive officer’s role. He has guided the company through a period of tremendous growth and positioned Tenacore LLC as a leader in the medical device repair industry,” said Tom Courtney, chairman and founder of The Courtney Group. “Tenacore LLC is positioned to build upon a solid foundation and combining the strengths of both Riley and Jim to lead the company to a new level of success.”

Riley VanHofwegen

Jim Willett

RADON MEDICAL IMAGING ACQUIRES PREMIER IMAGING MEDICAL SYSTEMS

Radon Medical Imaging (Radon), a medical imaging equipment maintenance and repair services company, has acquired Premier Imaging Medical Systems (Premier), a provider of maintenance services and sales for new, used and refurbished imaging and biomedical equipment.

A press release states that the acquisition reinforces Radon’s strategy to be an industry leader in the medical imaging market, strengthens its business by providing access to new solutions and technology and further expands its geographic footprint.

For more than 30 years, Premier has specialized in selling, servicing and repairing imaging equipment, including fluoroscopy, C-arm, X-ray and other modalities, and provides biomedical equipment engineering services. Premier has deep and proprietary expertise in dynamic flat panel fluoroscopy technology updates for GE Advantx, Legacy and Precision 500 analog fluoroscopy machines and has served numerous surgery centers,

‘BEARDED BIOMED’ AUTHORS CHILDREN’S BOOK

Healthcare technology management professional Chace Torres, aka The Bearded Biomed, recently announced his new “Ollie the Biomed” children’s book. It is a depiction of the profession known as biomedical equipment technician or “medical device doctor.”

In the book, Ollie experiences a workday repairing, calibrating and solving real-world problems found within the day-to-day job of a biomed. It illustrates the complex but rewarding career filled with many devices used in health care to treat patients. Biomeds are directly responsible for inspecting, repairing, calibrating and managing all aspects of every medical device found in hospitals.

“This is a profession struggling to build awareness as most of the workforce is set to retire within the next decade,” Torres said. “I wrote this book for my son to learn exactly what his dad does and why I love what I do each day. I hope to inspire kids across the world to seek out more information and become biomeds because it is truly rewarding and fun.”

hospitals and other third-party independent service organizations in the southeast region of the U.S.

“We’ve been partnering with Premier for more than 20 years and are thrilled to formalize our relationship and officially welcome them to the Radon family,” said Anthony Border, CEO at Radon. “Robin West has been a fantastic leader who has helped build Premier’s reputation for delivering high quality products, and his team of engineers are some of the best in the industry. We’re proud to have them on board for this next step on our journey.”

West, the CEO and owner of Premier, will join the Radon leadership team. He will continue to be a pivotal member of the team contributing to the overall strategy and direction of the company.

Radon assembles, sells, refurbishes, repairs and services medical imaging equipment across 10 different modalities, such as PET/CT, MRI and X-Ray equipment, among others. It serves hospitals, health systems and other health care providers across 13 states.

NEW U.S. APPOINTMENT FOR RIGEL MEDICAL

Electrical test and measurement company Seaward has announced a senior U.S. appointment as it continues to invest in resources and develop operations.

Gregory Jung has been appointed national business development manager at Rigel Medical in a move that sees continued expansion of the brand’s operations across North America. With a strong background in health care management, he will be working alongside the senior U.S. leadership team to develop new markets and commercial opportunities on the back of sector leading products, new launches and technical innovation.

With an office in Tampa, Florida, Seaward currently employs around 170 people and is a sector leading manufacturer of electronic test and measurement instruments used in a wide variety of electrical, medical, industrial and energy sector applications.

CEO Chris Callan said he will contribute significantly to increasing market share and supporting new product developments despite the challenging times.

“Our investment in talented people is the linchpin of providing top quality products and services to customers right across the world. We look forward to both continuing to grow their careers at Seaward and contributing significantly to our future success,” Callan said. “We are investing further in our growth strategy – developing our expertise and capability is a key part of this strategy. We offer exciting projects and technologies, and it has been fantastic to welcome new members of the team to strengthen our ability to introduce new products into our global markets.”

Seaward is part of Metrawatt’s GMC Instrumentation Group, a collaboration of separate specialist test equipment manufacturing businesses based in Germany, Switzerland and the USA.

PLUM 360 INFUSION SYSTEM RECEIVES BEST IN KLAS HONORS

ICU Medical Inc. has announced that its Plum 360 smart infusion system is the first to be recognized as the top-performing smart pump in both the EMR-Integrated and Traditional categories by KLAS Research, a leading global health care research firm. This is the sixth straight year the Plum 360 has been recognized as Best in KLAS and the first time any IV Smart Pump has been honored in both categories.

“The 2023 Best in KLAS report highlights the top-performing healthcare IT solutions as determined by extensive evaluations and conversations with thousands of health care providers,” said Adam Gale, president of KLAS Research. “These distinguished winners have demonstrated exceptional dedication to improving and innovating the industry, and their efforts are recognized through their inclusion in this report. Congratulations to all the winning vendors for setting the bar for excellence in healthcare IT. KLAS continues to be committed to creating transparency and helping providers make informed decisions through our accurate, honest and impartial reporting.”

The Plum 360’s Best in KLAS award as the top-performing Smart Pump EMR-Integrated underscores how closely aligned the Plum 360 is with the latest industry guidelines for interoperable infusion

systems, including those published by the Institute for Safe Medication Practices (ISMP), the Emergency Care Research Institute (ECRI) and those required to receive UL Cybersecurity Assurance Program (UL CAP) certification. And receiving the same award for stand-alone IV smart pumps reinforces the importance of the core differentiating features of the Plum 360.

“While nearly 180 clinical sites are utilizing the Plum 360 as an interoperable device, there are still very significant advantages when used without interoperability,” explained Dan Woolson, corporate vice president and general manager of ICU Medical Infusion Systems. “Features like secondary drug delivery, air-in-line management, and drug library compliance are important as stand-alone features. In an interoperable environment, they are amplified and further enhance safety by helping health care providers reduce medication errors, improve quality of care, streamline workflows and maximize revenue capture.”

Woolson added that Plum 360’s dual awards by KLAS as the #1 market-leading smart pump “helps to demonstrate the consistently high levels of service that ICU Medical provides to its customers – a commitment to service carries through to all the products we provide.”

HEALTH-ISAC UNVEILS NEW LOGO

The Health Information Sharing and Analysis Center (Health-ISAC), a non-profit, member-driven organization, has unveiled a new logo and branding scheme to reflect its commitment to ensuring the strength and perseverance of the health sector in the face of cyber and physical threats.

“Our newly refreshed brand dynamically highlights that through connection, we are better and stronger together,” said Denise Anderson, president and CEO, Health-ISAC. “We look forward to continuing to strengthen the ability of our members to ensure their organizations, the health sector and, ultimately, patients remain resilient against the multiple threats they face every single day.”

Health-ISAC plays an essential role in providing situational awareness around cyber and physical security threats empowering trusted relationships and timely intelligence sharing in the health care industry to prevent, detect and respond to cybersecurity and physical security events so that members can focus on improving health and saving lives. Health-ISAC strengthens operational resilience by connecting health care security professionals worldwide to share timely, actionable and relevant information in a trusted, collaborative environment. A nonprofit, private sector, member-led organization, Health-ISAC enables companies to proactively detect, mitigate and respond to cyber and physical security threats.

Health-ISAC is a force multiplier that enables health care organizations of all sizes to enhance situation awareness, develop effective mitigation strategies and proactively defend against threats every single day.

TECHNATION OPENS 40 UNDER 40 NOMINATIONS

TechNation is excited to announce that it is collecting applications for the annual 40 under 40 powered by YP at MD. Last year’s inaugural 40 under 40 class was filled with influential young professionals who have been honored for the great work they have done in the HTM industry. If you know an HTM professional who should be nominated for the 2023 40 under 40 class, please apply at 1technation.com/technation-40-under-40-2023/. The deadline to have all applications in house is Friday, April 28.

HTM WEEK CONTEST ANNOUNCED

TechNation celebrates healthcare technology management (HTM) professionals everywhere each and every day and especially during the upcoming HTM Week (May 14–20). TechNation joins health care facilities and organizations to promote awareness of – and appreciation for – the critical work of professionals who manage and maintain the vast assortment of health technology found in healthcare delivery organizations.

HTM professionals are encouraged to participate in the Rock Your Socks! contest for a chance to win a daily prize and an entry in the grand prize drawing! It’s easy to enter. Snap a photo of yourself wearing your most fun, craziest socks. It can be crew socks, dress socks, knee socks, fuzzy socks, any pair of socks. Then, visit 1technation.com/htm-week-contest to submit your entry.

Contest begins May 1st, and you can submit your entry anytime through May 18th. A daily $25 Amazon gift card will be awarded Monday through Friday of HTM Week. One lucky person will win the grand prize package that includes flight, hotel and admission to the MD Expo set for Orlando in late October!

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COMPANY SHOWCASE Datrend

Infusion pump testing used to be done with pipettes and a stopwatch. In the late 1980s, Datrend Systems developed and patented its first product, the Infutest 2000, to electronically test infusion pumps with better precision and improved efficiency. The same product, along with Oxitest (SpO2 simulator), were rebranded for DNI Nevada until their acquisition.

“While continuing to grow our own portfolio in biomedical test instrumentation, for a period of time Datrend also helped to develop other medical products such as laryngoscope, hypoglycemia alarm watch, noninvasive chiropractic treatment machine, diagnostic testing solutions (think viral testing), fitness sensors and more. These experiences helped us finetune our approach when creating our own products,” explains Datrend Systems Inc. Director of Business Development Owen Liu.

“Today, we are only committed to our product range and will continue to add and improve on solutions for biomedical engineering and testing,” he adds. TechNation recently interviewed Liu to find out more about Datrend and how it helps healthcare technology management (HTM) professionals throughout the United States and around the globe.

Q: WHAT ARE SOME ADVANTAGES THAT YOUR COMPANY HAS OVER THE COMPETITION?

Liu: Datrend’s quality management system is ISO 13485 certified, which is the standard used for medical device manufacturers. Although not required to produce test equipment, we felt it’s important for us to prescribe to a higher quality management system to meet different industry standards from different parts of the world.

Our leadership group and founders have extensive experience within the industry, one having a master’s degree in biomedical engineering and the other

having been a director of biomedical engineering for a number of years. These direct industry experiences really help us to empathize with customers’ challenges and find better solutions to make their job easier.

While we have grown over the years, we have still maintained our nimbleness to react to the market and requirements quickly. From making changes to our software in a matter of days to launching new products within a few months.

Q: WHAT ARE SOME CHALLENGES THAT YOUR COMPANY FACED LAST YEAR? HOW WERE YOU ABLE TO OVERCOME THEM?

Liu: The global supply chain and logistic network was without a doubt the biggest challenge we’ve had in the past few years. We are very fortunate that our customers understand the situation while we look for ways to reduce their lead times.

Q: CAN YOU EXPLAIN YOUR COMPANY’S CORE COMPETENCIES AND UNIQUE SELLING POINTS?

Liu: We have a solid group of engineers here at Datrend who can complement each other’s skill set to develop our products from scratch, from PCBs,

enclosures, firmware, software, GUI design, and all the way up to cloud and API integration.

Today, we are known for our multi-device automation and CMMS integration running on our Vision-Pad (vPad) platform, but we have been preaching the same message since our Infutest 2000. Almost all our products come with automation, and many are standard out of the box.

It has been almost 10 years since we came to market with our vPad (tablet-based) system and it has really helped us to take our user experience to the next level.

Q: CAN YOU DESCRIBE YOUR COMPANY’S FACILITY?

Liu: On one side, we look like Home Depot with our industrial shelving, then you’ll see a collection of all the tools we’ve added over the years such as lathe, milling machine, shears, pick and place machine, ovens. Then, you will encounter some of the more modern tools like laser cutters, ultrasound cleaners, 3D printers, and our two-story tall component management structure that stores a portion of our components and sub-assemblies.

Q: WHAT IS YOUR COMPANY’S MISSION STATEMENT, OR IF YOU DON’T HAVE A SPECIFIC ONE, WHAT IS MOST IMPORTANT TO YOU ABOUT THE WAY YOU DO BUSINESS?

Liu: Accuracy Matters … Making a great meal requires good ingredients, quality cookware and experience. Making an accurate instrument requires high-quality components, precise instrument, experience and math … a lot of math.

Q: WHAT PRODUCT OR SERVICE THAT YOUR COMPANY OFFERS ARE YOU MOST EXCITED ABOUT RIGHT NOW?

Liu: In the past, customers had to describe their issues over the phone. These days our vPad users can setup live-view sharing where we can look at the same screen as they are.

Of course, our customer still needs to provide permission for access each and every time, but this tool made our training, support and upgrade so much simpler compared to legacy systems.

Q: CAN YOU PLEASE SHARE SOME COMPANY SUCCESS STORIES WITH OUR READERS?

Liu: Just last week we were told in the 11th hour that a customer needed their products calibrated and received before the weekend so that he can use them on-site on Monday. We went through several avenues and found a method to ship and deliver his products on the same day. It took quite a bit of effort, but we were able to make that particular customer happy by minimizing the impact on his business.

Q: IS THERE ANYTHING ELSE YOU WANT READERS TO KNOW ABOUT YOUR COMPANY?

Liu: We have been learning from our customers for more than 30 years to be where we are today, and certainly we will continue to learn from them for the opportunity to solve their challenges through better automation and return on their investment.

Owen Liu Director of Business Development

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BIOVANTAGE ENGINEERING

Q: WHAT PRODUCT, SERVICE, OR SOLUTIONS DOES YOUR COMPANY PROVIDE TO THE INDUSTRY?

We provide maintenance and repairs on all Biomedical, Imaging and SPD equipment. We also offer full Biomedical programs to take the burden off our clients and keep them ready for Joint Commission.

Q: TELL US WHAT DIFFERENTIATES YOUR COMPANY FROM THE COMPETITION?

Our flexible contracts, pricing and response times are the best around. We also partner with medical equipment suppliers to get our clients the highest quality at the lowest price possible.

For more information, visit biovantagellc.com.

FRESENIUS KABI

Q: WHAT PRODUCT, SERVICE, OR SOLUTIONS DOES YOUR COMPANY PROVIDE TO THE INDUSTRY?

When I say the Ivenix Infusion System is a game-changer, that’s not an exaggeration. We specifically designed this system to address the usability and safety issues posed by legacy smart pumps. For instance, our system features an easyto-use touchscreen on the pump that’s both modern and familiar, “really smart” administration sets that virtually eliminate the chance for manual mistakes, infusion management software that makes managing the pump fleet as simple as possible, and the ability to seamlessly connect with the EMR, which takes ease and safety to a whole new level. And that’s just the tip of the iceberg.

Q: TELL US WHAT DIFFERENTIATES YOUR COMPANY FROM THE COMPETITION?

Fresenius Kabi is a global healthcare leader with a comprehensive portfolio of innovative infusion devices and intravenous fluids, and now it’s bringing the future of infusion to hospitals with the Ivenix Infusion System.

For more information, visit fresenius-kabi.com/us.

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AAMI UPDATE

FDA Recognizes First AI-Focused Document in List of Consensus Standards

At the turn of the new year, the U.S. Food and Drug Administration (FDA) recognized AAMI CR34971:2022, Guidance on the Application of ISO 14971 to Artificial Intelligence and Machine Learning, as a guidance document “appropriate for meeting requirements for medical devices under the Federal Food, Drug, and Cosmetic Act.” Additionally, 10 other new or updated AAMI documents were added to the federal regulator’s list of recognized consensus standards.

AAMI Senior Advisor for Industry Joe Lewelling noted that “not only is the FDA recognition a critical endorsement of what we hope will soon be an AAMI technical information report (TIR) and a British National Standard, it is also the first AI-focused document that the FDA has recognized.”

According to Lewelling, AAMI CR34971:2022 responds to an urgent, immediate need. Existing standards for regulated medical devices do not yet adequately address the potential risks of emerging AI and ML applications, which “could jeopardize patient health and safety, increase inequalities and inefficiencies, undermine trust in health care, and adversely impact the management of health care,” the CR states.

Seen as equally disruptive as it is promising, U.S. FDA experts are paying close attention to AI-driven medical devices. In early 2021, the FDA released its Artificial Intelligence/Machine Learning (AI/ ML)-Based Software as a Medical Device (SaMD)

Action Plan. The action plan describes a “multipronged approach to advance the agency’s oversight of AI/ML-based medical software.”

As part of the agency’s action plan, FDA liaisons participate in the standardization efforts of the AAMI AI Committee to address the risk management of AI-driven medical devices, including the development of AAMI CR34971:2022, which is the first AAMI CR to be recognized by the FDA.

A FIRST-OF-ITS-KIND DOCUMENT

AAMI CR34971 is a relatively new kind of guidance document from AAMI called a consensus report (CR). A CR is not subject to the same formal years-long process as a standard, and while similar in nature to a TIR, a CR is based on the collective knowledge and experience of a select group of stakeholders. These documents are developed to provide prompt, concise and practical guidance on narrowly focused topics of high importance, where limited data exists, where there is variation in practice or where there is confusion among stakeholders.

“The development of standards/TIRs can take a significant amount of time, and for quickly evolving topics [such as AI], we can’t wait,” said Pat Baird, co-chair of the AAMI AI committee and senior regulatory specialist at Philips. “A CR doesn’t have all of the details that a standard or TIR has, but it does offer good advice on the safety and efficacy of medical devices.”

Baird is part of the small task force of the AAMI AI committee that developed CR34971, which was reviewed by the full committee and by risk analysis experts at BSI. The committee then approved the consensus-driven report.

“For this CR, we have further reaching plans,” noted AAMI Principal Director of Standards Hae

Choe. “AAMI CR34971 will be the basis for a technical information report and then, possibly, AAMI will propose it as an international document. FDA recognition will definitely aid in this plan.”

The AAMI AI committee now hopes to publish its important next step, designated as TIR34971, within the first half of 2023.

PROMISING RECOGNITION FOR AAMI STANDARDS

Other standards newly recognized by the FDA include the new ANSI/AAMI ST98:2022, Cleaning validation of health care products—Requirements for development and validation of a cleaning process for medical devices and the AAMI/UL 2800 Series.

ANSI/AAMIST98 is a new standard which normalizes requirements for cleaning validation methods. It not only advances understanding of and conformance with cleaning best practices but has the potential to have an impact on the design and development of medical devices.

The document is “revolutionary in the sense that it is really the first document, globally … that gives requirements for device manufacturers as far as what they need to do to validate their cleaning [and ensure] their cleaning instructions actually produce a clean device,” said Ralph J. Basile, vice president of marketing and regulatory affairs for Healthmark Industries.

The ANSI/AAMI/UL 2800 series is the result of a years-long collaboration between AAMI and UL Standards & Engagement. FDA representative Shawn Forrest of the Digital Health Center of Excellence (DHCoE), Office of Strategic Partnerships and Technology Innovation (OST), and Sandy Weininger, a

senior electrical/biomedical engineer at the FDA and JC member, explained the importance of this work in a joint statement.

“Medical device interoperability is an essential objective to enable more efficient patient care, more robust science and improved insights into device performance across diverse populations,” they said.

“ANSI/AAMI/UL 2800-1 is a valuable resource to support stakeholders in developing and implementing safe and secure interoperable medical devices by providing a detailed framework to coordinate these processes.”

RIBBON CUTTING Isikel

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Isikel Clinical Equipment Technology (CET) is a new division to the already successful medical supply manufacturing company. This new division provides full clinical engineering services from T&M to full asset management.

Isikel CET General Manager Jason Martin recently shared more about the company.

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

A: We offer a full range of services, from asset management to customized programs, T&M, PMs and equipment moves!

Q: HOW DOES YOUR COMPANY’S STAND OUT IN THE MEDICAL EQUIPMENT FIELD?

A: Our team is comprised of experienced industry leaders.

From leading 100,000-plus asset management custom health care programs to our engineering team having decades of successful support experience at an expert level; Isikel is an experienced startup.

Q: DO YOU HAVE ANY GOALS YOU WOULD LIKE TO ACHIEVE IN THE NEAR FUTURE?

A: Establish our name in the market by providing unmatched expertise and superior customer service.

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

A: Isikel is a startup clinical engineering company and will partner to create the best program or support needed, tuned to the health care provider’s needs.

For more information, visit isikel.com.

ECRI UPDATE

Breaking Down the Barriers to Reporting Damaged Medical Devices

ach year, ECRI produces its Top 10 Health Technology Hazards report to help health care organizations direct their time and energy toward technology management activities that can have the greatest impact on patient safety. The No. 10 topic for 2023, “Underreporting Device-Related Issues May Risk Recurrence,” identifies some common barriers to reporting and offers recommendations to help eliminate, or at least lower, those barriers.

“Too often, when I’m out on the floor I find things that are broken, yet being used anyway.” That was the response from a long-time clinical engineer when asked about underappreciated patient safety concerns.

“Oh yeah, we see that problem all the time, but we figured out a workaround.” That’s how a clinician responded when asked about a device problem that ECRI discovered during its lab testing of the product.

Clinical engineers and biomeds are tasked with keeping patient care areas stocked with well-functioning medical devices. Clinicians are tasked with using the medical devices at their disposal to provide quality patient care. Each group depends on the other to do the job right. A breakdown in communication that leads, for example, to broken, malfunctioning, poorly manufactured, or poorly designed medical devices remaining in use creates the potential for patient harm.

Clearly, patient (and staff) safety is best served when faulty medical devices are reported through appropriate channels and removed from service. That doesn’t always happen, however, as the anecdotes above illustrate. For health technology managers, the question is: Why? And what can be done about it?

Following are some of the barriers to problem reporting that ECRI identified in its 2023 Top 10 Health Technology Hazards report, along with some recommendations to address them.

“I DON’T HAVE THE TIME.”

This may be the most common complaint that device users have about problem reporting. It also may be the most valid, and the most important to address. Clinicians frequently are busy with time-sensitive patient care tasks, and it can be difficult for them to interrupt what they’re doing, step away from patient care, and take the time to fill out the appropriate forms to report a problem.

The key to getting buy-in and participation from device users is to minimize the time and effort required to file a report. Facilities need a streamlined, easy-to-use and readily accessible method for staff to report device-related problems. “Reporting needs to be as easy as possible,” advises Mairead Smith, principal project engineer in ECRI’s Device Evaluation group. “Any extra steps in the process will interfere with clinicians performing their primary role of taking care of patients.”

Ideally, a reporting mechanism would include a report form that is easy to access, that offers prompts for key information, that has a minimal number of required fields, and that allows a free-text description of the problem. Also, the system should be structured so that frontline staff need to report an issue only once; that report should then be directed to other recipients as appropriate. For instance, reports should be distributed to clinical engineering and risk management staff who can respond appropriately.

“The more you can make event reporting a fast and easy part of normal workflow, the greater the likelihood of success,” notes Smith.

“I DIDN’T THINK A REPORT WAS NEEDED – NOBODY GOT HURT.”

When problems are reported as soon as they are noticed, they can often be remedied before patient care is affected. That’s the goal. So, remind device users that every report is important, even those describing problems that were identified before a device was used on a patient. The reporting of a “good catch” – an incident in which no harm occurred – can be every bit as useful as the reporting of an adverse incident.

There are also instances where staff may not realize that a

device issue could have contributed to an event. Users may assume that their own human error caused the problem, when in fact the design of a device may cause many people to make the same mistake. Teach staff how to recognize potential hazards – for example, by providing examples of what can go wrong in various tasks or with various devices – and advise staff to avoid making assumptions about a problem’s cause.

The bottom line here is to communicate to staff that every report can be an opportunity for clinical engineering departments or other investigators to identify and fix or replace damaged or malfunctioning devices. Every report provides an additional data point for health care organizations and risk managers to analyze. Every report helps paint the bigger picture of recurring or system-based problems that may be happening in the background. Using reported information, facilities can redesign systems to protect patients, visitors, and staff.

“I DON’T KNOW HOW TO REPORT A PROBLEM.”

Staff in each care area will need to be educated about using the organization’s event-reporting mechanism. Further, leadership should communicate the expectation that staff will report any incident in which a device did not function as expected. For their part, supervisors and staff should be encouraged to conduct open discussions (e.g., at staff huddles) to reinforce the process and share wins, good catches and lessons learned to prevent future incidents.

“WHAT’S THE POINT? NOTHING HAPPENS WITH THE REPORTS ANYWAY.”

Providing feedback to affected staff and other stakeholders can help combat this complaint. For example, thank reporters for their contribution and email them with status updates, as warranted.

“Also look for ways to promote the wins,” adds Smith. “When a report leads to meaningful improvements,

advertise that to your organization, and recognize reporters for their contributions.”

“I DON’T WANT TO GET IN TROUBLE.”

An organization’s leadership has the key role here. Staff may be reluctant to report an issue if they fear disciplinary action or other personal consequences, either for themselves or for a coworker. “If staff don’t feel safe reporting, they’re unlikely to do so,” cautions Smith. Leaders can alleviate those fears by promoting a culture of safety and learning that encourages staff to report product safety concerns without fear of reprisal. Consider reframing a report of a problem or issue as a “good catch” – an opportunity to identify a risk before it causes harm to a patient or staff member.

“SOMEBODY ELSE WILL DO IT.”

Maybe. But patient safety shouldn’t depend on “maybe.”

Everyone has a role to play in making health care safer. While a culture of safety starts from the top down, implementing that culture depends on contributions from everyone. Ensure that staff feel safe speaking up, help them understand the value in doing so, and look for ways to make reporting a valued and seamless part of their job functions.

TO LEARN MORE . . .

This article is adapted from ECRI’s Top 10 Health Technology Hazards for 2023. An Executive Brief version of that report is available for complimentary download at www.ecri.org/2023hazards. The full report, accessible to ECRI members, provides detailed steps that organizations can take to prevent adverse incidents. To learn more, contact ECRI at (610) 825-6000, ext. 5891, or by e-mail at clientservices@ecri.org.

For more information, visit ecri.org.

BIOMED 101

Are You Budgeting for Cybersecurity?

BY JOSEPH FISHEL

How do you budget for the unknown? Cybersecurity has so few knowns and many unknowns. It is a new category to budget. How do you identify what will affect the budget? What steps can you take to “be prepared.” If you don’t identify these expenses early, they can blow your budget for the year.

The first thing you should do is identify the knowns. Do you have any Internet of Things (IoT) implementations going in? Have you identified the installation costs as well as IT/IS staff support costs to assist in the implementation. What will the annual license fee be?

Is it going up? While these are affiliated with cybersecurity, they may fall under different budgeting categories. What other licenses for cyber tools or fees to IT/IS do you spend for certain support? These are items that have identifiable costs.

So, what about those things that are unseen? First, you need to identify what they could be and if they apply. Are you planning on an inventory of your equipment to add IT/

IS/Networking information to your database? You can’t run a cybersecurity program if you don’t know what assets you have and what type of information is on them, so you need this information. If you can, try to identify what the costs are. For instance, how much time will be utilized by in-house sources and what will that cost? What will be the cost to have someone come in and do the inventory? Depending on the size of the inventory it can be quite expensive so you don’t want to miss budgeting for it.

Another requirement may be the need to add a new field or fields to your database? If you are doing an inventory, you need to have somewhere you can collect the information as well as be able to data mine it.

Questions to ask yourself are, “Can you add these fields yourself or will it require expense to have them added to your CMMS?”

For existing inventory, do you plan to gather that information when a technician is in front of the device doing a PM or repair? There is a hidden cost in that the length of the PM or the repair increases thus driving up maintenance costs. This needs to be done and is probably the most efficient way of gathering the information. It will take a year to go through the entire PM schedule of inventory. Do you have a year to do this? Another option is to form a team to gather this information. All of these

options will cost money that is above and beyond the normal HTM budget.

How much time will be spent on patching? In the past, most equipment patching was left up to the manufacturer and often didn’t happen unless the devices were under contract, and it was part of the contract. Have you made an estimate of how much time will be needed to perform routine updates or patches?

When BlueKeep raised its head several years ago, we found that many of the devices hadn’t had the three service patches applied to them. We also found out that many of these service patches couldn’t be applied or they would break the device. Manufacturers had to create new software that would allow the three service patches to be applied to get to BlueKeep. Thousands of hours were spent patching up just to be able to apply the BlueKeep patch. Look back and see how much time you spent doing that and use it as an estimate. What cyber event will require this level of effort? It should be budgeted for.

What about new equipment coming in? The check-in times will increase as more information is gathered. Likewise, more and more equipment is being networked. This increases the time spent on it. To get a budgetary figure, look at the networked equipment that has come in over the past two years and take an average of the time.

Non-networked devices need to be budgeted for as well. They may also have a need for patching, and software upgrades, especially if they have the potential to be put on the network. They also can be corrupted if a corrupted thumb drive, tablet or computer is connected to them. This can be for servicing or by a patient trying to charge a device through a USB port.

One time eater, especially for management, is the creation and/or updating of the cybersecurity plan. This should be budgeted for whether it is addressed through a contractor, a dedicated employee or management. This is a very important piece and shouldn’t be overlooked as it sets the direction for you cyber program. Again, take a look at the time spent last year and add it into your budget.

These are just some of the things that should be considered and identified when creating a cyber budget.

Things like an IoT program subscription is an obvious expense, but what about updating an inventory to include cyber/network types of information? How much time will need to be added to the incoming inspection to gather information? Do you need to have additional data fields added or updated to your database? To gather data, will you hire for an inventory or add this gathering of information to PMs and service calls? How much time will be spent on patching, not only for normal patches but also for cyber-attacks as we saw with BlueKeep? These are just some of the things that need to be identified and calculated into your budget.

TOOLS OF THE TRADE

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Led by industry pioneer and veteran Bill Williams, the Houston, Texas based startup Isikel is set to produce high quality chemo-rated nitrile exam gloves. This will include glove lines that are latex free, medical grade, and offer multiple sizes. These gloves are perfect for use in all medical settings, as well as veterinary settings, laboratory, and more.

For more information, email support@isikel.com or visit isikel.com.

In the ever-evolving world of HTM, data overload is becoming an issue. As CMMS systems become more advanced and medical device discovery tools provide more data than we ever could have imagined, how we manage this data to add value to our organizations can appear to be an insurmountable problem. Smith from Nuvolo and Stock from Ordr explored what some leading organizations are doing to manage data overload and make the data work for them. More than 100 individuals registered for the webinar with 66 attending the live presentation. A recording of the webinar is available for ondemand viewing at WebinarWednesday.live. The recording includes an informative Q&A session with the presenters. Attendees provided feedback via a survey that included the question, “Was today’s presentation worth your time?”

• “It was a good presentation and provided some ideas. Integration of IOT discovery tools with CMMS is definitely a must.”

- Brian Lefler, Director Biomedical Services, First Health of the Carolinas

“Capital Equipment Planning in Challenging Financial Times”

us.sodexo.com

Sodexo Healthcare’s directors of capital planning Scott Skinner and Morgan Ayers-Comegys discussed methodologies and best practices to help healthcare technology management (HTM) departments make effective recommendations on capital equipment planning while navigating budgetary constraints. A wealth of useful knowledge was shared during a question-andanswer session. The presenters suggested some creative ways to approach leadership on this front. The presenters also stressed the value of the data and information biomeds can bring to the table. It was suggested that the HTM department find “stakeholders in the building” who need to know the information HTM can provide. HTM can talk with the supply chain decision makers, the finance department and radiology directors. They said it is important to share information about devices that HTM may not be able to service in the near future and other issues that will impact capital planning. Attendees provided feedback about the webinar in a survey that included the question, “What was your biggest single takeaway from today’s webinar?”

• “The multivariate approach to equipment placement planning ... and the flexibility of each hospital to adjust the percentages of the four categories.”

- Shannon Dingus, Indian Path Manager

Cynerio Security Evangelist Chad Holmes discussed how the role of biomedical engineers, clinical engineers and other HTM team members has expanded significantly over the past decade. Previously focused solely on device maintenance, they now find themselves in a world of IT tickets, growing security concerns and, in worst case scenarios, leading the patient safety response during a ransomware attack. As attacks have increased, so have the tools available to teams to understand the device footprint, locations, risks and security guidance available. Holmes was able to demonstrate common functionality used by BME teams from finding hidden devices to quickly patching and securing devices. Holmes shared additional insights during an informative questionand-answer session. The webinar was a hit with attendees providing positive feedback via a post-webinar survey. One of the questions asked was, “Was today’s presentation worth your time?”

• “Today’s presentation was very interesting to me. I am a first-year biomed student who has worked in health care for over 15 years, but I never really took into account the massive amount of equipment that needs to be maintained at my place of employment. Watching this presentation and seeing what I will be dealing with when I am employed as a biomed was really encouraging and makes me want to continue to put in the hard work in order to get my degree.”

- Jesse

Bauer, a student at MSCS.

“Defib

Maintenance: Completing Manufacturerbased PMs Faster Than Ever Before”

pronktech.com

Almost 500 individuals registered with 293 attending the live presentation. Pronk Technologies Regional Sales Director Julio Castro discussed important testing requirements for servicing defibrillators with emphasis in performing discharge (i.e. shock), pacer, electrical safety and performance tests required when servicing these critical devices. He explained how to maximize utilization of test equipment to ensure defibrillators are tested per the manufacturer’s requirements. Attendees also completed a post-webinar survey that included the question, “Why did you attend today’s webinar? “

• “I just got certified and want to be more involved in our field, know more about new equipment and new products to test the equipment. The webinar was very good and informative.”

- Elia Figueroa, BMET 3, Baptist Hospital of Miami.

“More Data More Problems – Data Reconciliation in the Modern HTM Environment”

“Real-Time Medical Device Visibility and Security in Action”

As the largest independent, technology-enabled clinical asset management company in the United States, TRIMEDX provides strategic planning and management of clinical assets to drive reduction in operational expenses, free up capital for new strategic initiatives and deliver improved safety and cyber protection. TRIMEDX was built by providers, for providers and leverages a history of expert clinical engineers to manage over $30 billion in clinical assets across thousands of locations.

BMET Apprentice

Please take a look at these opportunities to join RENOVO SOLUTIONS, the industry’s largest privately held HTM provider. We value knowledge, reliability, and integrity in our employees. If you are interested in being a part of a team that is committed to making a difference in the field of Healthcare Technology Management, we invite you to apply for one of our open positions. We are always looking for talented, passionate, hard-working people to join our team.

Biomedical Equipment Technician

United Infusion (formerly Willow Medical) is a leader in Infusion Pump sales, rental, and repair to medical professionals. We carry an extensive inventory of Infusion Pumps for sale and rental. Our company is a reliable source for the repair, preventive maintenance, and refurbishment of Infusion Pumps. We are honored to serve hospitals, nursing homes, home care, surgery centers, testing labs, veterinary, colleges, universities and emergency medical centers.

The InterMed Group is a technology management company fulfilling the needs of our customers for over 20 years. InterMed sells and services biomedical equipment for clients across the country and is growing quickly. As a result, InterMed is on the search for high-quality candidates to serve our many customers and contracts.

Agiliti is a nationwide company of passionate medical equipment management experts who believe every interaction has the power to change a life. We proudly serve within hospitals, healthcare facilities, and our 90+ local service centers to ensure quality medical equipment is in the right place at the right time for effective patient care. Make an impact in healthcare and grow your career with Team Agiliti!

InfuSystem is a growing healthcare service provider, specializing in medical devices and related products and services for patients in hospitals, clinics, ambulatory surgery centers, and other major service centers. We provide direct payer rentals, pump and consumable sales, and biomedical services and repair, serving all 50 states and Canada. Headquartered in Rochester Hills, Michigan, we have Centers of Excellence in Kansas, California, Massachusetts, and Ontario, Canada.

Associated Imaging Services has been offering nuclear medicine and ultrasound solutions to our customers since 1990. We specialize in the sales and service of new and refurbished nuclear medicine cameras and ultrasound systems throughout Kansas, Oklahoma, Texas, and the surrounding areas.

The focus at Medical Equipment Doctor is to partner with clients to keep their budget and costs in check through providing top-level pre-owned equipment sales, service and rental, for all of their medical equipment needs. This has this company being recognized nationally as the affordable solution to purchasing new. They are passionate about what they do and always keep the safety and comfort of the patients that use their equipment at the forefront of every step they take

Universal Medical Resources’ operating principles are based on practicing the core values of Collaboration with the nuclear medicine community; embracing Diversity of ideas, beliefs, and practices; commitment to Excellence in producing the highest quality outcomes; and recognizing our Ethical Community through actions guided by fairness, trust, honesty, and integrity.

ROUNDTABLE Employment

This month the roundtable article is focused on a hot topic – employment. TechNation asked experts about all things employment to help healthcare technology management (HTM) professionals prepare for their first or next job. Participating in the roundtable article on employment are Health Tech Talent Management LLC President/Owner Jenifer Brown; Stephens International Recruiting Inc. Vice President of Operations Tim Hopkins; Medasource Director of Clinical Technology and Cybersecurity Services Mike Mitsch; HTM Jobs duo Sydney Krieg and Kristen Register; and Agiliti Vice President of Clinical Engineering Service Solutions Meghan Schellhammer.

years in each position. Employers are hesitant to consider a candidate who “moves around a lot” even if they are at the management level.

HOPKINS: Most clients are looking for a resume that is concise and contains a stable job history. Style can vary from resume to resume, but it is important to use the same layout throughout the resume. Also, do not forget to add any training or certification to the resume. It is not uncommon for me to find out later from a candidate that they have completed a certification that is not listed on their resume.

HTM JOBS: It is important for candidates to match their credentials with those listed in a job description. Employers typically look at an applicant’s experience and qualifications right off the bat. They want to make sure that the candidate can perform the necessary tasks for the job. We also think it’s important to show off your personality in your resume. Including volunteer experience and extracurricular activities shows employers that you are a well-rounded candidate.

Q: WHAT DO EMPLOYERS FIND TO BE THE MOST IMPORTANT ELEMENTS OF A RESUME WHEN REVIEWING POTENTIAL CANDIDATES?

BROWN: Detailed work history to include the modalities of medical equipment serviced. As well as list any medical equipment training schools attended. Also, the length of time held in a position is closely reviewed preferably at least two

MITSCH: This is obviously subjective to the skill set in question; however, general elements of a desirable candidate’s background would highlight their ability to: 1) Adapt when required 2) Communicate effectively 3) Trustingly work independently. Employers want to see that a potential employee will be willing and able to take on variable

circumstances of a job which may not fall within the written job description. As well, a candidate being able to effectively and respectfully communicate with team members, management and third-party agents garners trust and reliability. Lastly, the ability to work independently relies heavily on the first two elements. Employees must seek to gain trust from their employers that they will be resourceful and mindful when working on their own.

SCHELLHAMMER: While specific equipment and system experience can be a differentiator for a candidate, the most important thing is that the resume conveys a willingness to learn, troubleshoot and look beyond the problem at hand. Medical equipment is now connected to the broader health care ecosystem, so genuinely solving a problem often requires thinking about more than the single piece of equipment in front of you. We value technicians who know how to collaborate with other departments and solve hidden issues that impact the turnaround time and time to repair. Most often, we find the best technicians are those who help implement more innovative equipment management practices that affect the broader flow of biomed equipment through a facility.

Q: WHAT ARE SOME TIPS FOR CREATING A SUCCESSION PLAN?

BROWN: For employers they need to have a defined career ladder established from a BMET I level all the way to a CE/ HTM manager. This should include detailed job descriptions for each level such as years of experience, specific modality skills needed and/or certifications.

HOPKINS: Communication and follow up within the organization. If you are a manager and have identified a successor, it is important to let them in on the plan. They may not be interested in taking the next step or lack the educational requirements for the position. Not all technicians want the extra responsibility of managing a team. If the candidate needs additional education or training, use internal resources to help fill the educational gaps.

HTM JOBS: A fatal hiring flaw is waiting until the need is immediate rather than creating a succession plan. Many employers reach out to HTMjobs.com with the same concern of, “I needed someone like yesterday!” Providing a path for employee development within the company prevents high turnover and longer time to fill. Being in communication with the human resources department and providing timelines and resources reduces a short turnaround to fill the position.

MITSCH: A good start would be to survey the skill sets your senior team members possess and create an incentivized action plan for mid-level resources to be trained on these skills. As we look to hire future generations of talent you may also consider the technical savviness they possess. With a

targeted recruitment approach, it is possible to create a succession plan which upskills green, or mid-level, resources in a timeframe much shorter than it may have been previously.

SCHELLHAMMER: This is crucial because we are dealing with a shortage of skilled workers (across all industries). An excellent first step is to build a good bench of technicians who are critical thinkers and show either an aptitude or an expressed interest in becoming a leader. Once these candidates are identified, it’s best to offer them opportunities to develop skill sets around understanding budgeting, staffing and analytics-driven approaches to optimizing cost and performance. It’s also essential to provide a clear path for biomed technicians to expand their skills, progress through BMET roles and potentially imaging roles as well. By outsourcing your low-end equipment, which accounts for up to 90% of medical equipment inventories and demands the majority of time, you can create more advancement and growth opportunities for your new talent.

Q: HOW IMPORTANT ARE CERTIFICATIONS?

BROWN: CBET and CHTM certifications still carry weight in the industry and can assist in obtaining that higher level of position and/or salary. Also, any additional IT certifications in networking and cybersecurity is a plus for a BMET. For CHTM candidates, additional certifications in project management (PMP) is a plus though higher education like an MBA degree carries even more weight.

HOPKINS: In most cases, lacking a certification is not a deal breaker, but it will put you ahead of the competition. Candidates that invest time and money in training are a step above the competition on paper. One client insisted on candidates possessing a CBET to qualify for a level II position, they passed on some very good candidates who didn’t have it.

HTM JOBS: Certifications are critical for HTM professionals, especially when looking to make a career change. Oftentimes, certifications play a role in employers deciding position titles, salary ranges, and key responsibilities for an HTM professional joining their organization. These accreditations show a professional’s level of commitment and dedication to advancing in their personal and professional growth.

MITSCH: There is no doubt certifications can be a good indicator of process and operations knowledge. However, in an industry of evolving smart technology, increased regulations, and broadened scope of operations, the CBET or similar type of certification may no longer be the benchmark. As industry scope continues to overlap more with IT and security, we might rather look at general education/training for biomed operations as a baseline

(certification or no) and emphasize more greatly certifications in IT, cybersecurity, clinical applications, etc.

SCHELLHAMMER: Certifications are important and highly encouraged. They can be a differentiator when multiple candidates are applying for a position. But candidly, we often place a higher value on experience and other attributes when reviewing candidates. As noted in earlier questions, the ability to take a holistic view, and the desire to learn and activate leadership skills are typically more important. They’re so important in fact, Agiliti offers a wide variety of opportunities for on-the-job-training and classroom career development for those interested in exploring biomed roles.

Q: HOW CAN A RECENT GRADUATE OBTAIN HANDS-ON EXPERIENCE?

BROWN: Hopefully, most biomed programs have “hands-on” lab training in their curriculums with an internship as part of their AAS degree. If not, I would suggest volunteering on your own at any nearby hospital or medical facility.

HOPKINS: I advise visiting your local hospital’s biomed shop with a resume in hand to give to the management team. It’s a great conversation starter, part of that conversation can be your willingness to gain experience by volunteering. Biomeds are always willing to help one another and making one contact could lead to an opportunity that you were not aware of.

HTM JOBS: Internships and externships are always a great way to gain hands-on experience. So many employers take students or entry-level biomeds under their wing to train them and set them up for success later in their career. Many also extend full-time positions to their interns when their internships are completed.

MITSCH: A graduate with no experience will be best suited to find an employer which will first and foremost grant them access to devices. This may be via contract, internship, apprenticeship program, etc. There are many companies out there, Medasource being one, which have opportunities for green candidates to take their first steps into the industry. Realize the opportunity for growth in any opportunity which puts you in the environment you want to work.

SCHELLHAMMER: For students who are still in school, developing technician skills in a general office or manufacturing setting is beneficial and can provide relevant hands-on training opportunities. Internships are available in health care and hospital settings, which allows recent graduates to explore potential career paths, learn about different technologies and equipment types. It’s also important to develop a natural curiosity about technology and connected ecosystems.

Q: HOW HAS COVID-19 IMPACTED EMPLOYERS’ PREFERENCES AND EXPECTATIONS?

BROWN: In today’s market, almost all employers – such as health systems – require employees to be COVID vaccinated. Even most third-party service organizations also require this because their clients are the health systems or affiliates. However, some do offer a “religious exemption” but do require proof of that.

HOPKINS: COVID added another challenge to the industry that is already struggling for talent. Mandatory vaccines have pushed many experienced engineers out of the field. In some cases, religious or medical exemptions are accepted by the organizations, but this is not a guarantee.

HTM JOBS: COVID-19 has left so many organizations in our industry incredibly understaffed. Current employees are overwhelmed with the workload and many biomeds have had to take on responsibilities below their paygrade. This has caused employers to become more lenient with their hiring criteria and bring on more entry-level candidates for the job. They often provide onsite training for specific modalities in order to get their employees up to the skill level they need for the job.

MITSCH: COVID-19 pushed the limits of many industries; none more than health care. I look back at the support teams we deployed at many field stations in highly impacted areas. Some ops running with an inexperienced staff and looking to any avenue of support they could find; the pandemic has since shaped the expectations of employers to look for candidates willing to “do what needs to be done.” This may mean they work longer hours, learn new skills, train new employees, etc.

Mike Mitsch Medasource

Tim Hopkins Stephens International Recruiting Inc.

Meghan Schellhammer Agiliti

Kristen Register HTM Jobs

Sydney Krieg HTM Jobs

Jenifer Brown Health Tech Talent Management LLC

SCHELLHAMMER: Since the onset of the pandemic, health care providers have experienced sharp increases in stress and burnout. This macro-trend, which was exasperated by the pandemic, coupled with a tightening labor force, has led many employers to change their recruitment and employment practices. In some of the best-run organizations, this includes eliminating time spent on non-value add activities, providing more career path opportunities and intentionally training technicians on more complex high-end technologies to expand their skill sets. Organizations that did not change and remained focused on the same old management and training practices are losing talent and struggling with both quality and productivity.

Q: WHAT IS THE BEST WAY TO PREPARE FOR THE LARGE PERCENTAGE OF BIOMEDS RETIRING FROM THE INDUSTRY?

BROWN: Having a succession plan in place with the career ladder established like I mentioned above, can offset the vacancies of positions. Also being open to hiring entry-level BMETs from the biomed programs and continue to move everyone up the ladder. This plan should also incorporate a strong internal mentorship program.

HOPKINS: Start recruiting early and stay engaged with candidates. It is not uncommon for candidates to have multiple offers during their job search. I would also advise gathering compensation surveys to justify additional compensation for current employees as well as staying competitive in the market.

HTM JOBS: As we know, 50% of the HTM field is over the age of 50 and nearing retirement. With this large wave of retirees, it is important to bring awareness of the HTM profession to the next generation of talent. Connecting with colleges, tech schools and military personnel is crucial to replenish the aging workforce. Upper-level technicians have the opportunity to mentor and pass along valuable knowledge to the next generation to sustain their departments and the HTM field as a whole.

MITSCH: I refer back to the questions regarding elements of a resume and succession planning. Take a survey of your senior biomeds’ skill sets and prepare to train and promote at the mid-level, hire and train at the entry level. Expand your skill set range of applicable candidates you would hire and consider various avenues for upskilling which may not be your traditional path. Look to your vendor partners for interim support or long-term hiring solutions. Be non-traditional in your approach.

SCHELLHAMMER: We see some of the leading in-house clinical engineering programs rethinking the old employment models. One important change is considering vendors as an extension of your internal team. Identifying strong partners and finding quality service organizations that can work

alongside your in-house team is important – helping you meet the historic and emerging demands of a clinical engineering team. It’s also increasingly important to offer more entry level positions with clear career paths. This can make your organization a place where good workers want to stay and grow. Finally, it’s also a good idea to get technicians focused and working on high-value equipment and connect that work to the organization’s mission.

Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT EMPLOYMENT?

BROWN: When all the economic changes that occurred when COVID happened as well as the shortage of good technical talent, other industries started tapping into our industry’s talent pool. Industries like manufacturing, IT and even truck driving were hiring in droves with high salaries. However, don’t be tempted to leave our industry because many of them who did leave, now regret it due to no work/life balance or job enjoyment or satisfaction.

HOPKINS: The demand for HTM professionals is not going away anytime soon. Employers need to be patient and resourceful when finding qualified candidates. Those looking to make a change within the industry need to position themselves to standout by obtaining higher level degrees and certifications.

HTM JOBS: With employment changing so much over the past few years, candidates are in an optimal position to make a career change. Many companies now offer generous sign-on bonuses, relocation assistance and incredible benefits to potential hires. We have also seen employers place a higher value on company culture than maybe they did before this hiring shift. Most make a conscious effort to foster employees’ work/life balance and happiness which in turn creates employee longevity at the organization.

SCHELLHAMMER: This is an amazing time for job seekers and those interested in technical roles that fit into the connected future of health care. Health care technologies are advancing quickly and rapidly, improving patient outcomes and patient experiences. Smart, hardworking and technically skilled people are needed to deploy, manage and repair these connected technologies. As mentioned earlier, retirements are accelerating, and about 46% of the current workforce is 50 or older. Many younger workers want different things from their jobs than previous generations. They prioritize contributing to the common good and identifying clear career growth paths. They often value these things as much as or more than salary. If you can successfully connect technicians’ work to measurable improvement in patient care, you will likely experience better recruitment and retention rates. We’ve done this at Agiliti and regularly promote our core brand belief: “Every interaction has the power to change a life.”

CORPORATE PROFILE

Tri-Imaging Solutions

Tri-Imaging Solutions is a fresh, innovative and ambitious company. Tri-Imaging began operations in 2013. The fast start resulted in a stateof-the-art facility to accommodate the company’s exponential growth.

TechNation recently reached out to the leadership of Tri-Imaging Solutions, including President Eric Wright, Senior Vice President of Business Development Wanda Legate, Senior Vice President of Operational Excellence Rich Springer, Vice President of Operations John Drew and Vice President of Technical Operations Josh Raines, for a question-and-answer session.

Q: HOW DID THE COMPANY COME TO BE?

WRIGHT: It was a simple desire to do your own thing. I grew up in this industry and fell in love with the equipment and parts piece, mainly because it was constant change and learning. Josh Raines was the technical and support side of Tri-Imaging, which accelerated the growth of TIS.

DREW : In the first decade we have seen various stages of growth. First, we started as a GE CT

equipment and parts company. Second, TIS added additional OEMs and modalities, specifically Siemens and Toshiba CT, then X-ray. Third, we launched our training program in which we are very proud to have created an apprenticeship program which introduces new imaging engineers to the industry. Our latest additions being our Hologic mammography program and new Flex Service options.

Q: HOW HAS TRI-IMAGING GROWN AND ADAPTED TO REMAIN A LEADING PROVIDER IN SUCH A COMPETITIVE INDUSTRY?

WRIGHT: Tri-Imaging has the ability to adapt quickly and be flexible to meet customers’ needs. We are outside-of-the-box thinkers, and this really allows us to come up with strategic solutions both for TIS and our customers.

Q: TRI-IMAGING IS A TRAINING INSTITUTION AND A PARTS COMPANY. IT’S NOT A PARTS COMPANY THAT OFFERS TRAINING. CAN YOU EXPLAIN THAT TO OUR READERS?

WRIGHT: Tri-Imaging Solutions is a diagnostic imaging support company providing replacement parts, equipment, service support and technical training. It is no surprise that statistically a large percentage of the current service engineers are close to retirement and will be leaving a large gap in the seasoned skills available to help guide those

entering the profession. Our strategic approach grew from this, and John Drew has been diligently working on rolling out a completely new way to train.

DREW : Tri-Imaging’s commitment to the industry does not stop with parts, training, equipment and service. A few years ago we realized the industry was starving for new engineers, and we needed replacement engineers for those retiring. We created the apprentice program to bring new engineers to the industry. We have continued to change the narrative by putting 15-20 imaging engineers in the field every year. We expect to see significant growth in this opportunity this year. Our apprentice program is not only designed to help Tri-Imaging, but the industry as a whole. We have placed many of these engineers across the country in both small service companies and large independent service companies alike.

Q: WHAT SEPARATES TRI-IMAGING’S TRAINING FROM OTHER OFFERINGS?

RAINES : It’s all in the details. It’s a great career path that takes knowledge and drive. It’s important to grow your knowledge to be an asset. Quality training, with a rewarded certification, is where our focus lies. We want to ensure that our students leave with the proper knowledge and skills to use in the field. We work with the apprentices to determine which specific models they want to learn. This sets us apart.

We also allow for more interaction between the students and the instructor by ensuring small class sizes to empower them to be engaged.

DREW : We stress the importance of continuing education and top-notch training. It goes back to our focus of “Empowering the Engineer!” Providing quality imaging parts is just a portion of the value we want to offer, especially with all the health care changes and uncertainty. We understand the best way to cut costs is to run efficiently. How better to do that than with your own team? Whether it is an in-house hospital group or service company – we are able to provide support in areas to strengthen, grow and, most importantly, save them time and money. We have a very low student-to-instructor ratio, with a majority of time spent in bays – hands on. In the basic and advanced classes engineers have the opportunity to familiarize themselves with mutli-modality equipment, which means they work with X-ray, cath labs, mammo, portables, and CT. This is something that significantly increases their value to employers by giving them a wide range of skill sets. For the engineer, this gives them a powerful step forward in their imaging career.

The time it takes to complete our basic X-ray and advanced X-ray courses at our facility is four weeks. After looking at what is most important, it came down to time. With the classes varying in time, we found the balance that is cost effective and achieves the

INDUSTRY UPDATES

desired outcome. We are getting the engineer in the field faster and reducing travel time, travel expenses and engineers’ time away from facilities.

Q: AS THE INDUSTRY SHIFTS, HOW IS TRI-IMAGING OFFERING ENGINEERS A NEW TYPE OF SKILL SET?

DREW : Today’s engineers require different skill sets than engineers in the past. With technology in the industry changing, engineers are now required to understand new software, new platforms and not so much component level electronics. Interpersonal skills are more important than ever in these demanding workplaces. The new generation’s forward-thinking, creative minds, and innovative ideas are creating the future of our industry.

Q: THE COMPANY’S MISSION STATEMENT READS “IMPACTING LIVES BY CREATING INDIVIDUAL, CUSTOMER-CENTRIC EXPERIENCES BASED ON A SHARED CORE BELIEF IN BETTERING PATIENT CARE THROUGH PERSONAL ACCOUNTABILITY, INTEGRITY AND ADMIRATION.” WHAT DOES THAT MEAN TO YOU?

SPRINGER : It starts with the culture! This company was built on the premise of empowering the customer. By listening and looking intently at what the customer is asking, we work to create a strategic partnership and offer a unique solution. You get a sense for that in every interaction when you walk through the facility. Everyone is aligned and committed to the same goal.

Q: WHAT, IF ANY, CHALLENGES HAS TRI-IMAGING FACED?

LEGATE : In the beginning of the pandemic, the industry as a whole experienced challenges we had not seen, or at least in my 25-plus years, from our customers and suppliers. We were all adjusting to the ever-changing dynamic; employees working remote, supply chain delays and challenges getting engineers in and out of the facilities. We have seen improvements in a lot of these areas, but we still experience issues with supply chain and equipment delays.

DREW : Imaging service will continue to struggle as the lack of service engineers will be an issue for the foreseeable future. Our apprenticeship program was developed to help the industry meet this growing demand. Supply chain issues will continue through the end of 2023. We expect to see continued industry consolidation and the customer to seek innovative solutions to meet budget constraints and uptime requirements.

Q: WHAT’S NEXT FOR TRI-IMAGING?

WRIGHT: We have been developing an extensive software solution to incorporate all aspects of our business. We believe this IT solution will change the way the industry evaluates and addresses their current challenges.

LEGATE : Tri-Imaging Solutions will continue to strive to live up to its name and be a solution for its customers. Additionally, TIS will provide cutting edge technical training, replacement parts, equipment and service support as a way to continue “Empowering the Engineer!”

For more information, visit triimaging.com.

RIGHT to repair

what is new and what you can do

BY K. RICHARD DOUGLAS

Maytag once used commercials to brag in about how long their products lasted. Today, planned obsolescence has led many products to saturate landfills, instead of offering years of use to consumers.

Part of the problem that has led to this situation is the lack of repairability of so many of these items by consumers or local repair shops. Instructions, tools, easy access and replacement parts are all missing in action. This doesn’t seem to be a simple oversight, but a determined decision by the manufacturers.

Many products are just not created to be sustainable. Others are not built to be repairable. The profitability of a company may best be increased or maintained if its products need to be replaced regularly.

The debate has waged for several years now over right to repair within the medical device servicing community. Manufacturers claim that it is a patient safety issue. HTM professionals point out that they are also focused on patient safety, and can repair or service the equipment confidently and safely. There is no argument that anyone is ignoring patient safety. The FDA has already determined that there is not quantitative proof that non-OEM service providers compromise the quality of devices in a way that results in measurable harm.

The manufacturers are entitled to earn revenues and also have rights to intellectual property. To what extent those rights are protected versus providing outside service providers with information needed to service devices is up for discussion. The problem is that there is no discussion going on because there are opposing views and the arbitrators for now are state legislatures and the U.S. Congress.

It appears, to some degree, that some OEMs are getting the message; at least one. The new Apple iPhone 14 is said, by tech insiders, to be substantially easier to repair than previous generations. It appears that Apple has done this purposefully.

Both the screen, and the back panel of the phone, are much

easier for a third-party repair shop to achieve. The iPhone has traditionally been a difficult phone to repair because of the need for proprietary tools and the arrangement and construction of internals.

Yet, it is not all wine and roses. Apple has incorporated software that prevents the replacement of components with after-market parts. The changes the company did make came out of pressure from the government and the company’s own customers and investors.

According to The Repair Association (Repair.org), as of January 2023, there were right to repair bills, or public filings, in 16 states, including Vermont, Colorado, Connecticut, Missouri, Montana, Oklahoma, New Hampshire, Texas, Washington, Delaware, Florida, New Jersey, Tennessee, Hawaii, Massachusetts and Oregon.

There are already bills that passed in Colorado and New York.

An investigation by the Public Interest Research Group (PIRG), Repair.org and iFixit of 50 appliance makers found that 86 percent did not supply full repair instructions. It is evidence such as that which mandates more effort in this campaign.

Wesley Reid, CHTM/CRES/CBET, director of Technology Management/ENTECH at Banner Health; Kevin O’Reilly, right to repair campaign director for PIRG and Kelly Starman, chief marketing officer at PartsSource, co-presented a TechNation Webinar Wednesday session last year titled: “Reclaiming Our Right to Repair: Understanding Challenges and Taking Back Control.”

The webinar looked at the current state of right to repair as it impacts the HTM profession and suggested ways for biomeds to address the issue.

WHO HOLDS THE POWER?

While the right to repair movement has pitted consumers and public-interest groups against manufacturers, it has also caused tension between the HTM community and OEMs.

“There is a shortage of repair technicians in the health care industry and the main concern for our customers is around how right to repair will impact their ability to repair devices in a timely manner to maintain uptime and positive patient outcomes. Not all OEMs contribute to the right to repair challenges, which we

emphasize as partners with both providers and OEMs to improve the availability, quality and affordability of patient care,” Starman says.

She says that one of her firm’s most passionate customer HTM leaders explains this situation as a continuum.

“At one end are manufacturers that collaborate with providers and willingly supply the information and tools to uphold the shared focus on patient safety. Manufacturers with no options for providers appear at the other end of this continuum, which is the focus of this movement,” Starman says.

The manufacturers who offer no options believe that non-OEM repair is inferior and presents a danger to patients. They also believe that providing diagnostic tools or replacement parts could result in trade secret theft.

The pandemic pointed to one downside of depending on outside service and repair, when many field service engineers (FSEs) were either not available or their presence provided a concern for either hospital safety or the safety of the FSE. Many of the FSEs were sick or hospitals had to put new infection control protocols into place that limited visitors.

Similar problems can present themselves outside of the extraordinary circumstances of a pandemic, such as when adverse weather conditions, weekends or supply chain issues provide obstacles to the availability of an outside source for repairs or service. There are often problems with availability of the OEM service person with substantial premiums for expedited service.

Within the tug-of-war that often exists between medical device OEMs and HTM professionals, as it relates to the right to repair issue, the OEM often wields more political persuasion.

“Industry groups that oppose expanding the right to repair have significant access to federal policymakers, which has been one of the most significant obstacles to action at that level of government. These groups represent manufacturers and have found success advancing claims that the right to repair presents safety risks. While data has thoroughly debunked these claims, we need to build support and spread awareness among those most impacted to make sure that legislators hear and understand this message. This includes the public as well as the hospitals and care facilities that rely on advanced medical technology every day to treat patients,” says Scott Trevino, senior vice president at TRIMEDX.

He says that despite challenges at the federal level, there

are encouraging developments.

“Many state legislatures have been introducing bills focusing on right to repair. Advocacy groups are more vocal than ever in protecting the right to repair, and even the rise in popularity of the term ‘right to repair’ among the public shows progress in advancing the cause,” Trevino adds.

CHALLENGES FOR BIOMEDS

There is little gained by HTM professionals complaining about right to repair and the barriers and frustration they may experience when confronting this issue. The only way any change can come about is if HTM professionals use a collective voice to address their concerns to state legislatures and their U.S. House and Senate representatives. If the representatives at the state and federal levels hear from enough constituents with the same concerns, then they will have incentive to advance those concerns when crafting new legislation.

What information is often withheld by OEMs that is required for servicing or repairing medical equipment?

“First the basics of a service manual with PM procedures and checklists are required to properly perform preventive maintenance and calibration verification in accordance with CMS, TJC, DNV, state and/or hospital regulations and policies,” Reid says.

He says that sometimes there are specialty tools such as calibration keys, phantoms, and passwords or dongles to bypass OEM software locks that are needed as well, depending on the nature and complexity of the device or system.

“Schematics, circuit theory, and part breakouts with parts identification are necessary on the repair side of the house. These are required to first understand and reference the circuit theory in order to intelligently troubleshoot the device or system. Then, by utilizing the schematics as a physical map of sorts, while measuring the inputs and outputs of the actual components with our test equipment, we can isolate the faulty component, board or assembly,” Reid adds.

He says that circuit theory in service manuals used to be the way we became proficient in understanding the operation of the device. Currently, the OEMs mostly omit that from the service literature provided to non-OEM technicians.

“At the DoD BMET school, students are taught to read and interpret circuit theory so that they do not need to attend

Tony Cody Baner Health

Wesley Reid Banner Health

Kelly Starman PartsSource

Scott Trevino TRIMEDX

manufacturer schools on every device and can troubleshoot down to the component level if necessary,” Reid says.

Even trained biomeds face roadblocks.

“Imaging modalities are at the front as the imaging-specific OEMs have led the way of taking away the rights of the equipment owners. Sometimes the access of local BMETs, when they have OEM training, is limited to the serial number and has an expiration. This has caused delays to bringing the equipment back on line even though the technician has had a proven track record of solving similar problems,” says Tony Cody, CHTM, tech management/ENTECH director at Banner Health in Colorado.

Cody says that the lack of right to repair help has increased the cost of ownership, thereby taking away an opportunity to acquire additional/better equipment. He says that it has also increased the downtime of equipment.

“BMETs are spending more time doing administration and less time maintaining and repairing equipment. It is causing frustration and disengagement of the BMETs,” he adds.

MAKE YOUR VOICES HEARD

What can the HTM community do to support right to repair? Every member of HTM should contribute to making their voices heard and taking action.

Sign a letter to state legislators to voice your support for right to repair. Document incidents expeditiously as they occur. Join the Linkedin Medical Device Servicing Community group.

Negotiation at the point of a capital purchase provides a strong bargaining position. Bring concerns to leadership in HTM so that those concerns can be relayed to the C-suite.

“Biomedical technicians can act in many ways to help stakeholders who can affect change understand their challenges. Even at the individual level, technicians can keep colleagues and leaders in their health systems informed of how access to materials, technical information and repair services affects day-to-day operations,” Trevino says.

He points out that there is strength in numbers, so getting more involved with professional groups and associations is a great way for biomedical technicians to amplify their message and reach the public and policymakers who are not as directly connected to health care operations.

“Educating others on the real-world experience that technicians have in such a vital sector builds a compelling case for the benefits that right to repair legislation could have throughout the health care system, from providers to patients,” Trevino says.

There are real budgetary considerations as well.

“The patient is the one that ultimately suffers. In-house BMETs can respond quicker than an OEM FSE. This allows the clinicians to have resources they need to provide the best care,” Cody says.

He says that having a fully supported OEM-based service model is not sustainable.

“The financial expense is much higher. The likely COSR

increase would be 15 percent or greater instead of an industry average 4 to 6 percent. The infrastructure for supporting the increase volume of work is not in place for the OEMs to provide quality and timely repairs,” Cody says.

“I have seen survey responses from biomeds who feel like they are not able to make a difference, and that is not the case. Every biomed can be part of the change in right to repair. They can make valuable contributions by: staying informed, following the conversation, recognizing when their rights are violated, documenting these situations, and sharing their stories internally and with peers,” Starman says.

She says thanks to TechNation for providing the incident tracker to make documentation a convenient process.

“It is also important for biomeds to share this data with their leaders and upstream in their organizations. They can impact change when they speak up and ask vendors for the repair materials needed to uphold patient safety,” Starman adds.

“To build momentum further, staying informed on legislative developments is essential. Policy proposals are often complex and affect people and industries in ways that are not always apparent at first glance,” Trevino says.

He says that the level of advocacy that has helped advance the right to repair in recent years is only possible with informed, vocal stakeholders.

“Helping policymakers understand the real impact on patient safety and efficiency in health care puts into context what is truly at stake. Hospitals can’t depend on legislation alone and should also focus on making progress within their organizations. Taking full advantage of the right to repair means making sure that biomedical technicians have access to the best possible training to deliver reliable service and maintenance across medical device inventories that are constantly growing in size and complexity,” Trevino adds.

Reid says that Medwatch form 3500 can also be used to voluntarily report adverse equipment related events to the FDA.

“Let your supervisor know if you see something that doesn’t look right, such as charging twice or more for travel when multiple devices are co-located on a repair quotation. Or perhaps, you are unable to get basic parts for a device well within your capabilities of repair due to claims from the OEM that you are not qualified. As a director, I am oftentimes successful at getting fair and reasonable results from the regional service and sales managers when these issues are brought to my attention from my team of professionals,” Reid says.

“I implore each of you reading this to join the resistance and fight for your right to repair. Because we’re not going to take it, anymore,” Reid adds.

TechNation, an advocate for right to repair in health care, offers a web form where biomeds can report incidents where an OEM has declined to provide keys, parts or technical assistance.

Find it at 1technation.com/right-to-repair-incident.

CELEBRATING9 Y !SRAE

LIVE:

APRIL 5 | Nuvolo

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APRIL 12 | *SPECIAL*

Right To Repair Update

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APRIL 19 | Sodexo

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APRIL 26 | Claroty

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CAREER CENTER

When A Task Isn’t Yours

BY KATHLEEN FURORE

Irecently heard from someone who has been asked to take on a task that’s not part of his job description. In fact, it is actually the responsibility of the person immediately above him. It’s not the first time he’s been asked to step in and assume a role that isn’t his. He feels the task is important and wants to do it. How can he make the case he deserves some extra pay, perhaps in the form of a bonus or stipend if a raise isn’t in the cards?

Certified personal empowerment life coach and executive coach Smita D. Jain acknowledges that the thought of negotiating an additional salary or perk can be daunting, especially if it is outside the conventional year-end performance discussion.

“However, you should ask for a raise if you are stepping up beyond your normal work responsibilities time and again,” Jain says. “Unless you ask, you may never get the raise that you deserve.”

Dan Belcher, founder and CEO at Mortgage Relief, agrees some sort of compensation is warranted in this kind of situation.

“The job description, I believe, is part of the contract between him and his employer,” Belcher says. “If you’re doing a job outside your job description, I strongly believe that you deserve some extra compensation for it, and it is the organization’s duty to give it to you.”

That doesn’t mean getting anything extra is a slam-dunk – especially if it’s expected right away. But taking a few steps, like those below, can put the process in motion:

• Check your contract. Martin Gasparian, owner at Maison Law, says that is the first thing he recommends doing before agreeing to take on additional responsibilities – especially if they are above your current pay grade. “There may be a clause, such as a ‘duties assigned’ section in the job description, which allows for this,” Gasparian explains.

“It’s vital to make certain that you will be properly insured if you consent to this extra work, and that you will have the training, support and resources necessary to fulfill the requirements … It can also help to agree on a proposed benefit, such as a pay increase or bonus, before commencing.”

If it’s important, do it. This might not be everyone’s approach, but Belcher believes that if the task is important

and the employee is willing to do it, he must do it. “This is the first step in building his case that he deserves some extra pay,” Belcher says.

• Prepare your pitch – and include facts to back up your request. “After doing what he is being asked to do without complaining, he should compile everything he does that is not included in his job description, then email his immediate supervisor and copy HR about his appeal to have a raise, a bonus or a stipend for the things he did outside of his job description,” Belcher says.

Jain suggests asking yourself why it is in the company’s interest to increase your salary and to document the answers with evidence that demonstrates you have taken on a higher workload or next-level responsibilities. “Rehearse the actual conversation and throw-back questions with a mentor, coach or trusted colleague to be better equipped to negotiate the raise,” she says.

• Be specific. “Be unambiguous about your expectation – state a single absolute figure or percentage hike [you’re asking for],” Jain advises. “Often people specify a wide range while negotiating salary and end up with offers at the lower end of the spectrum. Don’t show desperation about getting a raise; your employer will take advantage of the weaknesses you reveal during the negotiation process.”

• Stop apologizing. “Language like ‘I am so sorry to bother you’ or ‘I know budgets are tight, but …’ makes your negotiation personal and undermines your achievements,” Jain explains. “Remember, you are not asking for a favor by negotiating your salary; there’s no need to make excuses for your request.”

• Have a Plan B. As Jain notes, “No” doesn’t mean “Never.” “Be prepared to counter with something other than money in case of a ‘No,’ ” says Jain, who notes that compensation goes beyond monetary rewards. “Negotiate on paid leaves, flexible time arrangements or other benefits based on what’s important to you and your lifestyle,” she suggests.

Kathleen Furore is a Chicago-based writer and editor who has covered personal finance and other business-related topics for a variety of trade and consumer publications. You can email her your career questions at kfurore@yahoo.com.

BY KEVIN MURPHY

MAINTENANCE TO A TEE T

ransesophageal echocardiography (TEE) probes are vital to cardiologists when evaluating the structure and functionality of the heart. Likewise, proper handling and care of TEEs is vital to maintaining the integrity and functionality of the instrument. Follow the guidelines below to perform your maintenance to a tee.

STEPS TO PROPER CARE

1. Low-Level Disinfection

It is recommended that the end user of the TEE perform Low-Level Disinfection (LLD), which involves a non-corrosive wipe or spray. Performing LLD not only disinfects the instrument by killing harmful bacteria, viruses, and fungi, but it also allows the department to inspect the TEE for any damage and, if necessary, to perform corrective actions to prevent further damage.

2. Electrical and Leakage Safety Testing

After LLD is performed, electrical and leakage safety testing can be administered. The Intersocietal Accreditation Commission (IAC) requires that each TEE probe pass electrical leakage and safety testing before each use. Leakage testing ensures the electrical integrity of the device and verifies that the device is safe to use on patients. Testing can be completed with the use of a stand-alone ultrasound leakage tester with pass/fail indications, a numerical value of <100µA (IEC 60601), or an alternate value provided by the manufacturer. In the event of a leakage failure, test again to confirm. If there is a confirmed failure, remove the TEE from the solution and perform a corrective action. Passing TEEs can proceed to the High-Level Disinfection (HLD) process recommended by the manufacturer.

3. High-Level Disinfection

HLD is the final step in proper TEE maintenance. The IAC requires that each TEE probe pass HLD before each use. HLD consists of soaking the insertion tube in an approved disinfection solution, followed by a rinse and proper storage.

It is important to note that you should not exceed the recommended soak time or submerge the entire TEE. The soaking solution should not reach the end of the insertion tube at the strain relief end. These actions may lead to damage of the TEE. The control housing, strain reliefs, cable, and connector should be cleaned by wiping thoroughly with an approved cleaning solution or approved wipes.

Once HLD is complete, perform a rinse to remove any residue and dry the instrument with a clean, dry cloth. When possible, store the probe in a TEE-specific storage container or vertical hanging storage cabinet.

Consult the manufacturer for an approved list of solutions and recommended soak times.

TEE TRANSPORT

TEE maintenance is often handled by sterile processing departments. The transport of TEEs between departments has added potential issues that could be detrimental to the instruments. Unfortunately, TEE transport has been known to take place in pillowcases, storage bins, and even by hand. Improper transportation can lead to unintended damage to the TEE. It is vital to put procedures in place to document the current disinfection stage in conjunction with a TEE-specific storage and transportation container. The process protects both the asset and the employees who handle it.

MOVING TEE MAINTENANCE FORWARD

Understanding proper TEE maintenance, educating all departments, and initiating a standard process will reduce the cost of ownership, minimize downtime, increase efficiency, and allow your institution to provide outstanding care to your patients. For more information about TEE probes and other medical equipment and services, call (800) 958-9986 or visit avantehs.com.

Kevin Murphy is the Technical Operations Manager for the Ultrasound division at Avante Health Solutions.

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Years

THE FUTURE ‘Presence’ in Today’s Classes

BY ROGER A. BOWELS, MS, EDD, CBET

pring semester 2023 is in full swing. This is the third consecutive year that we have had an arctic blast here in Central Texas. Three days of no class gives me a chance to write from home. It reminds me of the word “presence” and what it means to classes these days. As I have mentioned, we have moved to somewhat of a “flipped classroom” where lecture material is online for students to access, and labs are completed in person. The jury is still out on whether it is working. Students, for the most part, are not enthusiastic about it. God knows the college has hired enough people to try to make it work. We now have a plethora of new instructional designers, “content matter experts” and three times the number of college administrators that we had just three years ago despite overall fewer students. I’m sure they know something I don’t. On a very positive note, we do have more real, modern medical equipment for students to learn with than we ever had before.

The flipped classroom idea is not a new one, even the Motorcycle Safety Foundation has rolled out this option for motorcycle training, where students take the classroom part online and then come in to do the range exercises on motorcycles. For us at the college, there is work to be done with the material. Just recording a video and providing information on each topic is not enough. This model assumes student self-motivation and self-direction.

Over the past two decades, I have taught multiple online classes for 4-year universities. Some of these classes had better content than others. For a technical college, there are some challenges. One observation I have made over the years is that students learn from each other as well as from the instructor. They also motivate

each other based on their interaction in class. Students’ concurrent presence is indeed important to the process. The dynamic of face-to-face classes provides spontaneous learning interactions that don’t seem to happen as often in online environments, even when learning management platforms offer opportunities for discussion and online interaction. Staged interaction is just that … staged.

“Presence” is a factor in education as it is in health care as it is in motorcycle safety. Working and learning in the presence of real, working equipment is preferred over simulations. It has more motivating effects. Talking with nurses, doctors and health care workers is preferred over the telephone, videoconference or texting. But sometimes we must do what we must do in cases where a “live” environment is not possible such as during the pandemic. The key is, I believe, to provide that live environment whenever possible with real factors and real instructor presence.

In all fairness, the Motorcycle Safety Foundation spent a lot of money in developing their online classroom segment, and after viewing it, and using it, I’m impressed with how in-depth it goes. I can see the advantage of standardizing instruction using quality materials. But it is one class. With a technical curriculum, creating each class in such detail and using such simulation for all the tasks involved with all the equipment involved seems like a formidable task. Complicating matters is ensuring sufficient motivation for students to be successful. Motorcycle simulators are rare but fun. Flight simulators are fun too … and useful. But they are tools that simulate the real environment and should be used in addition to the real environment.

I was reading an article posted by Wichita State University about presence in the classroom. They stress the importance of ensuring instructors include and inject the “real them” into their classes and ensure “connections between them and students and students with each other.” This is the hard part and the part that instructional designers and instructors must pay the most attention to.

Instructors in technical education also have the responsibility to include real-world examples and real-world experiences in the students’ experiences to better prepare them for their own experiences. The live presence is often the most effective in presenting this real-world interactive introduction. Field trips are one example where spontaneous interaction can take place between students, professionals and instructors. Internships, of course, are another example and probably the best example.

Technical instructors are the gateway to the students’ entrance into the career field. Most technical instructors have experience with real-world equipment in real environments with real tools and real people. Finding a way to always include this presence is key to being successful in motivating students.

Education is no doubt evolving into new methods to include virtual learning and asynchronous classrooms where students can learn at their own pace at their leisure. In no way am I against exploring every opportunity to improve our methods and student outcomes and perhaps even speed up the process by which individuals can train to become valuable members of the HTM community. Adding resources and methods for students to learn new skills is a good thing.

However, based on experience and the current increas-

ing need for qualified technicians, I would stress the need to not forget the basics and the need to make sure the graduates are not only technically prepared but are able to think on their feet and interact with each other and health care providers in a professional manner. To do this, let’s not forget the importance of technical instructors and their presence in technical education. Let us add to the toolbox of training future BMETs, not substitute tools.

On an unrelated but “important to me” note, I just noticed that BMET III Larry Sanlin, was named Professional of the Month by TechNation on February 1, 2023. I served with Larry on the USS Will Rogers SSBN 659 Gold crew in the 1980s and never knew that Larry went on to become a biomed after leaving the Navy. Larry and I were both in the Weapons Division on the sub and spent many hours conversing while patrolling in the depths of the North Atlantic. Larry was an outstanding individual back then and it is evident that he continues to excel at whatever he puts his efforts toward. Congratulations, Shipmate!

Roger A. Bowles, MS, EdD, CBET, is a biomedical equipment technology/ medical imaging technology instructor at Texas State Technical College-Waco.

20/20 IMAGING INSIGHTS

What Is The Cost of Good Enough?

BY TED LUCIDI, CBET

n today’s economy, every dollar saved helps keep service budgets in the black and health care costs a little bit lower. But is there a cost with trying to save too much? We’ve all heard the saying, “Pay me now, or pay me later.” It couldn’t be more true with all of the choices available to HTM teams today. Looking at search results for “MRI coil repair,” the interwebs and Googles show over 100 choices.

What qualifies a service organization to be YOUR choice today, tomorrow and moving forward? Is it price? Is it that they have a loaner? Is it that they have 1-day turn-around? Is it an overnight exchange from their warehouse? There’s a lot of criteria. Maybe the correct answer really should be, “It depends on the timing of the next failure.”A single failed MRI coil could cost a facility tens-of-thousands of dollars per day in lost revenue. What are the costs associated with a “good enough” repair solution? Low-cost repairs, overly fast turn-around times (quick fixes), or unqualified loaners/exchanges actually have the potential to significantly increase your service costs. Some items that many fail to consider are the intangible costs … costs associated with additional downtime due to a rushed or incomplete repair or a failed loaner or exchange. Additional shipping and travel to/ from a remote site just add to the headache. Decreased customer satisfaction and poor patient reviews due to rescheduled scans don’t help either. The few hundred dollars saved by choosing “good enough,” might just cost the facility 10-times that amount. I think the statement above is better stated, “Pay me now, AND pay me later.”The following are six key questions to ask about MRI coil repair processes to help you make wise, informed decisions that you, your team and your patients can live with.

Question 1: Are system cables replaced or are they

spliced? Replacing costs more, however; the longevity of the repair and life extension of the coil more than compensate for the extra money and help to lower the overall cost of ownership. Spliced cables can fail more often as they can separate over time, meaning more frequent repairs, more down time and potentially more performance issues. Sustainable processes, such as those at Innovatus, replace ALL of the individual wires in the system cable as well as the cable sheathing versus splicing single wires. The results are a higher first-time fix rate, decreased warranties and continued workflow.

Question 2: What testing methods are used, and how is product performance assessed? What is the process to find potentially hidden or intermittent electrical problems? Do you know? Once an MRI coil’s design is approved and the product is released to market, there’s no need for each one to be clinically tested on a scanner. Coils on the production line are modularly tested using custom test fixtures designed by R&D engineers. Innovatus takes this same approach for assessing coil performance before, during and post-repair. Modular testing methods break down the coil’s system and tests each section to the component level assuring the whole system is functioning optimally. Contrast that to the “good enough” solutions that, oftentimes, utilizes simplistic, point-of-failure testing. Single point-of-failure testing often fails to identify additional, underlying problems affecting coil performance and could potentially result in an incomplete repair.

Question 3: What mechanical repair capabilities does the provider possess? Is the provider able to restore OEM-like form and fit? Many coil designs are heavy and awkward, and many are on the receiving end of accidental trauma. You may be surprised to know that many of the coils received at Innovatus arrive fractured, arrive with missing or broken parts or, sometimes, arrive in multiple pieces. Having the ability to either source or fabricate qualified replacement parts is the difference between repairing a coil and replacing it. Rest easy, our team of mechanical wizards is able to restore your coil to

the condition you expect.

Question 4: What is the source of mechanical parts used in a repair? Are they sourced from soft molding, are they machined or are they 3D printed? While 3D printing can increase speed and accessibility, the results of this method may not last as long as molding or machining. It’s critical to know how your provider not only sources replacement parts, but if they are and how they are qualified for use in your product. The form, fit and function of replacement parts can directly affect the longevity, cost of ownership, performance and future downtime associated with your device.

Question 5: What steps are taken to provide a new repair solution? Does the provider merely try to get a newly encountered device working again, or is there a methodical approach to offering new repairs? Innovatus will not “try” to repair a product. Each and every MRI coil repaired is backed-up by full schematics, bills-of-materials and verified test procedures by coil make and model. Technicians use visual work instructions and still hand-write test results for each repair. The results of every repair are captured in the quality system and are maintained in the device’s history file.

Question 6: What qualifies a provider to repair YOUR product? What experience, research and processes are behind the repair? This is perhaps the biggest difference in repair providers. Do the technicians, engineers and staff have decades of experience versus basic skills? What testing processes, protocols and test devices are used for quality assurance regarding the repair? With a legacy in MRI coil manufacturing, Innovatus possesses the detailed knowledge base, engineering skills and mature ISO 13458:2016 certified quality system that uniquely qualifies them to not only repair but restore your coil’s performance.

If the price seems low, or if the turnaround time seems really fast, you may just want to do some digging. There is a cost to “good enough.” Surprisingly, the price of quality solutions isn’t much more than you think.

Ted Lucidi, CBET, is the director of commercial operations and business analytics at Innovatus Imaging.

BY JAKE BEALS

EFFICIENT VENTILATOR SERVICE AND REPAIR WITH RENEW BIOMEDICAL R

eNew Biomedical is changing the way biomeds approach ventilator service and repair. We’ve assessed original equipment manufacturer (OEM) processes and have worked hard to blend our dedication to quality work with OEM’s dedication to effective techniques. This hybrid has helped contribute to ReNew’s exponential growth and streamlined efficiency. ReNew offers a wide variety of service and repair options for 20-plus ventilators and is even an Authorized Service Center for Vyaire, capable of servicing units to meet and exceed OEM standards.

A considerable advantage of choosing ReNew is the capability of our ventilator program. Vyaire Medical has officially announced ReNew as an Authorized Service Center and service depot for service and non-warranty repair of LTV, ReVel, Vela and Bellavista 1000 ventilators for healthcare customers across the United States. After thoroughly vetting, testing, and training the staff, facility and benchwork at ReNew Biomedical, Vyaire recognized ReNew as an official service depot. In addition to repairs and service, ReNew stocks ventilator disposables, including circuits, filters, and PM kits, to extend the lifespan of your unit.

On average, if a ventilator enters ReNew and parts

are available, the entire process, including quoting, approval, bench work, and return shipping, takes just two weeks. The same hands that quote your unit are the same hands that repair it. By reducing unnecessary overhead, we offer fast, accurate quotes without hidden costs. Our streamlined, efficient process means you get your equipment back at a lightning pace.   It isn’t just OEMs we want to impress. We show our customers we are who we say we are and that servicing and repairing your equipment is our top priority. The best proof of our efficiency is our ISO 13485 certification, specifically designed for companies that service or handle medical equipment. Earning this third-party certification shows we stay on top of our game through efficient processes and a mindset of constant improvement. We conduct in-depth internal audits and a rigorous initial audit to ensure that our systems and processes lead to service that continues to exceed customer expectations. The better we serve you, the better you serve your patients; reliable, long-lasting equipment provides peace of mind and eases budget concerns.  Preventative maintenance (PM) covers the following:

• Diagnostic check of the device’s CPU

• Test power supply and all parameters (if applicable)

• Test the system’s internal clock (if applicable)

• Operational review of all system functions per OEM specifications

• Full biomed report with every PM

• Telephone support

• Complimentary cleaning of each unit upon return

• Free return shipping on all PMs

Our goal is to “Save the Lives of Life-Saving Equipment.” We take great pride in our mission and hold ourselves to a level of excellence that raises the industry bar. We stock many common parts for ventilator repairs to streamline the service process. Additionally, each biomed workbench ensures the unit meets or exceeds OEM standards before it leaves our facility and is ready to operate at the standard the care setting demands.

ReNew is ISO 13485 certified for the maintenance and repair of active medical equipment and is not beholden to the many cumbersome requirements levied on manufacturers who claim design rights. Focusing solely on repairing the device allows our technicians to take time and care for the device. Our customers can still receive faster turnaround times without sacrificing service quality or standards.

ReNew is an all-in-one biomedical service depot that offers on-site service, personal support and asset management/inventory counts. Call us today to see how we can help with your ventilator service, or ask about our other offerings to see how our team can save your bottom line. Let’s find a solution that works for you.

For more information, call 844-425-0987 or email service@renewbiomedical.com.

CYBERSECURITY A Balancing Act, The Two Sides of Cybersecurity

BY REGAN GARDINER

n organization can take a passive or active defense to cyber threats, but the best option is to create a balance of both. Hospitals, clinics, laboratories and health insurers are challenged every day with finding the balance between using cutting-edge medical systems to save lives and keeping up with the threats that would try to exploit those systems to steal patients’ health information, spread malware and hold a hospital’s network ransom.

A passive security posture relies on the establishment of policies and controls regarding the use of applications, services and networks to defend a network. Best practices include configuring rules, access control lists (ACLs), firewalls, rules-based access controls (RBAC), group policy objects (GPOs) and other controls on systems, software and networks. Limitations in user access to only the specific data, resources and applications are needed to complete a required task. An inherent weakness to a passive security posture is policy management. If not properly maintained, policies can be outdated, introducing unnecessary risk to the network. If not properly planned, policies may be overly strict, restricting access needed for continued operations and security. Additionally, undefined policies can confuse non-technical staff, which can create procurement roadblocks with vendors.

A Zero Trust model can also be implemented. Zero Trust is a more recent passive security model based on the principle of maintaining strict access controls

and not trusting anyone by default, even those already inside the network perimeter. All access is compared or measured against the controls.

Alternatively, an active security defense, which includes installing anti-virus and anti-malware that provides consistent scanning to detect, block, and remove viruses, malware, and ransomware, can serve to prevent identify theft, block phishing attempts, and avoid disruptions in business flow and patient care. In addition, utilizing industry best practices, budgeting for continuous network improvements, proactively scanning for system vulnerabilities such as unsupported operating systems, missing patches, and configuration weaknesses can aggressively protect an organization’s IT assets.

In an active security posture environment, attention to cybersecurity threat intelligence information is critical to identifying emerging trends. Threat intelligence also helps organizations make faster, more informed security decisions and change their behavior from reactive to proactive to mitigate risks and combat attacks. Full-scope testing provided by an external service can expose network weaknesses and is critical to lending awareness to a network team on where specific improvements can be rendered. A consideration of active scanning is that it can create significant machine resource usage and burden systems, or saturate networks, making applications or services slower, less reliable and reduce critical functionality.

Finding a balance in defending a health care organization’s network can be done by blending both passive and active defenses. Achieving a combined approach – leveraging the strengths of each and mitigating the weaknesses of either is a process that begins here:

• Start with a strategic plan for cybersecurity that

includes consensus or agreement from organizational leadership, finance, legal, front-line operations staff and IT.

• Proactively engage cybersecurity resources in equipment planning and purchasing.

• Seek solutions with vendors on security options instead of deploying systems that do not meet the cybersecurity strategic plan.

• Create a strong partnership between your cybersecurity and procurement teams to ensure that system standardizations are utilized.

• Provide and require information assurance awareness training for all staff.

• Provide required training to support staff on monitoring active vulnerabilities on the medical systems they support armed with the knowledge of known threats and counter-active procedures once detected.

• Perform routine risk assessments and network penetration testing as part of a risk management plan that would actively seek and deploy mitigating measures.

Securing a network will always present new challenges. If an organization balances both sides of cybersecurity, active and passive defenses, they can successfully secure their network from external and internal threats.

Regan Gardiner is a technical project manager with Blue Water Thinking LLC supporting VHA VISN 21, Healthcare Technology Management (HTM) Team prepare for its electronic health record transition to Cerner. She previously supported the Defense Health Agency’s MHS Genesis deployment and has a background in Health Information Technology Management.

HIMSS23 Artificial Intelligence, Machine Learning

Featured at Upcoming Conference

Artificial intelligence and machine learning are here to stay in modern health care, and their latest will be featured at the 2023 HIMSS Global Health Conference & Exhibition, widely considered the Davos Summit of health care and information and technology.

Slated for April 17-21 in Chicago, the event is bringing together the top healthcare AI/ML thought leaders and disruptors for can’t-miss experiences throughout the preconference program, education sessions and the exhibition.

PRECONFERENCE FORUM

The Machine Learning & AI for Healthcare Forum will explore real-world use cases and discussions with top AI/ML professionals. Sessions include:

• The Ethics of AI in Healthcare

• Building and Evaluating Business Cases for ML/AI in Health AI Governance: Frameworks and Technologies

• It Speaks, It Listens, It’s Your Daily Voice Assistant – Leveraging Voice Technology in Health and Wellness

• AI Economics – Driving Value at Scale

• 2023 AI in Healthcare: The Good, The Bad and The Hopeful

SESSION SERIES

The HIMSS23 AI/ML Session Series will offer a deep dive into AI/ML in back-to-back curated sessions. The series will show how organizations have leveraged technology to prioritize care based on risk and social vulnerabilities, analyzed metrics to better understand the population and used ethical machine-learning practices to improve caregiver workload.

• Artificial Intelligence (AI) Model to Predict COVID-19 ICU Mortality Risk

• Patient Clustering to Know Thy Patient

• Improving Nurse Staffing Schedules Using Responsible and Ethical Machine Learning

EDUCATION SESSIONS

Selected through a highly competitive peer-review process, the HIMSS23 education sessions will explore the use and implementation of AI/ML in health care, such as staffing optimization with AI; a cancer research hospital’s AI/ML journey; and an AI/ML community coalition improving asthma among low-income children. Sessions – led by world-renowned health care and innovation thought leaders – are available for continuing education credits.

EXHIBITION

Established tech giants and nimble startup companies offer hands-on demonstrations of innovative products and services as well as education sessions in hot topic specialty areas. View the HIMSS23 exhibitors featuring artificial intelligence. They include:

• Amazon Web Services, the world’s most comprehensive and broadly adopted cloud platform. It now has more than 200 fully featured services for computing, storage, databases, networking, analytics, machine learning and artificial intelligence and more.

• Automation Anywhere offers the world’s only cloud-native platform combining RPA, artificial intelligence, machine learning and analytics to automate repetitive tasks and build enterprise agility. It frees up humans to pivot to the next big idea, build deeper customer relationships and drive business growth.

• Consensus Cloud Solutions, the world’s largest digital fax provider, provides solutions – such as intelligent data extraction using NLP and AI and robotic process automation – that result in improved outcomes.

• Microsoft Corporation and Microsoft Cloud for Healthcare make it easier for organizations to create personalized patient experiences, give health teams connected and

secure collaboration tools and adopt data standards. AI combines multiple sources to give full visibility into data, relieves administrative burden and improves process and workflow automation to create actionable insights that deliver better care faster at a lower cost.

Also on the exhibition floor, the Innovation Hub & Startup Park will feature disruptive technologies and leading accel-

erators and incubators. They include health care innovations such as AI, blockchain and next-generation voice technology, 5G, digital therapeutics, 3-D printing, hospital at home care and more.

For more information, visit himss.org/global-conference.

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HEALTH-ISAC Product End of Life is not the Time to Roll the Dice on Risk

BY PHIL ENGLERT

When manufacturers declare the end of life or support for a product, the owner is often left with the decision to continue to operate. In health care, the decision to continue to use a medical device or patient care system is complex. The device or system likely still performs the clinical function -

ality it was acquired to perform. The capital or operational funds to replace the technology may be limited or unavailable. Replacing capital technology can disrupt business operations with downtime resulting in lost productivity and revenues. New medical technology may not be compatible with existing systems or processes, requiring additional investment in infrastructure and software. Employee training can be time-consuming and may require additional investment in human resources.

Overall, the decision to replace medical technology is complex and requires careful consideration of the costs and benefits involved. When cybersecurity is the driver, health care providers may choose to extend the life of their medical technology by investing in maintenance and compensating controls rather than replacing it outright. This can reduce costs and minimize disruption while allowing the health care provider to benefit from the technology. The decision to continue to operate unsupported technology may result in a risk transfer.

Risk transfer for technical support, including cybersecurity functions, refers to the transference of responsibility for potential risks associated with technical support to another party. Risk transfer aims to

protect the technology manufacturer or technical support provider from financial and reputational risks that may arise due to potential issues related to the technical support they provide. By transferring the risk to the customer, the manufacturer or technical support provider can limit their liability in case of any issues or problems that may arise while providing technical support services. This risk transfer is often a passive assumption by the customer rather than a legal agreement of a contract or service level agreement. During the supported product life, levels of risk (product support) are negotiated and agreed upon in warranty documents, service contacts or service level agreements. Each party consents to specifically defined responsibilities. The amount of risk can be transferred from one party to another over the supported product lifecycle. For instance, the medical device manufacturer may agree to provide patches or updates to newly discovered vulnerabilities within an agreed-upon time frame. The customer may agree to apply those updates to the equipment they own, or they may engage the manufacturer or other third party to complete that task. During the supported life of medical technology, risk transference can be fluid depending on the capabilities and capacities of each party. Risk transfer can occur at the end of a product’s life cycle.

When a product reaches the end of its life, the manufacturer relinquishes responsibility for continued support, including patches and updates. The risk associated with the continued operation of the medical technology is transferred to the customer. Overall, risk transfer at the end of a product’s life is an essential consideration for health care providers. It allows them to consider the benefits, liability and financial exposure of continuing to operate unsupported technology.

There are several key considerations to remember

regarding risk transfer, regardless of the specific context in which it is being applied. These considerations include:

• Risk assessment: Before accepting the transference of any risks, it is important to conduct a thorough risk assessment to identify potential sources of risk and their potential impact. This can help ensure that the risk transfer is appropriate and does not expose the customer to untenable risks or financial consequences.

• Financial considerations: The cost of transferring risk must be weighed against the potential cost of bearing the risk. In addition to the patient benefits and revenues, risk transfer can involve fees, premiums, penalties, and legal exposure, and it is vital to ensure that these costs are reasonable and justifiable.

• Capacity and expertise: The party assuming the transferred risk must have the ability and expertise to manage that risk effectively. For example, applying compensating controls, additional monitoring and ensuring a response plan is effective and updated may counter some of the risk reduction tasks previously performed by the manufacturer.

• Reputation and relationships: The decision to transfer risk can impact the reputation and relationships of the parties involved. For example, if a company transfers risk to a third-party maintainer of the medical technologies that subsequently performs poorly, the company’s reputation may be damaged.

• Compliance and legal requirements: Any risk transfer should comply with relevant laws, regulations, and industry standards. Failure to comply with these requirements can expose the parties involved to additional legal and financial risks. Overall, risk transfer is a complex process that requires careful consideration of the potential risks and rewards. By keeping these considerations in mind, businesses and organizations can make informed decisions about risk transfer that help protect their financial and reputational interests.

Phil Englert is the director of medical device security for Health-ISAC.

WHERE IN THE WORLD IS BEN C?

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TECHNATI N P LL

What’s

• Broken equipment

• Notepads

• Pens and dry erase markers

• Cellphone

• Motivational signs/messages

• Something to drink

• Hand sanitizer

• WD-40

Allison Woolford, CBET

Biomedical Equipment Specialist

Clinical Engineering – Periop Team Lead

Duke University Health System

1

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#IamTechNation

J oin us as we celebrate the TechNation community. You - each and every reader, Webinar Wednesday attendee, HTM Jobs user and MD Expo attendee - are the most important part of the TechNation community. Share a photo of yourself, a colleague or the entire biomed team on social media and tag it with #IamTechNation. Then, check each issue of the magazine to see yourself and all of the men and women that are TechNation.

Photo by Chaolin Hancock

Received my certificate of completion from the College of Biomedical Equipment Technology!

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The HTM Jobs’ team partners with the College of Biomedical Equipment Technology (CBET) to help their cohort of students learn everything there is to know about entering the workforce as an HTM professional.

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Successful installation and startup for the two CTs Revolution Maxima CT in southern highlands Tanzania (Sumbawanga and Iringa RRH).

Photo by Bryant K. Hawkins Sr.

Bryant K. Hawkins Sr. and Eric Massey hanging out in New Orleans!