TechNation Magazine July 2023

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P.12 SPOTLIGHT

p.12 Professional of the Month: Michele Manzoli, CCE

p.14 Department of the Month: The Woodlands Clinical Engineering Department

p.18 Association of the Month: Washington State Biomedical Association (WSBA)

p.20 Next Gen: Jennifer Vazquez

P.22 INDUSTRY UPDATES

p.22 News & Notes

p.26 HTM Mixer Recap

p.28 Ribbon Cutting: FSI

p.30 AAMI Update

p.32 ECRI Update

P.34 THE BENCH

p.34 Biomed 101

p.37 Tools of the Trade

p.39 Webinar Wednesday

P.40 FEATURE ARTICLES

p.40 Roundtable: Diagnostic Imaging Devices

p.46 Cover Story: Creating Team Synergy

P.50 EXPERT ADVICE

p.50 Career Center

p.52 [Sponsored Content] Innovatus Imaging

p.54 The Future

p.56 Right to Repair

p.58 [Sponsored Content] Agiliti

P.62 CONNECTED

p.62 Cybersecurity

p.64 HIMSS

p.66 Health-ISAC

p.69 Networking Notes

p.71 Get Connected Company Directory

PUBLISHER John M. Krieg

VICE PRESIDENT Kristin Leavoy

VICE PRESIDENT Jayme McKelvey OF SALES

EDITORIAL John Wallace

CONTRIBUTORS

Roger Bowles

K. Richard Douglas

Jim Fedele

Joie Marhefka

Manny Roman

Connor Walsh

David Witt

Steven J. Yelton

ACCOUNT

EXECUTIVES

ART DEPARTMENT

Megan Cabot

Emily Hise

Karlee Gower

Taylor Hayes

Kameryn Johnson

DIGITAL SERVICES

Cindy Galindo

Kennedy Krieg

Haley Wells

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 Michele Manzoli, CCE

Arrivederci to Italy; Ciao L.A.

BY K. RICHARD DOUGLAS

ost visitors to Europe agree that Rome, Venice and Florence are among the most beautiful cities in the world. They help make Italy the fifth most visited country in the world. The Sistine Chapel and the Vatican are close by and are only two of the many tourist destinations that make the country the third most visited in Europe. Add great pasta, wine and pizza and a trip to Italy becomes that much more inviting.

These are many well-known characteristics of the country. It is a nation that also offers good training for biomedical engineers.

Michele Manzoli, CCE, is a manager of clinical engineering at Cedars-Sinai in Los Angeles. Manzoli grew up in Italy.

He discovered biomed as a senior in high school.

“I found out about the field of biomedical engineering leafing through the booklet of my local university, during my last year of high school. I knew I liked – and was pretty good at – math and science, but I was also fascinated by the health care field. None of my parents or other relatives are health care workers, so the interest must have come from somewhere else, probably from the curiosity about how the human body works and the desire to help others through my work,” Manzoli says.

He says that the booklet also indicated that, among all engineering branches, biomedical engineering looked like the fastest-growing occupation at the time. He says that this fact reinforced his conviction to pursue the degree.

“I attended the University of Bologna (fun fact: it is considered the oldest in the western world) for my bachelor’s degree in biomedical engineering. That is where I first learned about the existence of clinical engineering, during my last year, after being exposed to all other possible paths within biomedical

engineering (like biomaterials, bioinformatics, biomechanics or genetic engineering). What interested me the most was the idea of pairing engineering and management skills into one professional profile, and of course the direct beneficial impact on people,” Manzoli says.

He says that he wanted a job that could offer him the opportunity to use his engineering knowledge and problem-solving skills, but also the chance to interact with a variety of other professions, at all levels, from front line staff to leadership.

“After a three-month internship at the local hospital, learning about medical equipment evaluations and procurement, I continued with formal education. There was only one university in Italy that offered a master’s program in clinical engineering, and it was 200 miles away from where I lived. So, I moved to the beautiful city of Trieste, known for the largest sea-facing square in Europe and for its strong wind (called ‘Bora’). During those two years, I learned from the most respected clinical engineers in the country, and I became more and more passionate about the HTM field,” Manzoli says.

Before getting his degree, he spent a couple of months in the U.K., interning at a major CE independent service organization, working on the quality management system (specifically – standard operating procedures).

After graduating, Manzoli’s first job was in medical device regulatory affairs. His team provided support to worldwide manufacturers and to the Italian Ministry of Health in the management of the National Medical Device Database as well as the National Classification of Medical Devices.

He still felt that he wanted to work in a hospital, despite enjoying his colleagues and the work environment where he worked.

“At the same time, I also sought another international experience to broaden my horizons. I had never been to the USA, did not know anyone, but had always wanted to pay a visit, at the least. That’s when I found out about the well-known UConn Internship Program nine years ago. I applied, interviewed

at 12 hospitals in New England and matched with Yale-New Haven Hospital,” Manzoli says.

He says that the internship was one of the most valuable experiences of his life, as it provided him with the knowledge and the tools he needed for a successful career.

“I am forever grateful to my mentors at the university and at the hospital. After surviving the two coldest winters of my life, when I was presented with the offer to join the Cedars-Sinai team in Los Angeles, I was intrigued by the idea of trying out the West Coast lifestyle. My position was initially clinical systems engineer (CSE). After a few years, I was promoted to senior CSE, and shortly after, the opportunity to step into management unexpectedly came up. It is so rare to be able to advance that quickly without changing workplaces. ‘This is my chance;’ was my first thought,” Manzoli says.

NEW FRIENDS AND NEW CHALLENGES

The challenges that come along with pursuing a career in a different country may seem like a full plate, but Manzoli says that moving into a leadership role was also a challenge.

“Stepping into management was definitely a big change for me. In addition to projects that continued to need oversight, I was a bit overwhelmed with the new responsibilities of the job. We have a team of over 30 members, and a medical equipment inventory of over 33,000. I am sure you get the idea. But I would also like to add that I’ve felt backed by the team and my leadership since day one, and that support has certainly made the transition more manageable. I love my new job and the opportunities that it presents me every day, and I feel very lucky and proud to work at Cedars-Sinai,” Manzoli says.

Away from the office, Manzoli keeps active with fitness and getting out on the town.

“I have a pretty active lifestyle. I regularly run 5Ks, play tennis and go hiking. But I also like cooking, trying different restaurants, exploring the city and going to exhibits and cultural events. There is always something going on in L.A. My vacations are also on the active side: This year, I’ll explore two Hawaiian Islands as well as Iceland,” he says.

In the American melting pot, Manzoli has made new friends, but still misses his family back in Italy.

“My whole family is in Italy, and I miss them every day. It was definitely a bold move to cross the ocean by myself. I am also very happy here; I believe I found my place in the world for this phase of my life (I do not exclude going back once retired). I was lucky enough to find a group of good (Italian) friends that I consider my second family. I met them just a month after arriving in Los Angeles, believe it or not, on a hike to the Hollywood sign. They have a variety of jobs and interests, so it is great to ‘unplug’ from work when I am with them and talk about other things. We try to gather at least once a week and cook,” he says.

For now, the medical community in Los Angeles benefits from this international clinical engineer’s knowledge and experience. For Manzoli, la vita è bella until he may rejoin his family back in Italy someday.

BIOMETRICS

FAVORITE BOOK: “Start with Why” by Simon Sinek

FAVORITE MOVIE: “The Matrix”

HIDDEN TALENT:

Apparently, I am a pretty good trip planner.

FAVORITE FOOD: Just guess

WHAT’S ON MY BENCH?

“#1 in California” coffee mug, fruit, some form of dark chocolate and way more pens than I need.

FAVORITE PART OF BEING A BIOMED?

Every day is a different set of challenges and it is an opportunity to make a difference.

DEPARTMENT OF THE MONTH

The Woodlands Clinical Engineering Department

BY K. RICHARD DOUGLAS

The Woodlands is a special-purpose district and census-designated place located north of Houston, Texas. The area spans two counties; Montgomery and Harris. It is governed by The Woodlands Township and administered by an elected board of directors, making it unique. It began as a bedroom community of Houston but attracted some large corporate residents as well. The area is subdivided into eight villages and many urban parks.

Three of the affiliated hospitals that serve The Woodlands and surrounding communities are: CHI St. Luke’sThe Woodlands Hospital, 237 beds; CHI St. Luke’s-Lakeside Hospital, 28 beds; and CHI St. Luke’s-Springwoods Village Hospital, four beds.

CHI St. Luke’s Health has a number of hospitals in the region.

“There are a total of 269 licensed beds covering over a 20-mile radius. The system has a total of over 7,000 hospital-owned devices with a total asset value of over $100 million. Each location contains all imaging modalities including three MRIs, seven CTs, one linear accelerator, mammography, cancer and comprehensive stroke centers. [There is] a community emergency center containing a CT, X-ray and ultrasound,” says Eugene Watkins, a manager in the system’s clinical engineering department.

The CE team is composed of five techs and a manager, along with a regional manager.

St. Luke’s Health is part of CommonSpirit Health, a nonprofit, Catholic health system.

Service contracts go through a review process that sends the contract up through the ranks.

“Contracts are reviewed and submitted by the CE manager to the regional director. The quote along with justification of the cost and 12-month history are submitted together. The document is reviewed by the regional

director before being submitted to the national office for final review and approval, before a P.O. is created to be paid and the final contract signed,” Watkins says.

Data collection is dependent on the team’s astute techs.

“The collection of data is heavily dependent on what the tech inputs in the Team Net database system. This process starts with the techs entering the series of equipment our team manages including model, department, and warranty or contract coverage. Data collection continues as the tech performs preventative maintenance, corrective maintenance, recalls and other services. The Team Net database system allows biomed to input various data and attachments to help support the equipment we service. The Team Net data system also allows the customers (nurses/ hospital staff) to submit requests for repairs on systems or equipment needing service,” Watkins says. Integration with IT is achieved through regional resources, available when the need arises.

“CE does not have a station/in-house IT person. However, CommonSpirit Health as a company has identified the need and created a CE/IT regional team. This team works with biomed to maintain direct network-related integrations with medical equipment,” Watkins says.

He says that the department encourages all techs to be knowledgeable and well-rounded on as many modalities [as possible] in order to provide the best service to its customers.

INVESTIGATING A BOOT LOOP

Technology has enabled a number of tasks that were not possible before. It also can present problems and challenges and diagnostic investigations that test the meddle of biomed departments and OEMs.

“Biomed participated in many different projects throughout the year as the hospital continues to grow. Some of the most recent projects biomed has participated in are the Philips telemetry monitors installation, anesthesia installation, infusion pump software

upgrades and the installation of the new MRI room,” Watkins says.

He says that problem-solving is a daily task for the department.

“One of the biggest situations biomed has been involved in would be with the Philips telemetry monitoring system. This is because biomed has to work with multiple departments to get a task accomplished, including networking. Updates pushed from networking can often cause our system to lose patient monitoring. When this happens, we often have to troubleshoot across several modalities or other department specialties in order to correct the problem. Many times, industry-specific terminology can create a barrier to resolving the problem,” Watkins says.

The Philips telemetry systems project has been a recent focus of problem-solving.

“Recent updates completed on the system caused it to go into what is called a boot loop. This is when the machine tries to restart but can’t complete the restart process and continues trying. While this issue occurs, the department loses patient monitoring. After CE worked through multiple troubleshooting steps, Philips had to be contacted and it was determined that the cause was a conflict between the Philips application and an anti-virus virus installed on the system,” Watkins says.

He says that the CE department scheduled a meeting between the CE/IT and Philips on steps to correct and resolve the issue.

“CE consulted with Philips and determined the best plan of action. Unfortunately, CE and Philips were not successful and we had to take the system down in sections to completely reimage each section. The process took about 20 minutes to an hour per section to completely reimage. CE often has to collaborate with multiple departments to resolve situations like these and prevent patient incidents,” Watkins adds.

He says that away from work, techs frequently attend Houston HTMA (Healthcare Technology Management Association) meetings.

“The department also has several techs that maintain AAMI biomed certification,” Watkins says.

In one of the nicest areas of the country to live in, the quality of health care cannot come up short. The Woodlands CE team makes certain that medical equipment is not compromised either.

“He says that the department encourages all techs to be knowledgeable and well-rounded on as many modalities [as possible] in order to provide the best service to its customers .”

The Woodlands Clinical Engineering Department maintains more than $100 million worth of medical devices.

All webinars and podcast are eligible for 1 CE credit from the ACI.

LIVE:

JULY 19 | Sodexo

Save the date for this live webinar. Participation is eligible for 1 CE credit from the ACI.

JULY 26 | Claroty

Save the date for this live webinar. Participation is eligible for 1 CE credit from the ACI.

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sponsored by MMS “Creating the New Biomed Pipeline”

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ASSOCIATION OF THE MONTH Washington State Biomedical Association (WSBA)

BY K. RICHARD DOUGLAS

The 42nd state to join the United States of America has been inhabited for 10,000 years, and although European explorers made a brief visit during the 1700s, American explorers did not set foot on the land until 1805. The state of Washington, in America’s Pacific Northwest, was created in 1889 and named in honor of the nation’s inaugural president – George Washington.

While known for vast forests and apples, the state is also home to a decades-old healthcare technology management (HTM) organization that serves its resident biomeds and others.

“The Washington State Biomedical Association (WSBA) was formed as a nonprofit organization in 1983. There is little information available specific to those start-up years, and into the early 2000s, due primarily to the storage methodology. There was no centralized database and most activities, meeting details and statistics were lost with the eventual failure of the ‘organizational laptop,’ ” says current WSBA President Steve Ellithorpe.

He says that the early years of the association were busy and purposeful.

“The field was growing, and professional certification was gaining momentum. The WSBA began connecting hospital-based biomedical technicians and managers, ISOs, vendors and manufacturers through monthly meetings (except December). These events were held at hospitals, vendor/supplier and manufacturer locations and various restaurants,” Ellithorpe says.

He says that the primary focus of the meetings was to bring the biomedical community together, network, and provide education, as well as introduce new technologies, experience

other biomedical shops and connect with vendor sales and service representatives.

“It was through these community connections and partnerships that allowed the WSBA to provide biannual symposiums. The WSBA also partnered with AAMI for the 1993 mid-year meeting and TechNation in 2018 for an MD Expo event; both in the Seattle area,” Ellithorpe says.

He says that with meeting locations predominately in Western Washington, the greatest attendance came from the greater-Seattle area. In the mid-1990s, one meeting a year was scheduled in Eastern Washington. In 2000, the WSBA symposium was held in Spokane and an eastside chapter was formed.

“The organization achieved a healthy engagement and turnover within the officer, board, and volunteers for most of the first two decades. Challenges with technology and competing virtual technologies, geography for local meeting travel and traffic, and fresh or new topics impacted meeting attendance and ultimately scheduled meeting frequency,” Ellithorpe says.

He explains that over the past 15-20 years, key individuals provided structure and leadership for the organization.

“Brandon Keith has served eight-plus years as an officer. Chris Walton served multiple years as an officer and as a volunteer. With his involvement, he created an officer handbook, further established a central document repository and used his experience to guide and mentor fellow officers and volunteers. Others, providing extended officer, board, or volunteer support, include Dennis McMahon, Ben Roberts and Jim Kenyon,” Ellithorpe adds.

During the onset and height of the COVID-19 pandemic, the flow of activities and planning for many organized groups was interrupted.

“Membership challenges have been cyclical over the years, and broader involvement for volunteers, board and officers has reflected this cycle. Dues were suspended for 2020-2021 to remove any barriers and accommodate virtual connection during the pandemic. Organizational sustainability relies on

membership dues, and they were reimplemented in 2022. Dues are used to maintain our website and digital presence, domain registration, meeting support and grant program,” Ellithorpe says.

He says that the association’s desire is to create a conduit for information and education to the WSBA membership and HTM community through these avenues.

“This is also ‘the why’ to sustain and further develop relationships through the technical programs/community colleges and vendor partners. It allows the WSBA to connect across the HTM community and provide opportunity for that community to engage, grow in their HTM career and strengthen the WSBA,” Ellithorpe adds.

KEEPING ON TOP OF THE REGULATORY ENVIRONMENT

One area that the WSBA has emphasized is providing members with education and up-to-date information on issues facing the HTM community.

“The WSBA maintains a focus on education for its membership. In the past year, year-and-a-half, the education was less on technology and medical devices. Instead, more regulatory and industry topics have been presented. Topics such as medical right to repair, liability in health care, FDA 510K process for device manufacturers, and biomedical soft skills. The WSBA is supportive of efforts for medical right to repair and is working to inform our biomedical community of on-going activities regarding this issue,” Ellithorpe says.

Annual meetings and symposiums have been thrown off-kilter by the pandemic and the disruptions it caused. The group’s last symposium was pre-COVID and the organization does not have a symposium scheduled in 2023.

The group made good use of technology to keep members engaged, even when the pandemic prevented in-person get-togethers.

“Association meetings have been held quarterly over these past few years. Specifically, since COVID-19, these meetings have exclusively been virtual. In 2023, we are planning a mix of virtual and in-person meetings. Access to hospitals as host locations has

changed over the years and become more challenging. Off-site locations are increasingly more expensive. Our officers and board are investigating more options,” Ellithorpe says.

The group also does its part to help the biomed community in Washington with funding for equipment.

“The WSBA does not have a scholarship program but does have a technology grant program for the local biomedical programs. This grant program makes up to $700 available annually for these programs to supply technology needs, such as test equipment or medical devices,” Ellithorpe says.

Additionally, the organization brings students from area training programs into the fold to get them involved.

“Beyond the grant program, the WSBA does maintain relationships with local technical schools/community colleges. Scheduled meeting notifications are distributed to program leaders and student membership dues are available at a reduced rate. Many of our symposiums over the years have been hosted at community college locations,” Ellithorpe says.

Again, the pandemic disrupted many scheduled events. The disruption has been difficult for many organizations to rebound from.

“It’s been over four years (pre-COVID) since our last symposium, and we are not planning a symposium in 2023. The WSBA and Oregon Biomedical Association (OBA) leadership have discussed partnering to develop a symposium and offering it across our collective memberships and HTM community. We are also seeking an opportunity to bring more regional events to the Northwest in the next one-two years,” Ellithorpe says.

Organizing and educating the HTM community in the northwest will grow stronger and more vibrant once more as the pandemic is in the rearview mirror. The WSBA will be leading the charge, helping biomeds and other members connect and stay informed.

NEXT GEN POWERED BY YP AT

MD

Jennifer Vazquez

ennifer Vazquez holds a bachelor’s in biomedical engineering technology and is the assistant unit director at the University of Cincinnati Medical Center. She is also the subject of this month’s Next Gen feature.

Q: WHERE DID YOU GROW UP?

A: Central Florida. If I named the town, most individuals have never heard of it unless you’re from the area.

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

A: Most of my training and upbringing has been on the job. I never received anything truly formal through school. I was blessed enough to be sponsored by my companies to train me themselves for certain modalities or have been sent to training by them dependent on the modality.

Q: HOW DID YOU FIRST DISCOVER HTM?

A: My first exposure was a high school research assignment that I eventually caused the entire class to do for a grade. I still wonder if people harbor some feelings about that.

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

A: I’ve always put off making a final decision in my professional growth. I never considered seriously what I wanted to do. I was always told that medical was well liked by my family as something to consider. Then, I just did well in my engineering class (which focused broadly on an open concept on machinery.) If it really wasn’t for my high school teacher that told me about the field, I would have never known about it. Thinking back on it, I don’t think I can argue that I just fell into it just by happenstance.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?

A: I don’t label myself based on my position. Positions offer boundaries. So, I only operate within my position in front of my client.

Q: WHAT INTERESTS YOU THE MOST ABOUT HTM?

A: I find the professionals within the field intriguing. The diversity in the field from the vast diversity of perspectives and personas are just interesting to watch.

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

A: I really don’t consider anything I’ve done as accomplishments. Everything I do is just a fulfillment of an ask. Accomplishments are a perceived concept. “Other duties as assigned” is still part of a job description. Regardless, it’s my job to fulfill the ask to the highest caliber of my ability.

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

A: It’s too soon to tell. I ride this thing day by day.

FUN FACTS

FAVORITE HOBBY: People watching

FAVORITE SHOW OR MOVIE: Really don’t have one

FAVORITE MEAL: Don’t have one.

WHAT WOULD YOUR SUPERPOWER BE?

Reading minds. Honestly this might make my hobby a bit more interesting instead of me having to guess.

NEWS & NOTES

Updates from the HTM Industry

INDIANAPOLIS TAPPED FOR 2024 HTM MIXER

MD Publishing President John Krieg recently announced that the 2024 HTM Mixer will be held at the Westin, in downtown Indianapolis. Healthcare Technology Management (HTM) professionals are encouraged to “save the date” for the May 2-3, 2024, event proudly supported by the Indiana Biomed Society (IBS). This event will be held in lieu of the annual IBS conference.

As with other recent MD Expos and HTM Mixers, a partnership with a strong HTM association is expected to fuel interest and help produce a successful conference.

“Really excited for this one,” Krieg said. “It will be an opportunity to partner with one of the leading state associations!”

The announcement came days before the very successful 2023 HTM Mixer in Baltimore.

For more information, visit HTMmixer.com.

FSI CMMS WINS MEDTECH BREAKTHROUGH AWARD

FSI, a provider of CMMS solutions for health care organizations, recently announced that its eBinders solution has been selected as the winner of the “Compliance Management Innovation Award” in the 7th annual MedTech Breakthrough Awards program. The program was conducted by MedTech Breakthrough, an independent market intelligence organization that recognizes the top companies, technologies and products in the global health and medical technology market.

FSI’s cloud-based computerized maintenance management software, CMS, helps teams operate efficiently. The software empowers teams to create safe health care environments and operations. Created in collaboration with Joint Commission Inspectors, FSI is the first to launch eBinders, a mobile-friendly “electronic binder” that ensures health care organizations are always prepared for compliance surveys from The Joint Commission, DNV and other local jurisdictions.

FSI’s eBinders helps hospitals organize and keep track of compliance reports and dashboards from one location within their CMMS, eliminating the need for physical binders, reducing errors through standardized naming conventions, and creating automatic reports that generate on a regular basis.

“Administrators can pull up any relevant documents using a

user-friendly search function at any time – whether they’re preparing for an inspection or talking to an inspector. Simple to use, eBinders users save time on reviews, cuts down on errors and provides the ability to eliminate physical binders,” according to a press release. “The efficiency eBinders offers helps users to physically run less reports and spend less time organizing binders. This allows teams to focus on getting inspection ready and staying compliant 100% of the time. Users can search documents on-demand and easily filter by date, PM types, custom attributes, location, status, compliance indicators and more.”

ISS SOLUTIONS, NUVOLO ANNOUNCE PARTNERSHIP

ISS Solutions Inc. and Nuvolo recently announced a partnership that will offer healthcare technology management (HTM) programs access to ISS Solutions’ enterprise asset management (EAM) and HTM expertise to optimize their Nuvolo Connected Workplace for Healthcare software deployments, streamline workflows, and improve reporting and data analytics.

ISS Solutions provides clinical equipment maintenance and HTM support to approximately 300 sites nationwide and is the only Nuvolo partner with this level of HTM experience and knowledge, according to a press release.

“After optimizing Nuvolo’s workflows for years for our own clients, ISS Solutions Inc. can now provide services to any HTM organization looking for assistance to configure, implement and optimize their own Nuvolo instance,” says Barbara Maguire, vice president of healthcare technology management at ISS Solutions.

ISS Solutions can assist in configuring the Nuvolo Connected Workplace for Healthcare CMMS to meet the needs of technicians, managers, support teams and leadership, while ensuring users have the data to meet regulatory requirements and manage HTM operations.

NEW LIVE DEMO VIDEO SERIES DELIVERS INFO

The inaugural TechNation Tools of the Trade Live Product Demo was a big hit with healthcare technology management (HTM) professionals.

Elite Biomedical’s front case for the Philips MX40 was featured in the May issue of TechNation and again in the first-ever Tools of the Trade Live Product Demo. Glenn Schneider, MHSA, chief service officer of Elite Biomedical Solutions, presented the live demo on the Philips MX40 IntelliVue.

Elite offers newly manufactured replacement parts for the Ph ilips IntelliVue MX40 case. The Elite MX40 front and rear case allows biomeds to keep units up and running with:

• Drop-in, rear case, replacement to the OEM component

• Silicone gasket and case assemblies (yellow and white side stickers, terminal seal, terminal cover and temperature indicator)

• Front case is compatible with both the new and old software revisions

• Provides equivalent ingress protection as OEM The session drew almost 50 HTM professionals for the

Among the services it offers, ISS Solutions can support:

• Data clean-up and standardization

• Balancing PM schedules

• Streamlining CMMS data entry requirements through automated workflows, including receiving and completing service requests and managing work orders and data

• Automating the process of ordering parts and vendor services

• Managing service contracts

• Creating customized reports to meet the specific needs of a team and organization.

“As the only CMMS designed specifically for HTM organizations that is built on the ServiceNow platform, Nuvolo’s market share has grown significantly among HTM departments, ISOs and clinical equipment manufacturers. As a Nuvolo Partner with both HTM expertise and certified ServiceNow professionals on staff, ISS Solutions is uniquely qualified to provide your organization with the support it needs to successfully implement and optimize your Nuvolo CMMS. Our team of HTM and ServiceNow experts, all experienced HTM professionals, can assist your health care organization throughout each phase of your EAM project,” according to the press release.

live presentation and attendees gave the demo a 4-star rating with 5 being the highest possible rating.

Attendees were asked, “What was your single biggest takeaway from today’s product demo?”

“Good to know that they have everything but the electronics for these devices. I am sure they are less expensive than buying from Philips,” said Dwight Bishop, a biomd at Cincinnati Children’s Hospital.

“It was short but simple and right to the point,” said BMET Spencer McLane from Cincinnati Children’s Hospital Medical Center.

“We will think about placing an order,” said Thomas Lariviere, a biomed with Mass General Brigham/Cooley Dickinson Hospital.

Elite Biomedical Solutions sponsored the live demo. The company is known for the manufacture, assemble and distribution of new replacement parts for infusion pumps and telemetry devices. It also provides depot repair and onsite service for clinical engineering departments.

RSTI EXPANDS CAPABILITIES WITH NEW MR/CT MANAGER

RSTI has added Ezequiel “Zeke” Hernandez as its new service manager, CT/ MR engineer – allowing for immediate growth and expansion of MR/CT capabilities including parts, training and service opportunities.

“We look forward to combining RSTI’s almost 40 years in the third-party industry with Zeke’s 14-plus years technical experience. Zeke’s skill set will be a perfect addition to continue our growth into MR and CT modalities, including, cold head replacement, helium fills, magnet maintenance, as well as MR and CT service support calls,” RSTI Exchange CEO Terry Speth said. “We appreciate you helping us in welcoming him to the RSTI team!”

Since 1985, RSTI (Radiological Service Training Institute) has been providing diagnostic imaging training. With a selection of over 35 courses each year, RSTI has trained over 15,000 service professionals from over 50 different countries in radiology, mammography, MR, CT, ultrasound, networking, PACS and DICOM.

JURY: PHILIPS GUILTY OF UNFAIR AND DECEPTIVE PRACTICES

Avante Health Solutions announced a signi fi cant turning point concerning the right to access, service and maintain diagnostic imaging medical equipment manufactured by Philips Medical Systems for Avante’s customers who own the equipment.

In April, under North Carolina’s Unfair and Deceptive Trade Practices Act, a jury in the Western District Court of North Carolina (case 3:20-cv-00021-MOC-DCK) awarded Avante a verdict fi nding that Philips engaged in unfair and deceptive practices by refusing to provide key information necessary to perform service, maintenance and repair of Philips’ Allura and Azurion cath labs and Philips CT systems. The monetary award, which is to be finalized by the court, is expected to be in the millions.

Further, the jury concluded that Avante’s advanced methods for servicing medical equipment do not misappropriate any of Philips’ trade secrets. The only findings for Philips related to activities that occurred prior to the issuance of the “DMCA Exemption” by the U.S. Copyright O ffi ce in October 2021. The jury’s verdict a ffi rmed Avante’s long-held “right to repair” position that Philips aggressively targeted independent service

organizations (ISOs) and sought to limit their access to information needed for service and maintenance of Philips’ medical systems.

The DMCA Exemption now permits owners of medical devices, such as hospitals and health care professionals, and ISOs to access system software for the purpose of diagnosing, servicing and repairing such devices. It speci fi cally eliminates liability for accessing controls to copyrighted software and related data fi les on lawfully acquired medical devices or systems when access is a necessary step in maintaining or restoring a device to work in accordance with its original speci fi cations.

“The right to repair medical equipment is central to patient care, safety and competitive, lower-cost service alternatives to reduce overall health care expenses in the United States,” said Jim Leitl, chief executive o ffi cer and president of Avante Health Solutions.

“Avante has the most skilled and well-trained service technicians in the industry, ensuring state-of-the-art services to all customers,” Leitl added.

To learn more about the DMCA Exemption, visit the Federal Registry and govinfo.gov.

HTM MIXER RECAP

Biomeds Flock to HTM Mixer Baltimore

BY JOHN WALLACE

MD Publishing, the parent company of TechNation and MD Expo, recently held a successful HTM Mixer in Baltimore with almost 300 people in attendance!

“This was by far the best attended HTM Mixer that we have had,” MD Publishing President John Krieg said.

The HTM Mixer was held at the Turf Valley Resort and was supported by the Baltimore Medical Engineers and Technicians Society (BMETS). The event provided valuable continuing education, networking and vendor engagement opportunities.

The Mixer served as a regional conference for HTM professionals eager to earn continuing education credits, explore solutions in an exhibit hall and network with peers.

“Thanks so much for a successful event. My staff and I learned a lot at the seminars and made contact with vendors that can help us with several issues at our hospital. We really enjoyed the event and the accommodations,” Frederick Health Biomedical Engineering Director Walt Scowden, BA, CHTM, CBET, said.

“The HTM Mixer by MD Expo was a great regional event, with great speakers and vendor booths,” Skytron Executive Sales Manager and BMETS President Michael Milan said. “As a sponsoring vendor, I had some enthusiastic conversations about real-world challenges, and was able to discuss the solutions we offer. The attendees seemed to really want to learn, and take advantage of all of the knowledge available from each vendor.”

“As The Baltimore Medical Engineers & Technicians Society (BMETS) president, I would say that we reached a lot of clinical engineers/biomeds/department heads that had not previously attended a BMETS meeting,” he added. “When discussing the purpose of our 40-year-old organization and what we

strive to deliver in our monthly meetings, people really understood the value of exchanging ideas and keeping up on industry trends and regulations. Four vendors who sponsored monthly BMETS meetings in the 2022-23 meeting year were in attendance at the HTM Mixer, and I suggested prospective sponsors go speak with them to hear firsthand the value that comes in presenting their services or products to the group.”

“That being said, yes, the HTM Mixer absolutely exceeded my expectations as BMETS president,” he added.

The educational lineup for the HTM Mixer featured several one-hour sessions designed to cover hot topics and great insights for attendees. Career development, leadership, certifications, electrosurgery, contrast injectors, health technology hazards, art of contract negotiations, cardiology for biomeds and ultrasound were among the topics covered.

“This was my third HTM Mixer as both a presenter and attendee and I continue to be most impressed by the consistent high quality of the sessions, the number and mix of supporting vendors, and the always popular food offerings and happy hour. It’s also especially refreshing to see the fun and networking going on among the attendees, vendors and the incredible MD Expo staff. Simply, I always leave more informed, recharged, rebalanced and proud to witness and be a part of such programs,” Milwaukee School of Engineering Adjunct Professor Larry Fennigkoh, Ph.D., PE, said.

“In addition to the Mixer’s technical sessions, what I’ve come to believe may be even more lasting and helpful, is the almost palpable therapeutic value of such programs,” he added. “While the attendees always seem attentive and eager to learn, they seem even more hungry for the interaction with their like-minded and dedicated fellow biomeds. Hospital biomed work is hard, and it is not uncommon for those in the trenches to get verbally banged up and bruised on a regular basis – making one start to question the value of their work. Attending such

Mixers can be a great way to heal, reenergize and prevent your passion from turning into some form of apathetic scar tissue.”

More than 40 of the leading HTM companies had booths in the exhibit hall to share solutions with attendees. A welcome reception, coffee breaks and a happy hour provided additional networking opportunities for everyone in attendance.

“Absolutely, not only met but exceeded my expectations,” Fennigkoh said when asked if the HTM Mixer met his expectations. “Just when I think there may not be anything new to learn, I get surprised with some new concept or pearl of wisdom I didn’t have before. Interacting with the other attendees and vendors always reinforces and validates the importance of what this entire HTM community is trying to do.”

MD Publishing recently announced the next HTM Mixer will be held in Indianapolis. The Indiana Biomedical Society (IBS) is supporting the HTM Mixer. The HTM

Mixer will be held in lieu of the annual IBS symposium.

“My recommendations to a biomed considering attending a future HTM Mixer or MD Expo is to engage with the vendor booths and see what products or services they offer, for real-world problems,” Milan said. “With the intersection of clinical engineering and IT, I foresee a lot more solutions to manage workflow, preventative maintenance schedules and diagnostic testing.”

“If you’re at all passionate about your career, attending any future HTM Mixer should be an absolute no-brainer. You will not find a better, value-added program anywhere. At only one day in length, it’s even worth using one of your vacation days if your employer won’t let you attend. These meetings can be some of the best PM you can give yourself,” Fennigkoh said.

For more information, visit HTMmixer.com.

RIBBON CUTTING FSI

SI offers a full suite of software developed for and by health care engineers, designed to enable health care technicians to lead and run efficient and safe hospitals. Its CMMS offers products related to compliance and regulations, space management and rounding, data and analytics, as well as a mobile application, just to name a few.

TechNation interviewed FSI CEO Zachary Seely to find out more about the company.

Q: WHAT ARE SOME OF THE SERVICES AND PRODUCTS YOU OFFER? IS THERE A SPECIFIC PRODUCT YOU ARE EXCITED ABOUT RIGHT NOW?

A: What makes FSI unique is that in addition to our deep software expertise, we offer professional services, including data collection, training, compliance and consulting to help ensure our customers are getting the most out of our products and are set up to succeed. Some of the newest elements we’re adding to our product suite in the near future will help with capital planning. These features will allow hospitals to leverage the rich data they have through their CMMS to ensure they can effectively apply their resources for the biggest impact. This is especially important today as many health care systems are faced with financial constraints and regular assessments of department expenses are top of mind.

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

A: What sets us apart from other CMMS providers is that we are purpose-built for health care. FSI has worked in this industry for as long as the company has existed, which is over 20 years. Our core focus has always been health care and hospital maintenance needs. That’s why so many of the members of our team have worked in hospitals, from biomed/HTM to operations and facilities management. Just as important, data integrity is at the forefront of our services. FSI started as a data collection and inventory service provider, which is still an important service we provide in-house. We believe that building the best software

alone isn’t enough to enable the outcomes that are critical to our customers. They need to have clean, complete and accurate data to get the best outputs from the software. In essence, we’re a one-stop shop for a health care system’s software needs – a robust portfolio of CMMS, mobile, rounding, compliance, etc. You can find everything you need from one provider.

Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY?

A: In addition to the features we’re launching related to capital planning, we’re making several investments on the HTM side. After meeting with some of our HTM customers, we’re looking to improve workflow with clinical equipment inspections and testing and enhancing our regulatory standards reporting compliance to TJC, DNV and other AHJ. Additionally, we’re expanding scalable integrations through our new public API and diving deeper into real time location services (RTLS), both a priority for our biomed/HTM customers. When tied into CMS’s drawing-based location tool, finding equipment that needs work done will be easier. At the end of the day, we are constantly investing to ensure we are the right provider so hospitals can get everything they need from us and our partners. We want to be known as a reliable partner that enables safe and efficient operations.

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

A: At FSI, we approach customer success a little differently from other software companies. We’ve recently launched The Neighborhood, an online community that allows FSI users to leverage each other, in addition to our in-house experts, to help solve real, practical, everyday problems and learn from their peers. Through discussion boards and regularly updated release notes and content, users have an online network and extension of their team to help them make the most of the product and learn best practices. We look forward to seeing your teams at the MD Expo this fall, or even someday around The Neighborhood – our team is always ready to meet new people in the biomed/HTM realm and see how we can be of service.

For more information, visit fsiservices.com.

AAMI UPDATE

AAMI Foundation Names 2023 Award Winners

The Association for the Advancement of Medical Instrumentation (AAMI) Foundation has awarded three deserving individuals from the health technology community with a 2023 award. Winners were recognized by thousands of their peers and received a monetary prize and plaque commemorating their achievements in June during the 2023 AAMI eXchange.

The 2023 AAMI Foundation Award winners are:

• The AAMI Foundation & ACCE’s Robert L. Morris Humanitarian Award: Shauna Mullally, Manager, Health Technology Planning, Infrastructure Planning Division, Department of Health and Social Services, Government of the Northwest Territories

• The AAMI Foundation’s Laufman-Greatbatch Award:  Dr. Ajit P. Yoganathan, Emeritus Regents’ Professor and the Wallace H. Coulter Distinguished Faculty Chair in the Wallace H. Coulter Department of Biomedical Engineering at the Georgia Institute of Technology and Emory University

• The AAMI Foundation & TRIMEDX John D. Hughes Iconoclast Award: Stephen L. Grimes, AAMIF, FACCE, FHIMSS, FAIMBE, Principal Consultant with Strategic Health Care Technology Associates, LLC.

MULLALLY RECOGNIZED WITH ROBERT L. MORRIS HUMANITARIAN AWARD

This award – honoring the late humanitarian Bob Morris – recognizes individuals or organizations whose humanitarian efforts have applied healthcare

technology to improving global human conditions.

Since late 2016, Shauna Mullally has been in the Canadian sub-arctic overseeing medical equipment planning and procurement for the Northwest Territories’ 34 communities’ health facilities and health and long-term care services. Having also worked with communities in Gambia, Zambia, Denmark, Guinea, Guinea-Bissau, and London, Mullally has showcased how healthcare technology management practices can enrich low-resource health care systems around the world.

Among her proudest achievements is the development of a birthing house for and with the women of the village of Penyem, Gambia. Over 200 babies have been born at the facility since then, and it is now a full health center for the village with a visiting nurse and doctor.

“I was drawn to engineering because I loved math and science, and once I got there I was drawn to biomedical and clinical engineering because I wanted to work in an area that was people focused,” Mullally told AAMI.

“There was no turning back once I saw first-hand what a lack of safe, available health technologies means to patients and caregivers in low-resource settings. There is a tremendous amount of good our profession can do in the world, particularly in places with very few resources,” she said. “It is meaningful for me to join the past recipients of this award, many of whom have been mentors to me. I believe in the work of AAMI and the ACCE in this area and feel very humbled to be recognized.”

YOGANATHAN HONORED WITH LAUFMAN-GREATBATCH AWARD

Named after two pioneers in the field – Harold Laufman and Wilson Greatbatch – this prestigious recognition honors an individual who has made a

unique and significant contribution to the advancement of healthcare technology and systems, service, patient care, or patient safety.

A member of the National Academy of Engineering, Dr. Ajit P. Yoganathan’s career is defined by the application of basic engineering science to develop meaningful health outcomes. Since 1975, all prosthetic heart valves implanted in the U.S. – more than two dozen valve designs – have been studied and evaluated in Yoganathan’s lab. Utilizing experimental and computational biomechanical techniques to study native and artificial heart valves, heart function, and congenital heart diseases, Yoganathan’s work has been called “foundational” for the development and evaluation of numerous cardiovascular devices.

Yoganathan also regularly works with medical device regulatory organizations. Since 1979, he has worked with the U.S. FDA and in the early 2000s Yoganathan served as Chair of the International Standards Organization committee for implantable cardiovascular devices, influencing the development of industry-defining standards.

“My interest in artificial heart valves was sparked in 1975, by an off-chance encounter with a cardiologist named Earl C. Harrison, MD, during my Ph.D. work at the California Institute of Technology. It launched an exciting and fulfilling 45-plus year journey. I have been working on U.S. and International Cardiac Valve Substitutes Standards (ISO 5840) since 1984,” he said. “I am truly honored by this award, since it recognizes my passion for impacting human lives and in ensuring safe cardiac devices for patients in need. This is my research philosophy: from bench to bedside, and more recently bench to bassinet – in dealing with heart valve devices for pediatric patients.”

GRIMES RECOGNIZED WITH JOHN D. HUGHES ICONOCLAST AWARD

The AAMI Foundation and TRIMEDX John D. Hughes Iconoclast Award recognizes an individual who pushes the boundaries of the healthcare technology management (HTM) profession and demonstrates individual excellence, achievement, and leadership.

Steve Grimes is a recognized authority and frequent national and international speaker on topics ranging from future challenges facing the health technology support industry to healthcare technology convergence, medical device security, risk management, maintenance management, and quality management issues. A friend and colleague of the late John D. Hughes, Grimes developed an appreciation for challenging the status quo to enable meaningful growth for an organization or professional field.

“To be successful, I believe our community must focus on necessary changes in the role and education of HTM professionals,” he told AAMI. “There’s a need to change the nature of HTM services delivered if we ever hope to match the evolution of technology we’re seeing take place before us.”

“I am fortunate that I have had the opportunity to work with, and advise leaders of relevant professional organizations on the roles their organizations should play to effectively address the needs of their constituents,” Grimes added. “This includes work I’ve had the opportunity to do on new standards, education guidelines, professional roles, and the general promotion of a systems approach toward healthcare technology management. Hopefully, some of what I’ve done has helped stimulate new and progressive thinking on how we can successfully face our challenges. In the end, I’m satisfied if I’ve helped in some small way to make the world a little better.”

Shauna Mullally Robert L. Morris Humanitarian Award

Dr. Ajit P. Yoganathan Laufman-Greatbatch Award

Stephen L. Grimes John D. Hughes Iconoclast Award

ECRI UPDATE

ECRI Names Health Technology Excellence Award Winner

CRI recently named the Guthrie Clinic in Sayre, Pennsylvania, as the winner of its 2023 Health Technology Excellence Award. ECRI’s annual award honors a member facility for implementing an exceptional initiative to improve patient safety, reduce costs or otherwise facilitate better strategic management of health technology.

The Guthrie Clinic, a rural integrated health system serving patients in New York and Pennsylvania, won this year’s award for its strategic approach to addressing staffing shortages exacerbated by the COVID-19 pandemic. Using an artificial intelligence (AI)-enhanced video and communications platform, the organization rapidly implemented a telesitting program to address its immediate need – a staffing crisis. Significantly, this initiative also served as the first phase and proof of concept for developing a virtual command center – called the Guthrie Pulse Center – that would centralize certain operational and patient care functions and provide greater access to clinical expertise regardless of where the patient was being treated.

“Shortages in the health care workforce are a top patient safety concern. We were impressed with the safety, quality and financial results that Guthrie achieved after setting up their system,” says Marcus Schabacker, MD, Ph.D., president and CEO of ECRI. “Their implementation of AI and video technology led to immediate improvements in patient safety, as well as demonstrable cost savings.”

Beyond addressing the staffing crisis, the Guthrie Clinic’s initiative positions the organization to better meet patients’ future needs as health care delivery models evolve. The project is intended to help the organization improve care – and improve access to care – in a variety of settings across the large geographic region that the health system serves.

“We’re thrilled to be recognized for the contributions the Guthrie Pulse Center is making to patient care,” said Terri Couts, RN, MHA, Guthrie’s chief digital officer.

“Building off of our positive experience with AI in addressing our original staffing challenge, we broadened our focus to provide additional supportive care to our intensive care unit (ICU) nurses and the patients we serve by providing an experienced remote critical care nurse as enhanced support for the bedside nurse. This allowed for a more experienced nurse to support the less experienced ICU bedside nurse with functions like blood administration, second signs of high-risk medications, procedural support, and general questions and monitoring. This support directly impacts the outcomes of our patients, helps our nurses feel supported, and allows us to keep our patients in the right bed closest to home,” explained Couts.

In addition to naming the Guthrie Clinic the 2023 award winner, ECRI recognizes the Johns Hopkins Armstrong Institute for Patient Safety and Quality (Baltimore, Maryland) as runner-up for its development and implementation of an innovative safety-event-reporting software application. Award finalists are Einstein Medical Center, Jefferson Health (Philadelphia, Pa.), Robert Wood Johnson University Hospital Somerset (Somerville, N.J.), and the University of Miami Miller School of Medicine (Miami, Fla.).

For more information about the Guthrie Clinic’s initiative, read The Health Technology Excellence Award: Recognizing Exceptional Health Technology Management. To see past award winners, visit the Health Technology Excellence Award Winners Circle.

For more information, visit www.ecri.org or email clientservices@ecri.org.

BIOMED 101

Unlocking the Potential of the Next Generation

r. Brian Bell works with students in the field of biomedical engineering technology education. By creating biomedical STEM kits that students can use anywhere, he has allowed students more flexibility in their learning, even with online courses.

Recently, he has implemented new hands-on labs using electronics kits designed for students to learn how to build their own patient simulator and vital signs monitor. According to Bell, “these hands-on projects are the best way for students to explore technology, manufacturing and engineering of health care devices.”

The goal of these kits is to expand the opportunity to learn about biomedical engineering technology.

“At HTM Workshop, our goal is to create great content in healthcare engineering and technology. In doing so, we hope to raise awareness of the HTM and biomed career fields,” says Bell.

These kits are now being used all over the country and the world to help students learn competencies in biomedical engineering technology.

WHAT DO STUDENTS DO?

First, students learn the correct way to solder using video training. Next, they apply the concepts they learn, such as heat, corrosion, and thermal conductivity, to create a good solder joint.

Finally, once students build and assemble their kit, they can analyze their own heart’s electrocardiograph.

COMPETENCIES STUDENTS LEARN

SPC students learn about electrocardiography (ECG), and by using the free educational resources from HTM workshop and the HTM Workshop YouTube Channel, they learn how to connect patients to an electrocardiogram, set patient alarms and identify common ECG artifacts.

Students also have to answer questions about the electronics and the health care side of technology, such as describing one type of digital filter used in patient monitors and calculating the gain of the TLC272 by measuring the change in voltage between pins 1 and 6 on the chip and researching the common alarm limits for different devices.

In addition to building their own electrocardiography devices, students get to create their own ECG simulator to test patient monitors and build on their electrical safety testing knowledge. Student can then use the ECG simulator to test different alarms on patient monitors or the ECG simulator they already built!

To show competency learners must:

1. Identify correct electronic components

2. Solder components onto PCB board

3. Verify and test the board

4. Troubleshoot and fix any issues that occur

5. Built and tested an electrocardiogram

6. Build and test a patient simulator (ECG and respiratory rate)

7. Test patient monitor alarms

WHAT DO STUDENTS SAY?

“The ECG Simulator project was an excellent addition to the course,” says a biomed student.

Bell’s efforts to provide students with hands-on

learning opportunities and to expand the knowledge and awareness of biomedical engineering technology are making a positive impact on the next generation of learners.

“The ECG Reader was like Legos but for biomedical devices, you get to put all the parts together and see how it works,” a student said.

The use of these biomedical learning kits has helped bridge the gap between traditional classroom learning and practical application. With these hands-on projects, students are not only learning important skills in soldering and electronics but also gaining valuable knowledge and experience in healthcare technology. By building their own devices and analyzing their own vital signs, they are actively engaged in the learning process and are more likely to retain the knowledge they acquire. As the use of these kits continues to grow, it’s exciting to think about the impact that they will have on the future of biomedical engineering technology and the talented and competent professionals who will shape the industry.

information, visit HTM-Workshop.com.

Photos 1 & 2 show SPC students soldering their ECG Reader kit. Photo 3 shows examples of two modes in ECG Simulator, there are a total of 8 modes, and students are able to create their own custom waveform. Photo 4 shows a student testing patient monitor with the ECG simulator.

Brian Bell, Ph.D., faculty biomedical engineering technology at St. Petersburg College in Florida and founder of HTM Workshop. For more

CANDIDATES

CONSULTING SERVICES

TOOLS OF THE TRADE

Newell Recruiting and Consulting LLC

"Newell Recruiting and Consulting, LLC is a veteran-owned business with over 20 years of experience in the healthcare technology management (HTM) industry. NRC is ready to serve the HTM community in the areas of growth, development, sustainment and retention."

In a career spanning over 20 years, positions held from Tech I to Team Lead to Manager to Director, NRC President and CEO J.C. Newell has a firm understanding of what is needed.

“If you are looking for a fresh opportunity, please allow us to help you find your fit,” Newell said. “We work with vendors and in-house facilities across the country and would be

excited to provide you with support and advocacy, in finding a place that provides you with what you need in location, salary and benefits. You are the talent, so we want to ensure that you have a place to shine!”

Let NRC be your one-stop-shop for your career needs.”

For more information, visit NRC-HTM.com

“The Importance of Traceability in X-ray QA and Testing Performance”

rtigroup.com

In today’s world of AI and advanced imaging solutions via software, is there a better path for the HTM community to streamline workflow and standardize X-ray test procedures? Why are many still using Excel and/or spreadsheets to generate reports and maintain records of X-ray QA and test data? Common spreadsheets permanently store the records of testing and QA activities, but the reality is that they truncate the traceability. RTI Group Training Manager Erik Wikström shared ways to improve traceability through the use of a built-for-purpose QA and testing software; Ocean Next. He also discussed the advantages of a cloud service that backs up and synchronizes the measurement database enabling immediate access to fully traceable data. Attendees provided feedback regarding the webinar in a survey that also asked, “Why did you attend today's webinar?”

• “I am a general biomed trying to expand my knowledge in the imaging sector as well as maintain my ACI certification through continued education,” -Daniel Craig, biomedical equipment technician.

“5 Ways HTM Teams Are Leading Healthcare Cybersecurity”

cynerio.com

Responsibility for improving cybersecurity practices in health care environments is typically owned by IT and security teams, but frequently requires significant input and action from their HTM colleagues. As these demands grow many biomeds are tasked with growing responsibilities despite tightening budgets, limited resources and timely demands. In this webinar, the Cynerio team discussed cybersecurity challenges faced by HTM teams, the origins of these challenges, and steps that leading teams are taking to protect patients and secure facilities while still having time to do their day job – keeping devices safe and operational. Attendees provided feedback about the webinar via a survey that included the question, “Was today’s presentation worth your time?”

• “Chad was very knowledgeable. I enjoyed his accurate breakdown of what cybersecurity is like in a hospital environment,” -Sevag Soghomonian, Children’s Mercy Hospital.

claroty.com

In the webinar, presenters Ty Greenhalgh, industry principal for healthcare, Medigate by Claroty, and Justin Heyl, director, enterprise risk management, Baxter International Inc., discussed cybersecurity strategies that both manufacturers and health providers can implement for legacy medical technology as a shared responsibility in the clinical environment and provide insights for designing future devices that are more secure. They also talked about legislation and regulation that is being bantered about in an effort to secure these vulnerable network entry points. Participants in the webinar were asked “What was your single biggest takeaway from today’s webinar?”

• “This webinar brought to light some things I had never considered in terms of being a target for attack … such as HVAC systems. Very interesting presentation that I enjoyed,” -Shannon Dingus, Manager, Indian Path.

“Preventing Cyber Pain in Healthcare: A Comprehensive Approach to Legacy Medical Technology Security”

ROUNDTABLE

Diagnostic Imaging Devices

TechNation recently invited several companies to participate in this roundtable article on diagnostic imaging devices. Participating in the article are Agiliti Vice President of Clinical Engineering Chris DeHart, MW Imaging Senior

Service Director

Tom Hanak, Probo Medical Director of Training and Field Service Hobie Sears and Innovatus Imaging Vice President of Sales and Marketing Matt Tomory.

Q: WHAT ARE THE BASICS THAT EVERY BIOMED SHOULD KNOW WHEN IT COMES TO IMAGING DEVICES?

DEHART: There are a few things every biomed should

know about imaging devices. First, they should have a foundational understanding of basic radiation theory and X-ray. Second, biomeds should take part in radiation safety training prior to working on any device that emits radiation. They should also have training on the specific devices they service and the proper tools and test equipment to use. Lastly, biomeds should have a desire to service and work closely with customers. Hospitals rely heavily on these devices and back-up equipment isn’t always available. Having effective communication skills with a high sense of urgency is important to keep the customer informed on service activity.

HANAK: When it comes to ultrasound devices, there are three things that are core. HTM professionals servicing their fleet of ultrasound systems should have a basic knowledge of ultrasound principals and theory, a general knowledge of transducer care and handling, and they

should have basic training on the particular platform they are servicing. Every ultrasound system and OEM are different in one way or another. When the engineer has basic system training, this increases their confidence and provides for a better evaluation of the system overall.

SEARS: There are several things to understand when moving into the imaging realm of service. These include the urgency of service, the greater the spotlight will be on you as the engineer and the amount of communication that you will need to provide to the various shareholders in the imaging department will be greater. Often biomeds are referred to as generalists, moving into imaging will also change that perspective … you are likely to become a specialist, or at least an engineer with specialist’s qualities. You must be prepared for these new challenges, which will include technical training, of course, it should also include soft skills training to fill in any gaps you may have in your communication/people skills. The technical stuff is generally easier for engineers and getting those soft skills refined takes as much, if not more, work and practice.

TOMORY: The basic functionality of the device or how to operate the device. When I first started with GE Ultrasound in 1999, I was not trained on an echo system called the Vivid 5. When I arrived, I could not immediately find the very obscure on/off switch which unfortunately was quickly noticed by the sonographer. At Innovatus Imaging, I teach an ultrasound applications/knobology class for service engineers which encompasses basic operation, imaging modes, terminology and functionality tailored for service engineers. Preventative maintenance would be the next step in the process followed by technical training to diagnose and repair the device.

Q: WHAT ARE SOME APPROACHES/STRATEGIES HEALTH CARE FACILITIES CAN USE TO MAINTAIN AND REPAIR THEIR FLEET OF IMAGING DEVICES?

DEHART: Hospitals have a lot going on, and it can be challenging to keep an aging fleet of imaging equipment running. Many times, this equipment is at end of service life with the OEMs, which makes accessing or sourcing parts a lot more difficult. Eventually, all devices will become unserviceable by the limitation of parts, and this is where customers must pay attention to the service frequency and equipment downtime to help make informed decisions on servicing their imaging equipment – or purchasing new modalities. Tracking equipment downtime is one of the most important strategies health care facilities can use because of the impact it has on patient care. If customers are unable to provide services for a patient and the patient goes out of network, the hospital loses out on revenue for that patient.

HANAK: Empower your engineering team by providing system training and making sure there is a good support system in place. Utilizing quality focused companies (ISO 13485:2016 certified) that offer services such as free technical support further enables your team to access knowledge related to troubleshooting difficult issues. While patient safety is the most important aspect of any imaging device, uptime is also critical to keeping everyone happy. These independent service organizations have the ability to send hero kits and parts for the systems, as well as provide loaner probes during repair. It is essential to have a great support system that can walk the engineer through the process of diagnosing the issue all the way through to the final function verification of the system.

SEARS: Generally speaking, invest in your greatest asset: your imaging engineering staff! Make sure the imaging engineering staff is well-trained and efficiently deployed. With staffing shortages these days, you need to be sure that your imaging engineers have the training and support they need. As well, if you have a staff that will be reduced due to retirement, you need to have a plan in place to capture that knowledge. (I’ve seen many folks retire with knowledge that could have been captured, yes it would have cost a bit more, but it would have been worth it.) With a trained staff you can create partnerships with companies you trust regarding parts and other necessary components, training, backup labor, etc. to keep your imaging equipment running efficiently.

TOMORY: This is more of a timeline: Before the purchase order is sent for the device, service training, manuals, diagnostic keys, etcetera must be negotiated so the facility may service after the warranty period. Research should also be done into the availability of parts and devices such as probes and coils – in the case of ultrasound and MRI – to ensure the ability to support post-warranty. Prior to warranty expiration, audit companies you can rely on for support including taking on-site or virtual tours, check for ISO 13485 certification, history of supporting the HTM community, scalability and reputation to ensure seamless transition to in-house service.

Q: WHAT ARE SOME IMPORTANT SERVICE ITEMS TO DISCUSS WITH THE OEM WHEN PURCHASING NEW DEVICES?

DEHART: For imaging equipment, it’s important that the features and functionality of the device fully meet the clinical care needs of the organization – which should be discussed thoroughly during the purchasing process. Service costs continue to increase, so if you can negotiate a longer warranty period upfront, this will help to reduce the service cost over time. You can also look to

negotiate service contracts prior to the sale as vendors may offer discounted service contracts at this point in time. Another service item you discuss is clinical training and support for the life of the device. With the current high rate of turnover in many front-line roles, having a plan for the ongoing training needs of new staff is really important.

HANAK: The initial warranty of the product should be addressed. Determining what is included in that warranty; what is the response time on service, what is the lead time on parts and probes, will access be provided so I can perform my own routine maintenance? You also want to address system training for your engineering team. When the OEM warranty has expired, have they provided your team system training so you can continue to service your equipment? You may want to discuss post-warranty services as well; know what the cost breakdown is for labor and parts, and how they handle repair and replacements for transducers.

SEARS: The discussion should include all the service items. Part of the buying process should be a comprehensive list of all the needs a hospital-based imaging engineer will require to provide service on the device after the warranty. This is, of course, easier to say than achieve. But it should include the delivery of real service manuals, training options and the ability to access OEM service-level tools on the unit. Will you get all these things? Maybe or maybe not, but you certainly won’t get them if you don’t ask.

TOMORY: As mentioned earlier, negotiate for training (comprehensive – not first look), access to diagnostics (full and detailed – not just pass/fail), service manuals (not basic but comparable to if not same as issued to OEM service engineers). Also discuss opportunities and conditions/barriers to upgrades in the event hardware or software improvements are made which may be bug fixes (unintended features ) or system enhancements/additional functionality.

Q: WHAT TYPE OF TRAINING CAN IN-HOUSE BIOMEDS COMPLETE TO BETTER SERVICE IMAGING DEVICES?

DEHART: First and foremost, biomeds should complete device-specific training for the equipment they need to support. After they complete formal training, there are a number of more informal tasks biomeds can do to build their knowledge, experience and comfort level with imaging equipment. They can help with “first look” service requests, like making sure equipment is plugged in and cords aren’t kinked, checking on environmental factors and making sure the room temperature (humidity) is at the appropriate level. These are simple tasks biomeds can do to help familiarize themselves with the equipment when they are first starting out. First look service requests can also include very light troubleshooting without disassembling the equipment, which is where engineers can get in trouble if they have limited experience. Another good place to start is with routine preventive maintenance because they can follow the step-by-step instructions.

HANAK: Basic knowledge of ultrasound principles and theory, a general knowledge of transducer care and handling, and basic training on the particular platform they are servicing are recommended. There are a multitude of training courses available. For those with zero ultrasound training I would recommend basic ultrasound theory to start then escalating to system specific training. System specific training is usually hands-on troubleshooting and repair for each model and will include system architecture and theory. There are other classes such as transducer handling and care, and networking and connectivity classes that can be taken as well.

SEARS: A biomed moving into any imaging modality should start with the basics. That doesn’t mean they can’t shadow/ work with an experienced engineer, but that kind of OJT is not a replacement for foundational training. It is best to have both: a solid foundation in training, and the ability to be mentored by an experienced engineer. Once the foundation

Matt Tomory Vice President of Sales and Marketing at Innovatus Imaging

Tom Hanak Senior Service Director at MW Imaging

Chris DeHart Agiliti Vice President of Clinical Engineering

Hobie Sears Director of Training and Field Service at Probo Medical

is strong, other training can be added on top with higher results. At Probo Medical we teach a basic ultrasound course just prior to any system course making it convenient to do both in one trip.

TOMORY: Technical training from the OEM or independent service organizations is critical but do not neglect the soft skills of the operational training I mentioned earlier. Without understanding how to operate the device, you may become a good engineer but not a great one. Also, do not neglect your communication skills. These are important in all aspects of life of course but technologists are under tremendous stress when imaging devices malfunction –repairing the technologist is as important as repairing the device. This will also be of great importance when this does not go according to plan which frequently occurs.

Q: HOW CAN INDEPENDENT SERVICE ORGANIZATIONS ASSIST WITH THE MAINTENANCE AND REPAIR OF IMAGING DEVICES?

DEHART: Independent service organizations (ISOs) can serve as a neutral third-party to support hospitals with developing service strategies that prioritize turnaround times while reducing costs. This can include onsite repair services and parts sourcing – or utilizing remote diagnostic and monitoring capabilities to see device status and even provide proactive service scheduling. ISOs can access and recertify imaging parts to ensure hospitals have the right part at the right time in the most cost-effective means possible. Lastly, ISOs can serve as a valuable partner when it comes to evaluating new technologies – providing an unbiased perspective during the capital planning process.

HANAK: Independent service organizations can assist with maintenance and repair of ultrasound imaging devices by offering multiple services such as probe repair, free technical support, on-site repair, sales of parts probes and system. These services allow the clinical engineering/HTM departments and the biomedical engineers the confidence to effectively support the ultrasound departments they service. MW Imaging offers all these services and we take pride in being an ISO 13485: 2016 certified company dedicated to providing the highest quality products and services to our customers. MW Imaging Corp. has deep tenure in ultrasound service and parts. Having been in business for 30-plus years our depth of knowledge exceeds the industry norm.

SEARS: ISOs are uniquely set to help facilities work on imaging devices, because we understand their needs better. Obviously, we are not the manufacturer and have many of the same hurdles in front of us as hospital facilities. We figured out how to be successful in spite of those hurdles and can therefore impart those ideas. ISOs, such as Probo Medical, are also very customercentric and have a high sense of urgency. We have

numerous ultrasound modality experts that work at the field level servicing our customers. So be it parts, training, service, equipment or consulting we are more likely to have the same mindset as a hospital facility, than an OEM.

TOMORY: ISOs are critical to the health of the U.S. health care system by providing cost savings, training, technical support, device repairs and replacement parts to supplement the OEMs. Health care providers must research potential partners (notice I did not say vendors) who will collaborate with them to provide fast, safe and effective service on imaging devices which ensure quality patient care as well as throughput and clinical satisfaction.

Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT DIAGNOSTIC IMAGING EQUIPMENT?

DEHART: Technology is advancing faster than it ever has before. The most important aspect about medical device purchasing and service is to have a multi-year plan. Planning for the future will help hospitals to care for their patients appropriately and will help to keep their organization viable in the health care space.

HANAK: When servicing ultrasound equipment it is always a good idea to make a current backup of the system settings, and labeling the backup with the current software version, date and the system IP address. This should be done any time there are changes made to the system setting for any reason. Yes, it seems simple but it could really help you out when your system has an issue.

SEARS: As a company Probo Medical is suited to help with the ultrasound imaging modality from the basics of training (basic and full system courses) to technical support as needed, helping you advance your career in imaging. When necessary Probo can provide parts, expertise and even onsite supplemental help, as you need it, to keep your imaging gear running at its greatest potential.

TOMORY: Diagnostic imaging equipment is specialized, complex and mission critical for patient care and diagnoses, health care provider revenue and there are many layers of hospital staff which rely on the safe, effective operation of that equipment. This is why radiology is its own department and imaging support is usually separate from biomedical support. The staff has unique needs so speed/uptime, first time fixes, longevity of repairs and minimal disruption are essential.

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.

Biomed Equipment Tech I, II, and III

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.

X-Ray In-House Service Technician II

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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!

SPBS, Inc. D.B.A South Plains Biomedical & Imaging has established a national reputation as a premier biomedical equipment services provider. With over 40 years of excellence, SPBS, Inc. provides medical equipment and repair services nation-wide to hospitals, clinics, doctors’ offices, imaging labs and other facilities. We’ve grown steadily and along the way, we’ve built a reputation as a trusted partner by providing reliable, accurate service.

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.

CREATING TEAM SYNERGY

BY K. RICHARD DOUGLAS

ristotle once stated that “the whole is greater than the sum of its parts.” The phrase describes what today would be termed “synergy.” In the workplace, this concept means that a team, or an entire workforce, combines to achieve more together than could be achieved by any individual.

This synergy, based on cooperation and interaction, provides a product or service that relies on the collective efforts of the entire employee contingent and management.

One of the elements that is intrinsic to the success of this synergy is the attitude and motivation of the employees.

In many jobs, the attitude is; “another day, another dollar.” Maybe the job involves monotonous work. Maybe it isn’t a worker’s dream job and/or maybe the job has even become a burden. There has to be a way to turn that image of work 180-degrees and make the experience enjoyable and fulfilling.

The important focus for organizations and leadership should be – What leads to job satisfaction? What type of environment lets employees feel appreciated? What can management do to show respect to staff and enrich their work experience?

While compensation is a variable that is unquestionably prized by workers, there are other components of the work experience that provide fulfillment and contribute to an employee feeling valued.

This is not a novel idea; it has turned up in studies of worker satisfaction over several decades. Employees like to feel appreciated. They are spending a third of their lives in the workplace and contributing intellectual capital, physical exertion and time away from family.

Appreciation is an important component of job satisfaction, and it turns up in studies consistently. Workers want appreciation from their bosses and colleagues.

Recognition and appreciation are intangibles that enhance the work experience and relegate remuneration to a distant second in terms of the job satisfaction. When the team and coworkers feel more like a family, the dynamics of the work experience change substantially and ownership of team goals becomes more personal.

“I have employed a number of techniques to keep my teams engaged over the years. First, an engaged leader helps keep the team connected and motivat -

ed. Stay positive – view the world as glass half full. Give everyone the attention that they need – not everyone is the same and some people need more or less attention than others,” says Greg Czajka, support services operations director of operations and strategy for Advocate Health in Wisconsin.

Czajka says, “Praise in public; coach in private.”

“Always assume the best intent and thank them often! Send out handwritten thank you cards to their homes. Always communicate the ‘why’ when asking them to do something. And last, but not least, spontaneous treats are always welcome in HTM,” Czajka adds.

RECOGNITION AND KNOWING STAFF BETTER

At the fall 2022 MD Expo in Temecula, California, Alan Gresch, then vice president of healthcare strategy for Accruent, gave a presentation titled: “How to Effectively Motivate Staff.”

This is a topic that Gresch has given plenty of thought to. In 2009, he wrote “Developing a Career Ladder” and “A Tale of Two Orientation Programs” for AAMI’s Biomedical Instrumentation & Technology publication.

Gresch says that one goal for any employer is to retain existing staff. He also says that leadership wants to create an environment where that organization is the “employer of choice.”

The gist of Gresch’s presentation is that if employees feel both satisfaction and engagement with their jobs, and they see their role as important in the organization, doing good for both patients and clinicians, then retention and job-approval are by-products.

As proof of the effectiveness of this approach, when he was in leadership with Aurora Health Care, his department's turnover, apart from retirements, was zero.

One of Gresch’s points is that leadership really needs to “know” their staff. This doesn’t only mean knowing something about each person, but also being aware of accomplishments that really help the team and organization.

Yet, getting to know staff really well in an age of protected personal information and more impersonal means for communicating may make this approach challenging.

Gresch says that he has found several ways that work well.

“First, we held quarterly staff meetings where we brought everyone from across the system together in a large auditorium. In this meeting, I opened by providing updates on the things we had accomplished in the previous quarter and sometimes brought in guest speakers – often leaders of clinical departments – to talk about how the work we do has

an impact on their ability to provide the best possible patient care,” he says.

Gresch says that at a point during the meeting, they would have breakouts that were dedicated to a specific area of the business (imaging service, biomedical service, business development and finance, operations support).

“It was during this time that I met with all the new hires from the previous quarter. It gave them a chance to get to know me on a more personal level and what I was all about. It gave me a chance to learn more about them individually, what brought them to us and what their long-term goals were,” he says.

He also points out that it was his expectation that every manager and supervisor on his team be constantly on the lookout for team members that went above and beyond.

“With this information, not only would I take the opportunity to thank them with a handwritten note and/or thank you card, but I would also report it to the regional vice presidents at the quarterly business review meetings I had scheduled. Regularly showing the team that all the credit for the great things we did was going to them and was extremely motivating,” Gresch says.

He says that a third point is that because his employer was a large system – 15 hospitals – he needed to regularly travel to the different sites for meetings with clinical leaders, financial leaders or administrators.

“I never missed the opportunity to stop in the HTM department at that site to check in with the staff. Every one of these check-ins were personal in nature. Over time, I got to learn the names of their wives and kids and significant things that were going on in their lives. I didn’t need HR for that,” Gresch says.

“Lastly, if you take the orientation and onboarding process seriously, this is the best time to collect all

the relevant information about your new team members. If you’re missing any information about existing staff, just ask them. None of this is prohibitive from a time perspective,” Gresch adds.

RECOGNIZE DIFFERENT PERSONALITIES

Part of building synergy is building a team out of employees who enjoy their time together while bringing together different personality types.

“I think motivation is one of the components to a staff member being successful. Motivation is not just a great speech, but it’s about your actions. We have two types of motivations; positive and negative motivation. Some biomeds are introverts. Then you have people like myself who are extraverts (never met a stranger),” says Bryant K. Hawkins Sr., TRIMEDX biomed department site manager at Children’s Hospital of New Orleans.

He says that to motivate staff members, they must first be part of a great group.

“So, before we can motivate, we need to make sure they all get along. My first step for motivating my staff is making sure the group really enjoys working with each other,” Hawkins says.

Hawkins says that key components of motivation include a passion to achieve happiness and a passion to avoid negative things. He says that some technicians are motivated by the rewards of achieving goals while others simply want to avoid risk. He says that it is leadership’s job to know what motivates their staff members.

“We need to tap into our staff motivations instead of coming up with this great motivational speech. Why do we need to care about motivation if we were considering hiring someone? Their resume only shows what they can do, and not what they will do. So, when you hire someone to your team, make sure they will gel with your team,” Hawkins says.

He says that inspiring staff members is more likely

“I never missed the opportunity to stop in the HTM department at that site to check in with the staff. Every one of these check-ins were personal in nature. Over time, I got to learn the names of their wives and kids and significant things that were going on in their lives . I didn’t need HR for that.” – Alan Gresch

than motivating them.

“People who are unmotivated does not mean they are not motivated. They may not gel with the team culture. They can also be scared or unprepared. We should not label them as unmotivated. To motivate someone, we need to inspire them. If you can accomplish that, they won’t take a job just to make more money, but would want to stay with the wonderful people they work for,” Hawkins adds.

GOALS – ONE STEP AT A TIME

An important component of motivating staff and new hires is to provide a concise career ladder for those who seek advancement in their careers. As mentioned earlier, Gresch wrote an article for AAMI titled: “Developing a Career Ladder.”

In the article, Gresch points out that a new hire would have to seek career advancement fulfillment elsewhere if your organization doesn’t offer opportunities to advance a career and move ahead. Some of Gresch’s requirements for a workable career ladder include: setting expectations for future performance, acknowledging an individual’s performance and accomplishments, providing career growth opportunities and linking the steps to job descriptions, competency standards and performance.

These things should be linked to department goals as well.

Gresch says that timeframes were irrelevant to achieving steps in the ladder. Instead, he summarized the criteria as: effort + initiative + business need = promotion.

Another component of staff satisfaction comes

from a combination of the goals expressed during daily or weekly “huddles” combined with feedback and gratitude expressed by leadership for goals attained.

“This is something I got from ‘The 4 Disciplines of Execution’ by Chris McChesney, Sean Covey and Jim Huling. It equates to a method of keeping score and is an indicator to your team that you’re winning. That in and of itself is motivating. Everyone wants to play for a winning team. The culture you create is that you all own the winning and the achievement of goals is a team effort. The huddles are a way to celebrate when you’re on track and give kudos to the team for their efforts. If you’re not on track, you provide a forum to brainstorm ways to get back on track and identify who needs help to overcome obstacles. This is a much more effective method than swinging a big stick,” Gresch explains.

Focusing on only offering the highest starting salary is mostly a non-starter in the totality of Gresch’s approach. Being competitive in the marketplace is OK, but a focus on salary as the only reward of employment does not draw the best candidates.

“I worked very closely with my HR department to complete a regular equity analysis every few years. This gave us assurances that we were in line with the going rate for positions. I also worked with them on developing verbiage for attractive postings. This is where we called out the quality aspects of the role. If you’re looking to make $1 or $2 more an hour and that’s your main motivation, I probably don’t want you on my team anyway. If, on the other hand, you’re looking for a place that is intent on helping you become the best version of yourself, provides the greatest opportunity for growth if you apply yourself, and genuinely cares about you as a human being, then this is the place you want to be,” Gresch says.

He says that his staff members were absolutely the best recruitment tool he had. This was true also for former imaging field service engineers (FSE) who worked in the department and referred other OEM FSEs to the department.

A CE or biomed department, made up of self-motivated and satisfied staff members, will achieve a level of service for their customers that will be superior by every measure. When employees are completely satisfied and engaged in their work life, then the concept of a job changes and the focus is shifted to common goals and a positive environment. That’s when team members become the best recruiters.

“So, before we can motivate, we need to make sure they all get along. My first step for motivating my staff is making sure the group really enjoys working with each other.” – Bryant K. Hawkins, Sr.

CAREER CENTER

How to Handle Politically Charged Topics

BY KATHLEEN FURORE

ith so much political upheaval these days, it seems almost inevitable that a controversial topic will come up, even if only tangentially — especially as the 2024 election season heats up. How should someone respond if a conversation with their boss starts taking a turn toward a politically charged topic?

Tread carefully. Remain professional.

That’s the approach that Jon Morgan, CEO of Venture Smarter, suggests when it comes to politically charged conversations in the workplace

“As the CEO, I believe in creating a culture of respect and inclusivity where everyone feels comfortable expressing their opinions and beliefs,” Morgan says. “However, it’s important to remember that not everyone will agree on every issue, and political discussions can quickly become divisive and unproductive.”

If and when a politically charged conversation begins, here are some ways to avoid what could become a very uncomfortable encounter:

• Remain calm. Jonathan Elster, CEO of EcomHalo, says taking that approach “can help defuse any potential hazards.”

• Politely steer the conversation back to work-related

topics. “You can say something like, ‘I appreciate your perspective, but I think we should focus on the project at hand.’ And if the conversation persists, it may be appropriate to respectfully express that you don’t feel comfortable discussing politics in the workplace and would prefer to keep the conversation focused on work-related matters,” Morgan suggests. “Ultimately, it’s important to approach these situations with tact and professionalism to maintain a positive and productive work environment.”

• Maintain your composure and stay neutral. It doesn’t matter if you agree or disagree. If you let the conversation continue, maintaining composure and remaining professional are musts, Elster says. “Hear them out, listen to what they are saying, and keep your emotions in check … and neither agree nor disagree with their viewpoints.”

• Know company policies. “Most businesses have policies regarding what can and cannot be discussed at work,” Elster notes. “If you feel that the conversation is crossing the line, respectfully point this out and refer to the policy.”

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.

20/20 IMAGING INSIGHTS

4-Steps for Reducing MRI Coil failures

BY TED LUCIDI, CBET

Iam currently updating a presentation on MRI coil troubleshooting for an upcoming HTM conference. One of the strengths of the presentation is that the content is based on your MRI coil failures. At Innovatus, we track and trend almost everything. We classify and segment failure analysis data and perform root cause analysis by make and model. We examine the data for patterns and partner with clients to proactively reduce future failures, ultimately reducing their support costs. It’s just one of many benefits of my role with Innovatus.

and electronic tuning. The remainder might be considered normal wear of mechanical and physical components. Sir Francis Bacon may have said it best, “Knowledge is power.”

Most MRI coils are bundled in the service contract of the system itself. It’s a great solution for maintaining uptime. But at what cost? Coil failures related to trauma and preventable damage are typically not covered by the service contract or honored under warranty. This means that you may be paying once for the contract and again for an out-of-pocket expense which could be as high as $80,000 or more. Warranties and service contracts typically only cover electronic failures and normal/general wear. In the event of trauma, preventable damage or mechanical/physical damage it may be prudent to address coil failures with a qualified MRI coil repair provider.

Armed with this information, let’s develop a comprehensive strategy to reduce your MRI coil failures, reduce support costs, increase uptime and increase your return on investment.

As I was assembling the data, it was so telling that I thought that TechNation readers would benefit from a preview. I examined two years of MRI coil repair data, spanning 330 different coil models and thousands of repairs. The data is current, accurate and statistically valid, as well as relevant to you, your facilities, and the coil models in your facility. Take a look at the information in the piechart. Over 50% of all coil failures are related to trauma and preventable damage. Over 50%! Less than 20% are related to random electronic/component failures

1. PARTNERING WITH END-USERS

As we see in the chart, the majority of coils sent to Innovatus Imaging for repair possess some level of mechanical damage, which often has resulted in single or multi-point electronic failures. One of the most effective ways to increase longevity is to ensure that best practices and OEM guidelines are being followed. Ben Franklin said, “An ounce of prevention is better than a pound of cure.” We recommend that service engineers perform a “Care & Handling Assessment.” Start with partnering with the department/site manager and explain the purposes and goals which are reducing failures and costs and increasing uptime. Assess if, when and how often the coils are visually inspected by the technologists, how they are stored, transported and cleaned. Even go as far as to observe how the coil’s cables are routed during set-up and how the patient is positioned and re-positioned. This can be easily performed without anyone’s notice during routine visits to the department. Follow-up with the department manager by requesting 15-30 minutes during a routine department meeting to review findings. Discuss best practices and provide, as well as solicit, ideas for improvement to reduce damage.

2. ADDRESSING WEAR/TEAR AND ELECTRONIC FAILURES

Even if best practices are employed, wear and tear, random electronic failures and unavoidable accidents will occur over time. The key to longevity, in these instances, is to select a service partner who addresses coil failures holistically. For sustainable repairs, the entire coil (both mechanically and electronically) should be assessed versus a quick fix of a single point of failure. Over time, all cables will breakdown and become intermittent. Be sure that your current provider replaces worn and damaged cables, versus splicing or repairing them. It will result in like-new performance and offer the longevity of a new or OEM replacement coil. Consider the slogan, “pay me now or pay me later.” It’s better to address all of the failures at one time versus sending a product in again for latent failures.

3. DISASSEMBLY AND IN-HOUSE REPAIRS

Although imaging service engineers are very well-qualified and the HTM community is based on the self-service model, do not attempt to repair an MRI coil without

the use of proper test equipment and proper repair and testing procedures. Improper repairs and/or repair attempts have the potential to induce patient harm, including burns. Even if your confidence and experience levels are high, do not attempt to repair an MRI coil without proper ESD (electrostatic discharge) protection. Opening the housing often breaks the electromagnetic shielding and may permit the risk of ESD to the internal components and unseen damage and latent failures may occur. Employees and patients may be put at risk even if repairs are attempted in approved ESD areas.

4. VENDOR QUALIFICATION

It can’t be stressed enough that partnering with a qualified repair provider is another key to longevity and sustainable performance. Perform a thorough analysis, or vendor qualification, of potential MRI coil repair providers as the third-party repair industry is currently unregulated and there is no standard of quality amongst providers. Assess if the provider is ISO 13485:2016 certified specifically for MRI coil repair. Insist on a copy of the provider’s current certificate and ensure that the scope of service includes “MRI coil repair” and not just “MRI service.” Assess the experience of the provider … their history, capabilities, approach to repair (holistic or quick fix), loaner availability, testing processes, warranty periods, historical support of the HTM community and warranty rates. Cost should be one of the lower-ranked qualifiers. Consider Gabriel Bell’s 15th century quote, “You get what you pay for.”

For more information and ideas, or to request a copy of our ISO 13485:2016 certificate, email me directly at tedl@innovatusimaging.com.

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

THE FUTURE Revisiting Social Skills

BY ROGER A. BOWLES, MS, EDD, CBET

April was a special month as MD Expo was held in the Houston area, and I had the opportunity to attend. I was able to participate in a panel discussion about starting a business. My sideline business of motorcycle training is quickly becoming full-time although I never intended it that way. I was happy to share my experiences in growing a business. I was surprised that the panelists that participated in the discussion with me had many of the same experiences although all of us started different types of businesses.

Since the MD Expo was in Texas, I saw many former biomed students and it always makes me feel good to see how they have become so successful and are now recruiting current students. I enjoy hearing their stories and their recommendations for current students. Discussions about the changing field and how much it has changed over the years were interesting. When I was a BMET student in 1990 and 1991, coursework included software skills (Word Perfect, Lotus 1-2-3, and BASIC), semiconductors 1 and 2, microprocessors, chemistry, and interpersonal communications come to mind, as well as medical equipment function and troubleshooting courses.

Interpersonal communications is one class that should still be required. Several years ago, the state of Texas passed a law that restricted all associate degrees offered by state-funded schools to 60 semester hours and bachelor’s degrees to 120 hours, unless a particular profession has a national body that requires more (such as nursing). In the process of streamlining programs, many good courses were eliminated. Interpersonal communications was one of those courses for us and the reasoning behind this was that some of that coursework could be incorporated into medical equipment courses. At least that was the idea. I’m not sure that has happened as much as it needs to happen.

“Bobby, you don’t have what they call the social skills.” If you recognize this line, you might be getting a bit long in the tooth. This line, of course, is from the movie, “The Waterboy.” Funny, yes, because of the delivery in the movie. But, unfortunately, the lack of social skills is becoming a huge problem, and, in some cases, it is costing students jobs.

In March, our program held its annual advisory committee

meeting. For many years, soft skills have been mentioned in these meetings, and ideas on how to teach them have been discussed. This year, members placed an even greater emphasis on this and how the overall people skills are slipping, and unlike in the movie, it isn’t funny.

Since the pandemic, we have noticed certain trends. Students spend time between classes in their vehicles, usually staring at their phones, instead of hanging out and interacting face-to-face with each other. And they no longer spend time in the library. At our school, our library has now been “repurposed.” In other words, there is no physical library on campus anymore. For an old-school instructor like me, that was a heavy blow.

Personally, I am infusing interpersonal communication opportunities into my classes, through face-to-face teamwork labs, presentations and role-play. Skills like active-listening, non-verbal communication, and writing professional emails are also stressed. As an example, I had a second-semester student, whom I had not met yet, email me and tell me (without introduction) that he would not be attending the first day of my class because his previous class that day had ended early, and he didn’t see the practicality of waiting around for an hour since we never do anything the first day anyway. Very good first impression.

In the fourth semester, I am spending more and more time preparing them for job-hunting. Many have never built a resume, never heard of LinkedIn.com or been on an interview. Some have contacted prospective internship employers via email and use text speak in their email or address the employer very informally (using words like “bro.”) So, these are things we need to fix and will fix over the next few semesters.

In other exciting news, my consulting LLC will hopefully be taking on a more active role in recruiting and vetting potential candidates for employers and employers for candidates. Of course, this will not be for entry-level people (students), as that would be a conflict of interest. Most likely this will mean partnering with full-fledged recruiters in many cases. But over the years, I have built up a few contacts in the industry and would like to help in that role. Details still need to be worked out, but I will post them when I know them.

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

RIGHT TO REPAIR

Philips’ Right to Repair Restrictions Are Illegal, Jury Finds

BY KEVIN O’REILLY, RIGHT TO REPAIR CAMPAIGN DIRECTOR, U.S. PIRG

ou read that right: a North Carolina jury found Philips’ Right to Repair restrictions illegal under the state’s Unfair and Deceptive Trade Practices Act. Among other wrongdoings, evidence presented made the case that Philips sought to make hospitals that pursued independent repair “suffer” and “feel some pain.”

We’ve long argued that locking hospital and independent biomedical repair technicians out of fixing critical medical equipment is bad for patient safety and increases health care costs. But getting this ruling from the courts is a big deal. It’s confirmation that the repair restrictions we campaign against are wrong – and it could springboard future Right to Repair victories.

HOW DID PHILIPS ILLEGALLY RESTRICT RIGHT TO REPAIR?

Andy Wheeler and his late father, Dan, went into business together nearly a decade ago. Their vision for their company, Transtate Equipment Co., was to provide hospitals with an independent, full-service option for buying, installing and servicing cath labs – medical devices used to diagnose and treat patients who suffer certain strokes and some of the most severe types of heart attacks.

Independent service organizations (ISOs) such as Transtate (which has since been acquired by Avante) provide hospitals with important alternatives to manufacturer repair. In many cases, ISO repair can be the more timely and affordable option. In 2018, the Food & Drug Administration (FDA) even concluded that “the continued availability of third-party entities to service and repair medical devices is critical to the functioning of the U.S. health care system.”

But early on, the Wheelers ran into a problem all too common in the medical device servicing world. Philips, like

makers of medical devices ranging from ventilators to infusion pumps, restricts access to necessary repair materials. The manufacturer refused Transtate’s requests for access to the information and software required to fix Philips’ Allura and Azurion cath labs – or even training to justify access to those materials.

A manufacturer refusing repair access probably isn’t news to you. What is news is that Transtate’s claims were confirmed by the jury, which found that “Philips refused to provide documents, programs, or information necessary to perform repair and maintenance on systems, in a timely or unhindered manner, to Transtate … so that they could properly service Allura and Azurion cath labs and/or CT systems.”

In addition to proving the limitations that Transtate itself faced, it was able to prove broader wrongdoing. The jury ruled that “Philips refused to provide training to ISOs including Transtate … that Philips says is required to service its medical systems, even where the ISOs are willing to pay for such training.” Philips was also found to have “deliberately delayed service or response to Transtate.”

With these rulings, the jury made clear that stonewalling hospitals’ and ISOs’ requests for repair materials, as Philips did, is illegal.

Hospitals without service contracts made to ‘suffer’ and ‘feel some pain’

Some of the most shocking (publicly available) evidence presented in the case suggests that Philips sought to punish hospitals that pursued independent repair rather than signing a service contract with the company by delaying service response.

These lucrative service contracts are a significant reason that manufacturers restrict repair in the first place. That was the argument that Rep. Neil Dunn (FL) made in a congressional subcommittee meeting last summer. The idea to lock out independent repair of the linear accelerators he uses in his cancer treatment clinic, he said, was “probably born in a C-suite somewhere where they’re saying, ‘We’re leaving 30% on the table. We should probably service our own equipment.’ I love these ma -

chines … but, I think the C-suite is wrong in this case.”

Ostensibly, Philips delayed service to protect that service revenue. Transtate presented evidence that a North Carolina field service engineer (FSE) was “instructed by Philips to not provide same-day service for customers that did not have service contracts with Philips; ‘If they don’t have a contract, they’d have to suffer.’ ” Similarly, an FSE was told to make non-contract customers “feel some pain.”

It’s particularly shocking to hear that kind of language in the context of devices that are used to treat patients who have suffered strokes and heart attacks. How is delaying the repair of cath labs in the best interest of anyone or anything other than the manufacturer’s bottom line? Here, service revenues were clearly prioritized over patient safety. That’s a problem –and one that makes the call for change that much more urgent.

WHAT THE PHILIPS RULING MEANS FOR THE RIGHT TO REPAIR MOVEMENT

Digging into the legal weeds, the fact that the company’s practices were found unfair and deceptive is significant. While a Texas jury ruled in 2017 that General Electric had a monopoly on the servicing and sale of anesthesia machines, proving that a manufacturer has monopolized a given market is very difficult. Indeed, many device-makers haven’t. That makes it difficult to replicate and build upon the result to increase hospitals’ repair choices.

Unfair and deceptive practices, however, do not rely on a manufacturer’s market share – it is the nature of the practice that matters. This precedent could help deliver pro-Right-to-Repair outcomes in future lawsuits against other device-makers.

Does that mean we put all of our eggs in the legal basket? Absolutely not. We need to continue pushing for Right to Repair legislation to require manufacturers to put repair materials in the qualified hands of hospital and ISO biomeds. In doing so, we might just reduce the amount of “pain” and “suffering” felt by independent fixers and patients alike.

Kevin O’Reilly is PIRG’s Right to Repair campaign director. Follow him on Twitter and LinkedIn.

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Professional of the Month, Shifting Gears and Department of the Month!

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trainingoptionsavailabletothedepartment’stechnicians. Inaddition managingequipmentattheeighthospitals, thelargebiomedteamalsoservesmorethan20orthopedic andsportsmedicinelocationsofferingphysicalandoccupationaltherapyacrosstheGreaterHoustonarea. PhysicianTheyarealsoresponsibleforequipmentattheSpecialty Groupwith848physiciansat191locationsandthe PrimaryCareGroupwith169physiciansat42locations. ThehospitalisaffiliatedwithWeillCornellMedicine, NewYork-PresbyterianHospitalandtheTexasAnnual Conference UnitedMethodistChurch.TheHoustonMethodistAcademicInstitute,which researchand educationinstitute,has facultyof742,with2,110credentialedresearchers.BIGTEAM,BIGPROJECTS ThechallengestoaddressCOVID-19surgestaxedthe resourcesofhealthcarefacilitiesacrossthenation,but requiredinnovationon grandscaleforthebiomedteamat HoustonMethodist.“AttheonsetoftheCOVID-19pandemic,therewas glaringneedtoreduceexposuretopatientswithinthe hospitalforourRTdepartment.Thankfully,ourHamiltonG5 ventilatorshave detachableinteractionpanel.RTasked haveventsinsidetheCOVIDroomandplacetheinteraction paneloutsidetominimizeexposure theRTtherapisttogoinsidetheroom.Theinteractionpanelwasattachedto tableoutsidethepatientroomandwehad dothisfor 90-100G5patientrooms,”Smithsays. Hesaysthattogetherwiththe medicaldeviceintegrationteam,theysuccessfullyopened virtualICU(vICU).“We had keyroletoplayinensuringthepatientphysiologicalmonitorswerecapable beingusedinthisnew,innovative setting,”Smithsays.TheteamtackledmanyotherprojectsrelatedtothevICU tomeettheneedsofpatientsandvisitorsduringthe pandemic.AnotherprojectwascenteredaroundAlarispump interoperabilityandtyingthemtopatientrecords. “Pharmacy,nursing,biomed,multipleITgroups,andthe

Hcapacitytoservesuchalargepopulation.Thatcapabilityis embraced HoustonMethodistHospital,affiliatedhospitals andotherfacilitiesscatteredacrosstheHoustonmetroarea. Werecentlyprofiledasmalltwo-techniciandepartment,butit takes biomeddepartmentattheotherend thespectrum managemedicaldevices such large-scalehealth network.Witheighthospitals,anacademicinstituteand2,509 operatingbeds,HoustonMethodistincludes27,947employees,withmanyworkinginbiomed.The85-memberbiomedicalengineeringdepartmentisledbySystemDirector AnthonyMaroulis.Othermembersofleadershipinclude CampusDirectorofClinicalEngineeringMarcBateman, Managers ClinicalEngineeringTerresaEverhart,Javier Ruiz,MiguelMezaandCoreaunJacksonandProgram CoordinatorsBrandonHightandNathanStathos.Theteam’s clinicalengineersincludeZachSmith,CristianDelgado, BailynPiecewiczandHaniKhalil.Thedepartmentalso consistsoftwoadministrationassistants,fivebiomed equipmenttechleads, biomedequipmenttechIIs,23 biomedequipmenttechIIIs,15biomedequipmenttechIs, biomedradiologyserviceengineersand dataentry specialist.Batemansaysthatthebiomedteamservicesmorethan 91,000medicaldevicesin-housethankstotheexceptional

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HELPFUL TIPS TO SOLVE BIOMED STAFFING CHALLENGES

BY MEGHAN SCHELLHAMMER

Healthcare staffing shortages may no longer be front page news, but healthcare technology management (HTM) leaders know the labor crunch hasn’t faded. In fact, it’s quite the opposite. HTM leaders need to find ways to fight burnout and turnover right now – to retain the talent they have today.

How can you improve satisfaction, engagement and retention of HTM staff? Here are a few strategies:

EMBRACE NEW TECHNOLOGY OPPORTUNITIES

New HTM techs have different expectations when it comes to seeking out their employer – with a heavier emphasis on culture, teamwork and advancement. However, let’s not overlook one of the biggest drivers of why biomeds become biomeds and stay in the field – the opportunity to work on innovative technologies.

The pace of technology development is only accelerating, and hospitals increasingly have more sophisticated technology entering their doors (ex. cybersecurity, robotics). Providing your HTM team with opportunities to get training on these new technologies – from the capital planning process, to how to service them, to how they can impact outcomes in your facility – can have a big impact on your team engagement.

ALIGN HTM WITH THE REST OF THE HOSPITAL

Nobody wants to feel like they’re working on an

island. Yet HTM staff commonly feel a one-way connection to the rest of the hospital. They are regularly on the receiving end of urgent demands but lack visibility into how their work fits into clinical care delivery and broader hospital operations.

Establishing meaningful connections between departments such as clinical and supply chain teams allow opportunities for mutual understanding – from where surging demands originate and the reasons why, to how their work supports patient care improvements and cost reduction goals.

SUPPORT CLEAR CAREER PATHS

HTM professionals face a unique challenge. Half say their employers provide little opportunity for advancement, and organizations are cutting resources needed to pursue it. To bridge this gap and show that careers in HTM can have real growth opportunities, hospitals should reinforce to HTM staff that their career has the potential to grow.

For example, BMET staff should see how they can progress into a role as an imaging engineer, and they should understand the resources available to them to support this career development – from internal training and mentoring to financial support for certifications and potential tuition reimbursement.

HAVE FLEXIBLE LABOR OPTIONS TO SUPPORT YOUR HTM TEAM

HTM teams are being asked to do more with less – maintain more equipment and service more complex and critical technologies. But the reality is that typical HTM teams spend a lot of time maintaining low-value, low-revenue equipment. One study estimated that HTM teams spend nearly half their time on non-value-added work like searching for equipment, assessing assets that aren’t

actually broken or dealing with vendor management.

This work can be frustrating and lead to burnout.

Utilizing on-demand, supplemental HTM labor can help address the issue. Have external partners identified who can step in and support you in a pinch. They can take on the high-volume, lower-value work of managing and maintaining equipment like beds or infusion pumps. They can also help you catch up on PMs and recalls. By having trusted partners available, you free up time for your BMETs to focus on higher-value tasks like working on more revenue-generating equipment.

MAKING THE JOB BETTER TODAY MAKES IT MORE APPEALING IN THE LONG RUN

By applying these strategies, you are positioning your hospital to attract and retain the top HTM talent needed to drive the future of healthcare delivery.

We manage it all from locating the pumps, cleaning, PMs, minor repairs, batteries and returning to your patient care areas. We provide daily and end of project reporting.

If you don’t have the need for support on all your pump PM’s then we also have hourly infusion pump specialists available to assist during pump month.

Meghan Schellhammer is the vice president of clinical engineering service solutions at Agiliti.

“HEMS One” by EQ2 makes things easier for HTM...

• Quickly identify equipment with ePHI and the proper steps to protect

• Fast access to contract information

• Easy to use interface: straightforward menus and spell check for data entry

• Assign work orders to all units of a specific model number in just two clicks

“HEMS One” empowers HTM and Biomed teams to do their best work! Schedule your demo of HEMS today: 888-312-4367 or EQ2LLC.com

We provide authentic imaging and biomedical parts through our OEM allegiant relationships.

“

is easily one of the best resources available for day-to-day questions, particularly technical. What I enjoy the most is the accumulated brainpower and experience for those legacy systems and devices that tend to linger and reference material is not available in E-form.”

- Lee Woodruff, HTM Director

CYBERSECURITY When

Medical Devices Go on Cloud Nine: The Risks and Rewards

BY NADIA ELKAISSI, CHTM

i cture this: The hospital wants to implement a medical technology that can upload the data to a server to allow clinicians to read results virtually. The vendor proposes a cloud solution as the best option to host the environment, with the justification being that the solution would remove any physical limitations and provide more options for expansion and accessibility. As healthcare technology manager (HTM) professionals, it is your role to evaluate the solutions and determine what is the best option for your hospital.

Cloud systems for medical devices have become an increasingly popular way to store and manage patient data. The technology has revolutionized the health care industry, providing a more efficient and cost-effective way to deliver patient care. Federal government agencies are even starting to migrate and adopt cloud-based solutions in their modernization strategies. One of the reasons the solution is gaining momentum is that it offers several benefits such as improved data accessibility, scalability and cost saving. However, like any technology, cloud solutions are not immune to vulnerabilities. It is necessary to ensure these solutions still follow the same security boundaries as any well-defined protected enterprise network.

Most cloud systems are software or services hosted on remote servers and are able to be reached anywhere with Internet connectivity. This is beneficial for health care providers as it allows access to

patient data from any location and is easy to modify solutions based off the current need. Choosing the right cloud service and deployment model is critical for medical device manufacturers and HTM professionals looking to leverage the benefits of cloud computing. Several popular models include Service models (Software as a Service (SaaS), Infrastructure as a Service (IaaS), and Platform as a Service (PaaS)) and Deployment models (Public, private, multi-cloud and hybrid). All options have their benefits and will provide different services, depending on the need. However, the goal when selecting a cloud solution should be that it is able to improve patient care without compromising safety and privacy.

Vulnerabilities are inevitable and may increase if the cloud solution is not scrutinized and configured correctly. One of the primary vulnerabilities associated with cloud systems is the risk of data breaches. Patient data is stored externally to a hospital environment, which opens the potential for hackers to gain unauthorized access to the cloud system and steal sensitive patient information. This can include Personal Identifiable Information (PII)/Protected Health Information (PHI) such as Social Security numbers, medication histories or diagnoses. In addition to data breach, since cloud-based solutions are accessed by the Internet and the servers are managed externally, privacy and regulatory compliance are always going to be a concern. Evaluating how patient data is tracked and verifying that the system is compliant with regulations are key to protecting the patient data. The ability to secure a medical system may help make the decision of whether to use cloud-based medical devices or physical medical devices.

As HTM professionals, it is our job to ensure that any solutions selected have a strong and effective

security plan. Some mitigation strategies should include enforcing powerful security controls, conducting risk assessments on the solutions and utilization of monitoring solutions. Enabling powerful security protocols (i.e firewalls, access control lists, encryption methods, multi-factor authentication, etc.) are necessary when managing and protecting the access of the patient data. Although systems may be limited in features if stronger security measures are taken, it is important to reduce the potential for data breaches. Another area that should be focused on when selecting the correct cloud solution is a detailed analysis of the risks and potential vulnerabilities of the product. A strong risk mitigation plan is important for reviewing the level of risk, which will help develop proper risk mitigation strategies. Lastly, requiring a monitoring solution for the product is imperative for tracking suspicious activities, recognizing and reporting potential security threats. Cyber-attacks are more prevalent and cloud solutions can be

more vulnerable depending on the chosen solution. Therefore, a monitoring software can allow HTM professionals to identify issues early and take action to mitigate the damage.

Cloud solutions for medical devices offer many benefits to health care providers, but they also present a number of vulnerabilities that must be addressed. By understanding these risks and taking proactive steps to mitigate them, HTM professionals can ensure the safety and privacy of the system and, more importantly, the patient data.

Nadia ElKaissi, CHTM, is a biomedical engineer with Healthcare Technology Management VA Central Office (19HTM).

HIMSS

HIMSS Celebrates Successful 2023 Conference

HI MSS is back! After a period of COVID-19 lockdown, the 2023 HIMSS Global Health Conference & Exhibition was a roaring success! It united more than 35,000 healthcare professionals from 90 countries to advance Health that Connects + Tech that Cares by driving solutions, generating opportunities and questioning the status quo.

HIMSS23 brought 1,200+ exhibitors and more than 200 general education sessions to Chicago’s McCormick Place Convention Center from April 17-21.

Visionaries across the global health ecosystem shared their expertise on trends and innovations in health information and technology. Hot topics included artificial intelligence, cybersecurity, health equity, workforce development, policy and care delivery.

Keynote speakers featured executives and leaders from Microsoft, Mayo Clinic, Amazon Pharmacy, Best Buy Health, VillageMD, World Health Organization –Europe, an NFL player-philanthropist and many others who inspired thousands throughout HIMSS23.

Government officials, investors, physicians, nurses, analysts and more also gathered for important discussions and made plans to meet again at HIMSS24, March 11-15, 2024, in Orlando, Florida.

HEARD AT HIMSS23:

• Hal Wolf, president & CEO, HIMSS: “ ‘HIMSS is back!’ people have been telling me …. They’re not

just talking, they’re having deep conversations.”

• Dr. Richard Gray, CEO, Mayo Clinic, Arizona, and vice president for Mayo Clinic, Phoenix: “This is my first year at HIMSS and my first day at the conference. And so far I’ve really enjoyed getting a chance to network with others who are interested in the transformation of healthcare, learning what they are doing and hearing from many of the experts and panelists (on) some of the ways that they are trying to overcome the implementation challenges.”

• Dr. Melissa Clarke, chief population health officer, 3M Health Information System, Washington, D.C.: “This is my first time at HIMSS and I’m really enjoying it. I just finished a panel about how technology is advancing health equity. I actually learned a lot from my fellow panelists around how data capture around social determinants of health is being used in the clinical setting. I’m looking forward to learning a lot more and I’m really excited to be here.”

• Ray Lowe, senior vice president and chief information officer, AltaMed Health Services, Commerce, Calif.: “I’m a 2023 HIMSS Changemaker of the Year Award winner. I come here every year. It’s a not-to-miss event … we just walked out of the DEI (diversity equity and inclusion) panel and Dr. Melissa talking about the challenges in D.C. resonates so well with my patient population in Los Angeles … and how we have to work to close the equity gaps.”

• Dr. Nick Patel, founder and CEO of Stealth Consulting, former chief digital officer at Prisma Health, Columbia, S.C.: “I’m here at HIMSS23 CXO Summit, it’s great to see all my colleagues share ideas, especially in this pivotal time in

healthcare … As a digital strategist, I help health systems think about digital transformation in a more prescriptive and pragmatic way in solving these challenges, as well as health tech companies and venture capital. I’m here, really, to learn from others and share ideas in how we can solve our healthcare crisis in prescriptive and part of digital health systems.”

• Cherie Pardue, associate vice president and associate chief information officer, Children’s Hospital of Philadelphia, Philadelphia: “I’ve been coming to HIMSS for over 20 years and really enjoy the environment, keeping up with current topics and definitely meeting all my friends.”

• David Kemp, Healthcare Lead Marketscale, Kansas City Metropolitan Area, MO: “They have engineers, healthcare professionals, nurses … they’re not about the plush, it’s more authentic here.”

• Jeff Mard, founder & CEO Chanell M, LLC, Longmeadow, Mass.: “The quality of conversations and opportunities they have because of investment as vendors far exceeded their expectations.”

• Paul Swider, Healthcare Technology Analyst, Acceleration Economy, Boston: “A vendor told me it was the best investment she spent. Navigating the process was easy and she got tremendous value and leads. I want to be a vendor next year. This was an amazing conference for me because of all the connections made at HIMSS.”

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

HEALTH-ISAC Weaving Cyber into Capital Planning, Part 1

BY PHIL ENGLERT

a pital budgets are shrinking for more health care providers as COVID-19 stimulus packages have ended and health care is reeling from cost increases for everything from supplies, drugs, space, transportation and labor. We have heard for years now that health care is rife with legacy equipment and technology debt. As we approach the capital planning period for many companies, I wanted to share insights and strategies to help health care leaders integrate and leverage the increasing cyber risks of aging technology into capital planning discussions. Last month marked the 10th anniversary of the earliest reported cyber-attack on a U.S. hospital and is a good time to consider strategies for bringing cyber risk into the capital planning conversation.

This two-part series will explore the need for raising awareness about the cyber risks in clinical environments and engaging clinical leadership with the impacts these risks may have on patient care delivery. The discussion will cover eight tips and techniques to make these discussions more collaborative and productive. Let’s get started.

In many health care organizations, ownership of medical device technologies is more often a matrix than a single responsibility. The clinical department may own the equipment if finance assigns it to that cost center, but other departments may also claim an ownership role in keeping it running (HTM) or keeping it talking on the network (IT). Mobile devices such as beds and infusion pumps may be allocated across several departments. Connected systems such as patient monitoring or nurse call, which reach like vines throughout the many patient areas, may be

allocated or simply assigned to a single cost center. And then there is the way the same endpoints or systems of endpoints are tagged, tracked and monitored by the many asset management methods present in a health care environment. Finance focuses on the “net present” value and uses a purchase order as a primary asset ID. This works fine for a single asset purchase but loses clarity when multiple components, modules if you will, make up an endpoint as with patient monitors, or if asset responsibility is shared by different departments. Information technology and healthcare technology management teams also have some role in asset management responsibilities, with separate asset tagging methods and distinct asset management systems.

It takes a cooperative and coordinated effort to ensure each stakeholder has a voice at the capital table to make informed decisions and gain the desired clinical outcomes, operating efficiencies, risk reductions, marketing advantages and other business drivers that go into capital allocation decisions.

As if that were not complicated enough, a growing portion of this aging technology has outdated and unsupported operating systems. It may contain firmware that is insecure and no longer available or is losing manufacturer support at increasing rates. The recent statutory authority granted to FDA over cybersecurity of medical devices may accelerate these trends. Manufacturers of legacy devices may not be able to make the updates to older technologies to meet the requirements for demonstrating reasonable assurance to the FDA that the devices are safe and effective for their intended use.

The best place to start this conversation is with the clinical leaders. Identifying the need for new or replacement medical technologies is typically a grassroots clinical department initiative. CxOs, physicians and foundations are also initiators of the capital investment process. Clinicians and clinical

leaders may or may not have a good understanding of technical issues cyber presents, but it is essential to effectively communicate the importance of cybersecurity risks and the potential impacts on clinical care delivery. Here are some tips to help you have productive discussions on cybersecurity with clinical leaders.

• Understand their perspective: Begin by understanding the clinical leaders’ priorities, goals and concerns. As a part of the environment of care team, you are already familiar with clinical settings and your technical teams keep you appraised of equipment and operational issues in various departments. Don’t assume the understanding you have is current or complete. Take some time with clinical leaders to get an update and maybe dig a little deeper. Ask which equipment they want to replace and why. Which equipment worries them the most. Which equipment frustrates their staff? Any equipment physicians refuse to use? This will help you tailor your discussion to their specific needs and give you some angles to demonstrate how cybersecurity aligns with their objectives. Bring up your concerns about aging technologies or equipment reliability. Sprinkle in a few operational statistics that may be useful in replacement justification statements. A good conversation will enrich the understanding for both of you.

• Focus on business impact: Frame the discussion around the potential clinical care impacts of various medical devices. Cyber is a failure mode that defies the predictability of engineering. Provide an asset list that includes helpful decision points. Include device type, safety risk score, asset age, OS status, vulnerability score, maintenance costs and replacement cost. These

details can provide reminders or details to have discussions around. Patient care delivery is a clinical leader’s primary focus and not asset management or maintenance operations. Simplify your key points as much as possible. If the department has hundreds of devices, consolidate the list and include equipment counts. Simple graphs or pie charts might be a good way to convey risk distribution. Discuss which equipment is most critical to care delivery and which equipment is most at risk for failure that will interrupt the ability to provide those services. Ask how they might plan to continue to deliver care without specific critical equipment. What is the response and recovery plan? Cyber is just another failure mode. You have a plan if a CT tube pops. What’s the plan if that same CT gets ransomed? Discuss how cyber events may impact equipment and how you are going to react. If IT calls and says an MRI was just accessed from Korea, do you cut the connection? Consider how you can help. Do not make the conversation so much about cyber as about operational resilience for continuing to ensure the ability to provide patient care.

Editor’s Note: This is Part 1 of a two-part article. Part 2 of this article will continue the discussion with additional tips and techniques to bring cyber into the medical device capital planning process.

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

Diag nos t ic Solut ion s i s a c u s tome r se r v ice ba se d pa r t s pr ov ide r t hat s pe c ia l i ze s i n a l l i mag i ng mod a l it ie s a nd manufacturers Created to offer hos pita l s a nd I SO’s a cos t ef fe c t i ve a nd t i me sav i ng solut ion for or de r i ng i mag i ng r e place me nt pa r t s , e qu ipme nt move s , u lt r a sou nd pr obe r e pa i r a nd on-site se r v ice.

Contac t u s today, we a re conf ident you w i l l see u s a s T H E Pa r t s Solut ion!

NETWORKING NOTES A Look at Subnet Mask

BY GARRETT SEELEY AND CLINTON WILLIAMS

In previous columns, we discussed the importance and usage of the OSI model and the settings of TCP/IP, specifically the IP address itself. However, we did not explore a complex side to IPv4 – the subnet, also called the subnetting, the subnet address or the subnet mask. We discussed how a subnet draws a line in the IP and helps to differentiate between the network and the host portion of the IP address. However, we glossed over an important part of IPv4 which is that the subnet address can contain a number other than 000 or 255. This is when technicians use subnetting.

Subnetting, in its simplest form, is the art of slicing an IP space into smaller pieces. Consider it dividing a pie into four slices and dedicating each section to a specific program or department. In a hospital setting, the IT department manages the pie and slices IP space into smaller chunks to isolate networks, manage network traffic, bandwidth, and monitor other metrics. For example, it’s good practice to keep radiology traffic isolated from cardiology traffic. That way the network will run more efficiently and have less congestion. Instead of having a single IP space support both departments, IT would use subnetting to slice the space into two subnets, isolating each department into its own space. The network traffic has less interference, and this helps to implement traffic controls. This is a preferred method of networking in a hospital because of the increasing number of machines on a network.

Several residential networks use a simple subnet. This is what most technicians are used to because it is what they have at home. In this type of network, there is one subnet and all the machines talk on the network in the same subnet. Because of the large number of hosts in a hospital, this is not realistic. It would be like talking at a noisy sporting event. There

would simply be too much traffic for the hosts to communicate effectively. To improve on this, TCP/IP separates larger networks into smaller sub netted networks using the subnet mask. In this way, hosts do not compete with traffic outside of their departmental function. To help understand this, recall that a subnet of 255.255.255.000 contains about 250 hosts, whereas a subnet of 255.255.000.000 gives over 65,000 hosts. This limitation on the number of hosts is set by the subnet in a binary number format. Recall that 255.255.255.000 is 11111111.11111111.11111111. 00000000 in binary. We call this a /24 subnet because there is a total of twenty-four “1’s” in the subnet. The slash is just a shorthand for the binary address of the subnet mask. In the previous articles, we spoke of drawing a line after the change in the subnet. That rule works if the subnet is written in binary or in decimal. Unfortunately, this does not give us enough hosts for larger hospital departments, say for example one using over 300 infusion pumps. Let’s explore what happens when technicians need a bigger network, or the subnet has something other than 255 or 000 in the octets.

Consider an unusual subnet of 11111111.11111111.111111 10.00000000. This is a /23 network. Notice there is still only one line in the subnet. In decimal form, it is 255.255.254.0. In this different from the previous subnet as the line has moved to the second least significant binary digit in the third octet, second from

the right. There is still only one line, however, the IP will not cross this line unless it uses a part of the third octet. For those that like math, crossing from host to network is clearer if the IP addresses are drawn out like the subnet mask in binary math. For further clarification, remember that this is also how we see hexadecimal addresses such as a MAC address or IPv6. In binary, it will be clearer when the IP binary number crosses least significant digit of the subnet mask. For this article, we will not go through that exhaustive process. There is a clear way to see the number of hosts in a subnet.

Imagine for a moment if each of the octets were a number and the subnet told you how big the network is by multiplying its number to the previous octet. For this math, use the table below. In this table, a subnet of 255.255.254.000 would give 1 x 1 x 2 x 255 hosts, for about 512 hosts. If more hosts are needed, change the subnet. A subnet of 255.255.224.000 gives 1 x 1 x 32 x 255, or 8160 hosts. This is plenty of space for a larger scale network. In addition, the hosts will know how to talk to the machines outside their subnet by using the LAN router. Network traffic will naturally segment along the subnet mask by using the dividing line between the host and network IP address. In this way, the subnet separates traffic and reduces congestion.

love doing binary math. For the rest of us, here is a chart to figure it out. Finally, for those that are hopelessly lost, there is one saving grace. Go online and look up the phrase “Online Subnet Calculator” That is ultimately what most network professionals do when they say “Well … it’s a /20 network.” Yes, there is literally an app for that. Get the app and compare the numbers here to it. Look for patterns and subnetting should become clearer.

Sometimes it’s important to find out how many subnet networks are in the subnet mask. This is represented by counting the unused part of the subnet mask in binary. Count the 1’s from the right to the left. If that were a binary number, what would the number be? Again, this is fun for people who

Ultimately, subnetting is an important element of networking in that it allows technicians to use larger groups of hosts, connecting devices with a similar function in a large network. It is scalable, manageable and segmented. Subnets can be isolated, and the traffic monitored from each other. For these reasons, most hospital settings use a sub netted network. As HTM professionals, we cannot simply ignore the IP and Subnet configurations of their medical devices. Our personnel are often asked to set the addresses on machines, and therefore it is best to have a firm grasp of network settings and their usages. Remember, if all else fails, there is an online subnet calculator and phone apps for this task. Use these tools to gain a better understanding of networks. The experience is irreplaceable.

Garrett Seeley, MS, CBET, Biomedical Equipment Support Specialist, VISN 17: VA North Texas Health Care System.

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MD Publishing, the parent company of TechNation and MD Expo, recently held a successful HTM Mixer in Baltimore with almost 300 people in attendance! The HTM Mixer was held at the Turf Valley Resort and was supported by the Baltimore Medical Engineers and Technicians Society (BMETS). The event provided valuable continuing education, networking and vendor engagement opportunities.

For more information, htmmixer.com

1. The TechNation team loves to bring live updates from industry events. Jayme McKelvey chatted with one of the attendees to hear why he chose to participate in the HTM Mixer.

2. AIV Vice President of Sales & Marketing Jeff Taltavull (left) is seen with the HTM Jobs duo Sydney Krieg and Kristen Register.

3. Attendees and vendors had an opportunity to network during the welcome reception Thursday night, sponsored by USOC Bio-Medical Services.

4. As the exhibit hall hours came to an end, attendees had a chance to win gift cards and prizes during the door prize raffle.

5. One of the most popular classes during the Mixer was "Clear Answers to Common Electrosurgical Questions,” led by Dale Munson.

6. During the May Bash finale, Royce Shipley was honored by the Baltimore Medical Engineers & Technicians Society (BMETS) Board for the work he and others did to start the organization 40 years ago.

7. Attendees were able to take advantage of up to four hours of education. The HTM Mixer Baltimore was approved by the ACI for up to 4 CEU credits upon completion of the course only.

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The Healthcare Technology Management Association-South Carolina (HTMA-SC) aims to build an educational platform to enhance the knowledge, skills and professionalism of the biomedical and imaging technician community that includes a collaborative network with OEM and ISO institutions focused on a safe and effective medical equipment environment for patient care. HTMA-SC hosts an annual conference built around education, enhancing skills, networking and professionalism. Below are photos from the 2023 conference that was held in May. HTMA-SC also offers scholarships, assists members in finding employment, helps other non-profit healthcare technology organizations and much more.

For more information, visit scba.wildapricot.org.

1. The HTMA-SC symposium kicked off for a one day event at the Columbia South Carolina Metropolitan Convention Center on May 3.

2. HTMA-SC board members Scott Keker, Kaylee McCaffrey, Shawn Lease and Dan Paladino were on hand.

3. Attendees learned how to perform a PM on a GE Logiq E9 ultrasound system thanks to Avante Health Solutions Field Service Engineer Todd Stackley.

4. Industry colleagues enjoyed the first HTMA-SC networking happy hour.

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6. Al Moretti, Brian Delphia, and Aaron Brengelman at the HTMA-SC networking happy hour.

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