Vol. 14 1technation.com ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL AUGUST 2023 50 Cover Story New Era: How to Recruit and Retain Millennials 18 Department of the Month Cleveland Clinic Martin Health Clinical Engineering 22 Shifting Gears Trumpet Player 108 Scrapbook AAMI eXchange
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“Having completed Phase I: Principles to Servicing Diagnostic X-Ray Systems at RSTI was a large factor in getting selected for my current position with Mayo Clinic in the Medical Imaging Department.”
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CONTENTS
P.12 SPOTLIGHT
p.12 Professional of the Month: Tim Stark
p.14 Company Showcase: BMES
p.18 Department of the Month: Cleveland Clinic Martin Health Clinical Engineering
p.21 Next Gen: Kaylee McCaffrey
p.22 Shifting Gears: Trumpet Player
P.26 INDUSTRY UPDATES
p.26 News & Notes p.30 Welcome to TechNation p.33 AAMI p.34
p.36 Ribbon Cutting: iServe Biomedical
P.44 FEATURE ARTICLES
p.44 Roundtable: Computerized Maintenance Management System (CMMS)
p.50 Cover Story: New Era: How to Recruit and Retain Millennials
P.54 SPECIAL EDITION
p.54 40 Under 40
P.79 EXPERT ADVICE
p.79 Career Center
p.80 [Sponsored Content] Innovatus Imaging
p.83 Right to Repair
p.84 [Sponsored Content] Avante Health Solutions
p.86 The Future
p.88 [Sponsored Content] Soma Tech Intl
p.98 Networking Notes p.100 Get Connected Company Directory
TechNation (Vol. 14, Issue #8) August 2023 is published monthly by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer
advertiser,
the publisher. ©2023
and/or
and not necessarily those of
ECRI
p.41
p.43 Webinar
50 44
P.38 THE BENCH p.38 Biomed 101
Tools of the Trade
Wednesday
P.92 CONNECTED p.92 Cybersecurity p.94 HIMSS p.96 Health-ISAC
40UNDER 40 YP ATMD August 2023 | TechNation 9
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
MD Publishing / TechNation Magazine 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290 800.906.3373 • Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com Proud supporters of
P.101 BREAKROOM p.101 TechNation Poll p.101 What’s On Your Bench? p.107 Biomed Brainbuster p.108 AAMI Exchange Scrapbook p.114 #IamTechNation p.110 Service Index p.113 Alphabetical Index Like us on Facebook, facebook.com/TechNationMag Follow us on LinkedIn, linkedin.com/company/iamtechnation Subscribe to TechNation TV, youtube.com/@TechNation_TV 108 10 TechNation | August 2023
PROFESSIONAL OF THE MONTH STAY THE COURSE
Tim Stark
BY K. RICHARD DOUGLAS
wo important priorities for many working people are to enjoy the work they do and to live in a place that is familiar, where family and friends might live. Unfortunately, the nature of the job market and opportunities often conflict with at least one of those priorities.
That was the case with Tim Stark, currently a field service engineer with Siemens Healthineers. Stark had spent 17 years as an in-home TV repair technician, so he had a firm grasp of electronics. He also had subsequent experience repairing appliances. When the TV repair business was closing its doors, a friend of Starks, who was involved with a hospital group, suggested he might make a good imaging engineer repair tech.
“About three years ago, I was working as an appliance repair technician. I was on Facebook, struggling, and asking for help to find work in the imaging engineer field, as I wanted to switch careers. Struggling to get my foot in the door anywhere, I then, decided to spend $5,000 of my own money and a weeks-worth of PTO to attend Phase 1 at RSTI,” Stark says.
He says that at about the same time, he had also completed his associate degree in electronics.
“After that class and degree, it was still a struggle. Then, I applied for that one job where someone was willing to take a chance on me, but I would have to move five hours away for this position in Iowa. I decided to take the position. I became very good at my position, working mostly on Samsung imaging equipment (mobiles and rooms),” Stark says.
He says that after close to two years, he applied for a job back in his hometown area in Wisconsin with Siemens Healthineers.
“I got the job. My job I was leaving for Siemens Healthineers did not want me to go. They offered me raises and begged me to stay, as I was doing such a good job. I wanted to go back home though, even though I loved the job and the people I worked with, and mostly the VAs I worked in,” Stark says.
Stark has been with Siemens Healthineers since January of 2023.
“So now I work with Siemens Healthineers in nuc med as a CT/PET/SPECT repair tech in Wisconsin. Just thought I would share this story if anyone is going through what I did a few years back. I always knew I would be good in imaging; just needed that one person to take a chance on me,” Stark says.
Prior to working as an imaging tech, Stark had already taken steps to get formal training in electronics.
“I slowly started night school back in the fall of 1995 on a two-year degree in electronics hoping to get a job in fixing consumer electronics (stereos, TVs, etcetera),” Stark says.
By 1997, work obligations conflicted with the night school schedule.
“So, after that semester I hung up school. [Fast] forward to 2013; I could tell that my TV repair job was coming to an end soon as the writing was on the wall. I knew I needed to go back and finish my two-year electronics degree as I was going to be out of work soon. I started back, finishing my degree at night as my in-home TV repair job had slowed down quite a bit,” Stark says.
It was about the time that he had taken the imaging training that he also finished the electronics degree as well.
YOU CAN MAKE IT
During all of the career growth and detours, Stark still recalls some of the challenges that prevented him from getting a biomed degree years before.
He says that the challenge was “coming into this (imaging) field from appliance and TV repair standpoint, with no real imaging background experience other than what I learned at
SPOTLIGHT T 12 TechNation | August 2023
RSTI and a night school two-year electronics degree.”
“I could not go into a two-year biomed tech program as it was offered only during the day and my job was during the day and the classes were offered at a school that was over an hour away. I wish the two-year electronics associate degree was treated as close to the same as a biomed tech degree during the interview process,” Stark says.
When not working and training, Stark’s pastimes don’t stray too far from his work.
“I enjoy taking things apart to see how they work and then putting them back together. Working on installing accessories and updating my truck and other toys I own,” he says.
Stark has a 21-year-old daughter and other family in the area where he lives now. The round trip, careerwise, was worth it.
Stark says that if anyone takes anything away from his story, it should be that if you are looking to switch careers, and have a good mechanical and electrical background that has not been in the medical field, you can make it in this field, just don’t give up on it; just keep trying.
“Someone will give you that chance and then go do the best job you can. Treat your customers with respect, as they are on deadlines just like you are, and you will get the same back from your customers/accounts,” he says.
This one tech’s experience is proof that setting a goal and knowing what you want will eventually lead you there.
BIOMETRICS
FAVORITE BOOK:
I like documentaries and any technical article on what my current project is.
FAVORITE MOVIE:
The Friday series and “Everybody Hates Chris” (sitcom)
HIDDEN TALENT:
Give me a project and with a little bit of research and some thought, I can get it figured out and done. I surprise myself sometimes on projects I thought there was not an answer to, or others gave up on.
FAVORITE FOOD:
I love to cook, so I love BBQ ribs and a good Wisconsin fish fry.
WHAT’S ON MY BENCH?
Well, my bench is a rolling tool bag. I like to have my phone available so I can take a picture(s) of wiring connectors and part layout before pulling things apart, as it helps to get things back together quicker. I’ve got to have my diet soda also. My laptop computer. Phone earpiece to call tech support while working on a unit and keeping my hands free.
FAVORITE PART OF BEING A BIOMED?
I like having the responsibility of scheduling my own calls around any other obligation I may have. Getting a job finished and the satisfaction of a happy customer. Other than any parts delays I may have, I am in control of how most days play out. I like the challenge of putting my days together and trying my best to make them work out.
August 2023 | TechNation 13
COMPANY SHOWCASE
Since 1989, BMES has specialized in patient monitoring and telemetry repair while building a reputation for quality workmanship, fast turnaround times and exceptional service.
“BMES grew to become a national biomedical equipment repair depot serving clients through the U.S. and Canada. We started as an on-site repair service company but transitioned exclusively to a repair depot service to meet the increasing demand,” explains BMES President and CEO Ed Evans.
Evans shared more about BMES in a recent question-andanswer session.
Q: WHAT ARE SOME ADVANTAGES THAT YOUR COMPANY HAS OVER THE COMPETITION?
EVANS: Our centrally located U.S. headquarters gives us a competitive advantage, ensuring biomeds get their equipment back in operation as quickly as possible. For core services, it typically takes 3-5 days from the moment we receive equipment to the second we send it back.
Of course, fast doesn’t matter if quality isn’t part of the equation. At BMES, the job isn’t done until it’s done right. All repairs are completed to OEM specifications and backed by a six-month warranty. What’s more, we have dedicated account representatives across the U.S. who make a biomed’s job easier, whether it’s solving problems or picking up equipment in need of repair.
Q: WHAT ARE SOME CHALLENGES THAT YOUR COMPANY FACED LAST YEAR?
EVANS: As with other repair depots, we felt the impact from the slowdown of the post-COVID demand for medical
repair services and refurbished equipment. BMES was built on our steadfast commitment to integrity, character and quality. It’s how we forged long-lasting relationships with customers who trust us for outstanding results. And it’s why we’ve grown steadily each year to serve more and more health care providers across the country.
Q: CAN YOU EXPLAIN YOUR COMPANY’S CORE COMPETENCIES AND UNIQUE SELLING POINTS?
EVANS: When equipment is down, it puts a strain on patient care. That’s why biomeds deserve a partner they can count on for fast, responsive and reliable service. Our technicians have a wide range of hands-on expertise and training on all the latest equipment. They’re proven problem-solvers who diagnose failures accurately and quickly. At BMES, we understand the pressure biomeds are under. Our company is designed to alleviate repair headaches so they can get back to full service fast. Think of us as a second bench or secret superpower – we’ve got a biomed’s back whenever they need it.
Q: WHAT PRODUCT OR SERVICE THAT YOUR COMPANY OFFERS ARE YOU MOST EXCITED ABOUT RIGHT NOW?
EVANS: BMES has been the leader in MX40 repairs for many years, which is why our success rate sets the industry standard. Our customers know that when they send us an MX40 for repair they can expect it back from us in 4-5 business days from the time it is received to the time it is shipped.
Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY?
EVANS: We’re always searching for ways to transform our customer experience. Each and every day we ask ourselves how we can improve to meet and exceed customer expectations. We’re seeking higher customer satisfaction scores, as well as employee satisfaction, which in turn drives revenue growth. Investing in technological solutions like our new customer portal gives clients
SPOTLIGHT
14 TechNation | August 2023
the opportunity to keep track of their equipment after it’s sent to BMES. In the future, we’ll continue to add more robust features to the portal, making it even easier to do business with BMES.
Q: CAN YOU SHARE SOME COMPANY SUCCESS STORIES WITH OUR READERS?
EVANS: We now have a dedicated Customer Success Manager, Bill Cahill, who interacts regularly with our customers to address their pain points or simply to check in on specific biomed needs. The Customer Success Manager leads the initiative, focusing on providing day-to-day solutions from simple to the most complex repair issues. His objective? Be the customer advocate to create a seamless experience between our sales and service staff, ensuring prompt and accurate solutions.
Q: CAN YOU DESCRIBE YOUR COMPANY’S FACILITY?
EVANS: BMES moved into a new facility in November 2021, adding an additional 13,000 square feet of repair space. Our warehouse and shipping/receiving departments are climate controlled to protect our reconditioned inventory. This new facility also provides BMES with the ability to expand our repair capacity for future growth.
Q: CAN YOU TALK ABOUT YOUR EMPLOYEES?
EVANS: BMES currently employs more than 30 people, with the majority on the operations team. Our technical staff includes multiple employees who have 10-plus years
of employment and 20-plus years of experience in the repair field. Three of our technicians have 48 years combined experience at BMES and possess a quality-first mentality in repair and customer support. Our industry has seen a labor shortage over the past several years, but we’ve increased our technical staff to support our ever-growing base of customers and internal needs. We take care of our team members, and they take care of our customers.
Q: WHAT IS MOST IMPORTANT TO YOU ABOUT THE WAY YOU DO BUSINESS?
EVANS: Our focus is keeping equipment healthy for patient care. We know that biomedical equipment is the heartbeat of health care facilities, and biomeds can’t afford downtime. When it comes to equipment repair and refurbishment, BMES always keeps the patient in mind.
Q. IS THERE ANYTHING ELSE YOU WANT READERS TO KNOW ABOUT BMES?
EVANS: Biomeds are critical to a healthy hospital ecosystem, and the job is increasingly complex. Equipment breakdowns happen, but repair issues shouldn’t. When biomeds work with BMES, they get a fast, responsive, reliable partner. Keeping a biomedical department running smoothly is a high-pressure, high-stakes job. At the end of the day, patient care is on the line. That’s why we’re steadfast in our commitment to “keeping equipment healthy for patient care.”
August 2023 | TechNation 15
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SPOTLIGHT
DEPARTMENT OF THE MONTH
Cleveland Clinic Martin Health Clinical Engineering
BY K. RICHARD DOUGLAS
There are a handful of health care systems that have garnered national and international recognition, often because of their research, discoveries and innovation.
Some are household names that are frequently referenced in news segments as thought leaders and experts in the treatment of certain diseases.
One of those health systems, on a short list for name recognition, is the Cleveland Clinic. Already at the forefront of innovative medicine at its inception in 1921, the integrated international health system remains highly ranked today. U.S. News and World Report recognizes the Cleveland Clinic as the nation’s number one hospital for heart care.
Joining the Cleveland Clinic family in January of 2019, Cleveland Clinic Martin Health in Stuart, Florida, became a part of the legacy.
“We are the clinical engineering department part of the Cleveland Clinic enterprise. We service three of the five hospitals in the Florida region. The hospitals are Cleveland Clinic Tradition, Cleveland Clinic Martin North and Cleveland Clinic Martin South,” says Eric Baltazar, CBET, supervisor of Cleveland Clinic Clinical Engineering Martin.
The three hospitals have a total of 521 beds. The team also manages equipment at three surgery centers, two medical office buildings, one stand-alone emergency department, six physical rehabilitation centers and five ambulatory primary care sites.
Staff includes eight BMETs, three equipment flow specialists, three CE imaging technicians and one data analyst. In addition to Baltazar, leadership includes CE Manager Richard Oakes and Regional Director Robert Morin.
“Service contracts are handled at the enterprise level and with our legal team. Our feedback is taken into consideration from a clinical engineering perspective. As all HTM professionals know, there are many variables to consider when taking on service contracts. Our goal is to ultimately do what is best for patient care and the organization,” Baltazar says.
He says that the department uses Nuvolo as the enterprise system for data collection and equipment tracking.
“Our technicians are responsible for documenting the work performed on devices and logging their time. We rely on our technicians to retrieve pertinent information from devices as they apply to new device entries. To ensure standard of enterprise nomenclature, that information is given to our data analyst, and she is responsible for entering device data into our CMMS,” Baltazar says.
The CE team has learned that having special insights into the workings of IT and its members’ responsibilities is instrumental to working together.
“As we continue to see more and more devices added to our network, we have sought innovative ways to bridge the gap between our IT team. We found that learning the different layers of the IT team were important to accomplishing tasks properly as well as being addressed by correct IT personnel. This led us to optimize our response time and overall efficiency when responding to requests requiring involvement from both teams,” Baltazar says.
18 TechNation | August 2023
ALIGNING WITH A LARGER ENTERPRISE
When a CE department becomes a part of a much larger system, there are inevitable changes that must occur to merge practices and protocols with the larger network. This kept the Martin team extra-busy as they made some necessary changes with the larger CE enterprise.
“We are involved in all aspects of cyclic replacements and capital purchases. As part of enterprise alignment, we were faced with having to merge our CMMS records to a new platform that would include tagging all our medical equipment with new asset and inspection tags,” Baltazar explains.
He says that the team received support from the extended clinical engineering team across the enterprise to accomplish this task on nearly 14,000 pieces of medical equipment.
“Although most of the task was covered over the course of a few weeks, corrections on our records would arise and were viewed as opportunities to evolve our practices to mirror those of the entire Cleveland Clinic Clinical Engineering team,” Baltazar adds.
Another step in the integration process involved the EHR. This called for some problem-solving skills and some additional time commitments to ascertain that everything
would work correctly within the larger enterprise.
“Problem solving stories are a part of everyday life for HTM departments. Most recently, we integrated our EHR to align with the enterprise. During that process our involvement in making needed configuration changes to EKG machines and radiological equipment served of great value to our hospital and integration teams,” Baltazar says.
He says that in the early stage of the process, the team’s technicians would be faced with longer than usual work days, coordinating on-site vendor support and working around clinical work flows.
“We also keep records of all MAC addresses in our equipment database for assisting IT/Cybersecurity,” Baltazar adds.
The team’s involvement in the HTM community does not end with the end of the wok day.
“Manger Richard Oakes is a Florida Biomed Society member. We have technicians certified through AAMI,” Baltazar says.
For this south Florida team of CE professionals, joining a storied health care system required some adjustments and changes, but the end result benefits the local community. Cleveland Clinic Martin Health Clinical Engineering team members have proven that they are up to the task.
“Problem solving stories are a part of everyday life for HTM departments. Most recently, we integrated our EHR to align with the enterprise. During that process our involvement in making needed configuration changes to EKG machines and radiological equipment served of great value to our hospital and integration teams”
August 2023 | TechNation 19
Cleveland Clinic Martin Health Clinical Engineering serves three hospitals in Florida.
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NEXT GEN POWERED BY YP AT MD
Kaylee McCaffrey
Kaylee McCaffrey is a board member of the Healthcare Technology Management Association of South Carolina and a sales specialist-biomedical engineering solutions with Avante Health Solutions. She has more than a decade of experience working within the HTM arena, including several years with MedWrench.
TechNation recently quizzed her about herself as a member of the Next Gen of HTM.
Q: WHERE DID YOU GROW UP?
A: I moved to Newnan, Georgia from Miami, Florida when I was in second grade and still reside in Newnan.
Q: WHERE DID YOU RECEIVE YOUR HTM TRAINING/ EDUCATION?
A: I started my career in the industry at MedWrench (an affiliate of MD Publishing). I worked there for 9.5 years.
Q: HOW DID YOU FIRST DISCOVER HTM?
A: As a new college graduate, I had no idea that the HTM industry existed. It wasn’t until having dinner with a former employee of MD Publishing that I discovered that the company was hiring for a start-up division. Before I knew it, I was learning about medical equipment and helping to build the soon to be go-to network for HTM professionals and industry experts.
Q: HOW DID YOU CHOOSE TO GET INTO THIS FIELD?
A: I like to think that it chose me. It didn’t take long for me to fall in love with this industry. Even though I’m not the one actually working on the equipment, I know that I’m part of something much bigger. At the end of the day, we are all in this industry with one goal … to provide a service with quality patient care in mind.
Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?
A: I enjoy that I can get out in the field and visit with my customers. In my previous role, I had basic knowledge of equipment that
HTM professionals work on, but it wasn’t until my role here at Avante that I actually had the opportunity to see it physically on a work bench. I have learned so much in my short time in this role and enjoy learning something new every time I pick up the phone or visit a biomed or imaging department.
Q: WHAT INTERESTS YOU THE MOST ABOUT HTM?
A: This industry is always changing and evolving. I look forward to doing the same in this industry and seeing what the future has to offer.
Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR?
A: My greatest accomplishment is earning both Rookie of the Year and Salesperson of the Year at Avante in 2021.
Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS?
A: Professionally, I would like to expand into a leadership role. Personally, I plan to grow more in my faith and spend more time traveling with my family.
FUN FACTS
FAVORITE HOBBY: Traveling, CrossFit, reading
FAVORITE SHOW OR MOVIE: “Dirty Dancing”
FAVORITE MEAL: Croquetas de Jamon (Ham Croquettes)
WHAT WOULD YOUR SUPERPOWER BE?
To read minds
1 THING ON YOUR BUCKET LIST: Go to Greece
SOMETHING YOUR CO-WORKERS DON’T KNOW ABOUT YOU: I am a certified scuba diver.
SPOTLIGHT
August 2023 | TechNation 21
SHIFTING GEARS
Trumpet Player
BY K. RICHARD DOUGLAS
The trumpet took its place in music history in many forms. In the last century, Louis Armstrong brought the art of trumpet-playing to a popular music audience and made it cool. Herb Alpert, along with his band The Tijuana Brass, once again put the spotlight on the trumpet as an instrument that could be the centerpiece of pop music compositions. The variations that could come from three valves, with the right player, were remarkable.
Boyd S. Campbell, CBET, CRES, CHTM, is co-owner of Southeastern Biomedical Associates Inc. in Granite Falls, North Carolina. He is a businessman with an appreciation for the trumpet that dates back to junior high. Playing an instrument wasn’t voluntary at first, since Campbell’s mother insisted that her sons learn to play an instrument.
“My mother was born during the time of the Great Depression, and during that time, there was no extra money for families. She wanted to take music lessons as a little girl but was unable to until later when she was in her 30s. This was a thrill to her since this was something that was one of the first things in her life that was considered ‘extra.’ I knew after taking piano lessons myself that joining the band in junior high was something that my parents would support as an extracurricular activity,” Campbell says.
He says that this was actually the only extracurricular activity that he and his brother were allowed to do because his parents didn’t have the time or funds to do after-school activities, as both parents worked, and then when he and his brother got home, it was time to work in the garden.
“As you can tell, we grew up in a poor family,” Campbell says.
He was introduced to the trumpet by accident.
“On the school bus one afternoon, an older kid was showing off his new trumpet. The look of that shiny instrument, and what I thought would be easy with only three valves, made me choose it. I am still learning today that there
is so much more than just those three valves,” Campbell says.
High school band provided Campbell with fond memories.
“We had a band director that made it so much fun to learn. I can still hear him calling out during marching band practice; ‘Campbell, get in step,’ which was usually followed by a kick in the butt. He always pushed us to be better, but also taught us how to love music,” Campbell remembers.
After those early days mastering the trumpet and music theory, Campbell got his first paying gig in 1987, playing in the musical production “Jesus Christ Superstar,” which was presented by a local performing arts group. By that time, he had already graduated from biomed school and left the area where he grew up. He made trips back to the area for rehearsals and performances.
“The other players in the group were people who were doing music for a living and I felt almost unworthy to play with this group, but yet grateful. The one thing about music I have learned; to get better, you play with people who are better than you,” Campbell says.
After “Jesus Christ Superstar,” biomed took priority and Campbell put down the trumpet for 21 years. He also worked on obtaining his CBET and CRES during this time.
In 2009, Campbell was just sitting at home and decided, out of the blue, to get out the old trumpet he had played in college to see if he could still play.
“Needless to say, it wasn’t beautiful music that came out, but I was surprised that I did still remember all the fingerings used. After a month or two, I decided to join the community band and within six months, moved from last chair to second chair and playing lead with a current band director that has helped me along as well. At that time, I was invited to join a swing band, which I found was one of the most-fun activities that I still do today. On occasion, I have also played with a local jazz band as well all while taking private lessons,” Campbell says.
He says that he can still remember the first night he came to rehearsal for the community band.
“I was scared and nervous being around all these people who had played in it for many years. I quickly learned that it wasn’t a competition, but more of a comradery. Everyone is so supportive of each other. When things
SPOTLIGHT
22 TechNation | August 2023
go well, you hear band members bragging on each other, and when things aren’t quite as well, nobody complains, but when it really goes bad; we laugh as a group,” Campbell says.
He says that being part of an organization that has people ages 18-80, with diverse backgrounds and skill levels, is nice. The fact that they all have a common goal to improve collectively to play a concert that others enjoy is nice also. Campbell says that when playing music; every contribution is important.
BEYOND PLAYING
His own contribution to the community band is only part of Campbell’s music story. He also collects brass instruments and created a music fund he named after his high school band director.
“My collection started by accident. I needed a cornet and didn’t want to spend a lot of money on one so I bought one off eBay made by the Olds company. I paid $100 for it, and when I got it, I was surprised at how well it played. It was a student model and this company had gone out of business many years prior. I found another horn that was the same model, but this one was a trumpet. It also played wonderfully. I started to do some research on this company and learned the history of how they started in Los Angeles, California in the early 1900s,” Campbell says.
These first purchases got Campbell thinking about how these were still good playing trumpets and he could find these student models at a good price.
“I had worked with a local music school going into lower-income areas and doing demonstrations, along with my trumpet teacher, to try and get kids interested in playing. I took these trumpets and let them see if they could make a sound with them, and also played them some myself, to show what all you can do with one,” Campbell says.
That’s when he decided it was time to start buying instruments and giving them out to kids whose parents couldn’t afford to buy one.
“As I looked for trumpets to give away, I started coming across more professional models made by the Olds company, mostly from the 1920s to the 1960s. As I played these different models, I found all had a unique sound, and before I knew it, I was wanting to acquire each model to see just how they were different. That is how the collection came to be,” Campbell adds.
The music fund is called The Miller Music Fund. Campbell
chose the name in tribute to his late music teacher, John Miller, who made learning music fun.
“While he taught us different rhythms, styles, composers and techniques, he also taught us to enjoy what we were doing. I remember my freshman year in high school, we played ‘Centerfold’ by the J. Giles Band and ‘Another One Bites the Dust’ by Queen. Those were a far cry from John Philip Sousa, which we also played. What really made me decide on the name though was one afternoon, I was leaving a band concert after playing with a community band, and someone drove up beside me and said, ‘John Miller would have been proud.’ I didn’t know the lady, so I had to ask who she was. It was his widow,” Campbell says.
Campbell purchases and restores brass instruments and turns around and donates them to middle and high school students. This allows the students to own instruments instead of simply renting one. Many of these children cannot afford to purchase an instrument, which are often expensive, so they now have the chance to own one.
Despite his love of music, the trumpet and other brass instruments, Campbell keeps busy running Southeastern Biomedical Associates with co-owner Greg Johnson.
“We are a multifaceted company that we share equally the responsibilities in. The day-to-day business consists of our biomedical repair technicians offering both field service and depot repair of medical equipment, calibration services as an ISO 17025 company, offering both on-site and depot calibration of test equipment, parts sales and exclusive channel partner with Fluke Biomedical in the Southeast U.S.,” Campbell says. The company’s trademarked motto is “Biomeds Helping Biomeds.”
Music in North Carolina has been further enriched through the trumpet-playing and giving by one biomed professional. More young people will know the joys of music and mastering an instrument, while the community will benefit by one entrepreneur’s contributions to the local music scene.
August 2023 | TechNation 23
Boyd Campbell plays, collects and donates trumpets.
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NEWS & NOTES
Updates from the HTM Industry
APPLICATIONS SOUGHT FOR PATIENT SAFETY AND QUALITY AWARDS
The Joint Commission and the National Quality Forum (NQF) are now accepting applications for the 2023 John M. Eisenberg Patient Safety and Quality Awards through August 7. The annual award program recognizes major achievements by individuals and organizations that use innovative approaches to improve patient safety and healthcare quality.
Awards are presented in three categories:
• Individual Achievement
• National Level Innovation in Patient Safety and Quality
• Local Level Innovation in Patient Safety and Quality
Those eligible for the Individual Achievement award will have demonstrated exceptional leadership and scholarship in patient safety and healthcare quality through a substantive body of work.
Initiatives or projects eligible for the National and Local Level awards will have involved successful system changes or interventions that make the environment of care safer or that advocate on the patient’s behalf. These innovative efforts may address new technologies, protocols, procedures, education, organizational culture, legislation, the media, patient advocacy, systems theory or another area. Organizations applying must
RALPH BASILE AWARDED SPIRIT OF AAMI AWARD
The Association for the Advancement of Medical Instrumentation (AAMI) has announced Ralph Basile as this year’s recipient of the Spirit of AAMI Award.
Each year, AAMI recognizes health technology’s best and brightest for their leadership, dedication, and contributions to AAMI and their fields.
The Spirit of AAMI Award recognizes the outstanding contributions of an AAMI member in volunteer efforts within the association. Basile has a record of more than 20 years of volunteer service, including his current roles as vice chair of sterilization on the AAMI Board of Directors and chair of the AAMI Committee on Standards Strategy. He has led many efforts to develop international standards and technical information
have at minimum one year (12 months) of data supporting the improvement made by the featured initiative.
Through the award program, The Joint Commission and NQF also seek to amplify best practices in patient safety and quality improvement by sharing strategies and tools identified within applications with its network of more than 22,000 healthcare organizations to inspire improvement on a national scale.
Last year’s award recipients included Dr. Jason S. Adelman of NewYork-Presbyterian/Columbia University Irving Medical Center and Columbia University Vagelos College of Physicians and Surgeons, North American Partners in Anesthesia’s Anesthesia Risk Alerts program, and Parkland Health’s Extending Maternal Care After Pregnancy initiative.
Launched in 2002, this award program honors the late John M. Eisenberg, MD, MBA, former administrator of the Agency for Healthcare Research and Quality (AHRQ). An impassioned advocate for healthcare quality improvement, Dr. Eisenberg was a founding member of NQF’s board of directors.
The 2023 recipients will be recognized at NQF’s next annual conference in February 2024.
reports and shared his knowledge in numerous articles and presentations. AAMI selected him for a Standards Developer Award in 2021.
“Frankly, it is unreal to me” to win this award, Basile said. “There are so many great participants in the AAMI community that contribute so much. I am shocked, humbled, and thrilled to be receiving the Spirit of AAMI Award.”
The Association for the Advancement of Medical Instrumentation (AAMI) proudly announces AAMI Awards for a remarkable group of individuals and teams from the health technology community. Winners of the 2023 awards received a monetary prize, a plaque commemorating their achievements and recognition at the 2023 AAMI eXchange.
INDUSTRY UPDATES 26 TechNation | August 2023
FSI NEARLY DOUBLES IN SIZE
FSI Services, a health care CMMS provider, has seen a 71% increase in new hires added to its product, development and customer success teams, all in preparation for a robust product roadmap, according to a press release. This includes capital planning, integrations, custom reporting, more biomed/HTM capabilities, and new compliance and regulatory standards features.
In response to a growing need for vendor consolidation in the health care space as hospitals struggle with reduced budgets and staffing retention, FSI is focused on an aggressive product roadmap to ensure facilities and HTM health care service professionals can utilize one tool for their respective departments.
“Our customer conversations have focused on two areas of interest: efficiencies and cost-savings,” said Zachary Seely, CEO of FSI. “Health care service professionals today are expected to do more with fewer resources – and we need to constantly evolve our product in a way that supports our customers’ needs. FSI was started by two individuals who walked those very hospital floors – and we’ll continue to build features that ensure accuracy and consistency in our customers’ data, from the asset
level to the executive level – critical data that impact larger business decisions within health care systems.”
FSI’s product roadmap includes a newly launched Public API platform that lays the groundwork for seamless integrations, a refreshed UI/UX, capital planning and condition assessment enhancements, and expanded HTM capabilities.
“The Public API platform is a great example of being customer-centric in our product strategy,” explained Derek Smith, director of technology at FSI. “We’ve grown our team nearly twofold so we can focus on product enhancements that have been identified by our customers as top priorities, develop key strategic technology partnerships, and ensure customers can easily integrate our product with their current partners using modern development tools.”
Launched in 2002, FSI was created by and for health care service professionals and engineers, offering a purpose-built CMMS specifically for health care-managed operations. FSI’s 1,000 plus hospital segments rely on a full suite of services and software that empowers their teams to use data to make smart decisions: including on-site data collection, barcoding, and CAD services.
August 2023 | TechNation 27
TSI LAUNCHES NEW CERTIFIER PRO FLOW ANALYZER
TSI Incorporated has announced the release of the new Certifier Pro Benchtop Flow Analyzer, the latest addition to the company’s line of advanced biomedical testing solutions.
As a biomedical technician or field service technician for medical equipment manufacturers, it’s important to be able to quickly and easily test equipment and get trusted results. Flow analyzers must be reliable, accurate and versatile enough to use on a benchtop or biomedical machine.
The Certifier Pro Flow Analyzer is a full-featured benchtop gas flow analyzer that combines high and low flow, pressure, and oxygen concentration measurements in an easy-to-use, all-in-one flow analyzer. The Certifier Pro utilizes TSI flow sensing technology that enables it to accurately measure flow over a wide dynamic range with fast response and low pressure drop.
The Certifier Pro Flow Analyzer is designed to offer high performance that fits into an equipment budget. It is built
rugged to withstand biomedical test environments and regular travel, and its simple design and operation reduce instrument complexities and costs.
“We are excited to launch the Certifier Pro Flow Analyzer 4090, which was designed with simplicity in mind,” said Ketan Mehta, vice president-product management and marketing at TSI. “The Certifier Pro’s familiar user interface and simple operation makes your biomedical testing easy.”
“The Certifier Pro Flow Analyzer is ideal for testing mechanical ventilators, anesthesia delivery machines, oxygen concentrators, medical insufflators, oxygen blenders, and more. Its large color touchscreen display is mounted at an angle for easy data viewing, and it incorporates an intuitive user interface that’s simple to understand and operate,” according to a press release. “Additionally, you can save your configuration setups for different models under test and quickly recall the configurations at a later time.”
NCBA EMAIL ADDRESSES 2024 SYMPOSIUM
In a recent email to NCBA members, vendors and partners, NCBA President Aaron Watts addresses rumors.
“Rumors are swirling and we are fielding lots of questions regarding the 2024 symposium, and our future at Pinehurst,” the email reads. “The resort and town are currently going through lots of changes, and with the U.S. Open coming to Pinehurst in 2024, the resort has already started its improvement projects in preparation for the event. Typically, with these types of events, resorts will see a large increase in attendance both before and after the event. Thus, significantly increasing the average price per room night, increasing food costs, and altering the timing of any trade shows.
To minimize the financial impact to the organization, its membership, and vendors, while fulfilling our mission to ‘Enhance BiomedicalProfessionals,’ we as the Board of Directors believe it is in the best interest of all parties to
relocate our Annual Symposium starting in 2024. Our general and fiscal responsibility as the BOD is to make the best decisions for this non-profit organization and its membership base. In making these tough decisions, we feel confident this resolution supports our mission, participants, and future as an organization.
More details will be announced at the 2023 business luncheon, and we look forward to fielding any questions our membership may have.
Please join us for our last year at Pinehurst. It has been a great venue and partnership over the years. We look forward to making this 45th Symposium one to remember!”
Registration remains open for the scheduled for August 14-17 at Carolina Hotel Pinehurst North Carolina. Attendees should register ASAP for the best class opportunities and hotel room availability.
INDUSTRY UPDATES
28 TechNation | August 2023
COMPANY OFFERS NEW CABLE MODULE FOR SINGLE-USE ENDOSCOPES
OMNIVISION, a global developer of semiconductor solutions, including advanced digital imaging, analog, and touch and display technology, has announced the availability of the OVMed OCHTA – an ultra-thin medical-grade cable module for single-use endoscopes. The OCHTA cable module connects very small 400 x 400-resolution imagers to endoscopes with ultra-thin 0.45 mm cables that are available in 1.5- and 2.5-meter lengths (or up to 4 meters if customized), allowing the option to add mini-LED illumination. This complete turnkey solution, including the lens and image signal processor, reduces cost and speeds time to market for medical-device OEMs.
“The medical industry is moving toward smaller, higher-resolution endoscopes with ultra-thin cables that can reach deeper inside the body. In addition, medical-device OEMs need the flexibility to customize their designs for specific endoscopy procedures,” said Ehsan Ayar, medical product marketing manager, OMNIVISION. “As the medical industry’s leading image sensor provider, we are addressing our customers’ needs for a turnkey imaging solution with the OCHTA cable module. The ultra-thin, customizable cable modules are medical-grade tested and ready to be integrated – lowering design and test time and simplifying the supply chain.”
2023 TECHNICAL CONFERENCE/EXPO DEDICATED TO GBIS PIONEER
This year’s Georgia Biomedical Instrumentation Society (GBIS) conference is dedicated to Dr. Mike O’Rear a true GBIS pioneer. He was a founder and developer of GBIS until his passing.
Healthcare technology management (HTM) companies are invited to Atlanta, Georgia, on August 11-12, to display their wares to biomeds from Georgia and the South -
hours on Saturday to setup and display products.
A Meet-N-Greet will be held at the Courtyard Atlanta Executive Park/Emory on Friday, August 11, from 6-8 p.m.
The conference will start Saturday morning at 7 a.m. with a welcoming from Children’s Healthcare and GBIS. Registration has several opportunities for vendors to support sponsorships and charities.
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August 2023 | TechNation 29
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WELCOME TO THE TECHNATION COMMUNITY!
CARDIOTRONIX
CRAIG HARMON PRINCIPAL/FOUNDER
Q: WHAT PRODUCT, SERVICE, OR SOLUTIONS DOES YOUR COMPANY PROVIDE TO THE INDUSTRY?
Without a doubt, it is our commitment to customer service deliverables. We are not a break/fix organization, we are a relationship driven company. We create cost effective solutions that deliver long term financial results.
Q: TELL US WHAT DIFFERENTIATES YOUR COMPANY FROM THE COMPETITION?
Products: New and ReCertified Defibrillators and AED’s, Ventilators, CPR assist devices, and IV Therapy devices
Services: Single-Source bundled services, On-Site Maintenance, Equipment “refresh” programs, service all brands, legacy equipment supported
For more information, visit cardiotronixhealth.com.
SOARING HEARTS
SCOTT CHASSAY
Q: WHAT PRODUCT, SERVICE, OR SOLUTIONS DOES YOUR COMPANY PROVIDE TO THE INDUSTRY?
We work on 80% of all cardiovascular equipment. We sale, buy, pm and fix cardiovascular equipment.
Q: TELL US WHAT DIFFERENTIATES YOUR COMPANY FROM THE COMPETITION? How we differentiate ourselves is that we provide free trip charge to the second hospital that is within 50 miles from first hospital. We also fly small airplanes which is quicker then the commercial flights because we can fly into the smaller towns.
For more information, visit soaringheartsinc.com.
INDUSTRY UPDATES
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AAMI UPDATE
AAMI, BSI Join Forces to Publish Guidance on Artificial Intelligence
AMI and the British Standards Institution (BSI) have jointly published guidance documents on performing risk management for machine learning (ML) or artificial intelligence (AI) incorporating medical devices.
AAMI Technical Information Report (TIR)34971:2023,
Application of ISO 14971 to machine learning in artificial intelligence – Guide, derives from a 2022 AAMI consensus report (CR). The U.S. Food and Drug Administration recognized the CR as a guidance document “appropriate for meeting requirements for medical devices under the Federal Food, Drug, and Cosmetic Act.” Developed in collaboration with BSI, the CR was the first AI-related guidance to receive this level of recognition from the Agency.
The British Standard is designated as BS/AAMI 34971:2023, Application of ISO 14971 to machine learning in artificial intelligence — Guide.
“The key difference about the TIR is that we’re doing it jointly with BSI,” said Hae Choe, principal director of standards at AAMI. “It is a dual-logo document. The documents are a little different because BSI doesn’t have technical information reports. They’re publishing theirs as a British Standard.”
Notably, the content of the TIR is substantively the same as the CR content, with only minor spelling and formatting differences between the U.S. and British versions. “The technical content is the same,” Choe said. But the TIR and Standard designations carry more weight—and the British Standard will extend the reach of the guidance.
To develop the CR and TIR, AAMI’s Artificial Intelligence Committee piggybacked on ISO 14971:2019,
Medical Devices—Application of risk management to medical devices, and the AAMI/ANSI/ISO 14971:2019, which is the US adoption of the standard. This widely used standard details how manufacturers can implement the risk management process of assessing and mitigating potential risks to protect the health and safety of patients as well as data and system security.
Rather than reinvent the wheel, the AAMI Artificial Intelligence Committee applied the standard risk management process to the elevated or unique safety-related vulnerabilities and risks of AI- and ML-enabled medical devices, including:
• Data management
• Bias
• Data storage, security, and privacy
• Overtrust
• Adaptive systems
“The risk management process is the same, but there are new ways to fail, different concerns, and different risk controls to consider,” said Pat Baird, senior regulatory specialist at Philips and co-chair of the AAMI Artificial Intelligence Committee, in AAMI’s inaugural Medical Device Safety in Focus report, Artificial Intelligence: The Trust Issue. “Recognize the fact that AI systems, data, and clouds are going to change and that is outside your control. Plan for it. Don’t wait until something bad happens and then try to figure out what you’re going to do about that. Have the infrastructure and mechanisms in place.”
In the near future, AAMI and BSI are planning to propose TIR34971 as in international standard through International Organization for Standardization (ISO) Technical Committee (TC) 210, Quality management and corresponding general aspects for products with a health purpose including medical devices, and IEC (International Electrotechnical Commission) Subcommittee (SC) 62A/Common aspects of medical equipment, software, and systems.
INDUSTRY UPDATES
August 2023 | TechNation 33
A
ECRI UPDATE
5 Ways Predictive Replacement Planning Can Improve Your Bottom Line
BY MARC SCHLESSINGER, MBA, FACHE
redictive replacement planning is a strategy that hospitals can use to reduce operational and capital costs and improve overall efficiency.
1. Predictive replacement planning (PRP) improves patient outcomes by helping facilities determine when medical equipment is at the end of its lifespan, ensuring equipment failures do not negatively affect patient care
Health care providers can use PRP, often referred to as capital equipment planning program, to manage their medical equipment more efficiently. By tracking usage data and analyzing trends, providers can predict when equipment is likely to fail, allowing them to replace it before it causes serious problems. This approach is especially important in health care, where equipment failures can potentially cost lives.
One of PRP’s key advantages is that it helps improve patient outcomes. By replacing equipment before it fails, providers can ensure that patients receive consistent, high-quality care. This is especially important for critical care equipment, such as ventilators and cardiac monitors, which are essential for keeping patients alive. By proactively addressing equipment issues, health care providers can prevent disruptions in care and allow their staff to focus on providing the best possible treatments for patients.
PRP can also provide significant cost-savings for health care providers. By replacing equipment before it fails, providers can avoid expensive emergency repairs and downtime costs. They can also minimize the risk of staff or patient injuries that can result from using faulty equipment. Overall, PRP is a smart investment that can help healthcare providers deliver better care while also saving money in the long term.
2. Predictive replacement planning helps hospitals save on costs. By avoiding unplanned equipment replacements, operational costs associated with emergency replacements are reduced.
PRP has become an increasingly popular strategy in the health care industry in recent years, as it can help hospitals and health care providers save on costs while ensuring the equipment is fully functional and reliable. With PRP, health care facilities can proactively plan and budget for the replacement of equipment, thus avoiding costly unplanned replacements.
One of PRP’s key benefits is that it allows health care facilities to avoid emergency equipment replacements, which can be very cost intensive. When unexpected equipment breakdowns occur, hospitals are often forced to engage emergency repair services or purchase new equipment at a rush. The operational costs associated with such unplanned replacements can be extremely high and can significantly affect the hospital’s budget. By implementing PRP and planning to replace equipment before it breaks down, health care facilities can minimize or eliminate these costs.
In addition to the costs associated with emergency equipment replacements, health care facilities also need to consider the costs of equipment downtime. When equipment breaks down, it needs to be taken offline for repairs, which can significantly affect the hospital’s efficiency and productivity. This downtime affects the hospital’s reputation, decreases patient throughput, and can also affect accreditation of certain programs (e.g., stroke center accreditation). With PRP, hospitals can avoid these interruptions, as they can plan to replace equipment during periods of lower demand. Overall, PRP enables health care facilities to reduce their operational costs while ensuring equipment is always up-to-date and fully functional.
3. With PRP, hospitals can schedule equipment maintenance and replacements based on actual usage data. This reduces over-maintenance and ensures resources are not wasted on over-maintenance.
Health care facilities rely heavily on various medical equipment and resources to provide quality care to their patients. However, managing these resources can be a daunting task because equipment and resources need to be well-maintained and replaced periodically to ensure they continue to function efficiently. This is where effective resource management comes in. PRP is a critical aspect of efficient resource management in hospitals.
INDUSTRY UPDATES
34 TechNation | August 2023
P
PRP enables hospitals to schedule equipment maintenance and replacements based on actual usage data. By analyzing real-time usage data of medical equipment, hospitals can identify potential maintenance issues before they occur and address them before they turn into bigger problems. This approach reduces over-maintenance and ensures resources are not wasted, ultimately leading to reduced downtime and increased equipment lifespans.
Another benefit of PRP is that it allows hospitals to forecast and plan for future resource requirements. By knowing when equipment will reach the end of its useful life, hospitals can proactively plan for replacements, avoiding unexpected expenses and ensuring continuous operations. In addition, PRP can help hospitals avoid equipment failures that can lead to safety issues that could endanger patients’ lives.
In today’s health care environment, hospitals are facing more and more pressure to provide quality care while managing costs. By implementing effective resource management, such as PRP, hospitals can reduce expenses, increase equipment uptime and deliver better patient outcomes. Hospitals that prioritize resource management can achieve better cost efficiencies, improve care delivery and enhance their reputation in the health care community.
4. Increased efficiency: With the ability to predict equipment failure, hospital staff can proactively arrange for equipment maintenance or replacement. This frees up time to focus on patient care.
Hospitals have a wide range of equipment in constant use, from heart monitors to MRI machines, that play a critical role in keeping patients healthy and that allow staff to diagnose and treat medical conditions. However, these machines are complex and prone to failure, which can cause complications in patient care and treatment schedules. That is why the ability to predict equipment failure makes a significant difference for hospital staff and ultimately benefits patients.
With predictive analytics tools and software, hospitals can proactively arrange for equipment maintenance or replacement rather than waiting for the equipment to fail. This not only saves time and money, but also helps to ensure that patients receive high-quality care without unexpected interruptions. This increased efficiency also translates into more time and resources to focus on patient care, as staff members no longer have to worry about equipment breakdowns and can instead prioritize patient needs.
5. Improved equipment standardization is an important topic for hospitals today. The standardization of equipment helps to ensure that hospitals are operating at peak efficiency, reducing operational costs and improving efficiencies.
Standardization’s goal is to simplify the purchasing process, minimize the number of vendors used and reduce the overall cost of equipment ownership. To achieve this, PRP can help hospitals predict when equipment will need to be replaced and when new purchases will be required.
One of standardization’s key benefits is that it can help hospitals save money on service contracts, clinician training and parts inventory. When equipment is standardized, it becomes easier to maintain, which means that repair and
maintenance costs are reduced. Additionally, equipment that is standardized is generally easier to train staff on, which can also reduce costs associated with training programs. Finally, by reducing the number of different components that need to be inventoried, the hospital’s materials management costs will be reduced.
Another benefit of standardization is that it can help hospitals save money on capital equipment purchases. By grouping like purchases to a single vendor, hospitals can take advantage of lower prices offered by vendors for larger orders. Additionally, when equipment is standardized, it is often easier to negotiate favorable terms with vendors since there is less need for customization. Reduced administrative efforts are another benefit of standardization, as there are fewer purchasing decisions to make and less time is spent on equipment reviews and selection.
In summary, improved equipment standardization through PRP is a strategy that hospitals can use to reduce operational and capital costs and improve overall efficiency. Standardization’s benefits include reduced service and training costs, lower parts inventories and reduced capital expenses through group purchases and reduced administrative effort. By embracing these strategies, hospitals can operate more cost-effectively and provide better patient care.
Predictive analytics technology is revolutionizing the health care industry by providing hospitals with the ability to predict equipment failure and proactively take steps to prevent it. This not only saves time and money, but also results in increased efficiency and more focused and attentive care for patients. As predictive analytics tools continue to advance, the potential for further optimization and improvements in patient care will only continue to expand.
Example of PRP driving standardization and cost-savings: ECRI recently completed an imaging-only predictive replacement plan and vendor standardization project. The project resulted in an estimated $18 million in savings over 10 years.
The project involved 14 hospitals. The goal was to move from nine imaging vendors to three vendors across all hospitals. This was accomplished by using ECRI’s Decision Visualization Tool. This tool allowed physicians and department directors to come together and make a unified decision when shown objective data.
The $18 million savings represents the cost savings for anticipated purchases that were realized by the move to three vendors. There will be additional savings in reduced maintenance, training and operational supply costs.
In conclusion, PRP supports good capital equipment planning and has numerous benefits for hospitals and ambulatory care facilities. It improves patient outcomes, reduces downtime and cost, enhances equipment performance and tracking, and more.
Learn more about how health systems, aging services facilities and ambulatory care settings can benefit from ECRI Predictive Replacement Service.
August 2023 | TechNation 35
Marc Schlessinger, MBA, FACHE, is a Senior Associate, Accident and Forensic Investigation at ECRI.
RIBBON CUTTING
iServe Biomedical
Serve Biomedical is a leading provider of medical equipment repairs. The company proudly supports the health care industry by offering personalized customer support to back up its quality services. iServe Biomedical prides itself on not over-charging for necessary services.
“We make it our responsibility to provide outstanding services to improve patient care. In the ever changing medical field, iServe Biomedical will be there to support hospitals, surgery centers, clinics and home health providers,” according to the company’s website. TechNation recently found out more about the company with a question-and-answer session.
Q: WHAT ARE SOME OF THE SERVICES AND PRODUCTS YOU OFFER?
A: We provide support for a wide range of medical devices, including infusion, respiratory, patient monitoring, oxygen therapy and more! We also sell OEM replacement parts, patient monitoring accessories and IMT Analytics test equipment. Additionally, we are very excited about our most recent collaboration with Rigel Medical as new distributors for their biomedical testing equipment.
Q: HOW DOES YOUR COMPANY STAND OUT IN THE MEDICAL EQUIPMENT FIELD?
A: We believe our commitment to patient care is what sets us apart from competitors. They are the center of everything we do. It is our mission to ensure medical equipment is always up and running safely and efficiently.
Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY?
A: As our team continues to grow, we are excited for plans to expand our presence by opening additional locations in the U.S. We are confident that opening new locations will enable us to better serve our clients and expand our reach.
Q: IS THERE ANYTHING ELSE YOU WOULD LIKE OUR READERS TO KNOW?
A: Our team is dedicated to delivering exemplary support services and products to meet all your medical equipment needs. We offer customized solutions tailored to your needs. With our certified technicians, we provide prompt and reliable service to ensure your equipment is always functioning at its best.
For more info you can email us at info@iservebiomedical.com or visit us at www.iservebiomedical.com
INDUSTRY UPDATES
i 36 TechNation | August 2023
LET OUR CMMS STREAMLINE YOUR WORKFLOW
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• Close a work order with as few as three clicks
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“HEMS One” empowers HTM / Biomed teams to do their best work! Schedule your demo of HEMS today: 888-312-4367 or EQ2LLC.com
PM Season has Arrived.
That means its time to:
Replace Damaged Parts
Check Faulty Batteries
Replace Damaged Power Cords and AC Adapters
Replace Cracked Cases
Send In for Repair
Calibration Tests
Error Messages
The manufacturers listed are the holders of their respective names and/or trademarks, and are not to taken as an endorsement or a liation with AIV, Inc.
OF INNOVATIO N Years August 2023 | TechNation 37
BIOMED 101
Tips to Extend Life of Equipment
BY MARK NEWELL
Health care providers are challenged with limited capital dollars and shrinking reimbursements. In addition, many are looking at ways to comply with sustainability compliance and doing their part for conserving energy and environmental resources.
Maintaining the security of networked medical devices adds an additional burden to an organization’s finances. The right to repair, being the ability for one to repair and maintain items by means other than the original equipment manufacturer, helps provide a practical solution to these challenges.
Are you seeing an increase in the number of products becoming “end of life” or “out of support” even though they are fully functional and meet patient care needs? It seems this is inherent in the design of newer devices – to have shorter life cycles, and in turn have continuous revenue. This results in customers being mandated to replace their equipment prematurely, in turn incurring a higher capital costs for a health care organization for said replacement, and in many cases, a higher operating cost too because of limitations in support options for the newer devices.
Not all patient care devices may have manufacturer-
provided solutions to address operating system obsolescence or other cybersecurity threats, more so when there is already a deflated short support life. When the manufacturer as the only support option states they have no remedy for an issue, considerations for mitigation is sometimes pushed aside and a costly replacement is presented as the only solution.
The fabrication of medical devices uses natural resources. The premature disposal of equipment puts a demand upon such resources as not all parts of a device may be recyclable for re-use or environmentally friendly for its disposal. For most medical equipment, this cost for removal and proper disposal is borne by the health care facility.
Health care providers are caught in a quandary when they have limited options for how to support the medical equipment they own. They have higher operating and capital costs tied to artificially shorter lifespans for items they cannot self-maintain, and are lacking timely access to a trained service provider. If one cannot train their own staff or find a qualified alternate service provider, this impacts two critical aspects of a health care organization: providing timely care to the patients it serves and ensuring equipment is being maintained and inspected on schedule. Cancelled patients means lost revenue, customer dissatisfaction and a physician dissatisfier. Delays in any scheduled preventative maintenance can also increase downtime impact for the health care providers’ regulatory compliance.
THE BENCH
38 TechNation | August 2023
A lack of in-house or aftermarket service options to repair and maintain owned equipment means that any service-related needs now become a waiting game. Effectively, any planned or scheduled maintenance can only be done when the manufacturer is available. That may mean cancelling patients during the day when patient volumes are the highest, or by paying a premium for afterhours or weekend service. Based upon net operating margins of most health care organizations, any premium service costs cut into a health care providers bottom line very quickly and more pronounced than regular service rates.
Many manufacturers are reinforcing their communication to health care providers that non-contract customers come last for response to any service requests. Ironically, several manufacturers are now also extending out their response times for contract customers, too, in light of no longer having external competition. Many have gone from a two-hour onsite response for a full-service contract customer to a four- or eight-hour onsite response. If one wants the two-hour response, the premium is very costly. For demand service a few manufacturers have extended it out to 24 to 48 hours onsite response. For niche products where the manufacturer offers no training, this is also starting to be seen as the new normal for products under a full-service agreement. This impacts hospitals in their mission of providing timely patient care to those in need and recouping their investment in the equipment.
The lack of right to repair has widespread impact.
Shrinking revenues means less money to replace capital. Lack of support options for maintaining equipment means items are being replaced at a schedule a manufacturer may dictate, not that of the equipment owner based upon what the owner can afford. Lack of competition, be it through third-party or trained in-house staff means higher operating costs and delays in care when something is not available for patient use. Lastly, equipment being replaced prematurely is negatively impacting the environment and related resources to produce that equipment’s replacement.
A long-term holistic solution for medical equipment service is needed for health care to better steward resources and ensure patients get the care they need when they need it. The right to repair helps address these challenges. What one can do to support this is to help get out the message by working with his or her organization’s senior leadership, the organization’s government relations staff and supply chain leaders, insurance providers, and any group purchasing organizations their health care organization may belong to. It comes down to awareness as to how not having options really drives up costs for health care.
August 2023 | TechNation 39
Mark Newell is director of operations support for HTM/CE at Advocate Support Center.
Contrast Injector Training • 100s of Error Codes not found in OEM Lit • Online and Onsite Training Available • Training BMETs since 2008 • Up to $5,500 in FREE Parts, PM Kits and Service • Massive Troubleshooting Library WWW.MAULLBIOMEDICAL.COM | 440-724-7511 | STEVE@MAULLBIOMEDICAL.COM ON-SITE AVAILABLE BIOMEDICAL When It Comes To CENTRIFUGES, One Name Stands Out • Free Tech Support • Depot Repair • Rental Units • Re-manufactured Parts • New Parts • Exchanges Your Centrifuge Solutions Center www.ozarkbiomedical.com 800-457-7576 VISIT OUR BOOTH! #509 40 TechNation | August 2023
Actual screenshot of the asset list
Easily add a new asset on the fly
See the current status
See all PMs in one place. Last performed, next due, overdue, etc.
See all open / unresolved problem reports
TOOLS OF THE TRADE
Cynch
Asset Management Platform and CMMS
Cynch is an asset management platform offering Computerized Maintenance Management System (CMMS) plus purchasing, inventory management, subcontracting and warranty claims. Assets are tracked from purchase through every maintenance or repair until final disposition for a complete and real-time audit trail. The platform is designed for easy addition of new assets on the fly to orders, customers and locations. Technicians can see their work queues, follow guided inspection and maintenance processes, add notes, upload photos, add MRO inventory parts, see assetspecific user/repair manuals and so much more to
automate their work and vastly reduce time to work order completion. Cynch also offers lightning-fast filtering and searching of large asset catalogs by customer location, asset type, asset status and work order status, plus your custom requirements to significantly reduce the number of clicks required to complete a process.
For more information, visit cynch.me.
REGISTER FOR OUR LIVE PRODUCT DEMO IN AUGUST! ELIGIBLE FOR 1 CE FROM THE ACI.
August 2023 | TechNation 41
LIVE:
AUGUST 16 | BC Group
Save the date for this live webinar. Participation is eligible for 1 CE credit from the ACI.
AUGUST 23 | Cynerio
Save the date for this live webinar. Participation is eligible for 1 CE credit from the ACI.
AUGUST 30 | RTI Group
Save the date for this live webinar. Participation is eligible for 1 CE credit from the ACI.
PODCASTS:
sponsored by MMS “Creating the New Biomed Pipeline”
ON-DEMAND:
sponsored by Sodexo “How Well do You Know Your Job: Test Your Knowledge”
sponsored by Claroty “Reporting from the Frontlines: A Journalist’s Perspective of the Cyberwar Raging in Healthcare”
LIVE PRODUCT DEMO:
Elite Biomedical Solutions demoed newly manufactured replacement parts for the Philips IntelliVue MX40 Case
Voytek Medical demoed the Bear Trap® and URSA® line of products
All webinars, podcast, and product demos are eligible for 1 CE credit from the ACI.
LEARN, GROW AND BE INSPIRED.
webinarwednesday.live
CELEBRATING9 Y !SRAE
“Is Cavitation Energy Effectively Reaching Throughout the Ultrasonic Tank, with Particular Attention to Multilevel
hmark.com
With the pressure of turning around surgical trays increased for the medical device reprocessing department, the advent of multi-level ultrasonic cleaners has presented its own challenges of ensuring cavitation is reaching all levels of the tank. The challenge of providing a clean and functional medical device using these types of ultrasonics is critical to the prevention of nosocomial infection transmission. Using a medical ultrasonic cleaner (i.e., sonic cleaner) is a major step in the cleaning process to achieve that goal. Healthmark Industries Special Projects Manager Jahan Azizi covered the following: How does ultrasonic cleaning machine work?; What are the differences between single-level and multilevel ultrasonic machines?; How does the cavitation process dislodge debris and remove soil from areas that are difficult to clean using other methods?; Why do we need to test and measure cavitation?; What are the standards for testing and measuring cavitations?; and How to test for the presence of cavitations at all levels? He also took questions from the 136 individuals logged in for the webinar.
Attendees provided feedback regarding the presentation via a survey that included the question, “Why did you attend today’s webinar?”
• “For the ACI credit, and I am interested in most information on biomedical engineering, networking and science issues. I do believe this was one of the most usable webinars that I have been able to sit in,”
– Martin O’Brien, biomedical technician/instructor, Advanced Systems Technology Inc.
Watch these webinars on-demand IN CASE YOU MISSED IT
rldatix.com
Presenter Travis Horstman, CBET, territory sales manager and biomedical advisor at RLDatix discussed how oneSOURCE meets compliance standards with up-to-date manuals and how the integration helps ensure elements of performance (EPS) are being met for accreditation. He was joined by Dustin Smith, CHTM, MBA, senior director, industry solutions at Nuvolo. Smith spoke about how Nuvolo utilizes the integration for work orders and checklist questions and how the integration meets compliance needs. Both speakers shared demonstrations during the webinar. The presenters also shared additional insights during a question-and-answer session.
Attendees provided feedback via a survey that included the question, “Was today’s presentation worth your time?”
• “Yes. As we are currently using Nuvolo and OneSource, it was good to confirm what I already know regarding these. We are working with OneSource to add the functionality to Nuvolo.”
– Ken Collins, principal IS program manager, Providence St. Joseph Health.
claroty.com
The webinar was presented by Medigate by Claroty Industry Principal-Healthcare Ty Greenhalgh, Ascension Director of Cybersecurity Skip Sorrels and Illumina Senior Staff Product Security Engineer Emily Holmquist. The easiest way to reduce medical device cyber risk? Don’t add it. Many healthcare delivery organizations (HDOs) fail to clearly assign liability of risk during the device assessment stage of procurement. The Model Contract-Language for Medtech Cybersecurity (MC2) suggests cybersecurity terms and conditions of medical device procurements and servicing between HDOs and MDMs. MC2 includes 14 core principles and 50-plus pre-negotiated clauses aligned with industry standards and best practices to address the security safeguards of medical devices. MC2 represents a groundbreaking joint effort between MDMs, HDOs and group purchasing organizations to collaboratively ensure patient safety. The recommended language, already agreed upon by prestigious organizations in the industry, is intended to approximate a starting place. Attendees provided feedback via a survey that asked, “What was your single biggest takeaway from today’s webinar?”
• “Honestly, thinking about medical device vulnerability from the contractual, pre-purchase perspective is new to me, so the concept opens up a whole new way of thinking for me. That was the number one takeaway, but secondly is that, as mentioned by Skip, you just have to jump in and bring what you know to the party, then gain experience in evaluating and helping non-technical folks evaluate”.
– Todd Magers, Solution Architect-Network Optimization, AHNAT.
“Meeting Your Compliance Needs with RLDatix (oneSOURCE) and Nuvolo Integration”
Tanks?”
August 2023 | TechNation 43
“The Contractual Cure for Cybersecurity Pain: The Power of Medical Device Negotiations”
ROUNDTABLE
Computerized Maintenance Management System (CMMS)
Technology advances fast in every industry, including healthcare technology management (HTM). TechNation reached out to several computerized maintenance management system (CMMS) companies and asked their experts to share insights with readers. CMMS is software that helps manage assets, schedule maintenance and track work orders.
Company representatives who shared their knowledge are Capital i LLC CEO Tony Danko, FSI Solutions Engineer Kevin Lund, TruAsset Director of Business Development Amanda Moser, Cynch! Business Development Specialist Alfredo Rey and EQ2 LLC Product Manager Rich Sable, CBET.
Q: WHAT FEATURES SHOULD HTM PROFESSIONALS LOOK FOR WHEN PURCHASING A CMMS?
DANKO: HTM professionals should initially assess their team’s appetite for change and change management. A new CMMS provides HTM leaders the opportunity to modernize the HTM program and incorporate new tools and potentially new rules. If change is not what you are looking for, and you just want a less “clunky” system, then look for one that fits your business processes and one that would be minimally disruptive to your organization. If you have a healthy appetite for change and are prepared to undergo some growing pain in the business process re-engineer realm, look for a system that has had a lot of operational research support in its development. Operational researchers focus on optimization and ensure the application developers create system workflows that bring out peak performance.
LUND: First, a cloud-based CMMS that can support the specific needs of multiple sites and departments throughout the enterprise. Next, it’s important that the
CMMS utilizes standardized nomenclature for assets, work orders, etc. because the use of free text limits the ability to accurately search and report on data. It’s critical to have a CMMS that documents and reports both asset risk criteria and OEM/AEM protocols for regulatory compliance. Finally, it may seem obvious, but it should be easy to use, both in desktop and mobile versions, to document assets and work order information anywhere at any time.
MOSER: HTM professionals specialize in a variety of roles within the organization. Outside of the basics of asset data and work order generation, the ability to customize a dashboard view and create shortcuts to the data that is a priority is key. Consistency through an application will allow those with all roles from technician to management to achieve their tasks most expediently. Other areas that are beneficial in the HTM environment are parts inventory management with par value notifications, contract management with asset-level coverage information, project management, and a service request system that allows customization for incoming staff requests and notifications for a prompt response. Integrations with other applications such as security, RTLS, test equipment programs and the FDA GUDID database also offer increased benefits.
REY: Look for true multi-tenant Software as a Service (SaaS) that offers extensibility. With SaaS software, there are no versions. All customers are always working with the latest features and get new functionality on a regular schedule with no upgrades. All hardware, maintenance, infrastructure, security and data encryption are provided for you, making the software inexpensive and easy to use. And with extensibility, simplified processes and procedures can be customized based on a biomed’s unique business practices for continuous innovation.
SABLE: One feature HTM professionals should look for when purchasing a CMMS is a mobility solution that works in offline mode to allow the technicians to become more productive by accessing and updating work orders or adding inventory in the field. Management tools like dashboards and
ROUNDTABLE
44 TechNation | August 2023
advanced custom reporting tools assist with decision making, capital planning and regulatory compliance. Interfaces and integrations with cybersecurity applications, real-time location services (RTLS), procurement systems or other external systems add value to the CMMS as it becomes the hub for managing equipment across the health system.
Q: HOW CAN A CMMS HELP HTM PROFESSIONALS PLAN FOR REPLACING OLDER DEVICES?
DANKO: A CMMS, like a medical device, needs to be well maintained. The CMMS is the system of record for historical maintenance and will tell the best story on device reliability. You will have to ensure all corrective maintenance transactions to include financial support to a device is captured to have the best decision support data on the other side. Align polices, processes and work instructions with your CMMS capabilities and limitations and you will have empirical data that can support any capital replacement program.
LUND: A CMMS has the ability to create a workflow that includes required fields when documenting allocated labor, materials and other associated costs for scheduled and unscheduled service, including both in-house and vendor allocated costs. It can identify and report on assets where extensive unscheduled service costs continue to accumulate, especially when it involves repeat repairs, as well as life expectancy and current condition assessment of each asset, plus the associated reporting needed. Also helpful is internal functionality, or an additional module, dedicated to helping HTM users identify and budget for the replacement of older devices.
MOSER: Maintaining device service history allows HTM professionals to evaluate the reliability of assets comparatively and individually. Reporting on the life cycle and expenses related to the asset greatly aids in determining when assets become cost-prohibitive to maintain. Tracking trends to catch when devices become less reliable is key.
REY: A CMMS should track total asset history to enable HTM professionals to assess the condition, performance and maintenance costs of equipment, facilitate proactive planning for replacements, optimize asset utilization and ensure the availability of reliable medical devices for patient care. To that end, a CMMS should track all physical assets, their purchase date, maintenance and repair history including costs. When certain criteria are met, such as maintenance and repair costs exceeding a certain threshold, the system can flag the item for replacement.
SABLE: The CMMS contains the basic information on the device like purchase date, purchase price, and the useful life of the device and can perform the straight-line depreciation of the asset and present the manager with the MEL (maximum expenditure limit) for each year. Also, the CMMS should be accumulating the service costs for labor, parts and service contracts which are used to evaluate the MEL and calculate the COSR (cost of service ratio) along with the MTBF (mean time between failures). So, rather than just make replacement
decisions based on age, managers can use all of this data to assist with replacement decisions based on devices that have become problematic, as indicated by increased equipment downtime along with increasing COSR and/or MTBF.
Q: HOW CAN A CMMS HELP WITH CYBERSECURITY MEASURES?
DANKO: The basic requirements of cybersecurity are easily tracked with a CMMS; asset inventory and tracking, patch management, and incident tracking and response. If you are looking to leverage your CMMS to become best in class at medical device cybersecurity management, you will want to look into integration with security tools. CMMS systems can integrate with security tools, such as antivirus software, intrusion detection systems, or security information and event management (SIEM) solutions. These integrations, coupled with the basics of asset management, allow for centralized monitoring and alerting, which enhance the HTM organization’s overall cybersecurity posture.
LUND: There are many cybersecurity companies who offer solutions. The key is to have an open API within the CMMS so that an integration can be easily created. It’s also important that a CMMS has the required fields needed for a cybersecurity system to function properly.
MOSER: The HTM community is more involved in cybersecurity than ever. With their CMMS holding an accurate inventory using integrations to security programs such as Asimily or Palo Alto systems, the CMMS software can receive alerts of vulnerabilities. These alerts can be addressed and documented at the asset level. In addition, many facilities will integrate their current SSO program into their CMMS for an added layer of security.
REY: A SaaS CMMS is different because it is built and hosted in the cloud using modern best practices in data encryption, redundancy, disaster recovery, user authentication, access controls, monitoring and more in addition to routine penetration testing to keep your data secure.
SABLE: The CMMS stores the IT fields (IP, MAC, operating system, software, etc.) for each asset which allows the HTM manager to quickly identify assets with malicious activity at the request of the information security officer. Also, the CMMS can be bidirectionally interfaced with cybersecurity products like Asimily, Medigate, Ordr and others so they can be set to automatically trigger events in the CMMS to take action to avoid security incidents while the CMMS sends complete asset information to the cybersecurity product. This provides a comprehensive cybersecurity solution to the HTM manager and chief information security officer.
Q: CAN YOU TELL READERS A LITTLE ABOUT WHAT YOUR CMMS OFFERS?
DANKO: We are a system agnostic service provider, and our technicians support various systems throughout the VA, DoD and commercial market. We focus on ensuring
August 2023 | TechNation 45
the business processes and workflow are aligned with that organization’s CMMS configuration. We support business process mapping and aligning the activities of the HTM department with the CMMS and vice versa.
LUND: FSI’s Custom Maintenance Software (CMS) is a CMMS developed by and for healthcare service professionals that can be customized for the specific needs of HTM, Facilities, EVS, etc. The CMS core offering includes the desktop version of CMS, CMS Tech, our mobile solution, and CMS Request, allowing HTM customers to request services and create work orders. FSI got its start more than 20 years ago by providing asset inventory and bar-code tagging services, which still is a major part of our business. What better way to implement a new CMMS than with an accurate asset inventory that can be easily maintained long into the future?
MOSER: TruAsset was built for the health care market and continues to evolve with the ever-changing needs of the HTM community. We offer all that you would expect in terms of asset data and PM schedules. We also offer the ability to store and track your contracts, test equipment, parts inventory, project management, purchase requests and more. We believe in attention to detail and streamlining processes. Our improvements and new features are customer driven and have included improved PM planning, preorder reminders to battle the delays in the supply chain, ways to shorten the documentation process for work orders, a lot of ways to organize and track work orders to efficiently monitor many situations and parameters, and so much more. Our robust reporting offers canned reports, the ability to customize listings for many areas to target the relevant data, and even automated reporting. TruAsset also offers many integrations from security, test equipment software, RTLS, FDA GUDID database, OneSOURCE, etc.
REY: Cynch is a cloud-based, feature-rich CMMS offering maintenance and repair operations plus purchasing and inventory management – all in one unified platform. Our MRO is a best-in-breed solution maximizing up-time for medical devices and other assets. We manage a proactive
maintenance schedule with parts ready in inventory and full BOM for the job, along with procedural instructions and live reporting features. We make sure there is a checklist for every PM and repair, simplifying steps and creating automations to help you delight customers, improve device uptime, reduce time to maintain and repair, and increase profits.
SABLE: EQ2 has 30 years of experience solely supporting health care with our CMMS called “HEMS.” This year we have introduced “HEMS One” – with its feature-rich asset management capabilities for both managers and technicians, designed in a way that makes it easy and efficient to use, with intuitive interfaces, fast processing times and lots of flexibility. It is a URL-based complete asset and work order management system along with tools to track record changes, service contracts, bulk inventory imports, business intelligence and technician dashboards, project management, and HTM parts inventory system. In addition to the comprehensive dashboards, the system has hundreds of reports included plus EQ2 can provide custom reports or the user can create their own reports. It integrates with numerous external systems used by HTM such as oneSOURCE, real-time location services, ECRI, cybersecurity applications, and procurement systems (Lawson, PeopleSoft, etc.) and many others. Our mobile apps work both online and offline so that work can be completed anywhere – even without a connection. In addition to comprehensive dashboards, the system has hundreds of reports included plus EQ2 can provide custom reports or the user can create their own reports. We also provide 100 percent U.S.-based customer support for all of our modules in HEMS One.
Q: HOW CAN BIOMEDS UPGRADE THEIR CMMS TO MEET THE EVER-EVOLVING NEEDS OF HEALTH CARE?
DANKO: The best way for biomeds to “upgrade” their CMMS is by developing and following standard data entry protocols. HTM leaders, engineers and analyst want to provide the best support possible to the biomed teams, but have difficulty understanding trends and systemic issues due to lack of data entry standards by the biomeds. Once the entire biomed team gets on board with standard transactional language, any CMMS can optimize the HTM organization.
ROUNDTABLE
Kevin Lund FSI Services, Engineer
Amanda Moser TruAsset, Director of Business Development
Alfredo Rey Cynch!, Business Development Specialist
Rich Sable EQ2 LLC, Product Manager
Tony Danko Capital i LLC, CEO
46 TechNation | August 2023
LUND: Evaluate how your CMMS provider/CMMS software is evolving and ask these questions:
• Are you locked into a specific software version or are updates provided on a regular basis, e.g., monthly, bi-monthly, etc.?
• Is the CMMS provider responsive to the evolving changes in health care?
• Is there a mobile application that can effectively be used anywhere at any time, regardless of Wi-Fi connection?
If the answers above are no, then an organized evaluation of new CMMS software may be required, along with a request for proposal, a thorough demonstration of the software attended by multiple members of your team and, finally, access to a CMMS sandbox to properly evaluate all the software and confirm what you were told during the demonstration.
MOSER: The best way is to establish communication with the CMMS representative you work with. If you can reach a human being when you need support and they can achieve the results you need promptly, they are also likely to truly listen to and implement the features you need. TruAsset monitors regulatory agencies for policy changes and engages directly with customers to determine the procedural changes being implemented to continuously grow with the needs of our clients. Most of the TruAsset updates are customer driven and occur around every 4-6 weeks.
REY: The solution is to switch from legacy processes to Cynch! Cynch MRO continues to release new features as industry best practices change. With the input of biomed customers, both new processes and refinements are developed to meet their specific requirements as the industry evolves to future-proof their CMMS purchase and optimize their ROI.
SABLE: Biomeds should identify their current shortcomings with the CMMS and should identify additional workflows to increase their productivity while simultaneously reducing the work effort. Adding mobile devices to the CMMS will increase productivity and simplify work order documentation. Dashboards and analytical tools along with capital planning tools will assist managers with their tasks and decision making. Finally, the CMMS upgrade must be able to interface with other applications such as cybersecurity applications, real-time location services applications, procurement systems and other desired applications. If looking at another vendor’s CMMS, I recommend creating an outline for your demonstration which is shared with the vendor that address the features identified in your initial CMMS assessment and ask questions relating to interfacing, reporting for compliance, etc.
Q: WHAT ELSE SHOULD TECHNATION READERS KNOW ABOUT CMMS?
DANKO: I have seen a lot of different CMMS over the last 25 years in the HTM field and I have heard time and again the top two CMMS are the old one you had and the new one you want, and the worst one is the one you have. Before you dump your CMMS, look into how you can leverage its
capabilities by adjusting workflows and business processes. Only then should you consider a change.
LUND: Your CMMS is a very important tool to your overall operations, but without proper management, its effectiveness can diminish. This is why FSI strongly recommends having one or more CMMS administrators overseeing the management of the system configuration and entry of the data. As health care evolves, your CMMS configuration must evolve as well. Additionally, don’t lose sight of the importance of the data being entered. Ensure the data needed is consistently entered so that reporting for operational and regulatory compliance meets the needs of your operations.
MOSER: The CMMS market is heavily saturated and there are so many to choose from that often people pick two or three and possibly overlook other great alternatives. When you are evaluating a CMMS system, a great method is to create a list of required features and features you would like to have. Then, use these lists to narrow down your choices based on what they offer. During demonstrations, look for small niceties. Just about any CMMS system is going to store asset information, allow you to set up PM schedules and offer a variety of reporting options. Many even offer modules for parts, contracts, etc. What does the CMMS you are evaluating offer to save time? What are the ways you can more efficiently go through your workflow, and track important metrics on work orders awaiting parts or unlocatable? Another often overlooked factor is customer service. How easy is it to reach a reliable human that can answer your question or do the legwork and return your call as opposed to bouncing you from person to person and taking up valuable time?
REY: Long-term profitability and success hinges on continuous improvements in productivity. The medical device MRO market is currently undergoing a digital revolution, automating and digitizing processes that once were paper based or managed on multiple spreadsheets. Unifying processes in a SaaS CMMS will allow you to train new employees faster, make happy and retain top talent, shrink time to complete tasks and eliminate rework. Customers will be delighted with the digital audit trail by serial number, ease of scheduling services online and a job done right.
SABLE: The CMMS is the source of truth for the assets and functions as the asset hub when interfaced with other systems. CMMS applications are continually under development to bring new technologies and features along with the ability to access the data using other devices and operating systems. The CMMS will be used for asset and work order management, your repair parts inventory, your AEM/OEM inventory and all costs associated with the asset. With all the costs and work orders stored in your CMMS, advanced dashboards, reporting tools and capital planning reports will provide HTM leadership with the information to make strategic management decisions in a timely fashion using real data from their system.
August 2023 | TechNation 47
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NEW ERA
How to Recruit and Retain Millennials
By K. Richard Douglas
While many members of the baby-boom generation enjoyed the music of the 1950s, most still thought of the music of the 1960s and 1970s as “their music.” The Millennial generation liked the music of the 1990s and early 2000s, and although there are some songs from the baby-boom generation that they like, their favorites remain within the songs produced during their younger years.
COVER STORY
50 TechNation | August 2023
Each generation embraces different fashions, music and culture, while offering a hat-tip to some elements of the previous generation.
Generation Y, better known as the Millennials, is made up of persons born between 1981 and 1996. They have a unique position in society as the generation near the end of a millennium when technological advances were exploding. When the baby-boomers also watched the modern-day advances in technology, the millennial generation embraced these advances from early childhood.
BY K. RICHARD DOUGLAS
The Millennials are also a generation that witnessed 9/11, from 20-year-olds down to five-year-olds; the Millennials have firsthand memories of the tragic event.
Absorbing both the explosive growth in technology and the unfathomable tragedy of 9/11 both shaped the worldview and proclivities of the millennial generation.
The idiosyncrasies that come with this generation extend into the workplace and the attitudes the Millennials bring to their work lives. More specifically, these attitudes include the role Millennials see their bosses playing, the work/life balance, the extended benefits and the opportunities for growth.
Every generation has a slightly different set of values and priorities that help define that generation. The Millennials are known to value collaboration, mentorship, creativity, embracing change, learning and tend to be task oriented.
Compared to the baby-boomers, who often stayed with the same employer for years and remembered their parents spending an entire career with one employer, Millennials are much more likely to jump ship and seek greener pastures if the work environment doesn’t suit their tastes.
This tendency is more common among this generation and those that follow it. As a matter of fact, Gen-Z, those born between 1997 and 2012, believe that an employer should be concerned about their mental health and that is a common priority for them.
Many Millennials are not confident that they can rely on Social Security as a supplemental means for retirement income. Millennials will start entering retirement around 2050, yet those who manage the Social Security fund predict short-falls in funding beginning in 2035.
For this reason, Millennials are very focused on retirement savings opportunities and employer benefits that facilitate savings. Much of their focus is on both investment choices as well as other financial services that their employer might offer. This could include budgeting information, debt management and emergency savings solutions. While these benefits may seem peculiar to generations that are older, they are attractive incentives to Millennials.
This is also a generation that makes use of more volatile or risky investments, such as cryptocurrencies along with individual stocks, and they would like to see these options included in retirement plans.
A 401k participant study conducted by brokerage firm Charles Schwab in 2022 found that 50 percent of Millennials and 50 percent of Gen-Z own individual stocks. Forty-seven percent of Millennials own cryptocurrencies. The study also found that 54 percent of Millennials started saving using a 401k plan and more use a mobile trading app than a traditional brokerage account.
Another finding of the study, not related to retirement investments, was that 27 percent of Millennials had changed employers during the previous 12 months. This was compared to only 7 percent of baby-boomers. Gen-Z engaged in this practice even more than the Millennials, with 38 percent having made the leap.
These changes, that depart from previous generations, offer insights to employers who want to recruit employees from these age groups. The figures also point to the need for developing retention strategies and attractive fringe benefit packages and work environments that satisfy these populations.
There is good cross-industry application of those work benefits that appeal to the Millennial generation and that knowledge does not preclude the HTM profession, where younger workers are in great need to replace their departing baby-boom counterparts.
ATTRACTING MILLENNIAL WORKERS
During the 1920s and 1930s, Willie Sutton was one of the most famous bank robbers in America. When asked by reporter Mitch Ohnstad why he robbed banks, Sutton replied; “Because that’s where the money is.”
Employers who are interested in attracting millennial generation workers, should keep Sutton’s response in mind. They will want to be the ones who check the most boxes on Millennials’ collective wish lists. For employers hiring HTM staff from this generation, the best leg-up can be achieved by knowing what is listed next to those boxes.
“It’s hard to speak for others on this matter, but seeing that I am a Millennial, I can give my perspective. Providing opportunities such as educational support, professional development [and] specialized training is a great tool to use. Sign-on bonuses or just having performance bonuses could be enticing as well. Providing a bonus is not a common thing out there in the biomed world from what I’ve heard from others,” says Chace Torres, best known for his “The Bearded Biomed” podcast and videos.
Steve Ellithorpe, CHTM, executive director of Enterprise Clinical Technology Services for Providence and president of the Washington State Biomedical Association says that it is important for an employer to connect with their (the millennials’) interest in the field.
“It’s one thing to identify job duties on a job description, but also important is to communicate how they can grow in that position or role. Is the department growing? Will new
August 2023 | TechNation 51
skills be necessary? Ultimately, how can we support that growth,” he says.
Recruiting Millennials involves meeting them where they spend a lot of their time — on social media platforms via their mobile devices, says Calvin McDowall, senior site manager for TRIMEDX at Winchester Medical Center.
“Job advertisements on various social channels (e.g., LinkedIn, Facebook, Twitter) are likely to catch their eyes. As a Millennial recently told me; ‘it has to come to me, and it has to feel like it was meant to be.’ Millennials also like to associate with brands, so get the message out about your company on what it does and the value it adds to the industry. It does not always have to be a job ad that catches their eye and piques their interest. The company’s constant presence in the industry is key to familiarization, plus referrals are important in finding valuable associates,” McDowall says.
He says that peer approval is a large component of this generation’s decision making, and many of them reach out to their personal and professional networks when considering new opportunities.
In a retention survey, conducted in 2022, by the Association for the Advancement of Medical Instrumentation (AAMI) Healthcare Technology Leadership Committee (HTLC), the organization found that compensation and benefits were singled out as the most important priorities leading to retention by respondents. That leading priority was followed by work environment/atmosphere.
When broken out by age group, these two top priorities remained in both first and second place for those under age 25. They also maintained the top two spots in the same order for all other age groups, including Millennials.
At least within HTM, there is very little that differentiates the top priorities for retention among different demographics.
In a follow-up article by AAMI Digital Staff Editor Brian Stallard, along with a recorded roundtable with HTM thought leaders Al Gresch, Elizer Kotapuri and Angela Bennett, the results of the survey were examined.
Because salary and benefits were singled out as most important by most demographics in the survey, it was concluded that employers of HTM professionals need to focus on being competitive in this area in order to retain staff.
BEYOND A GOOD SALARY
Hiring managers can benefit by understanding the work life wants and needs of the millennial generation. Armed with knowledge of what is important to this subset of potential employees, employers can articulate an attractive package in the first sit-down that appeals to this demographic.
While the HTM survey did not find a disparity between age groups in retention priorities, it does highlight the importance of offering a solid salary and benefits to the millennial applicant.
McDowall says that he finds that health insurance benefits and paid time off are important components for this demographic.
“When I interact with Millennials for open roles, very often, a competitive salary is the number one driver in their decision for initial employment with the company and eventually remaining with the company. They want to feel valued, so salary compensation is a great start. During the hiring process, a Millennial once expressed the value they bring was worth a higher compensation than initially offered. Another Millennial drove an hour further from home to take another job paying $3 more an hour,” McDowall says.
He says that health, dental and vision insurance are important to Millennials because it gives them peace of mind for the well-being of self and family.
“The Millennials I work with agree that if a medical event occurs, they have the comfort they can financially afford it without dependency on others,” he adds. Another important element that attracts millennial applicants and helps in retention is the ability to enjoy
COVER STORY
a work/life balance without interruption to income.
“Millennials enjoy living their life while still earning, therefore, paid time off is important to meeting that goal. I know several who boast about the PTO options obtained within their respective organizations. They appreciate the ability to take leisure time for vacation, family, or self, which contributes to their work-life balance,” McDowall says.
A FOCUS FOR HTM MANAGERS
The values and priorities of Millennials as a group extend into the HTM millennial population. These traits, which are implicit characteristics of the demographic, provide important insights for managers in creating a work environment that is attractive and reassuring.
Those same characteristics found within the millennial generation as fundamental attributes, including collaboration, mentorship, creativity, embracing change, learning and tend to be task-oriented, are also reflected in the Millennials employed within the HTM ranks.
HTM managers should recognize these important characteristics of this demographic and reinforce and embrace these elements as part of a work culture that appeals to Millennials.
“Within the work experience, they ask questions and consistently want to know how they bring value to the team and the work being done. They are capable, competent and willing to share ideas regarding the work they do. And sometimes how to do it better,” Ellithorpe says.
McDowall says that components of the work experience most important to Millennials include the flexibility of work schedules, training and development, inclusion in decision making as well as recognition and feedback opportunities.
“In my past seven years of monthly one-on-one discussions with Millennial associates, training and development is a notable area of discussion and importance. Millennials are fully aware when they lack the skills or knowledge in certain area(s) of a job function and often ask about training and development opportunities within the company,” McDowall says.
He says that through training and development, they feel more equipped to make a positive difference in the
organization while also having a competitive edge among their peers.
“Along with training and development comes opportunities for growth within the organization, project opportunities and career pathways. These opportunities have quickly become a top ask of this generation, as they are transitioning into director and above leadership roles. They want to move up in the organization and are seeking out opportunities to grow and fulfill their passion,” McDowall adds.
He says that during previous interviews conducted with Millennials, he has also been asked if the company is flexible on the starting time for the workday.
“It is important for them to be able to stagger their work schedule and accommodate their unique needs. Inclusion of decision-making is important as well. They want to be heard because they know their opinions and ideas matter. Recognition and feedback opportunities, whether from management or peers, are also more important. Of the countless recognitions and feedback provided across my team, they were met with positive results. I witness an increase in morale, team engagement and improvement in work performance,” McDowall says.
With acknowledgement of these priorities, the HTM survey priorities can be added.
“Fair compensation for work responsibilities. Not adding on multiple new responsibilities without compensation reflecting that change. Retirement offerings (401K/ESOP), medical/educational/family benefits and one many people don’t consider, but has really opened my eyes, is bereavement or Family and Medical Leave Act (FMLA),” Torres says.
Recognizing all of these important elements of the Millennial generation will help hiring managers construct a total offering that will attract and retain new staff from this important demographic. Knowledge is power and knowing the most intrinsic traits of a demographic provides important insights into appealing to their top priorities and retaining them for many years.
Knowledge is power and knowing the most intrinsic traits of a demographic provides important insights into appealing to their top priorities and retaining them for many years.
40UNDER 40
YP ATMD
TechNation magazine has announced its 2023 class of 40 under 40, powered by Young Professionals at MD Expo (YP at MD). The 40 professionals in this feature were nominated based on their professional achievements, earned merits and the positive influence they bring to the HTM industry.
YP at MD influenced the idea of starting the TechNation 40 under 40. Established in 2019, the purpose of the YP at MD networking group is to provide a space where younger professionals can network with their peers to share ideas, build relationships, and feel empowered to grow in their professional roles.
“Our first 40 under 40 class was announced in 2022 and was a huge success. TechNation is excited to keep our 40 under 40 an annual spotlight feature in the August issue. The 2023 40 under 40 class is made up of hardworking and dedicated HTM professionals who have done amazing work in our industry. We look forward to celebrating their achievements!” YP at MD Founder Megan Cabot said.
For more information on YP at MD, visit our site! 1TECHNATION.COM/YP/
54 TechNation | August 2023
Thank you to TechNation’s 40 Under 40 sponsors for recognizing the up-and-coming talent in the HTM industry. Your support of our young professionals will ensure the future of HTM is bright!
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AARON WATTS
Unit Director at Crothall Healthcare Technology Solutions
Mission Statement: “Nobody cares how much you know, until they know how much you care.”
-Teddy Roosevelt. This quote simplifies how I feel about my career. My personal accomplishments aren’t nearly as important to me as the future of this ever-changing field and opening the eyes of future biomeds that this job is more than a paycheck. Albeit a bit stressful at times, you rest easy at night knowing that you had a positive impact on someone’s life.
Fun Fact: I enjoy Clemson football, golf and I have my hands full at home with 3 boys.
IT Director of Clinical Engineering at Sharp Healthcare
Mission Statement: I hope to not only recognize my commitment to integrity and services to the HTM field thus far, but also improve my collaboration with other HTM professionals to develop solutions for issues affecting the HTM community and increase the HTM presence in hospital wide forums.
Fun Fact: When not working, I like to spend time with my wife and 6-year-old son who’s in various activities like taekwondo, piano lessons, etc.
40 UNDER 40 40UNDER 40 YP ATMD
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ANDREA RINCONES
Co-Founder/Sales Manager at A&G Biomedical
Mission Statement: I enjoy engaging people on their level and striving to give my all to everyone I come across to ensure people achieve their goals personally and professionally; my happiness is found through the happiness of others.
Fun Fact: I had a nonprofit organization in Venezuela and for Christmas we dressed like Santa to bring gifts to children in underserved communities.
Faculty at St. Petersburg College
Mission Statement: My goal is to promote and educate others about healthcare technology management by creating great resources and content in health care, engineering and technology. In doing so, I hope to raise awareness of the HTM and biomed career fields
Fun Fact: I used to play Division I soccer for a small college.
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BRIAN BELL
CATHERINE WHITE
Customer Success Manager at Asimily
Mission Statement: Learn and improve everyday while supporting others along the way and to stay positive, dependable, and take the opportunity to help improve patient care delivery.
Fun Fact: I am a twin and an honorable shellback.
VISN Chief Biomedical Engineer at Department of Veterans Affairs
Mission Statement: My mission statement is that of the Department of Veterans Affairs: “To care for him who shall have bourne the battle, and his widow, and his orphan.”
This is a statement from Abraham Lincoln’s second inaugural address, and defines the VA mission to serve veterans. I embody this mission in my everyday work as a healthcare technology management professional. In my career, I endeavor to serve as many veterans as possible through supporting the life cycle management of the highest quality medical equipment, the increase of patient safety and good stewardship of the resources provided to the VA.
Fun Fact: I can play the saxophone and I enjoy jazz music; it’s a good thing I went to Tulane University in New Orleans!
CLARICE HOLDEN
40 UNDER 40 40UNDER 40 YP ATMD
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COLLEEN HAUGEN-ORTIZ
HTM Quality Specialist at GE Healthcare
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Mission Statement: To teach others the importance of what we do and bring about real safety to patients and education to users.
Fun Fact: I used to sing in a Metallica cover band and I have travelled to over 40 states and 5 countries. I grew up as a “snow bird” living in a motor home.
Healthcare Technology Account Manager at Renovo Solutions
Mission Statement: To do the right thing the right way, even when no one is looking.
Fun Fact: I am a huge baseball fan and I love listening to the Rat Pack.
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COURTNEY HASCHKE LINKEDIN
D’JUAN JAMES
Director of Clinical Engineering at St. Elizabeth’s Healthcare
Mission Statement: “The apple doesn’t fall far from the tree.” I developed the same love and passion for HTM leadership like my father. I spent the first 10 years of my career as a clinical engineering specialist, where I gained the majority of my experience working in the operating room providing technical and clinical application support for neurological, orthopedic spine, anesthesia and otolaryngology surgical procedures. Along the way, I knew I wanted to have a bigger impact on healthcare technology through better implementation of patient safety and processes of medical equipment. That’s where my desire to be in a leadership role originated. Today, I have a very challenging yet rewarding job of managing medical equipment operations for a six-hospital system in Northern Kentucky as part of the Cincinnati metropolitan area; serving a community of 550,000+ people to achieve the best patient outcomes through healthcare technology management. The most gratifying feeling is that both my father and I are making the same impact within the health care industry.
Fun Fact: Since COVID, I have developed a love for golf and I enjoy learning about history. One of my favorite TV shows is the things and people that built America on the History channel.
Director of Biomedical Services at Crothall Healthcare Technology Solutions
Mission Statement: Our mission can only be achieved by passionate, engaged people. The culture where such professionals thrive must have a rudder –Crothall values provide that rudder. Crothall services values are integrity, collaboration, accountability, professional development and leadership.
Fun Fact: I am is a big gamer and a Star Wars nut.
DANIEL ENDARA
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Healthcare Technology Manager at Captial i, LLC
Mission Statement: After navigating the field as a technician for several years, I jumped at the opportunity to teach electronics engineering at the community college level and found the biomedical world there. I began my career with Capital i as a driven and detail-oriented healthcare technology manager dedicated to providing solutions for health care organizations across a diverse array of needs. With strong community ties, I bring a personal level of attention as well as vast company resources to assist my passion for education. It has allowed me to collect a diverse range of skills that I’m glad I can pass on to future HTMs.
Fun Fact: I traveled to 20 countries on 3 continents before I was 30. I am an Advanced Open Water SCUBA diver and enjoy hiking, movies, road trips, guitars, reading and traveling with my family.
Supervisor at Children’s Mercy Hospital
Mission Statement: We all have one goal and that is to provide the best care to our patients regardless if it’s in our hospital or someones elses.
Fun Fact: I make the best BBQ plate you will ever taste in K.C.
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DEREK BROWN
DUSTIN SMITH
Senior Director of Industry Solutions at Nuvolo
Mission Statement: I’m trying to do my part for health care after coming from a family of clinicians. I try to facilitate reductions in cost to health care organizations through better business processes and transparency in regard to workload and accreditation needs. I find value in change and progression. We live in an ever-evolving world and work environment. Acceptance of change will forever be what differentiates success. With this mantra, I seek understanding of new systems, software, ideas and potential. Through this search, I find new ways to challenge norms and promote new efficiencies.
Fun Fact: I have over 70 hours worth of tattoo artwork.
BMET at Harrison County Hospital
Mission Statement: My mission is to provide high-quality biomedical service to a rural critical access hospital. I strive to use my extensive information technology background along with my biomedical background to repair equipment in a timely manner to keep patient care and safety the top priority.
Fun Fact: I like to play video games, collect Funko Pops and spend time with my family.
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EARL MORRIS JR.
EDWARD REYES
Biomedical Equipment Support Specialist at Department of Veterans Affairs
Mission Statement: My mission is to purposefully use my passion and expertise to help veterans receive the highest quality of health care by ensuring all medical equipment and technology is available and safe for patient care. To inspire my co-workers and industry colleagues to achieve not only professional success but personal success which in turn, will produce a more balanced workforce. And, to be the best version of myself by leading with confidence, integrity and positivity; and to always be supportive and empathic to others in creating harmonious relationships.
Fun Fact: I have completed multiple half marathons and have been skydiving (despite being afraid of heights).
Biomedical Capacity Building Project Manager at Mercy Ships
Mission Statement: My mission statement is to use my God-given skills to ensure patient safety and share my God-given skills with my fellow biomeds from Africa so they can contribute to improving the health care system in their countries.
Fun Fact: I lived on a ship for many years but don’t know how to swim. Kind of embarrassing!
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ESSAH EMMANUEL
HECTOR GARZA
Senior Biomed at UHS
Mission Statement: I am a selfinspired professional who strives to do exceptional work. I am results oriented and strives to help my company reach new milestones on a regular basis.
Fun Fact: I have a 2014 red corvette.
Faculty Instructor of Biomedical Engineering Technology at St. Philips College
Mission Statement: To help teach the next generation of biomedical students that there is a great opportunity for being involved in everyday patient care everywhere.
Fun Fact: I like fishing, enjoying the outdoors and spending time with the family. I learned to play Fortnite after retiring from video games when I got married so my son could have a partner to play with online. I have a wife and daughter who have collected books over time and slowly took away my office at home.
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ISAIAH
LINKEDIN
LEDESMA
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Clinical Asset Defense Engineer at HonorHealth
Mission Statement: My personal mission is to contribute to the advancement of medical device security, ultimately ensuring the safety and well-being of patients. I am committed to staying up to date with the latest technologies and industry standards, and to working collaboratively with medical professionals, our HTM team and cybersecurity experts to develop and implement effective security solutions. Through my work, I aim to raise awareness about the critical importance of medical device security and to advocate for the adoption of best practices in this field. I am driven by a deep sense of responsibility to protect patients from the potential harms of cyberattacks on medical devices, and I believe that by working together we can make meaningful progress towards a safer, more secure health care system.
Fun Fact: I started skiing when I was 2 years old, and in my free time I enjoy traveling the world and going on adventures with my family.
Biomedical Service Manager at CME Corp
Mission Statement: “Stay in the fight.” Everyone is fighting a battle we know nothing about whether personally or professionally so lead with kindness. We are here to ensure healthcare providers can deliver the best care for their patients, to do this we need to be focused on the job at hand. I am a firm believer in promoting a healthy work life balance and strong work.
Fun Fact: I am a huge outdoorsman and enjoy all types of hunting and fishing adventures. I am also an avid runner, and firm believer in exercise. When the stress of the day adds up, l’ve found no better way to relieve tension than going on a run to clear my head. I enjoy running our family farm and raising a family that prioritizes spending time together outdoors.
JESSICA PITTERKA
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JOHN WALLER
JORDAN ANDERSON
Chief, Healthcare Technology Management at Providence VA Medical Center
Mission Statement: I love the day-to-day of the medical center but also have a passion for national HTM work groups and translating my expertise/guidance and strategic thinking and the operationalization of my ideas for the VHA HTM community. I am organized and an outof-the-box thinker.
Fun Fact: I am is an adjunct professor at the University of Rhode Island with the department of electrical, computer and biomedical engineering where I teach a biomedical engineering capstone design course and a clinical engineering professional elective course for undergraduate biomedical engineering students. I am also a certified Zumba instructor!
Dialysis Equipment Supervisor at St. Davids Medical Center
Mission Statement: My mission is to serve others and battery pack their purpose to become the best version of themselves through the lens of the Lord. I promote positivity, positive energy and positive outlooks in every situation I encounter. A life lived in fear is a life half lived.
Fun Fact: I go by Tank Fields. My wife (Kayla Fields) and I are middle school sweethearts with three young boys; Stone (5), Steel (3) and Slate (2).
40 UNDER 40 40UNDER 40 YP ATMD
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LANDON “TANK” FIELDS
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Director of Biomedical Services at Crothall Healthcare
Mission Statement: To provide world-class health care service through medical equipment that helps diagnose and treat patients who, in some cases, could be ourselves or a loved one.
Fun Fact: I enjoy parenthood, soccer and swimming.
Director of Biomedical Engineering at Choctaw Nation Regional Medical Clinic
Mission Statement: Provide the best possible patient care to the community we serve by providing safe and the-state-of-the-art technology.
Fun Fact: I am a vegetarian since birth and have never ever tasted any kind of meat that includes fish, chicken or any other animals.
MANASI GHATPANDE
LI CHIA LINKEDIN
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MARGARITA ALVARADO
Lead Service Engineer at FOBI Medical
Mission Statement: I have been a biomed/imaging tech over 18 years and I never stop learning, every day is a blessing. I want to continue my journey to become the best I can be and inspire others to do the same. The challenge is in ourself ... not competing with others but helping each other bring out the best. Our goals are prioritizing patient safety and leading the new generation to do the same. As a female minority, I hope to help build confidence in other women to be more than they thought they could be.
Fun Fact: I’m an adrenaline junkie. I love to skydive and do anything adventurous. Of course, spending time with my kids as well.
Director of Product Management at Fluke Biomedical
Mission Statement: (Professional) “We empower our everyday heroes to focus only on protecting lives.” (Personal) “Rise to the challenge, do the best you can, in the most enjoyable way possible, and leave an impact”.
Fun Fact: Both of my parents are deaf, so my first language is actually American Sign Language. My brother is also hearing impaired, like me, so we learned English later from family members and school.
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MICHAEL RAICHE
Director of Business Development & Marketing at Ampronix
Mission Statement: I am a blessed, groovy seasoned medical marketing and sales executive who has received presidential and multi-congressional awards with 15-plus years of government relations and sales team management experience with various leading organizations.
Fun Fact: I am a three-time world record holder in which one world record is still unbroken! I have set the world record for not blinking two times (my personal best is 1 hour 5 seconds) and am still the current world record holder for “Longest Rodeo Bull Ride While Wearing Eyeglasses” in which I rode a real bull in a semi-professional tournament for 7.8 seconds.
Manager of Clinical Enginering at Cedars-Sinai
Mission Statement: My mission is to use my gifts and talents to ensure the safety, effectiveness and sustainability of clinical technologies and systems, ultimately – along with and through my team –improving the health and the quality of life of my community.
Fun Fact: I am Italian, the correct pronunciation of my name is not what you think. It is [miʹkε:le]
MICHAEL THOMAS
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MICHELE MANZOLI
MIRANDA BARAS
Clinical Support Manager at Vizzia Technologies
Mission Statement: My mission in life is, and always has been, to improve the lives of others. I started my career in 2012 as an EMT/paramedic working on ambulances. In 2014, I moved to a clinical setting, working at the bedside in emergency departments and at a cancer center. Working in hospitals and clinical settings sparked my passion for healthcare technology and how it can be used to improve the lives of patients, families, caregivers and providers.
Fun Fact: I am deeply involved in animal welfare. While working for Animal Ark Rescue, I made a Tinder profile for a shelter dog named Henry. “Henry the Tinder Dog” went viral and was adopted!
Technology Director at Duke University Health System
Mission Statement: To deliver top quality patient care through exceptional technology management and transformative innovation.
Fun Fact: I enjoy spear fishing, scuba diving and almost all other water sports. I love nature and being outdoors. I was the captain of my high school robotics team and currently serve as the head coach for a local robotics team.
40 UNDER 40 40UNDER 40 YP ATMD
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MOHAMED BADAWI
NATHAN SMITH
Co-Founder & CEO of Imaging Diversified
Mission Statement: Using my expertise and creativity, I plan to improve the state of radiology worldwide. I plan to accomplish these goals through education, accessibility and support in radiology. My mission is to impact this world in a positive way and leave a legacy in my profession.
Fun Fact: I’m a big anime watcher! I get engulfed in the story lines and action. It all started with Dragonball Z and from there I was hooked. I continue to watch in my free time and connect with others that share the same love for it.
Biomedical Engineer — Senior Analyst at UNOPS
Mission Statement: Contribute with my experience and knowledge to equalize the gap that exists in clinical engineering and regulatory issues in Central American countries to raise the standards of care and quality for patients through healthcare technology management programs, education and alliances with international associations.
Fun Fact: I am a fan of Star Wars. I have plans to create a page for sharing information, tips and regulatory issues worldwide with the clinical engineering community that can allow others to share knowledge and find something that someone has already asked for, giving it a fun side with Star War’s themes.
OMAR GARCIA
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RILEY VANHOFWEGEN
President of Tenacore, LLC
Mission Statement: To provide clinical equipment life cycle solutions to the global healthcare technology community through quality service delivery and dedication to continuous improvement.
Fun Fact: I worked on commercial salmon fishing boats in Alaska as a teenager.
Supervisor at UC Health
Mission Statement:: Savor the challenge in life and enjoy the adventure. Identify your passion, and let it drive you forward. If you run out of growth opportunities, review your list of fears and make some goals. Fear is an incredibly strong feeling but understand that passion and purpose come from the soul, and they are immensely more powerful. Expose yourself to new situations and listen to others so you can broaden your perspective. Make a list of accomplishments, but also value the failures and mistakes. Forgive others, including yourself, and let gratitude bring you true happiness.
Fun Fact: I enjoy hiking, fishing, road trips, gardening, metal detecting, Dance Dance Revolution, adventure/ exploring, Jeeping, family time, and off-road unicycling. Yes, I enjoy repairing things on my own time as well.
ROSS MODZELEWSKI
40 UNDER 40 40UNDER 40 YP ATMD
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Director of HTM Cybersecurity at Sodexo
Mission Statement: My mission statement is what I like to call yesterday’s tomorrow. I believe who we are today is a combination of all the good and bad that has happened to us in our past (our yesterday), and our goals for who we want to be in our future (our tomorrow). Our present self is not defined by just our current achievements, but by the path we took to get there, what we learned from that path and, finally, the limitations of where we believe we can go. If we look negatively on our past, it devalues our current self and if we don’t set ambitious goals for our future, it limits our growth and potential. We have to understand where we have been and where we think we can go to truly maximize today. We don’t need to be perfect; we need to keep striving for better.
Fun Fact: My beautiful wife and I have 3 crazy kids, 2 dogs and a cat. Outside of work this chaotic group provides enough fun and excitement for one family. And, I wouldn’t have it any other way!
Senior Biomedical Engineer at Soma Tech Intl
Mission Statement: My goal as a lead biomedical engineer in the refurbished medical equipment industry is to prioritize the safety of our customers and their patients.
RYAN GONZALEZ SCHLESHIN DAVID
Fun Fact: I am a big fan of ice cream and relish the opportunity to sample different flavors from various locations. Whenever I visit a new place or travel to a different destination, my priority is to find an ice cream shop and try their different flavors.
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Regional Director of Operations (Midwest) at Crothall Healthcare
Mission Statement: Don’t sell yourself short; confidence and hard work go a long way.
Fun Fact: I love to travel and spend time with my family and friends.
BMET at Trimedx
Mission Statement: Keep inventory maintained and safe to use. Treat all medical equipment in a responsible way as if it will be used on myself, a family member or friends and do the best to keep all devices in good running condition. Connect with other teammates and health care coworkers, stay in tuned with updated knowledge.
Fun Fact: I volunteer to help and support even if others didn’t ask me to step in to help in a proactive way! Working on myself to be more patient and wait till they ask for my help because I think that would be better.
40 UNDER 40 40UNDER 40 YP ATMD
LINKEDIN LINKEDIN 74 TechNation | August 2023
TAJWAR KHAN TIM BOTROS
TERRENCE MACK
CEO, President at TIBS Corp.
Mission Statement: My mission is to make health care more affordable to all within the health care industry by providing alternative service and sales to health care professionals looking to meet a certain budget while holding to OEM criteria. I feel and think it is necessary to teach the next generation of people within the HTM industry the same skill sets I have learned. I do this by offering internships and scholarships and growth opportunities within our HTM small business.
Fun Fact: I love the game of basketball. I am a big fan of the Memphis Grizzlies, the Chicago Cubs, and the Dallas Cowboys. I am a foodie and since I spend a lot of time on the road I have a huge list of great places to eat. I love to travel and meet people.
CEO of RSTI Exchange
Mission Statement: (Personal) It is important to approach each day with a sense of determination to be a problem solver, no matter how challenging a situation may be. Keep a level head at all times. Take chances. Figure out a solution and stop dwelling on the issue. Move on and be better. (Professional) Improving the quality of diagnostic imaging service through knowledge, education and fully engaged hands-on learning.
Fun Fact: Terry Speth - but not Terry Speth “junior” (Terry Michael and Terry Ryan). Novice guitar player, risk taker and traveler!
LINKEDIN August 2023 | TechNation 75
TERRY SPETH
THANK Y U SP NS RS!
76 TechNation | August 2023
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78 TechNation | August 2023
CAREER CENTER How to Resign
BY KATHLEEN FURORE
ew data from FlexJobs’ 2023 Spring Work Insights Survey shows that 42% of 2,600 currently employed people who were interviewed are actively considering quitting their jobs. Reasons given included poor work-life balance, low or unfair pay, a toxic work culture, inflexible work hours and more. When employees decide to leave a job, what is the best way to handle the resignation? How much should they share about their reasons for quitting?
“Resigning from a job is not just about handing in your notice. It’s about managing relationships, preserving your reputation, and ensuring a smooth transition for both you and the team you’re leaving,” says Ryan Bradley, co-founder of Heady, a digital product consultancy that builds mobile apps and websites.
And the way you do all that matters, Keith Spencer, career expert at FlexJobs, stresses.
“Regardless of why you are quitting your job, how you leave your current organization matters because you don’t want to burn any professional bridges,” Spencer stresses. “Plus, you could encounter potential future employers that ask to contact your previous workplace, so you don’t want to leave a lasting negative impression.”
These five tips can help make the resignation go as smoothly and professionally as possible.
1. Notify your immediate supervisor before your colleagues. That, says Spencer, will allow you to exit gracefully. “Try to schedule a one-on-one meeting to tactfully explain your decision while also emphasizing the positive aspects of your time with that company,” he advises.
Bradley agrees that communicating with your direct supervisor to deliver the resignation in person is key. “This shows respect and allows for a more personal conversation,” he says.
2. Give a term of notice. That is always better than quitting on the spot, Spencer says.
3. Follow-up with a formal resignation letter. Address the
letter to HR and to your boss, and make sure it includes details about when your last day will be, Spencer suggests.
The letter – which Bradley calls “a formal record of your intent to leave” – also should briefly explain your decision, “without delving into too many personal details.”
Bradley says how much to share about your reasons for quitting is a personal choice and often depends on your circumstances and relationship with your supervisor or HR department. “Share only as much as you’re comfortable with, and keep the conversation focused on your future goals, not past grievances,” he advises.
“This helps maintain a positive atmosphere and reduces the risk of burning bridges. If you feel there are issues that need to be addressed, such as a toxic culture or unfair pay, consider providing constructive feedback in an exit interview or a confidential survey, if your company has those channels.”
4. Offer to help with the transition. That is an important step, “whether that’s training a replacement, documenting your tasks, or passing on any essential information to your team,” Bradley says.
“It’s also beneficial to your professional reputation and the teammates you are leaving behind if you offer to provide transitional help, make sure to finish outstanding projects to help tie up loose ends, document your top responsibilities and the processes involved,” Spencer adds.
5. Write a thoughtful goodbye email. This should include your contact information and go to your supervisor and closest colleagues “because they could become valuable networking connections in the future,” Spencer says.
The most important thing to remember is that the goal is to leave on good terms, Bradley says.
“You never know when your paths might cross with your colleagues or supervisors in the future,” he concludes.
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.
EXPERT ADVICE August 2023 | TechNation 79
N
20/20 IMAGING INSIGHTS Who Pays For What
BY TED LUCIDI, CBET
v er the past few years, we’ve noticed a few trends increasing in the HTM industry. One trend is that HTM departments (or asset management organizations) are covering the expenses associated with the repair of a device, but if the device is damaged beyond repair, the replacement/exchange cost is passed along to the owning department. Another trend is that HTM departments (or asset management organizations) are covering repairs associated with normal wear and tear as well as electronic and mechanical failures, but if the root cause of the device’s failure is due to preventable damage — trauma, negligence or misuse — the cost is passed along to the owning department.
The majority of the devices supported by HTM departments are truly repairable. Exceptions might be devices that have reached end-of-life, those for which quality parts supplies have diminished, and those which are not serviced by independent service organizations (ISOs). Another segment might include devices such as flexible endoscopes, highly specialized surgical equipment and ultrasound probes which may contain “proprietary parts.” Looking at ultrasound probes, the connector, pin-bank, wiring harness, cable sheathing, strain reliefs and lens may be repairable. The acoustic array or
“crystals” might be considered a proprietary component and, if damaged, might result in the probe being a total loss. With devices such as flexible endoscopes, the CCD camera would be comparable.
You may be surprised to learn that OEMs do not sell replacement parts to individuals, especially ISOs. With catastrophic failures, such as those to the acoustic array or a CCD camera, there are only a few options available. Many times, there is no repair solution, and HTM departments need to rely on an exchange model — whether through Innovatus, another ISO or the OEM. HTM departments are charged with maintaining equipment uptime and doing so in a cost-effective manner. Does maintaining uptime include replacing devices damaged beyond repair, or just repairing devices able to be serviced? There is no right or wrong answer, but there sure are a lot of opinions.
I believe that we’d all agree that no one (or in my experience, only a very select few impatient individuals) would purposely throw out or negligently damage a medical device. Yes, I’ve seen it happen. Depending upon your service philosophy, you may believe that HTM departments should cover all of the service costs associated with the devices they support. Or you may believe that clinical departments should be responsible for the proper care and handling of their clinical devices and share in the financial burden if a device is dropped. There’s no right or wrong answer yet health care costs keep increasing and preventable damage could be considered a contributor. Forcing clinical departments to absorb the cost of preventable damage is just one of many ways to potentially affect behavior, but there are
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80 TechNation | August 2023
others such as awareness, prevention, controls, training, re-training and, yes, re-training.
Innovatus is a trusted service partner for not only several OEMs, but also some major asset management organizations as well as other ISOs. As such, we’re asked to classify the failures on the devices we repair. After repairing over 180,000 ultrasound probes and 40,000 MRI coils, to say we’ve seen it all is an understatement. Let’s look at some scenarios.
What if, a device should undergo X, Y, and Z as part of its normal usage cycle, but the users are only performing X and Y. If the device fails because Z should have been done, whose fault is it? Does it matter who’s at fault? And should the clinical department have to pay for the device’s repair? Again, no right or wrong answer.
What if, a device should be cleaned or disinfected using THIS, but the department is using THAT (which is not approved by the OEM). Should the clinical department be responsible for the repairs to the device that has failed prematurely? Should the burden be on Infection Control, which may have instructed the clinical department to use the cleaner, despite it not being approved? Valid questions. Again, there is no correct answer.
Here’s a very common scenario. The seal surrounding the acoustic lens (rubber membrane) on an ultrasound probe will wear and degrade over time. This is similar to periodically having to replace worn tires or brake pads on your car. The root cause of replacing the lens or the seal would be considered part of normal wear.
We all understand the potential risks of not replacing tires or brake pads. Not addressing an open seal on an ultrasound probe in a timely manner can result in gel, chemical disinfectants and other contaminants entering the probe and inducing major failures. The root cause has now changed from normal wear to preventable damage, and the cost of repair has risen from a few hundred dollars to several thousand … or more.
FACTS
After being in the HTM industry and supporting diagnostic ultrasound for over 30 years, I can confidently say that most failures related to ultrasound probes have a root cause of preventable damage. Another observation that’s not much of a surprise, is that sonographers, echo
techs and other end-users really do share HTM’s goal in minimizing failure rates, maximizing device life cycle and conserving costs. I’ve found that once end-users understand the tell-tell signs of wear and tear, how prevention can minimize failure severity, and partner with HTM to address wearable items, that failures due to preventable damage decline.
GOOD NEWS
No matter if your organization or department fully covers all support costs or chooses to pass costs associated with probe replacements and preventable damage onto clinical departments, Innovatus can help. Innovatus has full repair capabilities and the ability to replace the acoustic array on about 100 probe models. By repairing more and replacing less, HTM departments can realize significant savings while extending probe life cycle. Innovatus can develop and present custom webinars and Lunch & Learn sessions for your clinical staff to raise awareness of preventable damage and how partnering with HTM teams can significantly reduce failure severity and support costs. Let us know how we can help you and your teams.
We encourage readers to download our visual inspection guide for standard probes on the Resources tab of our website – innovatusimaging.com. The guide is also available in hardcopy on heavy stock, upon request, which is ideal for posting. We’d also invite you to have us host a quick webinar for your end-users where we’d talk live and provide a live demonstration on visual inspections. Let us help you lower your bottom line and increase the life cycle of your ultrasound investment.
For more information or to arrange for a live demo or webinar, reach out to TedL@innovatusimaging.com
SPONSORED CONTENT August 2023 | TechNation 81
Ted Lucidi, CBET, is the director of commercial operations and business analytics at Innovatus Imaging.
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BY KEVIN O’REILLY
RIGHT TO REPAIR Right to Repair and a Circular Healthcare Economy A
s we push the boundaries of medical technology, the sophistication of our devices brings with it not only life-saving advancements but also new challenges. The current model of health care equipment procurement and disposal, characterized by a linear supply chain, is simply no longer sustainable. A transformation to a more circular economy, where medical devices are maintained, reused, and kept in circulation, is not just a theoretical ideal but a pressing necessity
This concept, outlined in studies such as “A Circular Economy for Medical Devices: Barriers and Opportunities for Laparoscopic Instruments” and “Transforming The Medical Device Industry: Road Map To A Circular Economy”, highlights the potential benefits and hurdles that we face in this transformation. These range from perceptions around infection prevention to ingrained behaviors of consumers and manufacturers, and regulatory structures that may encourage the proliferation of disposable medical devices.
The linear model has seen health care systems relying heavily on single-use disposable devices, which, while efficient in the short term, has long-term implications that cannot be overlooked. The resulting health care-generated waste, increased health care expenditures and public health damage are pressing issues that we must address. Moreover, these linear supply chains are also vulnerable to disruption and fluctuating demand, a risk laid bare by the COVID-19 pandemic.
The circular economy offers a solution. By keeping manufactured products in circulation, we distribute resource and environmental costs over time and repeated use. This approach is not only financially prudent but also environmentally responsible, helping us to work towards a low-emissions future.
However, to make this transition, we must overcome the barriers that currently inhibit the implementation of a circular
economy in the medical industry. One such barrier are the restrictions around medical device repair. The lack of access to repair materials and information leaves hospitals and health care providers at the mercy of the manufacturers’ business decisions. These restrictions can prematurely end the life span of a device, forcing providers to discard otherwise functional equipment.
This is where the Right to Repair movement becomes crucial. The premise is simple — to reclaim ownership of the devices we buy and use. In health care, that means ensuring that devices can be repaired, reused and kept in circulation longer, rather than being prematurely discarded due to business decisions or corporate policies.
Of course, manufacturers may argue that they impose these restrictions for safety reasons, given the complexity of their products. The data simply doesn’t back up these claims. When the FDA explored this question, they came to the conclusion that “the objective evidence indicates that many OEMs and third-party entities provide high-quality, safe and effective servicing of medical devices” and that “continued availability of third-party entities to service and repair medical devices is critical to the functioning of the U.S. health care system.”
On top of that, as the sophistication of technology advances, so too does the skill of technicians. In-house biomeds are often more than capable of managing equipment, provided they have the necessary resources and materials to do so.
Right to Repair is more than just a consumer movement. It is a necessary step toward creating a circular economy in the medical industry. By advocating for and implementing the Right to Repair, we can reduce waste, lower costs and improve the sustainability of our health care systems. It’s time to reclaim our ownership of the medical devices we depend on and transform our approach to health care equipment.
– Kevin O’Reilly is the Right to Repair Campaign Director at U.S. PIRG.
EXPERT ADVICE August 2023 | TechNation 83
TECHNICAL GUIDELINE FOR TELEMETRY TRANSMITTERS
BY QUI DU, TELEMETRY TECHNICIAN
elemetry transmitters are portable devices that continuously transmit patient ECG and Sp02 rates to central monitoring stations. These signals are transported from the transmitters back to the central station where data can be recorded and used to alert clinical operators when there is a change to the monitored parameters. The ability to analyze the change in the data helps nurses and doctors detect heart problems, pain or discomfort in patients early. This allows them to make necessary diagnosis to improve patient care and outcome.
The transmitters are typically attached to the patient and are always being transported with the patients wherever they need to go. Therefore, the most common issues found on these devices are physical and fluid damage.
In this article, we will discuss how physical and fluid damage affects the functionality of the telemetry transmitters, and how our repair service at Avante Health Solutions, can help with solving the issues.
Q: HOW DOES PHYSICAL DAMAGE AFFECT THE FUNCTION OF THE TELEMETRY TRANSMITTERS?
A: Depending on the model and design of the case housing, the physical damage could affect the functionality of the device in different ways, such as:
Philips IntelliVue M4841A
The battery terminal on this model is attached to the front case housing. Physical damage near the battery terminal could cause the battery springs to misalign, which could also cause a short or an open circuit at the battery terminal which would cause the device to fail the power on self-test.
Philips IntelliVue MX40 + GE Apex Pro & CH
This transmitter has a battery door that secures the battery in place to power the device. If the case housing or the battery door gets physically damaged or loosened, this will affect the “power-on” functionality of the device. After this happens, the device will no longer receive input power from the inserted battery to properly power the transmitter.
Mindray Datascope 608
If physical damage is found to the ECG block assembly, this could cause the device to malfunction and not accurately transmit the input ECG signals from the leads. In this case, the transmitter will get an intermittent signal or an incorrect reading.
Depending on the depth of the physical damage, sometimes it could affect internal issues such as loose connectors or damaged internal components. If you are experiencing this, the device normally is no longer functional, and it needs to be sent in for service immediately.
Q: HOW DOES FLUID DAMAGE AFFECT THE FUNCTION OF THE DEVICE?
A: Fluid damage usually builds corrosion on the case
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Avante’s Repair Service Flowchart Diagram
PHYSICAL / FLUID DAMAGE: CASE HOUSING ISSUES
• NO POWER
• NO SIGNAL
• LEADSET UNPLUGGED
• INTERMITTENT ISSUES
• NOT RECOGNIZED
• ECG EQUIPMENT MALFUNCTIONING
OUR SERVICE
• REPLACE CASE HOUSING ASSEMBLY
• INSPECTED CIRCUIT PCBs
• PERFORMED OEM STANDARD TESTS
• CHECK FOR CASE DAMAGE
housing. Corrosion normally can be found on the ECG block pins, battery terminal or comport pins of the telemetry transmitters.
For example:
• Fluid damage found at ECG block pins could cause the transmitter to be unable to receive the input ECG signals from the lead ECG electrodes. If this happens, there is a leadset unplugged issue with the transmitter. Will Biomeds know what a “leadset unplugged issue” is?
• Fluid damage found at the comport pins could cause the device to be unable to be recognized by the programming tools. If this happens, transmitters are not able to transmit data or receive input data from other interface equipment.
• Fluid damaged battery terminal could cause the device to have issues receiving power input from the inserted battery. In this case, the device will have interment power issues or no power.
For safety, do not use transmitters if they have physical or fluid damage. Always double check the telemetry transmitters to make sure they are free from physical and
AVANTE REPAIRED UNITS
• FREE OF PHYSICAL DAMAGE
• FREE OF FLUID DAMAGE
• DEVICE OPERATES TO OEM SPECIFICATIONS
fluid damage before putting them into service.
Avante’s team of technical experts can help ensure your devices are free from physical or fluid damage. Here is how our in-hour repair depot can help with solving these issues:
To remove physical and fluid damage, we will replace the case with a new case housing assembly. We will also inspect the circuit PCBs to make sure they are free of fluid or physical damage. Once the device is completely assembled, it will be put under rigorous quality and performance tests to ensure the transmitter functions are restored, and the device operates at OEM specifications.
For more information about Avante’s repair capabilities, call one of our experts at 800-449-5328 or visit avantehs.com.
Qui Du is a telemetry technician at Avante Health Solutions. He has a background in electrical engineering and has been with Avante for seven years.
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August 2023 | TechNation 85
THE FUTURE AAMI HTM Educational Standard
BY STEVEN J. YELTON P.E., AAMIF
s I often mention, educators strive to produce the best HTM program possible. We want our program to be great! This is also true of HTM programs in hospitals. As I write this column, I’m on my way home from the 2023 AAMI eXchange. One of the most exciting initiatives that I heard about at the eXchange, in my opinion, is the re-energized focus on HTM standards.
Have you thought of how you could use standards in your day-to-day work to improve outcomes? You may ask, “Why are standards important and, really, what are standards?”
AAMI has been working to enhance its standards department. One new hire is Michael Miskell. He is excited to be working on HTM standards which includes the standard for HTM educational programs. After reading this article, if you are interested in getting more information on the standards process or volunteering to work on any of these standards, please email him at mmiskell@aami.org.
As educators, we strive to make our programs better by sharing and using available resources. We are also looking for new and better ways to enhance the learning experience.
As most of you may remember, AAMI is the lead society for the Technology Accreditation Commission of The Accreditation Board for Engineering and Technology (TAC-ABET). This
society accredits HTM educational programs at the associate and baccalaureate level. AAMI strives to help programs achieve the level needed to secure accreditation by ABET. The programs accredited by ABET are exemplary programs and adhere to the high standards required.
AAMI has developed, or is working on developing, five HTM standards. These standards come under the Equipment (EQ) committee and are called EQ standards. The standards include ones that address the following areas: HTM program management, servicing vocabulary, technology acquisition, alternative equipment maintenance (AEM) and HTM educational programs. Some additional AAMI standards committees needing HTM expertise are: Quality Management (QM) and Software and Information Technology (SM). I feel that these standards will be important to HTM programs within hospitals as well as HTM educational programs.
I just participated in a standards session at the exchange led by two standards giants, Janet Prust and Ralph Basile. They were very helpful in answering many of my standards questions. Here is some of what they said. First, they defined a standard: “A standard is developed within a standards development organization (SDO). It is norms or requirements including uniform criteria, methods, processes and practices.” In general, standards enable products or services to effectively work together by defining common interfaces and protocols. Standards provide quality assurance; efficiency and cost reduction; innovation and competition as well as facilitating global collaboration.
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86 TechNation | August 2023
A
Janet and Ralph did mention that one of the biggest challenges with EQ standards are finding panelists. With your help, we can quickly eliminate that.
Now, I would like to focus a bit on the educational standard. A little history on the HTM educational standard. We have found that not all HTM educational programs are interested in becoming accredited by ABET, but they still want to adhere to some standard of excellence for HTM programs. That’s perfectly OK. To that end, AAMI is working on a standard for HTM programs called EQ110. I am one of the co-chairs of the working group for this standard along with James Linton.
We are interested in having additional volunteers work on this standard or one of the others. These volunteers include, but are not limited to, educators. We would also like end users such as employers in all areas of HTM to help. In the educator’s luncheon at the AAMI eXchange (with also included non-educators), much interest was expressed in this standard. We agreed that a good standard needs input from all factions of users, not just the educators. I find this diverse group of professionals to be very informative – akin to our advisory committee meetings at the college. Without them, our program would not be nearly as good.
This standard is intended to be an entry level standard for HTM educational programs. Programs which reach the level of this standard may still elect to advance to achieve TAC-ABET accreditation. With that said, programs with TAC-ABET accreditation should also make sure that they comply with the AAMI, HTM Standard for Educational Programs. We hope to have some guidance documents available along the way as we develop this standard. Stay tuned!
– Steven J. Yelton, P.E., AAMIF; is a senior HTM engineer for a large health network in Cincinnati, Ohio and is a professor emeritus at Cincinnati State Technical and Community College where he teaches biomedical instrumentation (HTM) courses.
August 2023 | TechNation 87
TOP 10 STERILIZATION FAQ FOR STERIS V116 AND V120
BY VICTOR FERNANDES, SOMA TECH INTL BIOMED
So ma Tech Intl Biomed Victor Fernandes recently shared some of the most common frequently asked questions about two models of STERIS sterilization devices.
1. WHAT ARE SOME THINGS TO CONSIDER WHEN PURCHASING AN AUTOCLAVE?
It all comes down to the application the autoclave is used for. The chamber size is probably the most important consideration, make sure your trays fit the chamber and always consider future growth and sterilization of instruments. The sterilization cycle options, the temperature range to achieve sterilization, the steam pressure capacity, control features, etc. are all important considerations. For the space where the sterilizer will be installed, the inlet water quality, drain installation and electrical requirements are all key factors to keep in mind prior to installation.
2. HOW OFTEN DO AUTOCLAVES NEED TO UNDERGO PREVENTATIVE MAINTENANCE?
Steam and water seriously wear down autoclaves. Therefore, it is critical to regularly maintain and serve the autoclave to keep it functioning properly. Many of these service contracts can vary based on how frequently the user would want to perform them. Most manufacturers recommend at least a yearly checkup on an autoclave. This is based on the usage rate of the machine; it may be recommended to perform it with more frequency at times. Soma Tech Intl offers a
variety of preventative maintenance service contracts for autoclaves. The PM process includes replacing the manifold kits along with various other components that are prone to failure with prolonged use and as the machine ages. Performance tests are done to verify that the unit does not have a leak and that the machine can still run through a sterilization cycle. For more information on the service contracts offered by Soma call 800-GET-SOMA.
3. WHAT IS THE REFURBISHMENT PROCESS LIKE FOR STERILIZERS?
The typical refurbishment process consists of removing and replacing all the old parts and components of the sterilizer with new ones. The interior of the steam chamber is thoroughly cleaned, removing stains and any debris that may have gathered on the unit. The machine’s frame is sanded and repainted to give it a cleaner cosmetic look. Pipes that connect the various manifolds and chamber are removed, sandblasted, rethreaded and coated with a high-temperature protective finish. While the steam, water and exhaust manifolds also undergo the same procedure, all the internal components and valves are replaced with new kits, other components such as pressure sensors, water level sensors are replaced. A new heat exchanger is also built into the sterilizer, all screens are upgraded to be the latest generation. The unit’s door has all its hardware and components replaced to ensure smooth operation. The rebuilt system then undergoes pressure and temperature calibration along with other various built-in tests such as leak and DART tests to ensure the sterilizer can perform optimally. The tests are performed over multiple days to ensure proper functioning of the unit.
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88 TechNation | August 2023
4.
WHAT TESTS MUST BE DONE BEFORE USING A STERILIZER?
Before operating an autoclave, it is important to perform a DART or Bowie Dick test to ensure that the unit can reach the appropriate temperature to perform the sterilization process. Spore tests are done to indicate to the user that the machine is achieving sterilization. Additional tests may be needed based on each facility’s standards and operating protocols.
5. HOW DO I LOAD ITEMS PROPERLY IN AN AUTOCLAVE?
Items should be placed strategically in the system, allowing the steam to pass through freely, while still allowing the heat to be distributed evenly. The chamber should not be overloaded, there should always be some space between items. If the autoclave chamber is overloaded, it can usually result in wet packs and proper sterilization will not be achieved which can cost a significant amount of time and effort. Not to mention wet packs can be caused due to other vacuum or pressure issues; however, proper loading of the chamber is a must.
sources of 208V or 480V to generate steam along with a regular 120V power source to power its main controls. Some generators include an auto-flush feature that allows the user to flush out the generator which helps keep the generator clean and extend its life.
9. ARE ALL MATERIALS SUITABLE FOR STERILIZATION?
No. Many materials are heat sensitive. Due to the high pressure and high temperature inside the autoclave chamber, the material may be damaged beyond repair. Materials such as plastics, rubber and heat-sensitive materials are not suitable for sterilizing in an autoclave and may require a different form of sterilization such as chemical sterilization. Be sure to check the compatibility of all materials before placing them inside an autoclave. This is mainly the reason why low temp sterilizers are gaining popularity as they sterilize with hydrogen peroxide and allow batteries, cameras and many other items that can’t be sterilized using traditional autoclaves. Every brand and model have a compatibility matrix for low-temp, we recommend you check the IFUs before considering the right model to purchase for your facility.
6.
HOW LONG DOES IT TAKE FOR THE MATERIAL TO BE STERILIZED?
This depends on several factors, the type of material being sterilized, the size of the load inside the autoclave, the specifications of the autoclave and the type of cycle selected on the autoclave. Most medical materials require a sterilization time of approximately 20 minutes after the desired pressure and temperature are achieved.
7. ARE THERE DIFFERENT TYPES OF AUTOCLAVES?
Yes, there are several types of autoclaves, including pre-vacuum, gravity, steam flush pressure pulse (SFPP) and high-speed autoclaves. Autoclaves may vary in size from table-top to large steam sterilizers. Some non-tabletop sterilizers may have two doors that can be installed in between two rooms as a pass-through setting to facilitate workflow between clean and dirty rooms. In the past decade many facilities have added low-temp sterilizers; this is due to new models of medical equipment that are only spec’d to be low-temp sterilized. Some of the market leaders in this category are ASP/Sterrad and STERIS V-Pro.
8. WHAT MODEL OF STEAM GENERATORS ARE USED WITH STERILIZERS?
Steam generators may be included with sterilizers either directly inside the unit itself if space is available or it may be an exterior generator that may supply steam to multiple sterilizers. STERIS, Electro-steam and General Boiler generators have slightly different sizes and plumbing configurations and require three-phase power
10. WHAT ARE SOME OF THE COMMON FAILURES IN AUTOCLAVES AND TIPS FOR TROUBLESHOOTING?
The most common failure experienced while using autoclaves are wet packs at the end of cycles. Typically, this may be due to overloading or improper packing of the items inside the chamber but it can also be caused by the unit not pulling a strong vacuum during cycles. This can be fixed by performing a vacuum leak test and other factors such as inlet water pressure and flow should be verified to be within specs to ensure proper functionality of the machine. Steam generator failures are also common and can be addressed by regular flushing of the steam generator. This will help prevent bursting of heating elements, increase the life-expectancy of the generator, and cycles will run at optimal speeds. Finally, door issues can also occur due to it being the part most handled by the users. Depending on the autoclave, always handle the doors with care and ensure that critical components such as handles, door guides, tension cables and hardware are not loose. Sometimes simple adjustments to a piece of hardware may be what’s needed to ensure smooth door operation. Remember to always perform thorough and regular preventative maintenance on autoclaves by replacing old and worn out components such as gaskets and seals in order to avoid failures in the future.
Victor Fernandes, Soma Tech Intl Biomed
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August 2023 | TechNation 89
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CYBERSECURITY
The Cybersecurity Escape Room: Protecting the ‘Unhackable’ Hospital
BY NADIA ELKAISSI, CHTM
e lcome to the TechNation Medical Center! In this virtual escape room adventure, you’ll step into the shoes of a cybersecurity expert tasked with protecting a cutting-edge medical facility from cyber threats. Throughout the way, you’ll learn valuable lessons on how to safeguard the hospital’s critical systems and ensure the highest-level security against cyber-attacks.
CHALLENGE 2: MULTI-FACTOR AUTHENTICATION: UNLOCKING THE DIGITAL FORTRESS
CHALLENGE 1: RISK ASSESSMENT: CRACKING THE CODE OF VULNERABILITIES
In the first challenge of the Cybersecurity Escape Room, we will start by conducting a thorough risk assessments on the medical systems in the hospital. Just as we analyze the escape room’s layout and puzzles, hospitals must identify and evaluate potential vulnerabilities in their systems. As a cybersecurity expert, it is your job to investigate a system’s architecture, access control requirements, data security controls, patch management, physical security controls, disaster recovery, vendor management, and even regulatory compliance. Reviewing the system architecture, evaluating how patient data and sensitive information are stored, and understanding all access allowed to the systems are key to identify any potential weaknesses or points of entry for unauthorized access or data breaches. By assessing their digital infrastructure, data handling processes, and connected devices, hospitals gain insights into areas that require enhanced security measures.
To protect the “Unbackable Hospital,” we will uncover challenges that demand multi-faceted approaches. Similarly, hospitals must employ strong authentication methods, such as multi-factor authentication (MFA), to fortify their digital fortress. Passwords can be easily compromised through various means like phishing or brute-force attacks. Especially for single- factor authentication, there is no robust method to verify that the person attempting the authenticate is indeed the user. MFA adds an extra layer of security because it forces users to authenticate their identity through multi factors, such as passwords, smart cards, or even biometrics, ensuring that only authorized individuals can access sensitive systems. It is important to review the medical systems and require a strong authentication which in turn will significantly strengthen the protection.
CHALLENGE 3: SECURE NETWORK ARCHITECTURE: NAVIGATING THE CYBER LABYRINTH
Just like an escape room, hospitals need a well-designed and secure network isolated architecture. This involves segmenting the network into isolated zones to limit unauthorized access and the lateral movement of cyber threats. Isolating medical devices such as patient monitors, infusion pumps, or imaging equipment into their own network segment will separate the systems from non-medical devices and services. The goal is to create distinct network segments to provide appropriate access controls and enhance overall security and privacy for medical systems and patient data. In addition, implementing firewalls, intrusion detection systems, and network monitoring tools creates a layered defense strategy, enabling the hospital to swiftly detect and respond to potential intrusions.
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CHALLENGE 4: ENCRYPTION- CRACKING THE CODE OF CONFIDENTIALITY
In the escape room, we discover encrypted clues that ensure confidentiality. Similarly, hospitals must prioritize encryption to protect patient data and sensitive information. As an expert, you must evaluate the medical systems encryption methods and determine if it is an acceptable method to protect the data in the medical system. Review the transport layer security, database encryption, file-level encryption and determine the appropriate encryption methods based on the specific requirements, regulations, and standards. By employing strong encryption protocols, both at rest and in transit, hospitals can prevent unauthorized access and maintain privacy and integrity of critical data.
CHALLENGE 5: REGULAR PATCHING AND UPDATES: SOLVING THE VULNERABILITY RIDDLES
In the escape room, we encounter riddles that require solving to advance. Similarly, hospitals must prioritize regular patching and firmware updates for their medical devices. Software vulnerabilities are often exploited by attackers, allowing them to gain unauthorized access and compromising data. Patching and updating the medical systems will address known vulnerabilities and protect against these potential exploits. Experts should be establishing a systematic process to patch management ensures that devices remain up-to-date and resilient against emerging cyber threats.
CHALLENGE 6: INCIDENT RESPONSE PLANNING: ESCAPING THE UNEXPECTED
Even in an “Unhackable Hospital,” surprises can still happen. To prepare for the unexpected, hospitals should develop comprehensive incident response plans. The plans should include identification, containment, eradication, and recovery. Experts should be discussing the steps to be taken during the cybersecurity incident and reviewing any potential vulnerabilities throughout the way. In addition to developing plans, there should be regular trainings and tabletop exercises to ensure hospitals are well prepared for any cyber threat.
As we exit the Cybersecurity Escape room, you have now gained some insight into protecting your “Unhackable Hospital.” By performing rigid risk assessments, controlling the methods of authentication, isolating the network architecture, employing encryption, ensuring regular patching, and planning incident responses, hospitals can significantly improve the security of their medical systems. Every measure we take will improve and build a more resilient barrier to cyber attack and in turn enhance patient care and safety.
Nadia ElKaissi, CHTM, is a biomedical engineer with Healthcare Technology Management VA Central Office (19HTM).
August 2023 | TechNation 93
HIMSS WHO, HIMSS Held Workshop for Digital Health Transformation
Paving a new, harmonized approach to the digital transformation of health systems in Europe and beyond, the World Health Organization European Regional Office and HIMSS jointly held a workshop for European countries at the European Health Conference & Exhibition on June 7 in Lisbon, Portugal.
WHO/Europe and HIMSS coached representatives from member countries in a session. They discussed how to design country-level action plans with measurable outcomes and identify current strategic assets to advance digital health. WHO/Europe and HIMSS last year cosigned a landmark Memorandum of Understanding to collaborate on this goal. The workshop was a follow-up to an introductory virtual workshop held on May 24.
“The workshop has helped identify where the countries are on their digital health journey — whether they’re brand new to it, they’re in the middle of it, or are very advanced,” said Tom Leary, HIMSS senior vice president and head of government relations. “We can help them identify the market suppliers and who they can talk to, these nuance issues, to get them the absolute highest level that they can achieve, given the resources each nation has.”
WHO echoed the sentiment.
“This workshop has been useful to take stock of the progress achieved so far by these countries, but also have an open discussion on the challenges ahead of us,” said David Novillo Ortiz, Ph.D., regional adviser on digital health at WHO/Europe. “We need to be more open about how we address weak points in our shared efforts to integrate digital tools into health care, mainly related to better monitoring of digital health for policy decision-making and ensuring that we use digital solutions without leaving anyone behind.”
The WHO/Europe and HIMSS MoU supports implementing the regional digital health action plan for the WHO European Region 2023-2030 that was endorsed by WHO/Europe Member States last September. WHO/ Europe and HIMSS have co-designed a Senior Health Leaders Orientation Programme for Digital Health, a series of three new and innovative workshops to build knowledge and capacity for developing and managing national data and digital health ecosystems.
HIMMS LAUNCHES GLOBAL HEADQUARTERS
HIMSS, an international advocate for digital healthcare transformation, is launching its Global Headquarters in Rotterdam, the Netherlands. HIMSS made the announcement at the HIMSS23 European Health Conference & Exhibition on June 8 in Lisbon, Portugal.
“Rotterdam is known as the ‘Gateway to the world’ and our new headquarters will help us better serve our constituents in Europe and around the world,” said HIMSS President and CEO Hal Wolf. “Our Global Headquarters underscores our ongoing commitment to reforming the global health ecosystem. I am proud of our accomplishment and excited about the future.”
Augmenting the Rotterdam location, the HIMSS
Americas Headquarters is in Chicago and the U.S. is also home to six satellite offices. For its Asia-Pacific reach, HIMSS has a base in Singapore. HIMSS holds its flagship events each year in North America, Asia-Pacific, the Middle East and Europe. It is a thought leader, advisor and provider of solutions worldwide in analytics and maturity, innovation, professional development and research.
The Rotterdam headquarters gives HIMSS access to an expanding group of members and colleagues across the world, notably the World Health Organization, European Region. HIMSS entered into a Memorandum of Understanding in 2022 with WHO/E to accelerate adoption of digital health solutions.
The Netherlands is also excited about its latest international organization to call it home base.
“We warmly welcome the HIMSS’ choice of the Netherlands as its global headquarters,” said Abigail Norville, deputy secretary general of the Ministry of Health, Welfare and Sport of The Netherlands and vice chair of the Global Digital Health Partnership. “Digital health is key to addressing the huge challenges facing health care today. This creates an extra opportunity for us to be at the center of the global digital health strategy.”
Plans for the global headquarters have been in the works since before the worldwide pandemic, and it gives HIMSS a more robust physical presence in a dynamic, diverse and centrally located European city. Rotterdam is also home to Erasmus University Rotterdam, a highly ranked international research university that conducts health information technology research. HIMSS also has regional offices in London, Berlin and Leipzig, Germany.
CONNECTED 94 TechNation | August 2023
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BEST IN CLASS
HEALTH-ISAC Weaving Cyber into Capital Planning for Medical Devices, Part 2
BY PHIL ENGLERT
a pital budgets are shrinking for more health care providers as COVID 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. June was the 10th anniversary of the earliest reported cyber-attack on a U.S. hospital. This is a good time to consider strategies for bringing cyber risk into the capital planning conversation.
This second installment continues the conversation 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 first installment set the stage by encouraging HTM professional to engage clinical department leaders and to weave cyber into the capital planning discussion. This includes understanding the clinical leader’s perspective and taking some time to understand their priorities, goals and concerns. Framing the discussion around the potential clinical care impacts of various medical devices helps clinical leaders understand how cyber fits within clinical operations. Let’s continue.
Provide context : Help clinical leaders understand the evolving cyber threat landscape and the specific risks health care faces. Threat actors target health care more than any other industry. Threat actors often
blunder around health care infrastructure encrypting valuable-looking files with little knowledge or concern for clinical impacts. Recent ransomware attacks have impacted medical device systems contributing to the death of multiple patients. One example is of fetal monitoring not being available at a central station delaying the detection of nuchal cord and fetal distress. In Germany, a negligent homicide investigation was initiated after ransomware impacted 30 servers causing a hospital to go on divert and delaying treatment of a critically ill patient. Patient care impacts and context will make the discussion more relatable to their own department.
Relate to their role: Explain how cybersecurity events may impact their specific role and responsibilities. Delays in obtaining lab results, or not being able to pull up diagnostic images may delay care decisions or treatments. For example, if talking with the radiology director, discuss the financial implications of losing a CT scanner or MRI for a few days. Discuss how these risks might be managed and how determining response plans before an event can speed restoration activities or identify the need for more resilient technologies. Tailor your message to show how cybersecurity supports their objectives and helps sustain and fulfill the patient care mission. Be empathetic about financial constraints. Prioritization based on mission impact is often helpful to identifying a starting point for mitigations. As an HTM professional, offer to help find workable solutions and map out a long-term plan. Let’s start with this, and next year we’ll revisit these other things.
Offer practical solutions: This is the key! Anyone can ring the alarm bell. Avoid overwhelming clinical leaders with technical details, or fear, uncertainty and doubt (FUD). Tie risks to cybersecurity standards and show how these metrics are measured and tracked. Technical debt has taken a while to accumulate and solving for everything all at once is not practical. Focus on actionable, incremental
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steps to improve the operational resilience of the department. Discuss tactical elements like employee training, incident response plans, regular vulnerability assessments and the use of security technologies wherever possible and compensating controls where traditional security controls are not available. Offer recommendations, best practices and examples of cybersecurity measures that mitigate risks. Help identify reasonable and achievable reductions in risk.
Avoid technical language: Avoid technical jargon and use simple, plain language to explain cybersecurity concepts. Translate complex technical terms into everyday language that non-technical leaders can easily understand. Use analogies and real-world examples to illustrate your points. If you are discussing cyber risks like unsupported operating systems, show how that does not meet current security standards which may lead to unexpected failures.
Follow up with clear documentation: Summarize the key points of your discussion in a clear and concise document. Include agreed upon actionable steps, recommendations and supporting materials. This documentation will serve as a reference for clinical leaders and help them prioritize and implement cybersecurity measures including advocating for the replacement of medical devices which pose significant and unmanageable risk to the care delivery mission.
Encourage questions and open dialogue: Create an open and collaborative environment where everyone is comfortable asking questions and sharing their concerns. Be prepared to address their questions and provide additional resources or explanations when needed. Active listening and respectful engagement will help build trust and credibility. Commit to meeting
regularly throughout the year to discuss changes in their needs, changes in supportability risks or emerging technologies that address existing cyber risks. Building a culture where cybersecurity is a tangible decision point requires ongoing communication and engagement. Your job is to inform business decisions by providing important data points that can be used in the capital planning process. Make cyber part of the maintenance operations and capital planning discussions. Which equipment is likely to become unrecoverable due to gaps in support, parts availability, or just becoming excessive in labor or parts costs? Clinical leaders must balance and make decisions against many competing needs. Your priorities may not be their priorities. Respect that.
Partner with IT and IT Security to help develop the data, strategies and tactics you can present and discuss. Better yet, bring them along. It’s a great opportunity to immerse IT staff in the clinical environment. Continue to provide regular updates, share relevant insights and foster a collaborative approach towards medical device cybersecurity across the organization.
Editor’s Note: This is Part 2 of a two-part article. Part 1 of this article appeared in the July issue of TechNation and is available at 1technation.com.
August 2023 | TechNation 97
Phil Englert is the director of medical device security for Health-ISAC.
NETWORKING NOTES Switch is Step One
BY GARRETT SEELEY, MS, CBET
u r previous articles addressed the importance of the OSI model and the use of TCP/IP both in small and large scale subnetting. As a continuation of these thoughts, we will cover the hardware itself. To build a network, technicians use three essential hardware concepts — a switch, an access point and a router.
Each of these are used by Internet subscribers every day. Each provides a valuable concept for networking, and each can be integrated in an all-in-one device, such as a four-port home wireless router. In a hospital, the most used of these components is a switch. It is a layer two device created to replace the layer one hub.
Hubs are a connective device that repeats a signal to all devices on its network ports. A hub is considered a physical layer or layer one device because it works as a message repeater. It copies a message between all devices, forwarding all information to all devices connected to it. This technique makes the HUB a simple communication device because it does not make any decisions. This technique would not be usable in large networks because the hub’s rebroadcasting technique congests network traffic too heavily. We need a device to limit network traffic. To make larger networks work more effectively, only the sending device and the receiving device need to be included in a communication. This is the function of a switch.
A switch repeats information, like a hub. However, it
does not repeat all the information to all devices. Instead, a switch uses a number to identify each device. This number is called a Media Access Control (MAC) address. A MAC address is preset in the networking interface card and is unique to that card. It identifies the whole device on a network. Switches ask devices for their MAC address and the switch remembers which MAC address is connected to which network plug (called a port). The incoming messages are encapsulated in a header that lists the source and destination MAC address. In this way, networking communications function like a letter. The actual message remains inside the encapsulation and the switch does not read the message. It only reads the header. Switches copy the entire message and header, sending that information only to the device or devices the message was intended for. A switch can do this simultaneously with multiple communications. In this way, the overall network traffic is minimized and restricted only to the devices that need the information. This is how an unmanaged switch performs its operation. Switches are part of the reason that networking became so important in the hospital environment. They greatly sped up a network and allow for much larger scale designs.
A managed switch is a switch that has additional sorting options. Managed switches, sometimes called smart switches, function like an unmanaged switch but also use access control and flow control options. The most popular form of access control is a VLAN. A Virtual LAN acts as if there is a divider installed in a managed switch. Consider how useful it would be to put only the devices that need to talk to each other on their own, private, unmanaged switch. In this way, they would only be able to talk to machines in their own network and there is no other traffic on the LAN. A VLAN accomplishes
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this effect by splitting up a managed switch into groups of devices and only sharing the information between those specific MAC addresses. The information is kept between a smaller number of devices and the overall network speed is faster. Switches use concepts called tags and trunks to accomplish this task. That information is more important to network administrators than a biomed tech. Just keep in mind that smart switches can use VLANs on all their network ports, effectively controlling the movement of information. This is used in conjunction to subnetting to limit traffic to one network segment. In this way, VLANs separate traffic and control MAC communications with just a few devices, limiting the overall number of switches needed by a network. VLANs can also be used by security personnel to isolate devices for troubleshooting or threat management. VLANs are often used with Access Control Lists (ACLs) to monitor traffic behaviors at the third network level. That will be discussed in a future article regarding routers.
A MAC filter is an access control setting that looks for or denies a specific MAC address. With an “allow only” list, called a whitelist, only the MAC addresses listed are allowed to communicate over the VLAN. A whitelist provides a high degree of access control. However, a whitelist also means that each network MAC address must be programmed into the switches for a network to allow access. This requires the most amount of setup and management from network security personnel. A blacklist is the exact opposite. If a security personnel knows of a MAC address that needs to be denied, it can be banned from the VLAN. This is usually reserved to known fake MAC addresses (called a spoofed MAC) that are commonly used by hackers. Since a MAC address also can tell something about the hardware, this can be used to make sure no new switches are added to the network. Both techniques control the number and devices that have access to a switch. MAC address filters are a powerful tool for regulating network traffic.
Switches also use flow control techniques with priority and Quality-of-Service settings. Certain traffic can be given priority over another so that some applications such as video or VOIP phones have priority over other devices. In this way, network flow is given to more critical communications and less critical communications are asked to wait until a path for their communication comes available. These settings are found in the options of the Managed Switch. Another flow control option is the Quality-of-Service settings. This option sets a device data access speed limit. This can be set per device or as an overall rule that all devices must comply to. It caps the speed of a network, effectively forcing devices to slow down to accommodate more devices on the network.
Regardless of the type used, all switches are the center of the network in a LAN. Switches are the main backbone of a hospital. They can be configured to use twisted pair or fiber wiring. In fact, most hospitals use both together to provide a high-speed data connection between buildings. If more devices need to be connected to the network, network administrators add and configure more switches. They are configurable and scalable. Combined with subnetting and filtering, switches are fast and secure. In fact, they are the fastest connectivity device used in a hospital. An entire network can operate without wireless or Internet connectivity, on just a few switches. They are truly the backbone of a hospital network.
Garrett Seeley, MS, CBET, is a biomedical equipment support specialist with VISN 17: VA North Texas Health Care System, Dallas Veterans Affairs Medical Center.
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TECHNATI N P LL
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WHAT’S ON Y UR BENCH?
• #1 and #2 Stabilant-22 Liquid and Gel forms – the single most important thing other than a screwdriver a BMET can have. A an electro-reactive polymer molecule that creates and enhances connectivity in in connectors pins switches and plugs. I have fixed everything from tele boxes to PLCs to monitors to battery connections to lab analyzers to RVs to Ham Radios. A miracle cure for misbehaving electronics no BMET should be without.
• #3 Tripp-Lite orange modular power cord shims – these prevent power cords from coming our of everything from EPIC computer monitors, Patient monitors, anesthesia machines, OR tables etc… These make service calls for power disconnects a thing of the past.
• #4 Ideal Sure Test Power Analyzer – this makes short work of power strip, Video Cart, Transformer and UPS testing and QA. No more lugging around a big EST analyzer. Plug it in review the values and attach the sticker. Done and did.
• #5 Last but not least the pocket screwdriver Pen. No BMET should exist without one. Tweaking brakes on an OR light, tightening loose video and data cables, wall plates data plates 1001 uses.
• #6 The iPhone that took this photo – a smartphone is now an essential BMET tool. Snap a photo of every asset # you work on. Also it has vendor and colleague contacts, iBooks provides service manuals and FAQs at all times, FaceTime for when you need help to fix something and technical apps like spectrum view and light meter, sound meter, etc.
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BREAKROOM August 2023 | TechNation 101
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BIOMED BRAINBUSTER
DOWN
1 Channel or duct
2 Angled surface formed on the cannula when a needle point is ground
3 Gas delivered in ambulances when needed
4 Patients’ records online, abbr.
5 Nonmetallic solid element that may be radioactive
6 Light metal used in the construction of many medical devices
7 Unable to walk easily
13 Roman 51
ACROSS
Leader in supply and repair of medical equipment, 2 words
for scientific tests
Smart
occurring radioactive metal
Gig segment
opposite
Short heart test, abbr.
Anatomical tract, abbr.
Type of bandage
US medical research branch, abbr. 22 Condition relating to an enlarged prostate, abbr. 23 Copper symbol 24 Measurement of radioactivity 26 Type of reactor 30 On the internet 32 US capital 33 Oxygen container 34 Gym exercise, 2 words 36 Discovered 39 Stranded cell stuff, for short 40 Airport vehicle
1
8 Area
9
10 Naturally
11
12 Nothing’s
14
16
17
19
of medicine which is a specialized form of radiology
Curve
Live peacefully together 25 Charged electron 27 Nashville state, abbr.
Requirement from a patient before treatment
Weight measuring device 31 Electrical connectors
Web address, abbr.
Nurse, abbr.
Sodium symbol
15 Break 18 Wheel___ - medical mobility aid 20 Diaphragm spasm 21 Type
22
23
28
29
35
37
38
Visit 1technation.com/crossword for an interactive puzzle. THIS MONTH’S CROSSWORD SPONSOR: BREAKROOM August 2023 | TechNation 107
SCRAPBOOK
On June 16-19, more than 2,100 healthcare technology management professionals, corporate representatives and members of the trade press gathered in Long Beach, California for the 2023 edition of AAMI eXchange. The annual conference and expo included educational sessions, an exhibit hall, engaging keynotes and networking opportunities. Next year’s AAMI eXchange will be held in Phoenix, Arizona from June 14-17, 2024.
For more information, visit AAMI.org.
7 1 2 5 4 3 6
BREAKROOM 108 TechNation | August 2023
1. Attendees had the opportunity to try virtual training through the AR/VR Xperience.
2. The first annual AAMI Golf Tournament was enjoyed by over 70 participants.
3. TechNation team members, Jayme McKelvey and Megan Cabot, pose with Yahira Ulloa. She won TechNation’s door prize in the annual MedWrench Scavenger Hunt.
4. Jose Zambrano showing off his snazzy TechNation socks during the AAMI eXchagne exhibit hall.
5. Herman McKenzie, Director of the Joint Commission, offers a keynote and takes audience questions.
6. AAMI News in Conversation was recorded live at the AAMI eXchange 2023.
7. BC Group was one of several test equipment companies showcasing their products inside the exhibit hall.
8. AAMI members listen to one of the keynote addresses.
9. Scott Trevino, senior vice president of cybersecurity at TRIMEDX, offering a keynote speech on cybersecurity risks.
10. Kurt A. Finke, member of the AAMI Board of Directors and vice chair of HTM, cutting the ribbon to open the 2023 AAMI eXchange.
11. Product demo on the floor of AAMI eXchange’s expo hall.
12. AAMI eXchange attendees relax and enjoy live music at one of the afterparties.
13. Erin Sparnon, senior engineering manager at ECRI, presents on talking about AI to clinicians.
12 13 8 10 9 11 August 2023 | TechNation 109
Company Info AD PAGE PARTS SERVICE TRAINING Company Info AD PAGE PARTS SERVICE TRAINING SERVICE INDEX Anesthesia PM Biomedical pmbiomedical.com • 800-777-6467 107 P P USOC Bio-Medical Services www.usocmedical.com • 855-888-8762 3 P P Asset Management Capital i capitali.us • 417-708-2924 103 Cynch cynch.me • 95 EQ2 www.eq2llc.com • 888-312-4367 37,100 Renovo Solutions www.renovo1.com • 844-4RENOVO 100 P P Association NCBA www.ncbiomedassoc.com • 24 Cables BETA Biomed Services www.betabiomed.com/ • 800-315-7552 25 PM Biomedical pmbiomedical.com • 800-777-6468 107 P P Cardiac Monitoring Cardiotronix cardiotronixhealth.com • (855)-4DEFIBS 29 P P Jet Medical Electronics Inc www.jetmedical.com • 714-937-0809 78 P P PM Biomedical pmbiomedical.com • 800-777-6469 107 P P Soaring Hearts Group soaringheartsinc.com • 855.438.7744 39 P P Cardiology Soaring Hearts Group soaringheartsinc.com • 855.438.7744 39 P P Southeastern Biomedical, Inc sebiomedical.com/ • 828-396-6010 105 P P CMMS Capital i capitali.us • 417-708-2924 103 Cynch cynch.me • 95 EQ2 www.eq2llc.com • 888-312-4367 37,100 TruAsset, LLC www.truasset.com • 214-276-1280 87,100 Computed Tomography AllParts Medical www.allpartsmedical.com • 866-507-4793 113 P P Diagnostic Solutions diagnostic-solutions.com • 330-296-9729 99 P P International X-Ray Brokers internationalxraybrokers.com/ • 508-559-9441 106 RSTI www.rsti-training.com • 800-229-7784 5 P P P Tri-Imaging Solutions www.triimaging.com • 855-401-4888 77 P P P Consultancy NVRT Labs Inc. nvrtlabs.com • 27 Contrast Media Injectors 626 Holdings weare626.com • 800-516-0991 4 Contrast Injector Tools contrastinjectors.com • 724-782-0227 82 P P Maull Biomedical Training www.maullbiomedicaltraining.com • 440-724-7511 40 P Defibrillator Cardiotronix cardiotronixhealth.com • (855)-4DEFIBS 29 P P PM Biomedical pmbiomedical.com • 800-777-6470 107 P P SakoMED sakomed.com • (844) 433-7256 16 P P Diagnostic Imaging 626 Holdings weare626.com • 800-516-0990 4 P Diagnostic Solutions diagnostic-solutions.com • 330-296-9729 99 P P International X-Ray Brokers internationalxraybrokers.com/ • 508-559-9441 106 Renovo Solutions www.renovo1.com • 844-4RENOVO 100 P P Tri-Imaging Solutions www.triimaging.com • 855-401-4889 77 Education/Training 626 Holdings weare626.com • 800-516-0990 4 P College of Biomedical Equipment Technology www.cbet.edu • 866-866-9027 11 P ECRI Institute www.ecri.org • 1-610-825-6000. 17 P 110 TechNation | August 2023
Company Info AD PAGE PARTS SERVICE TRAINING Company Info AD PAGE PARTS SERVICE TRAINING Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6703 106 P NVRT Labs Inc. nvrtlabs.com • 27 Renovo Solutions www.renovo1.com • 844-4RENOVO 100 P P RSTI www.rsti-training.com • 800-229-7784 5 P Webinar Wednesday www.triimaging.com • 855-401-4888 42 P Employment/Recruiting HTM Jobs www.htmjobs.com • 48 Endoscopy Healthmark Industries hmark.com • 800-521-6224 7 Multimedical Systems www.multimedicalsystems.com • 888-532-8056 6 P PM Biomedical pmbiomedical.com • 800-777-6471 107 P P ESUs PM Biomedical pmbiomedical.com • 800-777-6472 107 P P Fetal Monitoring Multimedical Systems www.multimedicalsystems.com • 888-532-8056 6 P PM Biomedical pmbiomedical.com • 800-777-6473 107 P P General SalesMaker Carts salesmakercarts.com • 800-821-4140 78 Infection Control Healthmark Industries hmark.com • 800-521-6224 7 Infusion Pumps AIV aiv-inc.com • 888-656-0755 37 P P Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701 106 P P Multimedical Systems www.multimedicalsystems.com • 888-532-8056 6 P PM Biomedical pmbiomedical.com • 800-777-6474 107 P P USOC Bio-Medical Services www.usocmedical.com • 855-888-8762 3 P P Installs/Deinstalls Tri-Imaging Solutions www.triimaging.com • 855-401-4889 77 Labratory Ozark Biomedical www.ozarkbiomedical.com • 800-457-7576 40 P P Mammography International X-Ray Brokers internationalxraybrokers.com/ • 508-559-9441 106 RSTI www.rsti-training.com • 800-229-7784 5 P P P Monitors/CRTs PM Biomedical pmbiomedical.com • 800-777-6467 107 P P Tenacore Holdings, Inc www.tenacore.com • 800-297-2241 32 P P USOC Bio-Medical Services www.usocmedical.com • 855-888-8762 3 P P MRI CM Parts Plus www.cmpartsplus.com • 877-267-2784 78 P P MRI Diagnostic Solutions diagnostic-solutions.com • 330-296-9729 99 P P Innovatus Imaging www.innovatusimaging.com • 844-687-5100 8 KEI Medical Imaging www.keimedicalimaging.com • 512-477-1500 29 Online Resource HTM Jobs www.htmjobs.com • 48 MedWrench www.MedWrench.com • 31 Webinar Wednesday www.webinarwednesday.live • 800-906-3373 42 P Oxygen Blender PM Biomedical pmbiomedical.com • 800-777-6475 107 P P PACS RSTI www.rsti-training.com • 800-229-7784 5 P Patient Monitors AIV aiv-inc.com • 888-656-0755 37 P P BETA Biomed Services www.betabiomed.com/ • 800-315-7551 25 P P Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701 106 P P iServe Biomedical iservebiomedical.com • 281-741-0849 102 P Jet Medical Electronics Inc www.jetmedical.com • 714-937-0809 78 P P PM Biomedical pmbiomedical.com • 800-777-6467 107 P P SakoMED sakomed.com • (844) 433-7256 16 P P August 2023 | TechNation 111
Company Info AD PAGE PARTS SERVICE TRAINING Company Info AD PAGE PARTS SERVICE TRAINING SERVICE INDEX CONTINUED Southeastern Biomedical, Inc sebiomedical.com/ • 828-396-6010 105 P P Tenacore Holdings, Inc www.tenacore.com • 800-297-2241 32 P P USOC Bio-Medical Services www.usocmedical.com • 855-888-8762 3 P P Refurbish AIV aiv-inc.com • 888-656-0755 37 Rental/Leasing PM Biomedical pmbiomedical.com • 800-777-6476 107 P P Repair Cardiotronix cardiotronixhealth.com • (855)-4DEFIBS 29 P P Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6702 106 Jet Medical Electronics Inc www.jetmedical.com • 714-937-0809 78 P P PM Biomedical pmbiomedical.com • 800-777-6467 107 P P Soaring Hearts Group soaringheartsinc.com • 855.438.7744 39 P P Replacement Parts Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701 106 P P iServe Biomedical iservebiomedical.com • 281-741-0849 102 P KEI Medical Imaging www.keimedicalimaging.com • 512-477-1500 29 PM Biomedical pmbiomedical.com • 800-777-6467 107 P P Software Cynch cynch.me • 95 EQ2 www.eq2llc.com • 888-312-4367 37,100 NVRT Labs Inc. nvrtlabs.com • 27 Phoenix Data Systems www.goaims.com • 800-541-2467 102 TruAsset, LLC www.truasset.com • 214-276-1280 87,100 Surgical Healthmark Industries hmark.com • 800-521-6224 7 Telemetry AIV aiv-inc.com • 888-656-0755 37 P P Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701 106 P P Multimedical Systems www.multimedicalsystems.com • 888-532-8056 6 P PM Biomedical pmbiomedical.com • 800-777-6467 107 P P Tenacore Holdings, Inc www.tenacore.com • 800-297-2241 32 P P USOC Bio-Medical Services www.usocmedical.com • 855-888-8762 3 P P Test Equipment BC Group International, Inc www.BCGroupStore.com • 314-638-3800 116 P P iServe Biomedical iservebiomedical.com • 281-741-0849 102 P Pronk Technologies, Inc. www.pronktech.com • 800-609-9802 2, 82, 100 QRS Solutions www.qrs-solutions.com/ • 877-254-7086 20 P P Southeastern Biomedical, Inc sebiomedical.com/ • 828-396-6010 105 P P Tubes/Bulbs Tri-Imaging Solutions www.triimaging.com • 855-401-4888 77 P P Ultrasound AllParts Medical www.allpartsmedical.com • 866-507-4793 113 P P Innovatus Imaging www.innovatusimaging.com • 844-687-5100 8 Ventilators PM Biomedical pmbiomedical.com • 800-777-6477 107 P P SakoMED sakomed.com • (844) 433-7256 16 P P X-Ray AllParts Medical www.allpartsmedical.com • 866-507-4793 113 P P Innovatus Imaging www.innovatusimaging.com • 844-687-5100 8 International X-Ray Brokers internationalxraybrokers.com/ • 508-559-9441 106 RSTI www.rsti-training.com • 800-229-7784 5 P P P Tri-Imaging Solutions www.triimaging.com • 855-401-4888 77 P P P 112 TechNation | August 2023
626 Holdings 4 AIV 37 AllParts Medical 113 BC Group International, Inc BC BETA Biomed Services 25 Capital i 103 Cardiotronix………………………… 29 CM Parts Plus 78 College of Biomedical Equipment Technology 11 Contrast Injector Tools 82 Cynch 95 Diagnostic Solutions 99 ECRI Institute 17 Elite Biomedical Solutions 106 EQ2 37,100 Healthmark Industries 7 HTM Jobs 48 Innovatus Imaging 8 International X-Ray Brokers 106 iServe Biomedical 102 Jet Medical Electronics Inc………… 78 KEI Medical Imaging 29 Maull Biomedical Training 40 MedWrench 31 Multimedical Systems 6 NCBA 24 NVRT Labs Inc. 27 Ozark Biomedical 40 Phoenix Data Systems 102 PM Biomedical 107 Pronk Technologies, Inc. 2, 82, 100 QRS Solutions 20 Renovo Solutions 100 RSTI 5 SakoMED 16 SalesMaker Carts ………………… 78 Soaring Hearts Group 39 Southeastern Biomedical, Inc 105 Tenacore Holdings, Inc 32 Tri-Imaging Solutions 77 TruAsset, LLC 87,100 USOC Bio-Medical Services 3 Webinar Wednesday 42 866-507-4793 allpartsmedical.com apmsales@philips.com AllParts Medical, a Philips company Portable X-Ray R&F and Fixed X-Ray C-Arms CT Confidence and reliability when you need it most. Cath lab MRI Biomed Ultrasound August 2023 | TechNation 113
ALPHABETICAL INDEX
SPECIAL EDITION
D uring the AAMI eXchange, TechNation hid 48 lucky ducks throughout the exhibit hall. Each duck had a tag instructing those that found the duck to snap a photo, post to social media using #lamTechNation , and bring the duck to the TechNation booth for a prize. Over 30 lucky ducks were exchanged for prizes. Enjoy a few of the photos posted to social media.
BREAKROOM
Photo by Cody Simmons, Owner at Simmons Biomedical Solutions LLC
Found this little guy from #IamTechNation lounging about at #aamiexchange23.
Found the Duck! #IamTechnation #aamiexchange23
Photo by Olivia Carter, career services coordinator at CBET
Kicking off Day 2 at AAMI! Come see The College of Biomedical Equipment Technology at booth #734! #IamTechNation
Photo by Kaitlyn Ware, Account Manager at USOC Medical
114 TechNation | August 2023
USOC Medical is one lucky duck at #IAmTechNation#aamiexchange23.
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