TechNation November 2023

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Vol. 14

NOVEMBER 2023

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

TIPS FOR GREAT CONTRACT MANAGEMENT FLEXIBILITY AND MONITORING PAGE 54

14

Professional

of the Month

Charles Woolfolk

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CONTENTS P.12 SPOTLIGHT p.12 Department of the Month: The ProHealth Care Biomedical Engineering Department p.14 Professional of the Month: Charles Woolfolk p.18 Shifting Gears: Answering the Call p.20 Next Gen: Emily Mengel p.22 Corporate Profile: Cox Prosight P.26 INDUSTRY UPDATES p.26 News & Notes p.32 AAMI Update p.34 ECRI Update p.37 Welcome to TechNation p.39 Ribbon Cutting: Bright Biomedical, LLC P.41 THE BENCH p.41 Tools of the Trade p.42 Biomed 101 p.45 Webinar Wednesday

46

54 FEATURE ARTICLES p.46 Roundtable: Asset Tracking p.54 Cover Story: Tips for Great Contract Management P.58 EXPERT ADVICE p.58 Career Center p.60 [Sponsored Content] Innovatus Imaging p.62 The Future p.64 [Sponsored Content] Capital i P.66 CONNECTED p.66 Cybersecurity p.68 HIMSS p.70 Health-ISAC p.72 Get Connected Company Directory p.74 Networking Notes

TechNation (Vol. 14, Issue #11) November 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 and/or advertiser, and not necessarily those of the publisher. ©2023

November 2023 | TechNation 9

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

VICE PRESIDENT OF SALES

Jayme McKelvey

EDITORIAL

John Wallace

CONTRIBUTORS

Roger Bowles K. Richard Douglas Jim Fedele Joie Marhefka Manny Roman Connor Walsh David Witt Steven J. Yelton

ACCOUNT EXECUTIVES

Megan Cabot Emily Hise

ART DEPARTMENT

Karlee Gower Taylor Hayes Kameryn Johnson

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg Haley Wells

EVENTS

Kristin Leavoy

WEBINARS

Linda Hasluem

HTMJOBS.COM

Kristen Register Sydney Krieg

ACCOUNTING

Diane Costea

CIRCULATION

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

86 P.77 BREAKROOM p.77 Bulletin Board p.78 [Contest] What’s on Your Bench? p.79 Biomed Brainbuster p.80 TechNation Poll p.81 CEAI Scrapbook p.86 #IamTechNation p.82 Service Index p.85 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

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

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10 TechNation | November 2023

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SPOTLIGHT

DEPARTMENT OF THE MONTH

The ProHealth Care Biomedical Engineering Department

P

BY K. RICHARD DOUGLAS

roHealth Care is one of the largest health care providers in Wisconsin, serving patients in Waukesha County and portions of Dodge, Jefferson, Racine and Walworth counties. The health system has been operating since 1914.

The team also has a big leg-up in the integration and cybersecurity areas with dedicated specialists on board.

“We have two biomed integrations analyst positions and a biomed security DBA imbedded in the department. They assist with all of the device integrations for our medical devices from EMR integrations to PACS, network connectivity and any other digital connections for devices,” Inderdahl says.

Many innovations and expansions have occurred since its founding. The system’s growth has tested its biomedical engineering department. The 29-member department includes Director Rob Bundick; Manager Nick Inderdahl; Supervisor Dan Blaisdell and HTM Program Manager Lani Bartkowiak.

Other members of the department include Medical Equipment Project Coordinator Rachel Schneider; Equipment Planner Haylee Miles; Biomed Equipment Lifecycle Planner Chuck Overeem and Biomed Engineering Database Administrator (DBA) Robin Shilkey.

The team also includes imaging techs, a procurement specialist, integration analysts, biomed engineers and an operations specialist.

Department members manage equipment at four hospitals, which includes 274-bed ProHealth Waukesha Memorial Hospital; 18-bed ProHealth Waukesha Memorial Hospital-Mukwonago; 63-bed ProHealth Oconomowoc Memorial Hospital and 40-bed ProHealth Rehabilitation Hospital of Wisconsin.

The group also provides equipment management at a freestanding outpatient cancer center, 15 clinics, 11 urgent care sites within clinics and to ProHealth Angels Grace Hospice.

All service contracts for medical equipment are managed by the department and most are budgeted under the department.

“Service contracts are scrutinized and we try to do as much as we can in-house. We invest in the training of our team so we can minimize contract costs. Of course, there are always those ‘one-off’ devices/systems that just make sense,” Inderdahl says.

STRATEGIC GROWTH The biomed department is active in a number of projects to continuously modernize its processes in order to manage the equipment inventory throughout the equipment life cycle.

“We are included in all aspects of the medical device/ system life cycle from purchase to sale of old/unneeded equipment. We handle the capital planning for fleet replacements as well as high-end devices,” Inderdahl says.

“We implemented the ORDR application as we saw a lack of visibility of the network posture our medical devices had in our environment,” he adds.

There was a lack of details on what these systems were doing on the network.

“ORDR provided this for our medical devices as well as all other things connected to the network. We could now see what our devices were talking to internally and, more importantly, externally,” Inderdahl says.

He says that the department then implemented GE’s SKEYE program to assist in two things – gather missing details of the networked devices to complete the informatics page in the CMMS and get a handle on the vulnerabilities that were appearing in the passive network detection platform, ORDR. “SKEYE monitors our ORDR system 24-hours a day and notifies ProHealth of medical devices that have a vulnerability or alarm that needs to be addressed,” Inderdahl says.

He says that these notifications then turn into a work order for the team to complete.

“This process is helping ProHealth Care maintain a strong security posture for our medical devices, to the extent that is possible. Our next venture is going to be segmenta-

12 TechNation | November 2023

tion at the firewall, with the help of ORDR and our IT teams,” Inderdahl says.

Coming up with solutions to challenges has stimulated the department’s expansion.

“Department growth over the last six years is a result of problem solving. The need for dedicated integration analysts, security DBA, HTM program manager, project coordinator, equipment planner, and life cycle planner resulted from various issues or concerns that were encountered,” Inderdahl says.

He says that many of the problems that the team has faced are common among HTM departments.

“The need to implement cybersecurity and the need to capture detailed informatics information to support cybersecurity and device integration was a problem we could not overlook. We added a cybersecurity DBA and another integration analyst to the department and that highlighted our strengths and weaknesses,” Inderdahl says.

“We learned early on that while we did a good job of capturing informatics information for device integration, we needed to capture more detailed information for a successful cybersecurity program,” Inderdahl adds.

He says that work orders were created for staff to review all networked equipment for informatics accuracy.

“We created detailed fields in our CMMS for technicians to enter data as these work orders were completed or as new equipment is onboarded. All data was reviewed by our security DBA or integration analysts for accuracy. Currently we are implementing a plan to ensure all window updates/ patches are installed and information captured and documented in the CMMS,” Inderdahl says.

Other growth opportunities arose from challenges related to additions to inventory.

“Our capital asset management program for all imaging modalities and many biomed modalities provided leadership with a cost forecast and plan to replace aging fleet. Responsibilities related to the planning, onboarding and installation of the equipment grew. This provided many challenges and opportunities to improve and help the organization,” Inderdahl says.

He says that these challenges allowed for growth by adding a program manager, a project manager medical equipment and an equipment planner.

“These new roles efficiently complete tasks previously provided by department leadership and staff,” Inderdahl adds.

Away from work, the team members are involved with AAMI and the local biomed association.

“Wisconsin Biomedical Association – Lani is a ‘Southern Delegate’ and assists with meeting and annual conference planning,” Inderdahl says.

The biomed team at ProHealth Care met challenges with problem-solvers and specialists, and as a result, have created a well-rounded HTM department for the future of equipment management.

November 2023 | TechNation 13

SPOTLIGHT

PROFESSIONAL OF THE MONTH Charles Woolfolk Prioritizing Family and Team

F

BY K. RICHARD DOUGLAS or many who have entered the HTM profession, there was initially an interest in health care, but a reluctance to pursue the clinician path. Not everyone is cut out to deal with some of the aspects of patient care.

That was the case with Charles Woolfolk, HTM manager in the Baylor Scott and White (BSW) Healthcare Technology Management Department in Temple, Texas.

“I think I always gravitated to the health care field but knew right away that I wasn’t interested in direct patient care. My wife had a client that told her about the HTM field and I was immediately interested in the opportunity to get started right away,” Woolfolk recalls.

Woolfolk enrolled in the HTM biomed/imaging program at Texas State Technical College (TSTC) in Waco, Texas. He says that he was a little late to register and Debbie Tharp at TSTC got him into the program about a week before the semester started.

“I didn’t know what to expect, but was happy to realize the curriculum and approach fit my learning style. I would say after my first semester, I became even more excited about the opportunity to make this my career. Once I started the position, it was eye-opening to see the great amount of focus required by HTM to maintain safe medical equipment,” he says.

The biomed program at TSTC suited Woolfolk perfectly and it allowed him to move on to a major health care employer.

“The small classes and hands-on learning approach was great for me. I feel like I was able to

14 TechNation | November 2023

graduate from the program with a good understanding of what to expect going into the field. I did my internship at Baylor Scott and White Memorial Hospital in Temple, and eventually finished my internship in dialysis where I was offered a position. Today we facilitate multiple internships per semester, and many interns have joined our team after graduation. Once I started in my position, I went to Fresenius Level I and Level II training,” he says.

Since entering the profession, Woolfolk has worked as a BMET I, BMET II and HTM Manager I. He has been in his current position for the past three years. His area of specialty is dialysis.

“I started in dialysis and currently manage the team covering our central Texas clinics and in-patient units. Every day presents a new challenge in dialysis and it keeps me learning daily,” he says.

Woolfolk also manages the biomed teams at BSW McLane Children’s Hospital and BSW Waco Hillcrest hospitals, including the Waco area clinics and Temple region clinics.

FAMILY AND TEAM FOCUS Challenges and special projects are a part of HTM. As both a manager and along with his team, the challenges have been addressed and projects completed.

“COVID-19 provided a unique challenge in the form of surge equipment. We worked a call rotation with other managers to stage surge ventilators for transport to needing hospitals within our system,” Woolfolk says.

He says that another responsibility was providing design input and regulatory guidance for a new in-patient dialysis water system. He says that his team successfully moved it to a brand-new suite with brand new equipment in August of 2022.

More recent projects have included configuring and inventorying approximately 700 infusion pumps

and syringe pumps for various projects within the system and multiple patient monitoring projects implemented in the past two years at Children’s Hospital and Waco Hillcrest “Nurse Call transition at Waco Hillcrest was house wide. It provided challenges to our biomed team during the transition which they met head on while supporting the transition,” Woolfolk says.

Off the job, Woolfolk enjoys spending time with his family and being outdoors.

“Fishing is a favorite hobby, and I like taking trips to the Boundary Waters in Minnesota for a week of fishing and camping, and cooler weather. I love all sports and enjoy cheering for the Duke Blue Devils with my family. I like to play golf when I get a chance, and my sons are taking an interest lately which gives me a great excuse with my wife,” he jokes.

Woolfolk puts his focus on his family and his team on the job.

“I am lucky enough to be married 15 years to the best wife and mother to our three kids; son (14), son (10) and daughter (3),” he says.

He says that his family is the most important part of his life. He also recognizes the important aspects of his work.

“I am a person that tries to enjoy everything I am doing, including tackling challenging issues/problems and working to improve processes for my team and myself. I enjoy my job because of the sense of fulfillment I get knowing my team always puts patient safety first. If patient safety is the true focus of the team, everything falls into place after that. I try to be as helpful as possible because people remember that and are willing to reciprocate,” Woolfolk says.

Temple, Texas is better for having this dedicated HTM professional on the job and as a member of the community.

BIOMETRICS FAVORITE BOOK:

“Blood Meridian” by Cormac McCarthy

FAVORITE MOVIE: “Road to Perdition”

HIDDEN TALENT: I play guitar.

FAVORITE FOOD: Crawfish Etouffee

WHAT’S ON MY BENCH?

I always have multi-driver, channel locks, Teflon tape, Sharpie and tape measure. That usually gets me through the day in the dialysis world.

FAVORITE PART OF BEING A BIOMED?

My favorite part of being a biomed is the opportunities to have a direct impact on safe and effective patient care, as well as the responsibility of calmly resolving urgent issues for the facility and clinical staff.

November 2023 | TechNation 15

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SPOTLIGHT

SHIFTING GEARS Answering the Call

A

BY K. RICHARD DOUGLAS

nswering the call of duty and serving the U.S. in any branch of the Armed Forces is a commitment that deserves respect.

The same can be said of people who commit to being a bone marrow donor. Although the latter does not hold the certainty of participation that enlisting in the military does, it is a selfless act meant to benefit others.

Some people make a commitment to military service and others make a commitment to registration with a bone marrow registry.

Yet a story about an Air Force biomed, which appeared in the Public Affairs news publication for Yokota Air Base in the western Tokyo area of Japan, described the experience of one Airman’s experience donating bone marrow.

The base serves as both a Japan Air Self-Defense Force and United States Air Force Base and is home to the 374th Airlift Wing and the 374th Medical Group.

Senior Airman Nikko Foster, an Air Force biomed with the 374th Medical Support Squadron, stationed at the Yokota Air base, attended the Medical Education and Training Campus (METC) at Fort Sam Houston in Texas for his biomed training.

One day, while leaving a class, he encountered a registration table for an organization called “Be The Match,” which registers people as potential bone marrow donors.

Biomeds know that their work is helping people, maybe even saving lives, so it wasn’t a stretch to

18 TechNation | November 2023

understand why Foster signed up. At the time, one of the personnel with Be The Match took a swab from the inside of his cheek. This cheek cell sample allows clinicians to determine a tissue type.

Bone marrow donations have the potential to save lives. The donated stem cells can offer hope to persons afflicted with forms of blood or lymph system cancers or other life-threatening diseases.

Because Foster’s job in the military could have him stationed almost anywhere, he listed his sister’s phone number on the application. Foster completed the paperwork and then went on his way.

In January, Foster received a call from his sister.

He had nearly forgotten about the bone marrow registration that he had completed two years earlier.

His sister informed him that he had been selected as a transplant candidate.

In real terms, what this means is that there was a match for human leukocyte antigen (HLA), the protein that is used to match patients and donors for blood stem cell transplants. The majority of patients do not have a fully matched donor in their own family. The match is not made based on blood type.

Healthy blood stem cells have the power to cure diseases like leukemia, sickle cell disease, multiple myeloma, severe aplastic anemia, lymphoma and other diseases.

TRAVELING TO TEXAS After receiving the notification, Foster had about a month to prepare, which required flying back to the U.S. He first had to visit a doctor to ascertain that he was healthy enough to make the donation and then he booked a flight to San Antonio, Texas.

Although complications associated with the procedure are rare, the Be The Match organization suggested that Foster have someone accompany

Senior Airman Anthony Tabor, left, and Senior Airman Nikko Foster, 374th Medical Support Squadron biomedical equipment technicians, are seen at Yokota Air Base, Japan.

Senior Airman Nikko Foster, 374th Medical Support Squadron biomedical equipment technician, is seen at Yokota Air Base, Japan.

him on the trip. Foster took one of his fellow biomeds, which would also give the co-worker the opportunity to visit with family.

The process was going to take five days. In preparation, Foster had to go to a clinic to receive shots of a drug called filgrastim. This is a drug that stimulates the growth of blood-forming cells. The drug can have side-effects in some cases, that include bleeding/bruising, blood in the urine, elevated heart rate, fever, back pain and some others.

The blood-forming cells, peripheral blood stem cells (PBSC), are then removed from the blood via an IV in one arm, which is passed through a machine that separates out the cells, and then the blood is returned into the other arm.

After Foster received the injections, he and his co-worker were able to explore San Antonio and enjoy some American food.

When all injections were completed, Foster and his co-worker went to the location for the procedure.

In his words, it was a “large, circular room with sunlight gently filtering through the window shades, creating a surprisingly cozy atmosphere.”

Foster, his co-worker and a nurse were the only ones in the room and the nurse brought them some breakfast tacos. The procedure took four hours, but can take up to eight.

The PBSC donation procedure can cause headaches or bone and muscle aches, as a result of the filgrastim, and these will fade within several days.

Foster says he would do it all again without hesitation. He is grateful for the chance to help someone, although he may never know who that person was. It is like enlisting in the military; you don’t always know all the people you are helping.

Be The Match can provide a kit to interested parties to swab the inside of their own cheek. The swab kit can be ordered online. The swab can then be dropped in the mail. Your HLA type will then be added to the donor registry. You will then be contacted if there is a match to a patient in need. As in Foster’s case, you may be contacted two or three years later.

For more information, visit BeTheMatch.org.

November 2023 | TechNation 19

SPOTLIGHT

NEXT GEN POWERED BY YP AT MD

F

Emily Mengel

irst Health Advisory Security Project Manager Emily Mengel holds a Bachelor’s of Science in biological engineering from Mississippi State University and a masters in biomedical engineering jointly from North Carolina State University and the University of North Carolina at Chapel Hill. She has also earned A+ and Network+ certifications. TechNation recently found out more about Mengel.

Q: WHERE DID YOU GROW UP? A: Trussville, Alabama (just outside of Birmingham) Q: WHERE DID YOU RECEIVE YOUR HTM TRAINING/ EDUCATION? A: After receiving my master’s degree in biomedical engineering, my first HTM job was at Carl Vinson VA Medical Center in Dublin, Georgia, as a biomedical engineer. There my supervisor and co-workers taught me the basics of the HTM industry, networking, medical device security and much more. It was a very hands-on job, and the experience laid the foundation for me.

Q: HOW DID YOU FIRST DISCOVER HTM? A: I learned about HTM from graduates of my graduate program who had gone to work at the VA. They both really enjoyed the HTM field, and after speaking to them I decided to apply to VA jobs across the country.

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: I’ve wanted to work in health care for as long as I can remember. My grandfather is a retired family practitioner. My parents are both engineers and instilled a love of problem solving at a young age. When it came time to choosing a major, I couldn’t choose between health care and engineering. That’s how I ended up in biomedical engineering and choosing a career in HTM.

surrounding asset management and how to leverage their software to meet their process improvement goals.

Q: WHAT INTERESTS YOU THE MOST ABOUT HTM? A: I enjoy studying data and analytics and understanding communication pathways. Medical device integration, cybersecurity and data analysis guiding process improvement are my favorite areas of HTM. I think data can truly help you improve and shows the true picture of what’s going on. As one former supervisor used to say, “Data doesn’t lie.”

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: Being recognized as a 2022 Health Care Leadership Award recipient was truly an honor. It is my goal to show young girls that they can be engineers and make an impact in their communities even behind the scenes of a hospital.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS? A: I want to complete my PMP coursework and exam to become a certified project manager and continue growing my knowledge of medical device security through certifications.

FUN FACTS FAVORITE HOBBY:

Crafting with my Cricut and Cricut press

FAVORITE SHOW OR MOVIE: “Parks and Recreation”

FAVORITE MEAL: Chicken parmigiana

WHAT WOULD YOUR SUPERPOWER BE? Teleportation

1 THING ON YOUR BUCKET LIST:

Travel to all 50 states by the time I am 50 (I’m currently at 30 states)

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: I enjoy getting to work with clients across the country and seeing how HTM practices are being implemented at different facilities. I also love advising clients on current best practices

20 TechNation | November 2023

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SPOTLIGHT

CORPORATE PROFILE

C

Cox Prosight

ox Prosight is an IoT enabled platform solution from Cox Communications, which is the largest private telecom company in America. At Cox, we are dedicated to empowering others to build a better future and celebrate diverse products, people, suppliers, communities, and the characteristics that make each one unique. Cox Communications is the largest division of Cox Enterprises, a family-owned business founded in 1898 by Governor James M. Cox. The Cox Prosight team’s mission is to help hospitals unleash the true potential of becoming a connected hospital by tracking, monitoring, and protecting assets, people and conditions utilizing real-time locating systems (RTLS). This powerful solution furthers Cox’s commitment to reinventing the health care journey to a more personalized, frictionless and overall better patient experience.

Q: CAN YOU EXPLAIN YOUR COMPANY’S CORE COMPETENCIES AND UNIQUE SELLING POINTS? Cox Prosight: Every hospital faces challenges around equipment location and utilization and the process to manage equipment in hospitals is typically manual which can be time consuming. We built Cox Prosight to face this challenge head on. Cox Prosight is an IoT-enabled solution that provides a hospital with the ability to track and monitor assets, environments, and people across a hospital facility. We take the manual processes of tracking and monitoring equipment, along with other use cases, and automate them with real-time location data to streamline operations for hospitals. Hospitals can gain real-time visibility into

22 TechNation | November 2023

the location, status and utilization of all your medical equipment. Prosight leverages location-based intelligence, enabling caregivers and operational leaders in a hospital to find equipment in real-time, along with increasing visibility on equipment status and utilization to help right-size equipment inventory and eliminate stockouts.

Our amazing customer success team leads all of our customers through deployment, training and scaling to meet their goals. We work with our customers every step of the way to ensure success through our proven, repeatable processes.

Q: WHAT ARE SOME ADVANTAGES THAT YOUR COMPANY HAS OVER THE COMPETITION? Cox Prosight: RTLS has been around for quite some time but there have historically been challenges around adoption and scaling. These obstacles to adoption are due to three main factors: 1) outdated, legacy technologies 2) proprietary, single-use architecture and 3) cost. Cox Prosight was designed to circumvent these historical adoption challenges.

Our solution is scalable, flexible and cost-effective enabling hospitals to realize a return on investment quickly and efficiently.

Additionally, our platform is hardware agnostic which allows us to create the best RTLS program with the right hardware based on our customers’ needs.

This enables our customers to get the most value out of the platform.

Q: WHAT PRODUCT OR SERVICE THAT YOUR COMPANY OFFERS ARE YOU MOST EXCITED ABOUT RIGHT NOW? Cox Prosight: Asset tracking is our bread and butter and what the solution was first built to achieve, but the extensibility of the platform is what makes us very excited for the future. By investing in Cox Prosight, hospitals have a platform that can be scaled

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to tackle other challenges including staff duress/ safety, environmental monitoring and hand hygiene compliance. Our goal is to enable hospitals to break down as many technology silos as possible by building a solution that enables them to scale and tackle additional challenges utilizing one platform.

We also kept in mind other critical technologies in health care and made our solution flexible to integrate where necessary.

Q: WHAT IS MOST IMPORTANT TO YOU ABOUT THE WAY YOU DO BUSINESS? Cox Prosight: As a proud member of the Cox Communications family, we take pride in every connection we build leading to creating moments that matter for our customers. Every person is someone’s loved one and we don’t take that lightly. We do anything we can as an organization to aid, assist or make easier the job of a health care worker so they can provide world-class care to their patients Q: HOW CAN COX PROSIGHT HELP WITH A HOSPITAL’S EFFICIENCY? Cox Prosight: Hospital efficiency is the cornerstone of improving health care and offers numerous benefits for facilities of all sizes, including: • Lower cost of care: When a hospital is thoroughly

running, less time and resources are wasted, which lowers the overall cost of patient care.

• Better workflows: Efficient hospitals have streamlined workflows to help staff quickly locate equipment and deliver fast patient care without compromising quality.

• Happier employees: Hospitals can improve employee satisfaction by investing in ways to make operations run smoothly, alleviating physician and staff stress. According to a study, happiness is one of the factors that contributes significantly to health system efficiency.

• Improved patient outcomes: According to an article from Forbes, “when employees are happy, they are more productive and more likely to provide quality care.” There are strong correlations between better patient care when employees are satisfied. Care is also less likely to be delayed, so patients can quickly receive the treatments they need.

While there are many benefits to improving efficiency in hospitals, it is challenging to know what changes to make. Technology is one of the best ways to drive operational efficiency, and there are affordable, proven solutions on the market, like Cox Prosight. Discover how investing in real-time location systems (RTLS) technology will advance the way your facility operates.

November 2023 | TechNation 23

SPOTLIGHT

Q: HOW DOES COX PROSIGHT IMPROVE OPERATIONAL EFFICIENCY? Cox Prosight: Cox Prosight provides the highest level of operational insight to help transform hospitals. From tracking and monitoring assets to forecasting inventory, here are the four ways this RTLS solution addresses common barriers to achieving operational efficiency.

1. Streamlined Asset Tracking: Equipment utilization is a common problem hospitals face. Only 42% of expensive medical equipment in hospitals is utilized, and many nurses report spending up to 1 hour per shift looking for medical equipment. When medical equipment is lost or stolen, most hospitals don’t have a way to find it, which leads to overordering.

With Cox Prosight’s asset tracking capabilities, health care facilities can locate all of their medical equipment in real-time. Whether equipment is needed for maintenance, patient care, cleaning, recalls, or rentals, staff can easily find it via a desktop, tablet, or smartphone.

2. Automated Environmental Tracking: Most hospitals have hundreds of temperature-sensitive areas to monitor, which can be a very time-consuming and expensive process for staff.

These rooms may contain items such as blood, specimens, or food. If the room temperature reaches an unsafe level, these items may spoil and can be very costly to replace.

Cox Prosight simplifies environmental monitoring by automating temperature checks and reporting.

The solution’s smart monitoring feature monitors and logs temperature readings 24/7 and alerts staff when they are at risk of being out-of-range. Hospitals can quickly generate automated reports with accurate and updated information to prepare for compliance auditing.

3. Inventory Forecasting: There is a fine line between having enough or too much medical inventory

– hospitals generally overorder medical equipment by 25%. Inaccurate inventory records can lead to increased costs, unexpected delays in demand fulfillment, and lost revenue. Not only does a lack of inventory affect staff, but it prohibits patients from receiving the quick care they need.

Hospitals can simplify management and forecasting with Cox Prosight’s medical device inventory tracking software. The software offers visibility into inventory levels, providing reliable usage data to identify trends and prevent overstocks and stockouts.

Administration can eliminate guesswork and order the correct size of inventory, every time. Cox Prosight improves hospital operations by reducing unnecessary equipment purchases and the chances of equipment loss.

4. Automated Nurse Call: During a 12-hour shift, the average nurse walks almost four miles a day. From moving back and forth to patient rooms and equipment closets, they don’t have time to waste. An RTLS system helps automate workflow processes and saves time while supporting better patient care. With RTLS-enabled staff badges, nurse calls are automatically canceled when a caregiver enters the room.

In addition, RTLS-enabled staff badges allow staff to activate smart alerts in the case of an emergency or duress situation. Cox Prosight triggers automatic notifications when staff signals for support at the press of a button.

“Our goal is to enable hospitals to break down as many technology silos as possible by building a solution that enables them to scale and tackle additional challenges utilizing one platform.”

24 TechNation | November 2023

Q: IS THERE ANYTHING ELSE YOU WANT READERS TO KNOW ABOUT YOUR COMPANY? Cox Prosight: The team at Cox Prosight is here to help your organization overcome operational challenges through real-time location intelligence. Let’s talk through what you are experiencing and see if we can help!

For more information, visit coxprosight.com.

A RTLS platform that helps streamline and modernize operations in your hospital.

Cox Prosight, the latest healthcare solution from Cox Communications, is an extensible, secure solution that provides the capability to track and monitor assets, environments, and people across a hospital facility.

Streamline asset tracking and improve utilization

Modernize operations, workflow and processes

Automate environmental and compliance monitoring

Improve staff efficiencies

Engage visitors through digital location services

Promote staff and patient safety

Increase patient engagement

Visit coxprosight.com to discover how our platform can impact your hospital.

INDUSTRY UPDATES

NEWS & NOTES Updates from the HTM Industry

SIERRA LEONEANS WELCOME NEWEST MERCY SHIP In response to an invitation from H.E. President Julius Maada Bio, Freetown has welcomed a Mercy Ships’ hospital ship, marking the sixth instance of the collaboration between Mercy Ships and the government of Sierra Leone. This time it is the Global Mercy – the world’s largest non-governmental hospital ship – which has docked at the Queen Elizabeth II Quay.

Mercy Ships’ newest state-of-the-art hospital ship will partner with the Ministry of Health to provide free specialized surgeries to Sierra Leoneans and targeted training for health care professionals until June 2024. Mercy Ships’ programmatic strategy has been carefully aligned with the country’s current strategic health care plan.

26 TechNation | November 2023

The life-changing surgeries delivered will include tumor removal, cleft lip and palate correction, cataract removal, orthopedics and reconstructive plastics.

In collaboration with national and international partners, Mercy Ships will provide education and training across the surgical ecosystem for more than 200 local health care professionals who will add capacity long after the ship leaves. The emphasis of these programs will focus on surgery, nursing, biomedical, sterile processing and anesthesia. This multi-year partnership will focus on strengthening the surgical care system by investing in Sierra Leonean health care professionals who will impact this nation for years to come.

HTM JOBS, BLUE WATER THINKING TEAM UP In a new partnership, HTM Jobs (HTMjobs.com) recently started working with Blue Water Thinking.

Blue Water Thinking is a prime contractor on the BME IDIQ contract vehicle aimed at providing biomedical support for VA medical centers across the country.

They have won several contracts off of the vehicle including two national biomedical staffing contracts supporting VA towards their goal of Cerner deployment.

HTM Jobs is assisting as one of Blue Water Thinking’s recruiters to fill several positions in VA hospitals throughout the United States.

HTM Jobs enjoys its employer partnerships and the opportunity to give back to the HTM community by assisting biomeds and health care facilities. Through partnerships HTM Jobs can fill jobs across the nation, support VAs and be a primary recruiter for every type of organization. HTM Jobs is trusted for its abilities and its impressive talent network.

HTM Jobs is utilizing the industry’s leading HTM channels throughout the TechNation brand.

“Guided by our principles of value generation, continuous innovation, customer-centricity, and vested collaboration, Blue Water Thinking proudly supports our federal clients in achieving their agency goals,” according to its company profile.

Blue Water Thinking is a Service-Disabled Veteran-Owned Small Business (SDVOSB) verified by the U.S. Department of Veterans Affairs. It established BWT to serve as trusted advisors focused on enabling clients to achieve their goals.

Founded by a decorated 28-year veteran of the United States Army, Blue Water Thinking understands and supports the mission of the nation’s war fighters, veterans, their families and caretakers.

“Our formula for success is simple: Build something good, take care of our people, keep our clients satisfied, nurture our work ethic and reputation, build long-lasting partnerships, enjoy what we do and give back as much as possible,” the profile states.

For more information, visit HTMjobs.com.

November 2023 | TechNation 27

INDUSTRY UPDATES

FSI LAUNCHES CAPITAL PLANNING PRODUCT FSI, a health care CMMS provider, has launched CMS Capital Planning, a tool that allows health care systems to budget and plan capital allocation specifically for asset repairs and replacements using data linked to FSI’s Custom Maintenance System (CMS) suite of products.

CMS Capital Planning centralizes asset information – such as condition, replacement costs and end of life – in one dashboard. Additionally, users can access historical repair and maintenance costs to make data driven decisions in the preparation of the annual budget for capital dollars. Armed with this information, facilities and HTM departments can advocate on behalf of their department to leadership, putting digestible data in front of stakeholders in order to save revenue and continue to provide excellent patient care, according to a press release.

“There has never been a convenient, cost effective and centralized way for hospitals to collect, analyze, manipulate and export key datapoints to provide their department’s capital plan for use in the larger hospital planning process,” explained Joe Stockman, director of product experience at FSI. “Therefore, FSI is really

28 TechNation | November 2023

taking the lead in the industry to provide a comprehensive software tool to those who want use data for smart financial decision making.”

With historic asset data, CMS Capital Planning aims to help health care systems save revenue and reduce risk, by allowing facilities and HTM departments maintain compliance and ensure assets are always in the best working condition.

“Having the right data points at our fingertips to present to leadership will be indispensable this year when we submit our financial plan,” shared Cody Hansen, senior manager, systems operations at University of Utah Health. “We can easily identify the assets that would make the biggest impact to repair or replace and determine the most efficient way to spend the capital dollars allocated to us.”

CMS Capital Planning is an optional add-on to FSI’s CMS Core product, which allows for seamless integration between the asset information collected everyday by technicians in CMS and the data points necessary for utilizing CMS Capital Planning’s features, the release states.

DIRECTMED PARTS & SERVICE ACQUIRES TECHNICAL PROSPECTS DirectMed Parts & Service has acquired Technical Prospects LLC. Founded by former Siemens engineer Robert Probst, Technical Prospects has operated from its facility in Appleton, Wisconsin, serving customers across the U.S. and internationally for nearly 30 years.

Since the company’s founding in 1997, Technical Prospects has been the leading parts supplier for Siemens imaging equipment, with coverage across multiple modalities. Today, the business provides timely, cost-effective parts, training, and service solutions, driven by a continued commitment to quality and dedication to customer service. Technical Prospects is led by president and CEO Jeremy Probst, who has spent 20-plus years in the medical imaging and engineering field.

“From our initial discussions with the DirectMed team, it was clear how closely our missions aligned to extend the life of medical imaging equipment and lower costs for health care providers,” said Probst. “This partnership with DirectMed will provide Technical Prospects with expanded resources to deliver an even higher level of service and expertise to our customers.

This will include a greater breadth and depth of parts, full systems and technical support. After almost 30 years of independent operations, we are excited to partner with

DirectMed for our next chapter of growth.”

Brad de Koning, president and CEO of DirectMed commented, “The team at DirectMed has long viewed Technical Prospects as the leading aftermarket Siemens imaging parts and service company in the U.S. The opportunity to partner with them supports our vision of becoming the most trusted resource in aftermarket diagnostic imaging equipment. We are all very excited to begin working with Jeremy and the Technical Prospects staff and expanding the DirectMed breadth of capabilities. There will be no immediate changes to the Technical Prospects brand, the Appleton operations, or the level of commitment to their customer base.”

Tanner LoRusso, vice president of sales for DirectMed, added, “Partnering with Technical Prospects not only expands our scope of parts and systems offering given their deep Siemens expertise, but widens our parts modality coverage further in cardiac cath lab, ultrasound, mammography, fluoroscopy and radiography. Technical Prospects’ mission of providing the medical imaging community with pre-owned, high-quality and cost-effective imaging parts aligns directly with our own.

We are looking forward to working with Jeremy and the rest of the Technical Prospects team in achieving our shared goals.”

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November 2023 | TechNation 29

INDUSTRY UPDATES

TECHNATION ANNOUNCES NEW FEATURE TechNation is introducing a new feature that gives readers a chance to interact with the HTM/Biomed community.

The new feature – called “Show Us Your Shop!” – will debut in the January 2024 issue of TechNation.

The Show Us Your Shop feature is where TechNation will share submitted photos of your biomed/HTM shops.

Clean? Messy? We want to see them ALL! Simply post your photo on social media and use the hashtag #ShowUsYourShop. A member of the TechNation team will

contact you for approval.

The Show Us Your Shop feature is a fun way for TechNation to combine the reach of social media with the power of print.

The TechNation community encompasses over 12,000 biomedical and HTM professionals, providing various ways to stay connected and up to date with industry news and events. Connect with us on Facebook @TechNationMag, on LinkedIn @iamtechnation or subscribe to TechNation TV on YouTube @TechNation_TV.

ARPA-H LAUNCHES PROJECT TO PROTECT DIGITAL HEALTH CARE INFRASTRUCTURE The Advanced Research Projects Agency for Health (ARPA-H), an agency within the U.S. Department of Health and Human Services (HHS), has launched the Digital Health Security (DIGIHEALS) project to protect the U.S. health care system’s electronic infrastructure. Through a Broad Agency Announcement (BAA), the project will solicit proposals for proven technologies developed for national security and apply them to civilian health systems, clinical care facilities and personal health devices.

“The DIGIHEALS project comes when the U.S. health care system urgently requires rigorous cybersecurity capabilities to protect patient privacy, safety, and lives,” said ARPA-H Director Renee Wegrzyn. “Currently, off-theshelf software tools fall short in detecting emerging cyberthreats and protecting our medical facilities, resulting in a technical gap we seek to bridge with this initiative.”

DIGIHEALS aims to ensure patients continue to receive care in the wake of a widespread cyberattack on a medical facility – like those that have caused hospitals to close their doors permanently.

By focusing on cutting-edge security protocols, vulner-

30 TechNation | November 2023

ability detection, and automatic patching, this effort seeks to reduce the ability for bad actors to attack digital health software and enable the prevention of large-scale cyberattacks. In addition to addressing cybersecurity vulnerabilities, the project aims to identify and fix software-related weaknesses that affect patient safety and experience.

“By adapting and extending security, usability, and software assurance technologies, this digital health security effort will play a crucial role in addressing vulnerabilities in health systems,” said ARPA-H Program Manager Andrew Carney. “This project will also help us identify technical limitations of future technology deployments and contribute to the development of new innovations in digital security to better keep our health systems and patients’ information secure.”

Proposals for DIGIHEALS must be submitted through the Scaling Health Applications Research for Everyone (SHARE) BAA. Multiple awards under the DIGIHEALS area of focus for the SHARE BAA are anticipated and resources available will depend on the quality of the proposals received and the availability of funds.

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INDUSTRY UPDATES

AAMI UPDATE

A Q&A with American Medical Association President Jesse Ehrenfeld

J

esse Ehrenfeld, MD, MPH, co-chair of AAMI’s Artificial Intelligence (AI) Standards Committee, assumed the presidency of the American Medical Association (AMA) in June. In this Q&A, Ehrenfeld explains recent AMA advocacy on issues related to augmented intelligence, the association’s preferred term.

Q: THE AMA HOUSE OF DELEGATES ADOPTED A POLICY IN JUNE THAT CALLS FOR MORE REGULATORY OVERSIGHT OF INSURERS’ USE OF AI IN REVIEWING PATIENT CLAIMS AND IN PRIOR AUTHORIZATION REQUESTS FOR HEALTH SERVICES. WHAT CHALLENGES IS THIS NEW POLICY TRYING TO ADDRESS? EHRENFELD: Let me start by saying that this year, leading that Recovery Plan for America’s Physicians is among my top priorities. Our work around improving telehealth, digital health, and that new policy came from growing concerns that health insurers are increasingly relying on AI in their prior authorization and claims adjudication processes. The challenge is that when used inappropriately, AI can lead to improper denials and ultimately prevent patient access to medically necessary care. Our new policy is straightforward. It calls for health plans using AI technology to use a thorough and fair process that’s based on clinical criteria and keeps humans in the loop – including reviews by doctors and other health care professionals who have the right expertise for the service under review.

32 TechNation | November 2023

Q: THE AMA ALSO HAS COMMUNICATED WITH THE OFFICE OF THE NATIONAL COORDINATOR (ONC) FOR HEALTH INFORMATION TECHNOLOGY ABOUT ITS PROPOSED RULE, HEALTH DATA, TECHNOLOGY, AND INTEROPERABILITY: CERTIFICATION PROGRAM UPDATES, ALGORITHM TRANSPARENCY, AND INFORMATION SHARING (HTI-1). WHAT ARE THE KEY TAKEAWAYS FROM THIS? EHRENFELD: Since 2019, we have urged ONC to make sure that certified EHRs [electronic health records] can protect sensitive health information. We support efforts to promote the sharing of health information, but the current regulatory policies and EHR technology stack are insufficient to ensure that patients, their caregivers, or physicians can direct how sensitive health information is shared. So, we’re asking ONC to correct this failure of EHR technology and policy by updating the ONC certification requirements and information blocking regulations in terms of AI connected to an EHR. Physicians currently are provided very little information about how the AI uses patient medical information or how the AI was trained or develops. Many physicians are or will soon encounter AI embedded within their EHR workflows. When asked, physicians and our members tell us that they need clear and meaningful information on things like: • What is the health care AI’s clinical effectiveness?

• What is its validity?

• How do we know that it’s safe to use?

• What are the limitations?

• What are the data privacy protections embedded in the technology?

• How have considerations around bias been handled?

Very little AI transparency is required for tools and technologies that are not already regulated by the FDA and unregulated AI products are becoming more and more

commonplace in health care settings. So, we support ONC’s AI transparency policies, which would require EHR vendors to provide physicians access to information about the AI that’s being used in conjunction with patient medical records and the EHR. Q: THE AMA’S COMMUNICATION TO THE ONC STATES THAT THESE ISSUES PUT PHYSICIANS, RATHER THAN AI VENDORS, AT RISK, CORRECT? EHRENFELD: Correct. We have seen what we think are inappropriate proposals through rulemaking that would place the liability for the output of an algorithm solely with the end user, i.e., the physician. We think that liability ought to be most appropriately placed with the individuals who are best suited to mitigate the risk.

And in many cases, that’s not going to be the end user. It’s the developer, the software vendor, the implementer, or the entity that bought or licensed the technology. And again, in our health care system today, that often will not be the physician. So, to solely place all the liability when there is a problem with the output of an algorithm on the end user seems misguided.

Q: DO YOU THINK THAT THE UNSETTLED POLICY ENVIRONMENT IS HOLDING PHYSICIANS BACK FROM ADOPTING AI TECHNOLOGIES? EHRENFELD: I think it is too early to tell what exactly is going to happen. I’m an optimist. I have a background in clinical informatics. I’m board-certified in informatics. So, I recognize the power of these tools and I just want to make sure that we’re doing everything we can at the AMA to reduce the barriers to adoption and ensure that they’re working for patients and physicians.

Q: YOU CO-AUTHORED AN EDITORIAL FOR THE JOURNAL OF MEDICAL SYSTEMS ON AI IN MEDICINE AND CHATGPT. WHAT INSPIRED THAT? EHRENFELD: Well, there’s a lot of misunderstanding about ChatGPT, what large language models are and are not. And I think there is this sentiment in certain parts of society that AI tools will replace physicians. And I think that’s the wrong approach. The AMA really tries to push the concept of augmented intelligence, not artificial intelligence. And where I see the real exciting opportunities are to use these tools to detether physicians from their computers to bring more time and attention back to our patients, which drives patient satisfaction and drives and restores the joy in the practice of medicine for physicians. There are so many administrative tasks that I know these tools will be helpful for, but focusing on how we replace clinical decision making doesn’t seem to be the right place to start. Rather, simplification of processes, added efficiencies through the use of emerging tools, is I think where the money’s going to be.

Q: IS THERE ANYTHING ABOUT AI YOU WANT TO COMMUNICATE TO THE AAMI COMMUNITY OF HEALTH TECHNOLOGY MANUFACTURERS AND HEALTHCARE TECHNOLOGY MANAGERS? EHRENFELD: Just getting back to the liability issue, you might imagine why a manufacturer or software developer would be enthusiastic about having liability for a device, an algorithm software, placed solely with the end user. But I’ll tell you, a lot of companies that we interact with and trade associations share a perspective that if we do erroneously place liability solely with the end user, that will kill the market and that there will be a reluctance to use and purchase these products. So, making sure that we get that liability question addressed and answered in a rational way, I think there’s a need and I think we’re seeing more alignment with our perspective and others in the health care ecosystem than we were initially.

For more information, visit aami.org.

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November 2023 | TechNation 33

INDUSTRY UPDATES

ECRI UPDATE

Addressing Patient Care Challenges Through Innovative Health Technology Management

E

CRI’s annual Health Technology Excellence Award competition provides insight into exceptional technology management initiatives undertaken at health care organizations around the world. The 2023 competition yielded multiple examples of health technology managers using innovative approaches to address challenges facing their organizations. Two of the most impressive submissions from the 2023 cycle are outlined below.

THE GUTHRIE CLINIC: USING AI AND VIDEO TECHNOLOGY TO ADDRESS STAFFING CHALLENGES The Guthrie Clinic (Sayre, PA) is a rural integrated health system that serves patients in hospitals and clinics across a 9,000-square-mile region in the states of Pennsylvania and New York. Delivering high-quality care in a rural environment can be a challenge. During the pandemic, the challenges grew exponentially. The health system’s beds, emergency rooms and clinics were becoming overwhelmed with patients. At the same time, many local nurses and other care providers were deciding to take positions in other regions or to leave health care altogether.

The organization’s strategic approach to addressing this challenge earned The Guthrie Clinic ECRI’s 17th Health Technology Excellence Award, which was formally presented to the organization in a September 2023 ceremony.

The ​Challenge: Address staffing shortages exacerbated by the pandemic, while also positioning the rural health system to better serve future patients in a changing health care landscape.

The Project: The Guthrie Clinic’s approach involved rapidly implementing a telesitting program to address the immediate need – a staffing crisis – but also to serve as the first phase and proof of concept for a virtual command center based on an 34 TechNation | November 2023

AI-enhanced video and communications platform.

The first phase of this project – the telesitting program – led to immediate improvements in patient safety during a time of crisis, as well as demonstrable cost savings (an estimated $7 million per year reduction in labor costs).

Previously, patients who were at risk of falling either were going unwatched or were watched by overqualified staff, who were called on to perform the sitting function when other staff were unavailable. With the telesitting program, cameras in the patient rooms allow just a few telesitters at a central location to provide fall coverage for dozens of patients across the health system. The AI functionality built into the video system interprets the images in real time and highlights circumstances that require the sitter’s attention, providing an added layer of safety.

This implementation led to better patient coverage using fewer staff, thereby improving patient safety while also freeing up skilled nurses to perform other patient care duties.

The success of the telesitter program facilitated the second phase of the project: the implementation of virtual critical care nursing. Using the same AI-driven platform along with other technologies, a central team of nurses now supports the bedside nurses staffing ICUs across the health system. The program provides an additive level of care: bedside nurses can consult with, or offload some tasks to, a central team of experienced nurses.

This initiative has allowed the organization to consolidate resources in a centralized location, standardize practices across care areas and facilities, and expand the reach of providers to help improve care, including access to care, across the broad region served by the health system.

JOHNS HOPKINS: BUILDING A BETTER EVENTREPORTING SYSTEM Health care organizations implement safety-event-reporting systems to provide a means for clinicians and other staff to document incidents that have (or that could have) adversely affected patient care or led to other harm. The goal is to identify problems and implement improvements to avert future incidents. The effectiveness of such programs can be hindered,

ECRI’s Jason Launders presents the 2023 Health Technology Excellence Award to Terri Couts and the rest of the Guthrie Clinic team.

however, by common barriers to reporting – namely lack of staff awareness about the reporting process, the time and effort required to submit a report, fear of retribution, and challenges in analyzing and responding to the reports that are received.

To eliminate or minimize such barriers, the team at the Johns Hopkins Armstrong Institute for Patient Safety and Quality (Baltimore, MD) examined event-reporting processes, both internally and externally, and assessed the functionality of available software applications. Unable to find a system that could effectively reduce the barriers to reporting and support productive use of reporting data, the Johns Hopkins team decided to build a better one. The organization’s exceptional efforts earned it recognition during ECRI’s 2023 Health Technology Excellence Award competition.

The Challenge: Design and develop a safety-event-reporting software application that (1) makes it easier for frontline health care workers to report safety events, (2) increases transparency throughout the reporting and review processes, and (3) helps leaders and analysts make sense of the reports in this unique dataset and prioritize opportunities for improvement.

The Project: The Johns Hopkins team convened focus groups with event reporters and reviewers from various disciplines, it conducted usability testing, and it initiated discussions with patient safety experts throughout the United States. This effort led to a few guiding principles: The software application needed to be intuitive and efficient, since any given reporter might use the system only once or twice a year. Also – and importantly – the application needed to consider the workflows of event reviewers, since they’re the ones who’ll be interacting most often with the software and data.

Led by these principles, software developers worked in close coordination with the Johns Hopkins team – which in turn consulted with user experience experts, human-centered designers, and future users of the event-reporting system – to develop an event-reporting software application that features: • A single, short submission form.

The Johns Hopkins Hospital, Baltimore, MD.

• A machine-learning algorithm that automatically categorizes reports based on the event description.

• Communications functionality that supports seamless collaboration and transparency, allowing reporters to open reports they submitted and continue to communicate with reviewers.

• Innovative qualitative analytics using machine-learning algorithms that have been optimized using years of Johns Hopkins historical data.

Metrics related to user satisfaction and user engagement illustrate the success of the effort. Perhaps more importantly, however, the system has improved the organization’s ability to make effective use of event-reporting data, paving the way for real, positive change.

HOW TO APPLY FOR THE 2024 AWARD To be considered for the 2024 award, which is open to members of any ECRI program, visit https://www.ecri.org/ health-technology-excellence-award. Applications will be accepted through the end of January 2024. To learn more about the projects described above, as well as others that have been recognized through this program, scan the QR code.

For more information, visit ecri.org.

November 2023 | TechNation 35

SPECIAL REPORT

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INDUSTRY UPDATES

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Bright Biomedical LLC

right Biomedical LLC Owner and Operations Manager Bobby de Sosa, CBET, describes the company as a partner that works with customers. TechNation recently found out more about the company.

Q: WHAT ARE SOME OF THE SERVICES AND PRODUCTS YOU OFFER? A: We assist facilities with their Alaris infusion system fleet maintenance. When a hospital or equipment supplier needs to get their equipment up to date for annual maintenance, repairs, etc. we send our team in. We help them reach compliance from A-Z with the goal of reaching 100% completion within the timeframe. On top of maintenance, we also provide asset management solutions. This involves taking inventory, maintenance scheduling and strategizing, assisting with implementing new fleets and recall remediation. Infusion pumps and all associated devices can really take a lot of time out of your technician’s already tight schedule so having our focused pump services can free up time for your technicians to perform at their peak. This is what we do. No training is necessary, just give us directions and we will reach the target. I’m excited to work on infusion pumps because even though they are seen as introductory biomed equipment, the importance of patient safety can’t be overlooked. ECRI labeled infusion pump safety as their #3 concern for patient safety in 2023 and #1 in 2017!

Q: HOW DOES YOUR COMPANY STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: Bright stands out in the medical equipment field because of “The Bright Method.” It’s a workflow system designed to handle large quantities of devices. Most facilities have thousands of pumps, and this requires a system to handle them efficiently. Time and time again, The Bright Method has proven itself. We often receive positive feedback on the way we approach infusion pump maintenance and receive compliments on the quality we bring to the table.

Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY? A: Great new clients. With The Bright Method, we’re looking to prove the concept as much as possible.

We’re looking to fill our schedule with great people who want the best for their patients. My goals for the future are to apply myself as a CBET and add on to the list of equipment we service. We’re going in the direction of patient monitor and defibrillator maintenance. With more work I will be able to provide more jobs to excellent technicians and even help teach the next generation as interns! After all, that’s how I started.

Q: IS THERE ANYTHING ELSE YOU WOULD LIKE OUR READERS TO KNOW? A: We don’t call ourselves Bright because we think we are smart. We call ourselves Bright because our mission is to B Right to our clients, the equipment and to the patients.

For more information, visit BrightBiomedical.com or email info@brightbiomedical.com.

November 2023 | TechNation 39

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November 2023 | TechNation 41

THE BENCH

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Exploring Alternative Maintenance Programs for Medical Devices

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BY CHATGPT EDITOR’S NOTE: This Biomed 101 article was created by asking ChatGPT to “write a 1,000 word article about alternative maintenance program for medical devices.” n the fast-paced world of health care, the proper maintenance of medical devices is critical to ensuring patient safety and the delivery of quality care. Traditionally, health care facilities have relied on manufacturer-recommended maintenance programs to keep their medical equipment in optimal condition. However, in recent years, alternative maintenance programs have gained recognition as viable alternatives.

In this article, we’ll delve into the concept of alternative maintenance programs for medical devices, exploring their benefits, challenges and the growing trend towards their adoption.

THE CONVENTIONAL APPROACH TO MEDICAL DEVICE MAINTENANCE Historically, health care facilities have followed manufacturer-recommended maintenance programs, often referred to as original equipment manufacturer (OEM) service contracts.

These programs typically involve: • Scheduled Maintenance: OEMs provide a predetermined maintenance schedule for each medical device, outlining when inspections, calibrations and parts replacements should occur.

42 TechNation | November 2023

• Exclusive Parts and Service: Facilities under OEM contracts are usually required to purchase replacement parts and services exclusively from the manufacturer, which can be costly.

• High Costs: OEM service contracts can be expensive, especially for larger health care facilities with extensive equipment inventories.

• Regulatory Compliance: Adherence to regulatory standards and guidelines is a primary concern, and OEMs are expected to help facilities meet these requirements.

THE RISE OF ALTERNATIVE MAINTENANCE PROGRAMS In recent years, health care providers have started exploring alternative maintenance programs as a way to address some of the challenges associated with OEM contracts. These alternative programs offer several advantages: • Cost Savings: One of the most significant benefits of alternative maintenance programs is the potential for cost savings. By working with third-party service providers or in-house biomedical teams, health care facilities can reduce service contract costs and access competitively priced replacement parts.

• Flexibility: Alternative maintenance programs offer greater flexibility in scheduling and customizing maintenance

routines to match the specific needs of each facility. This adaptability can lead to improved equipment uptime and patient care.

• Reduced Downtime: Quick response times and on-site repairs by in-house biomedical teams or third-party service providers can significantly reduce equipment downtime, ensuring that health care providers have access to the tools they need when they need them.

• Extended Equipment Lifespan: Properly executed alternative maintenance programs can extend the lifespan of medical devices, delaying the need for costly replacements.

• Compliance and Accreditation: Many alternative maintenance providers are well-versed in regulatory compliance and can help health care facilities meet accreditation requirements, ensuring patient safety.

CHALLENGES AND CONSIDERATIONS While alternative maintenance programs offer numerous benefits, they also come with their own set of challenges and considerations: • Regulatory Compliance: Ensuring compliance with regulatory standards is a crucial aspect of medical device maintenance. Health care facilities adopting alternative programs must be diligent in meeting these requirements.

• Qualified Personnel: Effective alternative maintenance programs require skilled biomedical technicians or third-party service providers with the expertise to handle a wide range of medical devices.

• Risk Management: There is an inherent risk in deviating from OEM service contracts. Facilities must carefully evaluate the potential risks and benefits and have contingency plans in place.

• Parts Availability: Some medical device manufacturers may limit access to replacement parts for devices under alternative maintenance programs. Facilities must ensure a reliable supply chain for parts.

• Documentation and Record-Keeping: Proper documentation of maintenance activities is essential for regulatory compliance and accountability. Facilities must establish robust record-keeping procedures.

CASE STUDIES: SUCCESS STORIES IN ALTERNATIVE MAINTENANCE To illustrate the effectiveness of alternative maintenance programs, let’s examine a few real-world case studies: • Large Hospital System: A large hospital system with multiple facilities decided to transition from OEM service contracts to an alternative maintenance program. By partnering with a third-party service provider, they

reduced their maintenance costs by 30% across their entire equipment inventory. The flexibility of the new program also allowed them to schedule maintenance during off-peak hours, minimizing disruptions to patient care.

• Rural Health Care Clinic: A rural health care clinic with limited resources opted for an in-house biomedical team to handle maintenance. While initially requiring an investment in training and equipment, this approach saved them over 40% on maintenance costs in the first year alone. The clinic also reported improved equipment reliability and uptime.

• Specialized Medical Facility: A specialized medical facility required maintenance for highly specialized equipment not covered by OEM service contracts. They collaborated with a niche third-party provider with expertise in their specific equipment. This partnership ensured the availability of replacement parts and reduced the risk of downtime due to equipment failure.

THE FUTURE OF ALTERNATIVE MAINTENANCE PROGRAMS As health care continues to evolve, the adoption of alternative maintenance programs for medical devices is expected to grow. Factors contributing to this trend include: • Cost Pressures: Health care providers are under increasing pressure to reduce costs without compromising patient care. Alternative maintenance programs offer a viable solution to achieve cost savings.

• Technological Advancements: Advances in medical device technology are making it easier for biomedical technicians and third-party providers to diagnose and repair equipment, reducing the reliance on OEMs. • Regulatory Support: Regulatory bodies are recognizing the value of alternative maintenance programs and are working to provide clearer guidelines and standards for their implementation.

CONCLUSION Alternative maintenance programs for medical devices are gaining momentum as health care facilities seek cost-effective solutions without compromising patient safety or quality of care. While these programs offer various benefits, they also come with challenges that require careful consideration and planning. By striking a balance between cost savings and regulatory compliance, health care providers can ensure the longevity and reliability of their medical equipment while reducing the financial burden associated with OEM service contracts. As the health care landscape continues to evolve, alternative maintenance programs are poised to play an increasingly vital role in the delivery of quality patient care.

November 2023 | TechNation 43

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“What used to take us 3-4 hours now takes 25 minutes!” is the feedback from a case study that presenter Dr. Michael Olding, head of product management at RTI Group, shared during the presentation. A case study looking at how to achieve significant time savings when performing X-ray testing was the subject of his talk. In a hospital environment, maintaining X-ray equipment means covering many modalities and departments, with the demands for efficiency higher than ever. Olding looked at how performing X-ray testing can be simplified and made more efficient, while maintaining full traceability from X-ray test exposure through reporting. Attendees can avoid arduous calculations and manual analysis and discover how everything can be automated to save time and get systems back up and running more efficiently. Attendees provided feedback via a survey that included the question, “What was your single biggest takeaway from today’s webinar?”

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“I have not had time to attend a show in the past year – this gave me an excellent opportunity to see a good product,” said Mary Coker, project manager, Cone Health.

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Kontakt.io Global Head of Healthcare Practice Kapil Asher and Matt Cannell, senior director, professional service at Kontakt.io, shared their real-life experiences in deploying RTLS solutions across multiple hospitals. During this engaging discussion, they provided valuable lessons learned.

The experts also shed light on how Kontakt.io’s cuttingedge technology facilitates the quickest deployments in the industry. The webinar also offered exclusive tricks and tips that hospital leaders must know before planning for an RTLS deployment project. The presenters shared additional expert insights via a question-and-answers session. Attendees provided feedback regarding the webinar via a survey that included the question, “Why did you attend today’s webinar?”

•

The new TechNation Tools of the Trade live demo series is proving to be very popular with HTM professionals. The August Tools of the Trade live demo featured the Cynch ERP platform. Cynch is a best-of-breed SaaS CMMS plus asset management system that includes real-time asset history, maintenance, repair, purchasing, inventory management, subcontracting and warranty claims. Customers login to the Cynch portal through their own websites to manage their entire operation in one place. Technicians can see their work queue, follow a guided inspection and maintenance process, add notes, upload photos, add MRO inventory parts to the work order, see asset-specific user/repair manuals and much more. Cynch also offers lightning-fast filtering and searching of enormous asset catalogs. Attendees provided feedback via a survey that included the question, “What was your single biggest takeaway from today’s product demo?”

“Wireless technology helps speed up X-ray testing,” said Timothy Hoof, CBET, Indian Health Service.

“The Kontakt.io Playbook: Expert Insights on Successful RTLS Deployments in Hospitals”

“To know how to implement RTLS in hospital facilities and save revenue/time and scale its resources,” said Elijah Mwanyange, Biomed/CBET, Adventist Healthcare-Whiteoak.

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Chad Holmes and the Cynerio team discussed the explosive growth of Generative AI and how it is leading to numerous innovations. Among the most promising opportunities are those in the health care industry, where limited resources and historic underinvestment are leading to dramatically increased rates of successful cyber-attacks. Holmes discussed the immediate benefits of Generative AI in health care. The Cynerio team demonstrated the values Generative AI provides to forward-thinking health care organizations.

Attendees also provided feedback via a survey following the webinar. One question attendees answered was, “Was today’s presentation worth your time?”

•

“Yes. Very interesting to hear how AI is now influencing the medical technology sector,” said Jeremy Ekalo, BMET II, City of Hope.

IN CASE YOU MISSED IT Watch these webinars on-demand

November 2023 | TechNation 45

ROUNDTABLE

ROUNDTABLE

T

Asset Tracking

his month, TechNation asked several industry insiders to share the latest regarding asset tracking technologies. Participating in the roundtable article are Kontakt.io Senior Director of Healthcare Enterprise IoT Solutions Kapil Asher, Cox Prosight Product Director Jaiganesh Balasubramanian, Vizzia Technologies Clinical Support Manager Miranda Baras, Capital i CEO Tony Danko and Midmark RTLS Director of Hardware Research and Innovation H.T. Snowday.

Q: WHAT ARE THE DIFFERENT ASSET TRACKING TECHNOLOGIES? ASHER: There is a wide variety of asset tracking technologies in the market and the selection of the right technology depends on the use case and the business requirements that need to be solved. We

46 TechNation | November 2023

focus on tracking technologies that are most used in a health care environment below: • Bluetooth Low Energy (BLE): Using BLE location sensors attached to medical devices, this technology can be used with any open source BLE “scanners” the health system may have already invested in to provide location services.

• Wi-Fi: Battery operated location sensors that utilize specific Wi-Fi access points capable of providing location services.

• Proprietary Active RTLS: Battery operated location sensors that utilize a proprietary RF protocol like 900MHz, providing location services in conjunction with add-on technologies like InfraRed. • Passive RFID: Passive location sensors powered by external scanners providing location services only when tags pass a particular chokepoint.

BARAS: Real-time location systems (RTLS) utilizes a combination of wireless technologies such as: radio-frequency identification (RFID); Wi-Fi; Bluetooth Low Energy (BLE); ultrasound; and infrared. More equipment manufacturers are

introducing a variety of inexpensive BLE devices.

The Vizzia IoT Lab at the University of New Mexico is testing several new sensors to ensure they can achieve clinical grade requirements that hospitals demand for room level accuracy versus zone level.

DANKO: Some of the different asset tracking technologies commonly used in HTM are RadioFrequency Identification (Passive RFID and Active RFID), Barcoding, Real-Time Location Systems (RTLS), Global Positioning System (GPS), NFC (Near-Field Communication), Ultrasound and Acoustic Technologies, Bluetooth Low Energy (BLE), Infrared (IR), Cloud-Based Software and IoT Platforms.

SNOWDAY: Technology, such as a real-time locating system (RTLS), can bring new efficiencies to teams tasked with having the right equipment at the right time. Asset tracking and management specifically is a foundational use case for RTLS, which provides location information and utilization insights. It’s important to consider that different technologies have varying levels of locating precision. Ask yourself … Do you need to know the exact location of the asset in question or will general location suffice?

An infrared (IR) sensory network provides highly accurate room, bed and chair-level location data. IR locating technology is definitive location data – it’s a 1:1 relationship between the tag and sensor. Assets rarely need to be located to the definitive room level, so choosing IR is more about what you want to do with RTLS in the future when considering automating nurse call or optimizing patient flow. As an alternative, BLE uses an algorithm to estimate an asset’s location. With an appropriate density of sensors, a near-room location – within three meters – can be achieved. Equipment tags emit BLE signals to multiple plug-in BLE sensors. The network of sensors detects and transmits location coordinates to determine and display a location in the cloudbased software, making it low maintenance yet secure. There’s also leveraging a typical hospital Wi-Fi Internet network; however, it typically provides only zone-level location information. Wi-Fi networks with more access points are better able to estimate locations, yet because these signals pass through walls and ceilings, the location data is estimated, not definitive.

Q: WHAT ARE THE ADVANTAGES AND DISADVANTAGES OF THE DIFFERENT ASSET TRACKING TECHNOLOGIES? ASHER: The biggest advantage of BLE is its open-

source protocol. This is the only technology that allows interoperability between tags and the location service infrastructure. BLE lets users choose tags from multiple vendors and does not lock them within a monopolistic ecosystem. This creates a price and technological competition that benefits the customers. Moreover, modern network infrastructure, such as lighting, tablets, TVs, etc., all have BLE capabilities, allowing the creation of a dense location service infrastructure that is unmatched by any previous generation asset tracking technologies. BLE is also inherently a low power-consuming protocol that enjoys a longer battery life compared to all other active technologies, making maintenance of the system easier. Combined with cloud software, BLE truly can meet most HTM requirements from a data-sharing point of view. While Wi-Fi can provide many advantages of BLE, like utilizing existing network infrastructure, it requires licenses to utilize those capabilities. The biggest disadvantage of Wi-Fi is battery life. Wi-Fi demands high power consumption, requiring constant battery replacements by HTM departments. It is not unusual for health systems to abandon a Wi-Fi based tracking system because of time-consuming battery management. Proprietary Active RFID, as the name suggests, this technology locks the health system into a closed ecosystem that does not work with other tag suppliers. In addition, there is the need for an overlay network and location sensors in the ceilings, requiring power and network cable drops in various areas of the building and making the deployment expensive. This technology outperforms Wi-Fi in terms of battery life longevity but is not as good as BLE. Passive RFID technology is as good as the last time the tag passed a chokepoint. The data from this technology is not real-time and, in many HTM use cases, not very useful. Like proprietary active RFID, this also requires expensive installation and cable drops. The only advantage of passive RFID is that the tags are battery-free and never require any replacement, making them maintenance-free.

Ultimately, the use case requirements should dictate the choice of technology. HTM leaders should select an asset tracking solution that is easy to maintain and provides a high return on investment (ROI).

BALASUBRAMANIAN: RTLS technology is a vital part of any hospital’s infrastructure. Effective RTLS will help your hospital in its journey to become a leader in the health care industry. As such, it is important for providers to consider which RTLS option is correct for their needs. Wi-Fi-based RTLS technology utilizes pre-existing wireless access points to track assets.

The primary benefit of a Wi-Fi-based system is that it

November 2023 | TechNation 47

ROUNDTABLE

Kapil Asher Kontakt.io

Jaiganesh Balasubramanian Cox Prosight

Miranda Baras Vizzia Technologies

Tony Danko Capital i

HT Snowday Midmark RTLS

uses a hospital’s pre-established infrastructure, Disadvantages are line-of-sight required, manual eliminating the need for additional infrastructure scanning, limited data capacity. RTLS advantages are costs. Infrared, or IR, RTLS technology is powered by real-rime tracking, high precision, versatility. technology that is like a television remote. A major Disadvantages are cost, complexity, interference. benefit of IR is that it can be significantly more GPS advantages are global coverage, real-time accurate than other RTLS technologies. Ultratracking, versatility. Disadvantages are limited indoor wideband is a radio-based form of RTLS technology accuracy, dependence on satellite signal, power that aims to provide short and stable tracking consumption. BLE advantages are low power technology. The leading benefit of UWB RTLS consumption, cost-effective, ease of deployment. technology, by far, is location precision. Ultrasound Disadvantages are limited range, accuracy. Cloudidentification is a RTLS technology that utilizes simple, Based Software and IoT Platforms advantages are inexpensive badges and tags to transmit and centralized management, data analysis, scalability. communicate locations using microphones. On Disadvantages are dependent on other technologies, average, ultrasound can track assets within 3-5 cost of implementation. meters. Bluetooth technology is common across all sorts of devices. On top of ease of use, SNOWDAY: IR is appealing to health it’s far and away the most diverse form systems because of its high of RTLS technology. BLE provides asset granularity. Not only does it “BLE is gaining tracking advantages like geofencing, empower comprehensive workflow popularity because it’s solutions, but biomedical teams zonal coverage, choke point coverage and maintenance management – among can leverage the precise more cost effective and specifically a variety of others. location data to reduce time spent searching for equipment. One easy to install – think BARAS: When selecting specific consideration for tag placement is days not months. ” technologies for these use cases, it is that IR tags do need to be exposed crucial to align the technology choice for sensors to pick up their signal. IR - HT S N OW DAY with the specific requirements and can also have an expensive upfront desired level of location certainty. installation cost for a typical wired Technologies such as RFID, Wi-Fi and BLE typically solution or ongoing labor and maintenance costs if provide estimated location information, which is choosing wireless. BLE is gaining popularity because suitable for less demanding applications where it’s more cost effective and easy to install – think proximity or general location is sufficient. On the days not months – without disrupting patient care or other hand, technologies like infrared (IR) and going down the path of a construction project. Its ultrasound (US) offer more precise and certain near-room accuracy is satisfactory for meeting goals location data, making them well-suited for use cases like tracking equipment where you need a general that demand high accuracy and reliability. location. It allows for tag size and placement flexibility, which is useful when considering how the DANKO: RFID advantages are high accuracy, equipment can be placed in conditions where the tag efficiency, long read range (Active RFID), Durability. may be hidden from view such as in cabinets, Disadvantages are cost, interference, limited range misplaced in the laundry or even accidently disposed (Passive RFID). Barcoding advantages are costof in the trash. Wi-Fi locating is beneficial when effective, simplicity, widespread adoption. health systems want to piggyback on existing

48 TechNation | November 2023

infrastructure. However, it’s the least accurate of the locating technology. The difference can be as much as the software showing an IV pump is located in room 204 on the second floor, but because Wi-Fi penetrates structure, it’s actually located in the room above, 304 on the third floor. Regardless of the technology used for asset tracking, biomedical teams reap the benefits productively and financially. They can find equipment needed for preventive maintenance faster, create more organized and informed approaches to their daily workflow and how they communicate with clinical teams, reduce costly unnecessary equipment expenditures and optimize inventory fleet with more insight into utilization and movement history.

Q: WHAT ARE SOME OF THE NEWEST FEATURES AVAILABLE? ASHER: Modern RTLS systems offered by Kontakt.io are packed with features that not only address traditional biomed asset tracking but also offer a comprehensive IoT platform that integrates various environmental sensing capabilities such as temperature, humidity, air quality, light, motion, air pressure and carbon monoxide. The data is freely available with open-source integration protocols that can be used by facilities management and security systems. Combined with built-in RF and InfraRed sensors, Kontakt.io provides the industry’s most accurate room-level location certainty in asset tracking. Another trend is the use of AI to redefine RTLS’ capabilities. We can use AI to analyze patterns and predict trends, scan for hidden waste and inefficiencies, protect devices and networks from malicious attacks, and integrate with user applications to get insights within seconds.

BALASUBRAMANIAN: RTLS 2.0, as it’s been termed, offers significant advantages and improvements over legacy RTLS solutions. RTLS 2.0 allows hospitals to deploy a platform solution and unlock several uses cases including asset tracking, staff duress and workflow, environmental monitoring, patient wandering/elopement/workflow without the need to constantly add more infrastructure. The newest features include the ability to integrate with other health IT systems like asset management or EMR/ EHR without significant cost hurdles eliminating the silos which exist in these systems today.

BARAS: The Vizzia InVIEW data analytics platform continues to integrate with other key hospital workflow solutions such as CMMS and EMRs. To ensure that mission-critical data is secure, Vizzia

recently achieved the System and Organization Controls (SOC) 2 Type II compliance certification.

Vizzia has also conducted a successful machine learning (ML) pilot that yielded substantial operational improvements across several inventory KPIs to include up to a 52% improvement in key out-of-stock metrics and reducing overstock rates by up to 20%.

DANKO: Artificial intelligence (AI) and machine learning are being used to analyze the data collected from asset tracking systems. This enables predictive analytics, anomaly detection and optimization of asset management processes. Some asset tracking systems are also incorporating environmental sensors (e.g., temperature, humidity, accelerometers) to monitor the conditions of assets and measure utilization based on device movement parameters.

SNOWDAY: At Midmark RTLS, we believe innovation fuels success. Though we have been successful in the on-premises nature of our business for the last 30 years, we were the first RTLS partner to lead to the cloud, where we believe the future of RTLS technology is headed. This allows a true enterprise solution for health care systems with multiple facilities, while avoiding the burden on IT. With BLE locating technology, we were able to remove the network complexity through a simple yet sophisticated RTLS architecture. Through this innovation, we’ve been able to track equipment as it moves across facilities so biomedical teams can better manage their inventory and reduce costs.

Location specific notifications and inventory distribution are other improvements in advanced asset tracking technology. For location notifications, staff can be notified in-the-moment when a piece of equipment leaves or enters an unauthorized area.

These real-time notifications help reduce loss and better manage capital expenses. To achieve improved inventory distribution, each unit in a facility can choose the level of inventory they need to operate efficiently, and their RTLS can monitor it.

When the number of assets for a designated area falls out of the selected range, an automatic alert can be sent to biomedical teams, creating a more proactive inventory management approach.

Q: HOW CAN ASSET TRACKING SYSTEMS HELP A HEALTH CARE FACILITY SAVE MONEY? ASHER: Asset tracking systems help a health care facility save money in major ways: • ROI on asset utilization – Asset tracking solutions

November 2023 | TechNation 49

ROUNDTABLE provided by Kontakt.io help health facilities significantly increase asset utilization, eliminating the need to purchase buffer quantities of IV pumps or beds and wheelchairs. We are also saving hospitals hundreds of thousands of dollars by reducing rental equipment and preventing the loss of small devices.

• Improvement in productivity – Although a soft, intangible return on investment, helping biomed engineers search for medical devices for PMs in seconds improves their efficiency significantly. The time saved is utilized to stay on top of PMs, satisfy Joint Commission mandates on 100% PM compliance, and repurpose extra time to learn new skills.

BALASUBRAMANIAN: Asset tracking systems can help reduce search time for equipment for nursing, clinical engineering and biomedical teams.

Improvements translate into the various teams focus more on care, equipment maintenance and replenishment. Asset tracking can help improve utilization of equipment, hence reducing yearly repurchasing of equipment not needed and reduction in rental costs. In addition, it can help reduce loss of equipment by alerting when equipment leaves a building or has been left unattended. Asset tracking can help improve and automate various asset workflows including preventive maintenance, rental returns and replenishment.

BARAS: As the number of devices per hospital bed has nearly doubled to 15, utilization rates of medical equipment only average 42%. After an RTLS solution is deployed in a hospital, utilization rates of equipment typically increase to 75% or greater. This results in a reduction of the rental fleet size and lower equipment purchases. The additional benefits include reduced search time by nurses who spend up to an hour per shift looking for equipment and biomeds trying to locate devices for PMs and product recalls. A 350bed hospital can save on average $487,000 annually and 255,000 hours.

DANKO: One of the most difficult data points to capture is asset utilization. A good asset tracking system will enable health care facility staff to easily locate available assets and reduce the need for over-purchasing or renting equipment, leading to significant cost savings.

SNOWDAY: With increased asset visibility and real-time location data, biomedical teams can right-size their inventory more effectively. One Midmark RTLS customer in Michigan reduced capital expenses by $1 million because they were able to determine that they didn’t need additional

50 TechNation | November 2023

equipment; they just needed to use what they had more effectively. They downsized their fleet from 900 IV pumps to 600, and their utilization rate jumped by 133%. Another large cancer center improved OR cardiac case start times by 25% with the real-time asset location data. They were able to more efficiently prepare operating rooms with the high-demand surgical equipment, allowing them to reduce surgery delays.

Q: WHAT SHOULD AN HTM/BIOMED DEPARTMENT LOOK FOR WHEN PURCHASING AN ASSET TRACKING SYSTEM? ASHER: There are four factors that a biomed department should consider while choosing an Asset Tracking system: total cost of ownership, ease of installation and maintenance, use case scalability and location accuracy. Kontakt.io is best suited to meet all these criteria. Since we are based on open standards such as Bluetooth Low Energy and Wi-Fi, we can leverage the economies of scale achieved by these technologies into our products, making them less than a third of the cost of other RTLS providers.

Being cloud-managed, Kontakt.io eliminates the need for physical or virtual servers and databases, reducing the burden on the IT teams. Our room-level accuracy sensors are completely wireless, eliminating the need for additional power or data cable pulls. Finally, open standards systems also offer biomed the flexibility to choose IoT sensors from multiple vendors, breaking the shackles of monopolistic RTLS systems. This is very helpful in scaling the RTLS platform to incorporate niche use cases that are beyond the scope of HW product development by the vendor. For example – leak detectors, vibration sensors, or specific mechanical or environmental condition monitors.

BARAS: It’s important to have a clear understanding of the challenges facing your health care facility and all the various clinical uses cases that need to be included (i.e., devices, patients and staff ). Typically, RTLS solutions fall into two broad categories of hardware and software. Look for a full-service partner that can provide onsite support for installation, training and ongoing maintenance.

Talking with several biomed leaders at other ‘go live’ facilities will provide keen insights on lessons learned.

DANKO: When an HTM department is considering purchasing an asset tracking system, it is important to consider the return on investment. By conducting and demonstrating a positive ROI, the department

will be better positioned to gain approval for capital investment. It is also important to evaluate the support and training the asset tracking provider offers. A system that has limited support and training will frustrate the organization and render the system ineffective over time.

champion open and APIs, and we believe that should be the standard for RTLS today.

BALASUBRAMANIAN: There has been considerable technological evolution over the last few years with BLE leading the way. BLE provides significant cost savings while providing improved battery life of tags SNOWDAY: Midmark RTLS approaches real-time and ease of deployment and maintenance. Investing locating with three components: in an extensible IoT platform should be considered • Software. RTLS is a journey, not a destination. Your compared to a purpose-built asset tracking solution.

RTLS solutions should be scalable so that they grow A platform will provide extensibility to other with your RTLS goals over time. RTLS doesn’t focus problems the facility wants to solve in the future solely on solving singular problems, but instead including wayfinding, staff duress, environmental takes location-based information and applies it to monitoring and patient flow solutions without a similar challenges and goals such as significant reinvestment. With increasing asset visibility and mancaregivers and clinicians on the agement, patient and staff safety and go, a solution that provides the “Artificial intelligence workflow capacity. staff the mobility and visibility in (AI) and machine • Hardware. RTLS technology success the palm of their hands would be is grounded in accuracy. Different lolearning are being used important to realize broader cating technologies offer different benefits. to analyze the data levels of granularity, and it’s important to determine how accurate your BARAS: Health care workers face collected from asset location information needs to be. Lopersonal safety risks, staffing tracking systems. This cating people and locating equipshortages and burnout. Staff ment may not necessarily need to be safety is top of mind for hospital enables predictive the same level of granularity. leaders, as workplace violence is • Service. The key to RTLS success is four times more common in health analytics, anomaly just as much about the right partner care than in other professions. detection and and process as much as it is the techVizzia offers a silent staff duress nology. From success coaching to alarm which provides room-level optimization of asset best practice implementation to anaaccuracy to immediately report management processes.” the exact room location to lytics education, a dedicated and clinically versed RTLS partner is what designated security personnel, - TO N Y DA N KO makes all the difference in a sustainenabling them to provide able RTLS program that drives reimmediate help. sults. A partner can help you channel RTLS data into continuous process improvement DANKO: Asset tracking systems are a great and workflow efficiencies. management tool provided your department invests the time maintaining and monitoring the asset Q: IS THERE ANYTHING ELSE YOU WOULD LIKE TO tracking devices. I have seen too many times SHARE WITH TECHNATION READERS? throughout my career an asset tracking systems that ASHER: As RTLS becomes more affordable, fast-todies on the vine and having to recapture the devices deploy and agile, we see significant market growth. within the first three to five years.

Hospitals of various sizes are now rolling out RTLS solutions, many of which are working with Kontakt.io.

SNOWDAY: When choosing an RTLS, it’s important to Many companies are working towards integrating consider not just short-term but long-term goals as multiple use cases and analytical dashboards into well. How are best practices established? Does your our robust location services platform, which is facility want to leverage your RTLS investment and developed on the principles of open-source use the sensory network for patient flow or staff protocols. We are democratizing data sharing so safety? Selecting which needs and initiatives you end-users can benefit from real-time location in want RTLS to support in the future will help you make multiple facets of patient care, including staff the right decision today. location, patient throughput, environmental condition monitoring and wayfinding. At Kontakt.io, we

November 2023 | TechNation 51

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COVER STORY

TIPS FOR GREAT

CONTRACT MANAGEMENT FLEXIBILITY AND MONITORING

54 TechNation | November 2023

I

COVER STORY

BY K. RICHARD DOUGLAS n an age of tight budgets, funding cuts and costly regulations, health care organizations have to pinch pennies and make well-considered decisions about anything that impacts the bottom line.

That means that the C-suite is going to notice budgets and expenditures more than ever before.

The biomed department plays an important role in this endeavor, with input and expert insights into medical equipment management, the balancing of internal and external servicing and negotiations and agreements with vendors and OEMs. One of the areas of equipment management oversight is contract management; both the level of contract services required versus in-house management and the negotiation of costs or contracts that must be implemented and maintained.

Like many undertakings, there is the surface appearance of approaching this endeavor and the more nuanced version of managing contracts that requires insights that are often overlooked.

Some of the considerations include coordination with clinical departments and physicians, methods for tracking contract life cycle and associated vendor forms, interactions with vendors and setting expectations and parameters, as well as considering areas of leverage.

COST-SAVING CONSIDERATIONS Upsetting the apple cart can be a good thing. Changing the status quo can yield improvements, and in some cases, cut costs.

“An efficient contract management plan is the foundation to furthering efficiencies in other pillars of HTM; from operating and capital budgeting, cost-saving initiatives, capital refresh, staff training to cybersecurity assessment,” says Darwin Fontanares, MBA, CHTM, CBET, BSBMET, senior manager of IT/Biomedical Engineering at Stanford Health Care Tri-Valley in Pleasanton, California.

With the biomedical engineering department taking the lead on equipment management decisions, Fontanares says that his department was able to cut costs.

“Prior to 2018, medical equipment contract funding was spread across clinical areas on a distributed budget, where each department owned their contracts individually. Biomed suggested to our chief of finance that in order for our organization to make informed decisions on contractual medical device agreements, we recommended that the budget be consolidated into a single source biomed cost center,” he says.

Fontanares says that as subject matter experts, the biomedical engineering department would be the sole decision maker on optimizing medical equipment management plans by reducing costs, while increasing productivity.

“Within a year, we were able to save the organization hundreds of thousands of dollars by categorizing maintenance agreements as full-service versus PM-only contracts and by delegating service plans as OEM, third-party or in-house,” he explains.

REVIEWING VENDOR PERFORMANCE A framework for managing service contracts considers vendor assessment and evaluation, negotiations and workflows.

This topic was the focus of the fall 2022 MD Expo session, “Contract Management Techniques” presented by Brian Miller and Dean Skillicorn, CBET, CHTM. The presentation covered the topics of negotiating agreements, building contract structures, analyzing the available data and understanding contracts and related information.

The presenters say that it is crucial to have data from the performance of your equipment to review what is in the contract compared to performance.

Everything that is included in the contract should be clearly understood. They suggest that HTM take steps to ask vendors to bring more flexibility in contracting.

In addition to an intimate knowledge of the language of your service contracts, the presenters suggest knowing how your vendor is staffed, what geographical considerations impact availability and readiness and discussions at point of sale (POS).

They also say that the vendor is evaluating your organization as a whole. Some vendors provide products and services used in many departments.

Vendor review meetings should be a given with service contracts.

Skillicorn suggests that vendor review meetings occur at least annually depending on the volume of business that is being done with the vendor.

“High volume gets done quarterly, medium volume gets done semi-annually, and minimal volume annually. This really needs to be coordinated with the supply chain management division of the facility, not by HTM, IT or facility services. Supply chain management typically should be the center of vendor relations.

Using this practice keeps the vendor at a distance to management situations with contracts and severe service issues,” he says.

Miller says that fleet management, balancing in-house and outsourced services and gathering and leveraging the correct data in equipment manage-

November 2023 | TechNation 55

COVER STORY ment is one of the pillars of a well-run health care service (SaaS) approach that allows for collaboration organization. and capturing several relevant data points.

With regard to vendor meetings, he says that they “Creating a master-list spreadsheet through should be held regularly with a defined cadence apSmartsheet helped create quick accessibility to full propriate to the equipment’s redundancy (or quantity) oversight of all biomed contracts. Data point columns within the facility, frequency of usage, it’s criticality to include the manufacturer, model, serial numbers, start patient care, revenue generating potential, it’s acquisiand end dates, length of term, aggregate cost, annual tion cost and/or service agreement cost, monthly cost, full-service cost, its historical reliability and the versus PM only, network integration, power of the clinical users.

MediTract # (live link to contract “An efficient contract “Also, the in-house personnel need database), ITS # (PO requisition to collect and bring their own data, tracking), invoice frequency management plan is end-user feedback, etcetera to these and overall contract approval stage the foundation to meetings to align with the vendor’s status,” Fontanares says. data,” Miller adds.

He says that furthermore, for furthering efficiencies What happens if it appears that the veneach line item, they embed a “comdor is underperforming in its obligations? in other pillars of HTM; ments quick-link” to document “Does the vendor’s performance important granular details, such as from operating and meet their agreement’s terms and convendor contacts, internal contract ditions? If yes, renegotiate to include administrator personnel, purchasing capital budgeting, your terms. If no, escalate the issue to specialists assigned to the contract, the vendor’s executives and micromancost-saving initiatives, special amendment requests and age the vendor until performance imunique terms and conditions. capital refresh, staff proves, while also looking for an alter“At any given moment, we can native vendor, transition to in-house provide a substantial status update training to service delivery and note for future to clinical staff administration, and equipment replacement discussions,” vendors alike,” Fontanares says. cybersecurity Miller says.

He says that the data can be assessment.”

He says to also document and restreamlined through filters and pivot port everything and share a summary tables that would assist in making with the clinical care team; ensuring informed decisions on budget foreeveryone on your team is aware of the casting, determining what can be issue(s) and resolution. converted to third-party or in-house HTM should have information inservice from OEM and opportunities hand during these vendor perforfor biomed staff training to contribute mance meetings to be prepared and to overall cost-savings. make the meetings as constructive as “Also, by having full oversight of possible. the portfolio of contracts per vendor, “Use work order records generatit provides leverage on negotiating Darwin Fontanares ed by the health care organization’s additional discounts. The Smartsheet Stanford Health Care computerized maintenance managecan also assist with managing devices Tri-Valley ment system (CMMS) and those from that integrate with both the hospital the vendor. Hopefully both sets innetwork and vendor networks to clude pertinent date and time logs, parts details, test ensure appropriate security assessments are compliequipment details and personnel involved. I recomant. It also serves as a digital dashboard to keep track mend the vendor provide their data in advance of the of receiving vendor invoices in a timely manner to meeting so it can be reviewed, and questions prepared ensure Biomed is on track with accurate operating to make the meeting more productive,” Miller says. costs each month. Keeping track of the length of terms also assists with forecasting and creating TRACKING AND MONITORING GUIDANCE spend-plan roadmaps for capital refresh as technolIt’s one thing to embrace contract management ideas ogies evolve,” Fontanares says. and another to effectively implement a means to track He says that aside from all the aforementioned every component that impacts decisions. The Stanford benefits of strategic contract planning, this body of Health biomed team developed an efficient approach work helps translate to the executive administration to tracking all important aspects using a software as a that HTM is more than just a cost-spending depart-

56 TechNation | November 2023

COVER STORY ment; the biomed department can show its added value to the organization and enterprise as a whole that it is also a cost-saving center.

STRATEGIC LEVERAGING The vendor, by no means, holds all the cards in negotiations. There are incentives that HTM can propose to incentivize the vendor to adopt to more of HTM’s terms.

“Leverage examples include (A) an upcoming equipment purchase at the health care organization that the vendor would like to participate in, (B) the current vendor’s service agreement expires in less than one year, (C) the vendor has multiple equipment items and/or multiple different service agreements throughout the health care organization that you can combine into one,” Miller suggests.

He says that even before leveraging any of these, ask for your terms to be included as the vendor might be agreeable.

“Most large organizations will respond that their terms and conditions are boilerplate, standard, etcetera, however, everything is negotiable. Meet with the clinical care team (end-users), purchasing/supply chain, etc. and determine what terms are needed, then prioritize them and assign a value to each; making it a business discussion with your vendor,” Miller says.

It is at the point of sale that the buyer holds the most leverage. The OEM is most willing to listen to requests at this moment in order to close a sale. What should HTM, or those who HTM is advising, be focused on at this important meeting?

“It’s about price and response; especially, if the equipment or its technology is new to the marketplace. The equipment sale closing is always paramount to the point of sale (POS) service agreement; so, you must communicate and strategize with the clinical champion, who wants the equipment, to make sure you are both on the same page,” Miller suggests.

He says that the goals are to get the equipment, at the lowest price, with the best service coverage and come in under the capital and operational budget (i.e., make the CFO happy).

“If the equipment is ubiquitous in the marketplace, obtain competitive service agreement quotes from [an] ISO or multi-vendor service organizations,” Miller adds.

Leverage can also be exercised at the point when a vendor’s system or equipment is not performing up to expectations, unresolved service issues or when it compromises patient care. This is when a “make-right” structure is considered.

Skillicorn says that the make-right should be routed through supply chain management (SCM) as it

controls the vendor relationship.

“SCM should bring everyone to the table and openly discuss the issues internally in the organization with all stakeholders. Once that happens, then the vendor is brought in to discuss. The key to this is management of users/clinicians/physicians from running directly to the vendor and making demands that may or may not be supported by the organization at a higher level. Centralizing this through SCM contains the emotional side on interactions with the vendor. When this process is followed, it removes emotions, politics and potential threats to business operations,” he says.

Because these negotiations involve equipment used by clinicians, the input of those clinicians is important to the process. The problem may arise that the clinicians are not “business people.”

Many physicians have experience in the ownership of practices and have learned many business principles, but others are simply focused on medicine.

How does HTM communicate with clinicians regarding contract negotiations and expectations?

“It depends on the clinician. Some wish to learn and be educated on the business of equipment and managed or direct service, while others just want it fixed and are not interested in the details,” Miller says.

He added that he believes the best way to communicate with the clinical team is to understand their workflow, issues, etcetera before there is a problem.

“Find their pain points, log jams, historical issues with specific equipment, process of reporting service issues, etcetera, and you will likely learn you speak different languages, but the goals are the same: resolving the problem quickly with clear communication. Then, lay out a plan to ensure they get what they want: functioning, reliable equipment and systems,” Miller suggests.

With these considerations, contract management and negotiations can prove to be an area of cost savings, increased vendor performance and concise tracking, increasing the HTM department’s value even more.

Brian Miller Cortechs.ai

Dean Skillicorn St. Luke’s Health System

November 2023 | TechNation 57

EXPERT ADVICE

CAREER CENTER What to Do When Bullied at Work

I

BY KATHLEEN FURORE

was quite surprised to read statistics from the 2021 WBI U.S. Workplace Bullying Survey from the Workplace Bullying Institute showing that an estimated 48.6 million Americans are bullied at work in some way. Since this is apparently a quite-common occurrence, I wondered: What can workers do if they feel they are being bullied by anyone they work with – whether that’s a supervisor or co-worker? It’s a topic that Bonnie Low-Kramen, author of “Staff Matters, People-Focused Solutions for the Ultimate New Workplace,” says she is passionate about – and it’s something clients she’s worked with have experienced.

“One of my students had her exec take her head in his hands as he shook it from side to side saying, ‘Did you bring your brain to work today?’ ” says Low-Kramen, who is quick to stress that the first thing to understand is that “bullying has no place in any workplace!”

When it does happen, here are some steps victims can take, according to Low-Kramen and Clarke Duncan, founder of OutsourcingStaff.ph.

DOCUMENT, DOCUMENT, DOCUMENT. “Keeping a record of all bullying incidents, including dates, times, locations, what happened, and any witnesses, can be helpful if the situation escalates or if HR needs evidence,” Duncan says.

Low-Kamemn agrees, and stresses that specificity matters.

“Saying, ‘He is always mean to me’ won’t help. Saying, ‘On March 9, he called me a moron and threw a pen at me at the staff meeting’ will help,” she says. “Keep notes of who else was in the room to be witnesses. Bullying is evaluated by frequency and severity.”

CONSIDER CONFRONTING THE OFFENDER. “If they feel safe doing so, the victim should calmly express their feelings to the bully and ask them to stop their behavior,” Duncan says. “Often, individuals may not be aware that their actions are causing distress.”

“Be ready to act immediately following the bullying. Stay calm, direct and clear,” Low-Kamen advises. Say or write, ‘We

58 TechNation | November 2023

need to talk about what just happened in the meeting. No one speaks to me like that. It is not productive.’ Another way she suggests broaching the incident is to say, ‘You may not know it, but what you just said was offensive and rude. I like working here but that can’t happen again.’ ” If all else fails, file a report. “If the bullying continues, it’s time to involve Human Resources or higher management,” Duncan says. “Formal complaints should be lodged, and backed by the documented evidence.”

“Say, ‘XYZ happened and I have documentation. This feels like a hostile work environment,’ ” Low-Kramen echoes. “If a company truly has a zero-tolerance policy for bullying, then something might be done in the form of coaching for the bully.”

While there’s no sure way to know how a company might respond to a bullying incident, exploring company policies might offer some clues, Low-Kramen says.

“Company leaders can choose to build a company culture that is rooted in respect and dignity. That would translate to having strong policies and expectations around bullying/ harassing behaviors that are communicated pre-hiring of staff and executives,” she explains. “This culture of accountability can be communicated on the website, in hiring materials including job descriptions, and in board materials.”

The bottom line, Low-Kamen says, is that no job is worth tolerating bullying, extreme or not.

“Holding bullies accountable is the only way the behaviors stop. Also, even when a company seems to have strong policies around bullying, the big difference is if top executives empower HR to put teeth into those policies or if the policies are simply words on a paper,” she concludes. “The staff knows if leaders are willing to stand up for them by holding people accountable for their actions.”

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

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November 2023 | TechNation 59

EXPERT ADVICE

20/20 IMAGING INSIGHTS

5 UPDATED Steps to Sustainable MRI Repairs

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BY TED LUCIDI, CBET always appreciate revisiting topics from earlier 20/20 articles. It allows me the ability to assess the content with a new perspective and learn if there’s an opportunity to provide additional, or more up-to-date, information. It also re-presents content to those who may not have been supporting imaging modalities, or those who may not have been TechNation subscribers, at the time. We released our first TechNation article back in January 2019, and provided readers with 5 steps for obtaining sustainable MRI coil repairs. Following are 5 UPDATED Key Questions to ask about MRI coil repair processes to help you make wise, informed decisions that you, your team and your patients can live with.

CABLE HARNESSES Question: Are system cables replaced or are they spliced? A common practice in the coil repair space is to splice or bridge failed wires in a coil’s system cable.

Splicing, or bridging, a failed cable is a very cost-effective means of addressing a damaged or intermittent wire. It also offers a very rapid turn-around time. That being said, spliced or bridged wires within system cables can result in latent failures. There are, sometimes, dozens of wires within a system cable. If a single wire has failed, you can bet that others have failed, or are on their way to failing. The end results are more-frequent repairs, more down time, and potentially, more performance issues. Sustainable repair processes replace all of the wires in a system cable, resulting in higher first-time fix rates. Replacing costs slightly more, however; the longevity of the repair and life extension of the coil more than compensate for the additional cost and helps to lower the overall cost of ownership. Some of the latest coil models from Philips utilize fiber optic cables. Innovatus Imaging has the ability to fabricate traditional replacement

60 TechNation | November 2023

system cables, but also fiber optic cables. This approach to repair is just one of the reasons that we can provide a 6-month warranty period.

Replacement Cable Fabrication TESTING METHODS Question: What testing methods are used to troubleshoot and assess overall performance? And, is the provider able to find potential hidden electrical performance issues? Simplistic testing, or single point of failure testing, often fails to identify additional issues affecting a coil’s overall performance. Single point of failure repairs are, as above, quick and cost effective. A more sustainable approach is one that is holistic in nature. As a former manufacturer of MRI coils, we utilized and currently employ, modular testing, which breaks-down the coil into individual segments and assesses the performance of each section. A holistic approach to repair is one that can help to identify borderline QC problems, result in higher first-time fix rates, fewer latent failures and greater long-term value.

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SOURCE OF REPLACEMENT PARTS Question: What are the sources of mechanical parts used in the repair? And, is the provider able to perform mechanical repairs, and to what level?

Mechanical repairs may prove challenging for some providers. Some repair providers are only able to address electronic failures. Others provide varying degrees of mechanical repairs. 3D printing is one of the latest technologies available and parts fabrication can occur at a relatively low cost. While 3D printing can increase speed and accessibility, the parts fabricated via this method may not always last as long as traditional methods such as molding and machining. It’s critical to know how parts are sourced for your repairs as they can affect the longevity, cost of ownership, and future downtime. Innovatus Imaging has a whole team of engineers on staff and in-house. Specialties range from quality, electrical, mechanical, acoustic, and those specializing in RF applications. We have a full machine shop that includes mechanical design, rapid prototyping, full fabrication, verification, validation, and qualification of replacement parts, and all parts meet the OEM form, fit, and intended design.

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Replacement Part Fabrication INSPECTION AND ENGINEERING PROCESSES Question: How does the provider develop new repair capabilities? Do they just perform the spot, single point of failure repairs as mentioned above, or do they have an engineering process? You may not know, but OEMs do not provide schematics, bills-of-materials, testing procedures, or detailed specifications for MRI coils.

Innovatus Imaging will not perform spot, single point of failure repairs on a coil model that we haven’t engineered. We’ll not TRY to repair a device. There is an entire engineering process, which includes development of schematics, visual work instructions, detailed testing procedures, bills of materials, etc. for every coil model we repair. All documentation is captured in an ISO 13485:2016 Quality Management System … Even down to the shipping and packaging material details.

QUALIFICATIONS Question: What experience, research, and processes are behind the repair? This is perhaps the biggest difference in suppliers. Do the technicians have decades of experience versus just basic electronics skills, and what testing processes, protocols, and simulators are used for quality assurance regarding the repair? With experience in coil manufacturing and research to identify best-in-class methodology and testing, Innovatus Imaging applies some of the most proven processes available to each repair. As a trusted repair provider for several prominent OEMs, we’re held to a very high standard, and that standard is consistent for every client.

WHAT’S ALL THIS MEAN FOR YOU? All of the above translates into a device on which we’d image our closest family member. The Innovatus Imaging approach to repair is distinctly different, in a good way, and it enables the industry’s longest warranty period. After 40,000 coil repairs, we can say with authority that by using Innovatus Imaging, you can have increased uptime, increased return on investment, and a life cycle that’s not just been extended, but reset, at a fraction of the cost of replacement.

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

November 2023 | TechNation 61

EXPERT ADVICE

THE FUTURE Back to School

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BY STEVEN J. YELTON, P.E., AAMIF s I write this column for the November 2023 issue, we are fully into the 2023 fall semester at Cincinnati State. I’m reminded of the November 2022 issue where I discussed the new school year and the excitement expressed by our students. There is one big difference this year. We were not able to run either of our biomedical instrumentation courses because of poor enrollment.

This school year has started with a robust interest in the healthcare technology management (HTM) field from our cooperative education and full-time employers. We still have interest in our program from students; however, we do not have the numbers required to run the HTM courses multiple times per year.

Our program remains relatively small but solid. In order to make the program more efficient, it was made a major off of the electronics program a few years ago. We continue to wrestle with methods for increasing enrollment as we have cooperative education and full-time employers anxious to hire our students and graduates.

For many years, our biomedical instrumentation classes only ran one time per year and that was always in the evening. Since Cincinnati State is a cooperative education college, half of the biomedical students would be working full time when the courses ran which required us to run the courses in the evening. This worked well because we meet largely at local hospitals and the evening provided a good time for classes to gain access to areas of the hospital that are very busy during the day. This made it nearly impossible for access for the classes during the day.

I have had many discussions with my advisors with-

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in our local hospitals and HTM industry. As you can imagine, they are very concerned about how they will fill their need for new HTM technicians. They have even discussed the possibility that they could train their own technicians in-house. As I mentioned to them, training the students is not the problem, attracting students is the issue. If the hospitals attract technicians, we can easily get them the coursework that they need to complete an Associate of Applied Science degree.

As with anything, there are many positives depending on your point of view. When we only run our courses one time per year, the courses are virtually guaranteed to run. Students need these courses to graduate and therefore we will make every effort for them to run when promised. With fewer students graduating, there is a feeding frenzy in our area for HTM technicians. This is true of recent graduates as well as experienced technicians. Again, good for the techs, not so good for employers.

As I mentioned earlier, Cincinnati State is a cooperative education college and the HTM program requires students to have at least one semester of related cooperative education experience in order to graduate. In the co-op model predominantly used at Cincinnati State, the student alternates periods of in-class education with on-the-job training generally at a hospital, OEM or third-party vendor. Some college programs place students at work sites in the summers between school years for an “internship.” Co-op at Cincinnati State where students work year-round is much less prominent.

An unexpected issue with the lack of available students and technicians is cooperative education students are electing to accept full time jobs prior to completing their degrees. Their intention is to complete their degrees, but this means that we have students that don’t return to school full time but rather work full time and try to finish school part time. This plan is fine as long as the student is able to complete

the degree. It becomes difficult when they are working full time and at times are required to attend service training where they must miss school.

We certainly will continue to stress the importance of the online component of our program while tempering it with live classroom and laboratory instruction. We are constantly updating our classes and striving to improve the online component of the courses. We hope that as we stress this component of our program, we will be able to attract more non-traditional students as well as the traditional student.

As a final way for us to produce additional HTM technicians, we will continue to work closely with employers in the recruiting process. As I have mentioned many times before, if an employer offers someone a position based on them attending an HTM program, we find that the success rate of the student is much higher. We have had employers come to us at the college and tell us that they have hired a technician with some troubleshooting and electronics skills but need to attain biomedical instrumentation and related course work. We work with that student to produce an educational plan that will enable them to complete their coursework for an HTM degree in a timely manner. They are able to use their work at the hospital to satisfy their cooperative education requirement for graduation.

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.

November 2023 | TechNation 63

EXPERT ADVICE

ADD DATA MODERNIZATION TO YOUR HTM SHOPPING LIST!

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nformation is the lifeblood of health care operations. From patient records to financial information, data are used to make decisions that impact the lives of millions of people. Many health care systems are still struggling to manage their data in an effective way. This is because of several factors, including legacy systems that are outdated and inefficient, siloed data that is difficult to access and share, and lack of data governance and quality standards. As a result, health care systems are missing the opportunity to use their data to improve patient care, reduce costs, and keep up with stakeholder expectations.

What is data modernization all about? Data modernization is the process of taking the data you are already collecting and transforming it into more usable assets. This involves cleansing to remove errors and inconsistencies, establishing governance policies and procedures, implementing quality standards, integrating data from different systems around your facility, and making data accessible to users in a timely and efficient manner.

Data cleansing primarily identifies and corrects errors and inconsistencies. This can include finding and removing duplicate data, fixing typos and formatting errors, filling in missing values, and converting data to a consistent format. This is a 64 TechNation | November 2023

crucial step in data modernization, as it ensures your data is accurate, reliable, and ready for analysis or decision-making.

Data governance focuses on managing data throughout their life cycle. This includes establishing policies and procedures for data collection, storage, use, and disposal. Ensuring there are rules for accuracy, reliability, and security of data is critical to your health care system.

Data quality and stewardship ensures your data meets the needs of their users and are managed effectively. By developing and implementing quality standards, monitoring data quality, and ensuring that data are used appropriately, your organization’s data accuracy and reliability will improve. This will increase user confidence in data, reduce errors and rework, and improve the effectiveness in decision-making.

Data analytics is the process of extracting insights from data. This can be done using various techniques and tools, such as statistical analysis, machine learning, and artificial intelligence. You will be able to make better predictions and optimize operations by using your modernized data to identify trends and patterns.

Modernized data in the clinical environment has improved patient care and reduced costs. Clinical data modernization can help health care systems to develop personalized treatment plans for patients based on their individual needs and medical history.

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It can help health care providers make better decisions about patient care by providing them with access to real-time data and analytics and identifying and mitigating potential safety hazards.

HTM data modernization can help health care systems to streamline their operations and reduce waste. It can help reduce errors in equipment maintenance, hazards and recall monitoring, repair parts ordering, and other administrative processes. Modernized HTM data also optimizes the entire device life cycle from acquisition planning to final equipment decommissioning. This is enabling your HTM organization to become a leader in capital and operational cost savings.

In a rapidly changing environment, data modernization is essential for health care systems to adopt innovative technologies, such as artificial intelligence

and machine learning, which rely on copious amounts of data. It is essential for health care systems to modernize their data if they want to transition to value-based care – focusing on measuring and improving the quality and outcomes of care.

Capital i can help you to implement a data modernization solution that meets your health care system’s specific needs, budget, and timeline. Our three-phase process focuses on your specific system, and we work with you to ensure that you are equipped to maximize the reach that your data can have in the future. If you are not already investing in data modernization, it is time to add it to your HTM shopping list!

For more information visit capitali.us or email us at sales@capitali.us.

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November 2023 | TechNation 65

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CYBERSECURITY Zooming Through the Cyber Highways: The Journey to TLS 1.3

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BY NADIA ELKAISSI, CHTM

he increase in networked medical technology has made it more of a necessity that healthcare technology management (HTM) professionals protect sensitive information. With the transfer of patient information across the network, there are several ways to secure sensitive data. One option is the utilization of the Transport Layer Security (TLS). TLS is a protocol that enables privacy between communicating applications and users on the Internet. TLS can be thought of as a layer of protection, building a tunnel over the communication between the two endpoints. The tunnel encrypts the data to ensure that the integrity of the communication is maintained.

This becomes extremely useful when focusing on data related to PII/PHI. Although TLS, in general, is beneficial for the protection of data, it is imperative that systems are always upgraded to the latest TLS version approved by the OEM to minimize vulnerabilities.

TLS is considered a fundamental element in ensuring secure communication over a network. It focuses on three key areas: confidentiality, authentication and integrity. Over the years, TLS has significantly improved its features since its original form as a Secure Socket Layer (SSL), one of the original names for secret handshake communications between two endpoints. From SSL, it slowly transitioned to TLS 1.0 to increase the protection of communications from 66 TechNation | November 2023

SSL vulnerabilities. Now, TLS has gone from versions 1.0 to 1.3, each time improving the features and performance capabilities and reducing the potential for vulnerabilities.

TLS 1.3 contains some key improvements from TLS 1.2, to include the upgrade of the cryptographic algorithms, the addition of forward secrecy and the improvement on the speed of connections. In TLS 1.2, there were some known cyberattacks such as FREAK and LogJam, due to weaknesses in the cryptography. Therefore, one of the changes made in TLS 1.3 was the use of a simple cipher suite instead of the complex cipher suite TLS 1.2 utilized. With this change, several of the legacy algorithms with known vulnerabilities were eliminated. Forward Secrecy was made mandatory, which ensured unique keys were generated for current sessions. This removes the potential for keys to be compromised as a new key is generated for every session. Lastly, TLS 1.3 reduced the time required to secure a connection which improved the performance. There are multiple additional feature changes that were made in TLS 1.3, however the above mentioned are some of the more noticeable changes to keep an eye out for.

While planning to transition to TLS 1.3, some may question if it would be wise to upgrade all systems with TLS to TLS 1.3. While ideally the answer would like to be “YES! Upgrade them all!”, we must understand the critical implications if the system was not verified that it can support TLS 1.3. Although it would be prudent to upgrade a system to 1.3, to enhance security, it may disrupt critical health care devices if the system is not ready for the upgrade. Before any

upgrade should take place, it is always recommended to perform a few proactive steps to reduce the potential for downtime. Some of these steps could include something as simple as communicating with the device manufacturer about the device compatibility with the upgrade and/or testing on a sample device. Communication with the manufacturer is always a key step before upgrading, because it allows one to understand the specific requirements for upgrading to TLS 1.3. For example, the OEM can review the algorithms that the system requires and confirm that there is no dependency on older cryptographic modules. Once it has confirmed that the device is compatible with the upgrade, it is a good idea to test the new protocol on an individual device before implementing an entire system.

Although sometimes tedious, following a more proactive approach will ensure a successful upgrade to TLS 1.3.

TLS has made great progress from its start, and the enhancements have only improved security with the removal of vulnerable features and upgrade of the algorithms. Despite a few challenges, TLS 1.3 is significant in the process towards a more secure Internet. By upgrading systems in a health care environment to TLS 1.3, you are building a safer, quicker and more reliable system that fosters a better health care environment for providers and patients.

Nadia ElKaissi, CHTM, biomedical engineer in the Healthcare Technology Management VA Central Office (19HTM).

November 2023 | TechNation 67

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HIMSS

2 Organizations Earn Another Davies Award

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STAFF REPORT

he Davies Awards program promotes the HIMSS vision and mission by recognizing and highlighting use cases, model practices and lessons learned on how to improve health and wellness through the power of information and technology. Showcasing healthcare delivery systems, physician practices, community health organizations, long term and post-acute care sites and public health organizations, the HIMSS Davies Award shares evidence-based case studies that are driving the reform of the global healthcare ecosystem through the power of information and technology.

HIMSS has recognized University of Missouri Health Care as a 2023 HIMSS Davies Award recipient. MU Health Care is one of only four organizations to receive the Davies Award a third time.

MU Health Care’s focus on using data to evolve and optimize health IT systems were prominently featured in three case studies submitted for Davies consideration. The thoughtful analysis of data identified an opportunity to refine pediatric early warning scores (PEWS) resulting in a more effective alert, reducing unnecessary transfers to the pediatric ICU. Improving alerting also enabled a significant reduction in hospital associated pressure injuries (HAPIs). Meanwhile, standardizing the surgical processes with TIGER care plans significantly reduced length of stay for bariatric surgery patients.

The MU Health Care case studies are: • Advancements in Pediatric Early Warning Score Alerting • Reducing Hospital Acquired Pressure Injuries • Standardizing the Elective Surgery Process

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“Delivering on our mission of saving and improving lives is a total team effort,” Deb Dow, chief information officer at MU Health Care, said. “This award recognizes our health care professionals that are turning data into action to drive improvement in the delivery of care.”

MU Health Care’s health IT operations are led by the TIGER Institute for Health Innovation, a unique private-public partnership between the University of Missouri and Oracle Corporation. The Tiger Institute was formed more than decade ago as a model for leveraging industry collaboration and better health care. Their work has improved the health and safety of patients, reduced costs and shaped the future of care for Missouri and beyond.

“Earning a third HIMSS Davies Award demonstrates our commitment to excellence in leveraging health IT in care delivery,” said Dr. Thomas Selva, chief medical information officer at the University of Missouri. “Clinician-lead, data-driven and IT-enabled is the cornerstone of why we are an industry leader in health care innovation.”

Also, HIMSS recently recognized Northern Light Health as a 2023 HIMSS Davies Award recipient, the second Davies Award for the organization.

Comprising of 10 member hospitals with 987 licensed beds, a single physician-led medical group, eight nursing homes with 585 long-term beds, and 37 primary care locations, Northern Light Health is Maine’s only integrated health care system.

As part of its mission to make health care work for the patients they serve, Northern Light Health leverages technology to improve patient outcomes and engagement as well as streamline both the clinician and patient experience.

Northern Light Health’s submission for the Davies Award focused on its ability to drive evidence-based practices through thoughtful applications of informa-

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tion and technology.

The three case studies each highlight the use of analytics to drive adoption of technology to improve patient outcomes as well as the care team’s experience with the EHR. The Northern Light Health Davies Award case studies are: • Monoclonal Antibodies: A Reduction in Hospital Admissions in COVID-19 Therapy Northern Light Health • Reducing Medication Errors by Revamping mCDS Alerting: The Goldilocks Principle • Comprehensive and Standardized Cardiovascular Care Leads to Decreased Readmissions Northern Light Health’s success is deeply supported by a “people, process, and technology” based culture and a strong clinician-led governance model.

“Receiving the HIMSS Davies Award is a significant accomplishment for any organization, but to receive it twice is quite an honor,” says April Giard, chief digital & innovation officer at Northern Light Health. “I am so proud of the culture we’ve been able to develop at Northern Light Health that allows for a true partnership between our IT, informatics, and clinical teams in order to provide high quality patient care.”

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HEALTH-ISAC The Times They Are A-Changin’

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BY PHIL ENGLERT he evolving landscape of healthcare technology, with an increasing focus on software-driven and cloud-based medical devices, presents significant challenges and opportunities for healthcare technology management (HTM) professionals.

We don’t need Bob Dylan’s prophetic anthem for change to remind us of the everlasting change in healthcare technology. Medical devices are increasingly designed to send data to a cloud for data aggregation, analysis and distribution to caregivers. Additionally, the FDA recognizes software as a medical device which is not dependent on specific supporting hardware but rather can be installed on a variety of traditional computer devices including laptops, tablets and mobile devices.

Healthcare technology management professionals — sometimes called “biomeds” or clinical engineers — are traditionally responsible for keeping medical technologies operational. They traditionally focus on the physical products known as medical devices. Assigning and affixing an asset tag has long been part of the incoming inspection process. As medical devices diverge into more software-based technologies and less physical products, HTM must disrupt traditional processes to manage software-driven and cloud-based medical device technologies. With many years of operational benchmarking in the health care environment, I want to continue the conversation within the HTM community and add a few personal insights along the way.

The first step is opening the aperture and welcoming the challenge of managing more ethereal assets. If your organization relies on The Joint Commission accreditation process, then all medical equipment must be included in the medical device inventory. The inventory must include high-risk devices that includes all life support equipment and any other device which if it fails 70 TechNation | November 2023

may result in serious injury or death to a patient of staff.

FDA Software as a Medical Device (SaMD) used the International Medical Device Regulators Forum (IMDRF) definition as “software intended to be used for one or more medical purposes that perform these purposes without being part of a hardware medical device.”

In 2014, the IMDRF SaMD working group1 recognized four classes of medical devices including Category IV “that provides information to treat or diagnose a disease or conditions in a critical situation or condition is a Category IV and is considered to be of very high impact.” The IMDRF provides an example for each category. For Category IV one example is “SaMD that performs diagnostic image analysis for making treatment decisions in patients with acute stroke, i.e., where fast and accurate differentiation between ischemic and hemorrhagic stroke is crucial to choose early initialization of brain-saving intravenous thrombolytic therapy or interventional revascularization.”

More recently, software execution is moving from local execution to cloud-based solutions. The article “Hey You, Get On the Cloud: Safe and Compliant Use of Cloud Computing with Medical Devices”,2 published in BI&T magazine in January 2021 highlights the rapid adoption of cloud computing with medical devices along with the compliance issues and risk management challenges. The easy scalability combined with the elastic and inexpensive compute instances is evidenced by the growth of AWS, Google, Microsoft, Oracle and IBM. It didn’t take long for medical device manufacturers and healthcare delivery organizations to take advantage of this trend that had more and more medical devices feeding data to cloud environments.

To manage this diffusion of where health care data originates and is managed, HTM professionals will need to acquire and enhance their skills and understanding of software development, data analytics, cybersecurity and cloud computing. Understanding how software interacts with medical devices and how data is collected, processed and transmitted to the cloud is crucial to identify-

ing all the system components to evaluate for inclusion or exclusion in the medical equipment management plan. As medical devices become more connected and reliant on the cloud, the risk of cybersecurity threats increases. HTM professionals must become adept at assessing and mitigating cybersecurity risks to ensure the safety and integrity of patient data and device functionality. With cloud-based technologies, many medical devices can be remotely monitored and updated. HTM professionals should be proficient in remote monitoring tools and techniques to ensure devices remain in optimal condition and to troubleshoot issues remotely.

The healthcare technology field is continually evolving. HTM professionals should be adaptable and open to innovation, staying current with emerging technologies and best practices in the industry. Hybrid computerized maintenance management system (CMMS) and configuration management database (CMDB) will be needed to track both hardware and software as well as the upstream sources or dependencies. As more devices and systems communicate with each other through the cloud, HTM professionals should have expertise in interoperability standards and protocols to ensure seamless data exchange and device integration within health care ecosystems.

Managing and interpreting the vast amount of data generated by software-driven medical devices is crucial. HTM professionals need skills in data analytics to make sense of this data and provide valuable insights for patient care. Collaborating closely with device manufacturers and software developers is

essential. HTM professionals should have the ability to communicate with vendors to address technical issues, updates and maintenance requirements for software-driven devices.

Dylan ends his song with a warning. “And the first one now / Will later be last / For the times they are a-changin’ ” Bob Dylan’s anthem of hope urges us to recognize the eternal nature of change and to embrace its’ happening. The role of HTM professionals is expanding beyond traditional medical device maintenance to encompass a broader range of skills related to software, data management, cybersecurity and cloud technologies. To effectively manage software-driven and cloud-based medical device technologies, HTM professionals must embrace these changes and continuously update their knowledge and skills to ensure the highest level of patient care and safety. The time to work this into the HTM skills and processes is now.

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

References 1) https://www.imdrf.org/sites/default/files/docs/imdrf/final/ technical/imdrf-tech-140918-samd-framework-risk-categorization-141013.pdf 2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8641424/ November 2023 | TechNation 71

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NETWORKING NOTES Firewalls: The Invisible Digital Safeguard

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BY SHAWN BYRNE

ne of the unsung heroes of the cybersecurity space are firewalls. Heroes because of their ability to maintain a network’s integrity. They provide a critical defense against unauthorized access, malware and cyberattacks. Because of cybersecurity’s ever-evolving landscape, firewalls serve the role as a primary guardian. All security measures, such as a firewall, provide a pivotal role in fortifying networks and protecting data from malicious adversaries. In this column, we will explore firewalls and their essential functions as that stalwart of the network.

Network firewalls are a security barrier that is positioned between internal networks and the rest of the Internet. The primary function is to control traffic flow based on predefined permission and security rules.

This will permit or block data packets based on what the administrators of the firewall prefer. Firewalls accomplish this task by watching the ports that software use. In this way, it acts as a digital checkpoint that will inspect any data or information that enters the network from external sources. It is important to note that a firewall can also run in a computer.

In addition to the network firewalls, which is a network hardware like a router, the host-based firewall directly protects an operating system. Whether network or host based, all firewalls perform the same role.

One may wonder where this role fits in on the Open Systems Interconnection (OSI) model. The firewall and its critical tasks involve monitoring the traffic at Layer 4, also known as the transport layer or port layer. This layer focuses on end-to-end communication and data flow control. Firewalls can and do leverage this layer as it is a critical layer for the

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passage of data packets and their avenues, more specifically communication ports.

Software communicated to other software on different hosts (e.g., computers) from IP address and port number to IP address and port number. Communication ports, or ports, serve as gateways through which data packets may enter or exit a host system through networks. Each port has a specific number, and each number corresponds to a specific application/service. A great and common example is port 80 which is associated with HTTP traffic, which is used for web browsing. For example, 142.251.16.139 is an IP for Google. Placing 142.251.16.139:80 in a web browser will bring up the website for Google’s search engine. Port 443 is a secure version of a website. At the time of writing this, my system will not work on 142.251.16.139:443, but will work on 142.251.16.139:80.

This is because the software at that IP address is set to only respond to port 80. Firewalls can employ filtering that is based on certain ports to allow or deny traffic purely based on the port number. Because it is a standard number, a firewall knows that port 80 is for unsecured websites and port 443 is for secured websites. The firewalls, both on the host and on the network, understand the purpose of the transmission based on the port number used. This allows administrators to personally tailor firewall policies, all the while blocking malicious traffic and permitting secured data packets.

There are rules in firewalls that are fundamental for managing network traffic, respectively called egress and ingress rules. Ingress rules dictate what traffic is allowed to enter a network and prevents unauthorized access. On the other hand, egress rules control what traffic can leave a network. This prevents data from leaking or outbound malicious connections. Both rules utilize certain communication protocols called transmission control protocol (TCP) and user datagram protocol (UDP). TCP is more commonly used for web browsing, but its main purpose is for connection-ori-

ented communication. UDP is based on connectionless communication, making it commonly used in applications like online video games. If egress and ingress rules are properly configured, only legitimate and necessary traffic will enter and exit a network, bolstering the overall network security. Modern firewalls have what’s called stateful inspection rather than simply filtering packets. This method considers the active connections and their states. By maintaining the record of each connection and their status, a firewall can ensure that incoming packets are a part of a legitimate connection. With this enhanced security, malicious malware and vulnerabilities can be prevented, specifically during and beyond the connection initiation process. In this way, a firewall can also consider the IP address destination and typical communications to that IP. Many firewalls are also integrated into intrusion detection and prevention systems (IDPS) to bolster security even further. These types of systems will actively monitor the network flow for any suspicious patterns and more-known attack patterns, which further enhances the real-time protection that firewalls provide against threats. Evolutions of this thought include access control lists and unified threat management systems, such as Cisco ISE. More articles will follow on these subjects. For now, consider a firewall as a good first step in both system and network security.

In conclusion, firewalls provide a critical defense against unauthorized cyberattacks, malware and even general access. Port security allows firewalls to filter traffic with precision, allowing the proper safeguarding of networks and data in the ever-increasing Internet world. As cyberthreats continue to evolve and vulnerabilities continue to be exploited, firewalls are undoubtedly able to adapt to the new challenges and evolve right along-side them.

Shawn Byrne is a staff biomedical engineer at VHA North Texas-Dallas.

November 2023 | TechNation 75

76 TechNation | November 2023

Bulletin Board

An online resource where medical equipment professionals can find all the information needed to help them be more successful! The easy to navigate Bulletin Board gives you access to informative blogs, expos and events, continuing education opportunities, and a job board. Visit MedWrench.com/BulletinBoard to find out more about this resource. Follow MedWrench on facebook.com/medwrench & linkedin.com/company/medwrench

CONTINUIN EDUCATIONG

Visit MedWre n BulletinBoard ch.com/ details and for more to these upcom register for ing classes.

1, 2023 Nov. 27-Dec. tions lu Tri-Imaging So rse ou C T GE VC

Nov. 28 -Dec. 2, 2023 RSTI Principle MRI Phase 1: s of Serv icing MR I

9, 2023 December 5- se 2: ha P I R M I ST R I Service Advanced MR

UPCOMING EXPOS & EVENTS Join RSNA for their fall conference in Chicago!

November 26-30, 2023 Join CMIA in Anaheim, CA for their annual conference!

January 18-20, 2024

November 2023 | TechNation 77

BREAKROOM

WHAT’S ON

Y UR BENCH? • • • •

Raysafe Dosimeter Fluke Multimeter Computer Tool kit

Greg Goll

Manager Projects and Medical Imaging Services at WellStar Health System Submit your bench to be featured in TechNation at 1technation.com/my-bench/.

DYNAMIC NATIONWIDE HTM SOLUTIONS MEDICAL DEVICE REPAIR & MAINTENANCE Onsite Repair and Maintenance Services Including: • General Medical Devices • Anesthesia · Ventilators • Sterilizers • Diagnostic Imaging • Surgical Lasers • General Lab Equipment, including Microscopes • Beds and Stretchers • Surgical Tables and Lighting • Access to inventory • Service requestor • Technician on-call 24-hours a day, 7-days a week • Customized Online • Client Portal INFUSION DEVICE ANNUAL PREVENTATIVE MAINTENANCE

• MMS will deploy a team of technicians to your facility to complete Annual Periodic Maintenance on your Infusion Pumps • Daily updates and final reports provided at completion of project

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TODAY!

78 TechNation | November 2023

1.888.492.3400 salessupport@multimedicals sales support@multimedicalsyste ystems ms.c .com om www.multimedical www .multimedicalsyst systems. ems.co com m

ENDOSCOPE REPAIRS • Repair estimate within 48 hours, quick turnaround time • Extensive list of Loaners available at no charge • All makes/models of Flex, Rigid and Semi-Rigid Scopes • Processors, Cameras, Scope • Accessories and Attachments, etc.

SHORT AND LONG TERM BIOMEDICAL STAFFING • On-demand BMET/HTM Technician(s) • One Week - One Year • Manufacture Remediation/Recall Support • Inventory Verifications • Support with IT Security Projects EQUIPMENT SALES • All types of medical equipment- new or refubished • All equipment is patient ready with warranty • Rent-to-own options available!

RECRUITING SERVICES • For more information, contact us!

BIOMED BRAINBUSTER Visit 1technation.com/crossword for an interactive puzzle.

THIS MONTH’S CROSSWORD SPONSOR:

ACROSS 1 New annual awards from TechNation magazine 6 Transabdominal sonography, abbr.

9 Baseball score, abbr.

10 Diagnostic test to isolate pain in the spine 12 Pre-owned 14 Cerebral angiogram: _____ gram when looking for changes in blood vessels 18 Business promotion, abbr.

19 Particles with electric charges

34 Abbreviation for Ottawa Ankle Rules, determining the need for radiographs in acute ankle injuries 36 Dental issue for patients 37 Inflamed 40 Complete 41 Intracranial Angioplasty for stenosis or ______ 42 Overseer of govt. office bldgs., abbr.

DOWN 1 Test to control which side of the brain controls speech 2 Lessens pain, for example

21 Barium ____: imaging test using x-rays to look to the upper CI tract above the stomach

3 Storage platform for digital information

23 Sandra ___, in “Grey’s Anatomy”

4 Progress

25 Premier company offering a range of services for patient monitoring equipment including repairs, rentals, replacement parts, cables, accessories and full units for purchase 30 Nose related 32 Monetary unit of Japan

5 Deplete or exhaust 6 Test out 7 Blood group letters 8 ____gram: performed to diagnose blockage in the salivary flow due to stones or strictures

11 Color 13 Naval rank, for short 15 Finding the source of 16 Allowing to leave a hospital, say 17 Tissue examination 20 Resistance measurement 22 Madison’s state 24 ____graphy: technique for displaying a cross section through a human body 26 They’re often scanned to check density 27 The E in ENT 28 TLC part 29 Gets a good job, for example 31 Laser disk, for short 33 Historic period 35 Current measurement 38 Gala 39 Top grades

November 2023 | TechNation 79

BREAKROOM

TECHNATI N P LL

What is your favorite part about attending an MD Expo?

47%

NETWORKING

33%

EDUCATION

13%

EXHIBIT HALL

7%

TRAVELING TO NEW PLACES

Connect with TechNation on LinkedIn at linkedin.com/company/iamtechnation to participate in our next poll: What’s one thing you wish you had more of?

80 TechNation | November 2023

CEAI SCRAPBOOK

The Clinical Engineering Association of Illinois (CEAI) recently held its annual meeting as a means to meet its objectives. The objectives of CEAI are to promote cooperation, education, formal/informal exchange of ideas and technical information related to clinical engineering. It will help promote better patient care and reliable maintenance, operation and application of clinical equipment. The annual meeting was a success with attendees and vendors coming together to network, learn about products and services as well as attend continuing education presentations including “HTM Keys to Compliance” by Herman McKenzie from The Joint Commission. For more information, visit ceaiweb.org.

1: TechNation and HTM Jobs take a group photo

3: CEAI had a great lineup of education throughout

5: CEAI attendees visiting with vendors during exhibit

with industry friends while attending the Pinstripes

the entire symposium.

hall hours.

Bowling Social Event.

4: Shawn Molloy (left) and Greg Czajka (right) pose

6: Industry friends from RSTI, HTM On The Line,

2: Bryant Hawkins from HTM On The Line live pod-

for a photo in front of the HTM Jobs and TechNation

reLink Medical and Maull Biomedical stop by the HTM

casting at the CEAI Symposium with attendees and

booth during the exhibit hall.

Jobs and TechNation booth to say hi and take a quick

vendors.

photo with Kristen Register and Megan Cabot.

1

4

2

3

5

6

November 2023 | TechNation 81

SERVICE INDEX sakomed.com • (844) 433-7256

USOC Bio-Medical Services

www.usocmedical.com • 855-888-8762

79 17 3

Asset Management Capital i

capitali.us • 417-708-2924

Cox Communications coxprosight.com •

Cynch

cynch.me •

EQ2

www.eq2llc.com • 888-312-4367

Midmark RTLS Solutions, Inc.

midmarkRTLS.com • 877-983-7787

Vizzia Technologies

https://vizziatech.com • 855-849-9421

P P P P P P

31 25 73 37 7 4

Cables iServe Biomedical

iservebiomedical.com • 281-741-0849

PM Biomedical

pmbiomedical.com • 800-777-6468

cardiotronixhealth.com • (855)-4DEFIBS

PM Biomedical

pmbiomedical.com • 800-777-6469

Soaring Hearts Group

soaringheartsinc.com • 855.438.7744

79

soaringheartsinc.com • 855.438.7744

Southeastern Biomedical, Inc

sebiomedical.com/ • 828-396-6010

Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231

CMMS Capital i

capitali.us • 417-708-2924

Cynch

cynch.me •

EQ2

www.eq2llc.com • 888-312-4367

TruAsset, LLC

www.truasset.com • 214-276-1280

Vizzia Technologies

https://vizziatech.com • 855-849-9421

diagnostic-solutions.com • 330-296-9729

RSTI

www.rsti-training.com • 800-229-7784

Tri-Imaging Solutions

www.triimaging.com • 855-401-4888

P P P

29 79 80

P P P P P P

NVRT Labs Inc. nvrtlabs.com •

85 69

P P P P P P

626 Holdings

weare626.com • 800-516-0991

Contrast Injector Tools

contrastinjectors.com • 724-782-0227

Maull Biomedical Training

www.maullbiomedicaltraining.com • 440-724-7511

73 37 72,75 4

Cardiotronix

cardiotronixhealth.com • (855)-4DEFIBS iservebiomedical.com • 281-741-0849

PM Biomedical

pmbiomedical.com • 800-777-6470

SakoMED

27

16 59

P P

40

29 59 79 17

Diagnostic Imaging 626 Holdings

weare626.com • 800-516-0990

Diagnostic Solutions

diagnostic-solutions.com • 330-296-9729

Tri-Imaging Solutions

P P P P

P

P P P P

P P P

16 33

21

Education/Training 626 Holdings

weare626.com • 800-516-0990

College of Biomedical Equipment Technology www.cbet.edu • 866-866-9027

ECRI Institute

Elite Biomedical Solutions

elitebiomedicalsolutions.com • 855-291-6703

NVRT Labs Inc. nvrtlabs.com •

RSTI

www.rsti-training.com • 800-229-7784

Webinar Wednesday

www.triimaging.com • 855-401-4888

16

P

11 36 65

HTM Jobs

P P

P

27 5 38

Employment/Recruiting www.htmjobs.com •

82 TechNation | November 2023

21

Defibrillator

www.ecri.org • 1-610-825-6000.

31

5

P P P P P P P P

Contrast Media Injectors

www.triimaging.com • 855-401-4889

80

33

Consultancy

sakomed.com • (844) 433-7256

Cardiology Soaring Hearts Group

Diagnostic Solutions

iServe Biomedical 59

Cardiac Monitoring Cardiotronix

TRAINING

SakoMED

SERVICE

pmbiomedical.com • 800-777-6467

PARTS

Computed Tomography

Anesthesia PM Biomedical

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

52

P P

SERVICE INDEX Multimedical Systems

www.multimedicalsystems.com • 888-532-8056

PM Biomedical

pmbiomedical.com • 800-777-6471

SakoMED

sakomed.com • (844) 433-7256

Monitors/CRTs 6

pmbiomedical.com • 800-777-6472

SakoMED

sakomed.com • (844) 433-7257

79 17

iservebiomedical.com • 281-741-0849

Multimedical Systems

www.multimedicalsystems.com • 888-532-8056

PM Biomedical

pmbiomedical.com • 800-777-6473

General SalesMaker Carts

salesmakercarts.com • 800-821-4140

79 17

P P P P

P P 78 P 79 P P 59

63

Infection Control Healthmark Industries

hmark.com • 800-521-6224

aiv-inc.com • 888-656-0755

Bright Biomedical, LLC

brightbiomedical.com • 877-318-1768

Elite Biomedical Solutions

elitebiomedicalsolutions.com • 855-291-6701

iServe Biomedical

iservebiomedical.com • 281-741-0849

Multimedical Systems

www.multimedicalsystems.com • 888-532-8056

PM Biomedical

pmbiomedical.com • 800-777-6474

SakoMED

sakomed.com • (844) 433-7258

USOC Bio-Medical Services

www.usocmedical.com • 855-888-8762

Installs/Deinstalls Tri-Imaging Solutions

www.triimaging.com • 855-401-4889

6

www.rsti-training.com • 800-229-7784

USOC Bio-Medical Services

3

www.usocmedical.com • 855-888-8762

MRI CM Parts Plus

63

www.cmpartsplus.com • 877-267-2784

Diagnostic Solutions

33

Innovatus Imaging

P 76 P 65 P 59 P 78 P 79 P P 17 P P 3 P P 40

P P P P

KEI Medical Imaging

Online Resource HTM Jobs

52

www.htmjobs.com •

MedWrench

44

www.MedWrench.com •

Webinar Wednesday

38

www.webinarwednesday.live • 800-906-3373

Oxygen Blender iServe Biomedical

59

iservebiomedical.com • 281-741-0849

79

pmbiomedical.com • 800-777-6475

PACS Patient Monitors AIV

P P P

40

aiv-inc.com • 888-656-0755

Elite Biomedical Solutions

65

elitebiomedicalsolutions.com • 855-291-6701

iServe Biomedical

59

iservebiomedical.com • 281-741-0849

PM Biomedical

79

pmbiomedical.com • 800-777-6467

SakoMED

17

sakomed.com • (844) 433-7259

Southeastern Biomedical, Inc

85

sebiomedical.com/ • 828-396-6010

Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231

www.usocmedical.com • 855-888-8762

69 3

Refurbish aiv-inc.com • 888-656-0755

SakoMED

sakomed.com • (844) 433-7261

P

P P P P

5

www.rsti-training.com • 800-229-7784

AIV 5

P P P P

29

www.keimedicalimaging.com • 512-477-1500

USOC Bio-Medical Services 21

P P P P

8

www.innovatusimaging.com • 844-687-5100

RSTI

Mammography RSTI

79

pmbiomedical.com • 800-777-6467

PM Biomedical

Infusion Pumps AIV

PM Biomedical

diagnostic-solutions.com • 330-296-9729

Fetal Monitoring iServe Biomedical

P P P P P

78

ESUs PM Biomedical

TRAINING

hmark.com • 800-521-6224

SERVICE

Healthmark Industries

PARTS

Endoscopy

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

P P P P P P P P

P

P P P P P P P P

40 17

P P

November 2023 | TechNation 83

SERVICE INDEX CONTINUED

brightbiomedical.com • 877-318-1769

Cardiotronix

cardiotronixhealth.com • (855)-4DEFIBS

Elite Biomedical Solutions

elitebiomedicalsolutions.com • 855-291-6702

PM Biomedical

pmbiomedical.com • 800-777-6467

SakoMED

sakomed.com • (844) 433-7262

Soaring Hearts Group

soaringheartsinc.com • 855.438.7744

elitebiomedicalsolutions.com • 855-291-6701

iServe Biomedical

iservebiomedical.com • 281-741-0849

KEI Medical Imaging

www.keimedicalimaging.com • 512-477-1500

PM Biomedical

pmbiomedical.com • 800-777-6467

SakoMED

sakomed.com • (844) 433-7263

RTLS Cox Communications coxprosight.com •

Midmark RTLS Solutions, Inc.

midmarkRTLS.com • 877-983-7788

Vizzia Technologies

https://vizziatech.com • 855-849-9421

P P

coxprosight.com •

Cynch

cynch.me •

EQ2

www.eq2llc.com • 888-312-4367

NVRT Labs Inc. nvrtlabs.com •

TruAsset, LLC

www.truasset.com • 214-276-1280

Vizzia Technologies

https://vizziatech.com • 855-849-9421

29

P P P P

65 79 17 80

65 59

P P P P P P P P P

29 79 17

P P P P

25 7 4

hmark.com • 800-521-6224

84 TechNation | November 2023

iServe Biomedical

iservebiomedical.com • 281-741-0849

Multimedical Systems

www.multimedicalsystems.com • 888-532-8056

PM Biomedical

pmbiomedical.com • 800-777-6467

SakoMED

sakomed.com • (844) 433-7260

Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231

USOC Bio-Medical Services

www.usocmedical.com • 855-888-8762

Test Equipment BC Group International, Inc

www.BCGroupStore.com • 314-638-3800

iServe Biomedical

iservebiomedical.com • 281-741-0849

Pronk Technologies, Inc.

www.pronktech.com • 800-609-9802

SakoMED

sakomed.com • (844) 433-7264

Southeastern Biomedical, Inc

sebiomedical.com/ • 828-396-6010

P P 65 P P 59 P 78 P 79 P P 17 P P 69 P P 3 P P 40

BC 59

2,72,76 17 85

Tubes/Bulbs Tri-Imaging Solutions

www.triimaging.com • 855-401-4888

21

Ultrasound Innovatus Imaging

www.innovatusimaging.com • 844-687-5100

P P P P P P P P P

8

Ventilators 25 73 37 27 72,75 4

Surgical Healthmark Industries

aiv-inc.com • 888-656-0755 elitebiomedicalsolutions.com • 855-291-6701

76

Software Cox Communications

AIV

Elite Biomedical Solutions

Replacement Parts Elite Biomedical Solutions

TRAINING

79

Repair Bright Biomedical, LLC

SERVICE

pmbiomedical.com • 800-777-6476

PARTS

Telemetry

Rental/Leasing PM Biomedical

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

6

iServe Biomedical

iservebiomedical.com • 281-741-0849

PM Biomedical

pmbiomedical.com • 800-777-6477

59 79

X-Ray Innovatus Imaging

www.innovatusimaging.com • 844-687-5100

RSTI

www.rsti-training.com • 800-229-7784

Tri-Imaging Solutions

www.triimaging.com • 855-401-4888

P P P P

8 5 21

P P P P P P

ALPHABETICAL INDEX 626 Holdings…………………………

16

Elite Biomedical Solutions……………

65

Pronk Technologies, Inc. ……… 2,72,76

AIV……………………………………

40

EQ2……………………………………

37

RSTI……………………………………… 5

BC Group International, Inc………… BC

Healthmark Industries………………… 6

SakoMED……………………………

17

Bright Biomedical, LLC………………

76

HTM Jobs……………………………

52

SalesMaker Carts……………………

63

Capital i………………………………

31

Innovatus Imaging……………………… 8

Soaring Hearts Group…………………

80

Cardiotronix…………………………

29

iServe Biomedical……………………

59

Southeastern Biomedical, Inc………

85

CM Parts Plus …………………………

63

KEI Medical Imaging…………………

29

College of Biomedical Equipment Technology……………………………

11

Maull Biomedical Training……………

40

Southwestern Biomedical Electronics, Inc.…………………………………… 69

Contrast Injector Tools………………

59

MedWrench…………………………

44

Cox Communications…………………

25

Cynch…………………………………

73

Diagnostic Solutions…………………

33

ECRI Institute…………………………

36

Midmark RTLS Solutions, Inc.………… 7 Multimedical Systems………………

78

NVRT Labs Inc.………………………

27

PM Biomedical………………………

79

Tri-Imaging Solutions…………………

21

TruAsset, LLC……………………… 72,75 USOC Bio-Medical Services…………… 3 Vizzia Technologies…………………… 4 Webinar Wednesday…………………

38

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

sebiomedical.com | (888) 310-7322

November 2023 | TechNation 85

BREAKROOM Photo by Douglas

#IamTechNation Join us as we celebrate the TechNation community.

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

Redwine

Douglas Redwine spoke to college students about ca reer pathways at the iWork 2023 even t and networking with Healthcare Tech nology Manageme nt industry colleague s, including Webb Clark.

Massey Photo by Eric

pi in Mississip MI-4 PET CT PM on a GE l Regional Support with Crothal ario Wug and Crothall Specialist Mgineer Brian Howell.

Imaging En

Photo by Shawn Br

yant

Congrats to Rylie and Skylar who mentioned they [Patient Data Mo were able to get dules] tested in 485 GE PDMs 1 month with Pr onk Technologies Gear.

86 TechNation | November 2023

S AV E T H E DAT E IRVINE, CA | FEBRUARY 18-20

attendice.com #attendICE

For the past 10 years, the Imaging Conference and Expo (ICE) has strived to create a conference like no other. Imaging professionals come together for top-notch education presented by world-class instructors.

As a result, ICE is able to offer valuable CE credits accredited by AHRA and ACI. Whether it’s the continuing education, the exclusive exhibit hall offering solutions to save time and resources, or the productive (and fun!) networking, ICE provides attendees the perfect opportunity to enhance their knowledge and grow in their careers.

LAS VEGAS, NV | APRIL 7-9 For over 20 years MD Expo has provided worldclass educational sessions, top-flight networking opportunities and an exhibit hall filled with the latest technology, service and equipment options. Make plans to join us at the M Resort & Casino in the spring.

mdexposhow.com #MDExpo

I N D I A N A P O L I S , I N | M AY 3 - 4

htmmixer.com #HTMMixer

HTM Mixers serve as a regional conference for HTM professionals eager to earn continuing education credits, explore solutions in an exhibit hall and network with peers. Our 2024 event is proudly sponsored by the Indiana Biomedical Society.

NEW ENGLAND | OCTOBER 8-10

New England • October 8-10, 2024 mdexposhow.com #MDExpo

In line with the spring MD Expo, our fall event provides opportunities for meaningful interactions with HTM thought leaders and peers from around the nation. In addition to educational sessions, networking opportunities and an exhibit hall filled with the latest technology, service and equipment options, the fall MD Expo offers a Reverse Expo, directly connecting decision makers and vendors with valuable face-time.