ICE Magazine - March 2020 by MD Publishing

THEICECOMMUNITY.COM

MARCH 2020 | VOLUME 4 | ISSUE 3

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

PEER

TO PEER

LEADERSâ&#x20AC;&#x2122; TIPS & TRICKS FOR BUILDING A SUCCESSFUL IMAGING DEPARTMENT PAGE 38

PRODUCT FOCUS

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ICEMAGAZINE | MARCH 2020

OFF THE CLOCK

Joe Phillips hits a high note away from work.

ADVANCING THE IMAGING PROFESSIONAL

MARCH 2020 RAD HR

The importance of putting yourself first to avoid burnout.

44 38

IMAGING NEWS

ICE shares news, trends and hot topics from throughout the diagnostic imaging community.

FEATURED ARTICLE 38

Peer to Peer Leaders Share Tips, Tricks and Workarounds for Building a Successful Imaging Department

INSIGHTS 44

Rad HR Management: Start With Yourself First

Director’s Cut Wisdom Leading

PACS/IT Betty or a Chatbot?

Department/Operational Issues The Rise of Data and Decision-Making

Coding/Billing To 3D or Not to 3D

Emotional Intelligence Learning to Say “No” When Your Plate is Full

60 62

ICE Break

Index ADVANCING THE IMAGING PROFESSIONAL

SPOTLIGHT

IN FOCUS Becky Allen loves working with health care heroes.

BECKY ALLEN

s an active child, Becky Allen was always in motion … until she wasn’t. She had a fair share of sudden stops that resulted in injuries requiring X-rays. Her childhood experiences with diagnostic imaging planted a seed that blossomed into a career.

Rebecca “Becky” Allen, MS, CRA, R.T.(R), is currently the enterprise director of radiology at UC (University of Cincinnati) Health where she is responsible for the primary leadership role for all radiology services in collaboration with the chair of the department of radiology/chief of imaging for UC Health and the endoscopy department at the University of Cincinnati Medical Center. 10

ICEMAGAZINE | MARCH 2020

When asked how she ended up in her career field she reflects on that active childhood. “It is kind of funny. As a child, I played lots of sports and had lots of X-rays taken. It really started in middle school for me,” Allen recalls. “From the time I was a junior in high school I knew I was going to go to X-ray school. It was when I was doing X-rays and CT scans I started asking ‘How can I help others?’ and that is how I got into the management side of it.” While her high school classmates were still trying to figure out what they wanted to be when they grew up, Allen was deciding which scholarship to accept. She turned down a basketball scholarship at Morehead State University when the coach who had been

recruiting her was replaced and instead accepted an academic scholarship. Upon graduation, her career began as a radiologic technologist at St. Luke Hospital West in Florence, Kentucky followed by a stint as a member of the radiology faculty at Northern Kentucky University. Fast forward to 2020 and her employment history reflects her career growth. She has served several roles along the way including clinical coordinator, director of diagnostic and oncology services and divisional director of radiology, interim assistant vice president of operations and more. Each job title came with specific responsibilities that empowered Allen as she grew into the imaging leader she is today. She had success and her fair share of mistakes along the way. The support of a strong team and a ADVANCING THE IMAGING PROFESSIONAL

dedicated mentor helped her navigate the ups and downs. “My two biggest accomplishments have been when I won the GE Award for Excellence through the AHRA in 2004 that was submitted by the staff and the second one is when people that have worked under my supervision go on to a bigger job, that is the most rewarding,” Allen recalls. “That gives me a feeling of great accomplishment because I know I have helped set them up to succeed.” Prior to the success, Allen was fortunate to have a leader who believed in her. He allowed her to make mistakes, learn from those mistakes and become a leader in her own right. “I had a fantastic mentor when I first started my management career in Andy Riddell. He was the COO at the time. How he mentored me is that he invested in me. He allowed me to grow and make mistakes and learn from them in the best way possible,” Allen says. “I can’t imagine not having him when I first started my career. I worked directly with him for six years. He was also a leadership coach, which probably helped. Just knowing the amount of time he invested in me, I knew he cared and wanted me to be successful. He was the best.” Her success could also be due to the fact that she loves her job because she is able to work with talented individuals who perform miracles. One example that stands out in her memory is when she witnessed the interventional radiology team treat a woman who had just come in with a stroke. “I just witnessed technologists, nurses and physicians save lives,” Allen says. “My job is to knock down barriers so they can actually improve the lives of patients. I truly know I have one of the best jobs in the world and I am pretty blessed for it.”

She sees the work she does as being behind the scenes. She does not desire the spotlight and strives to be a servant leader to help others be the best they can be on a daily basis. “Honesty, passion and empathy,” are the words Allen uses to describe her leadership style. “I try to do servant leadership. Removing barriers and get to know people and get to know something personal about them. You really want to form that bond with everyone. It is truly a practice and I try to practice it,” Allen explains. She challenges her radiology department to find and share ways to improve the overall operation. “Let’s upend everything and change the way we do everything. We have upended our organizational charts and we (leadership) are just in support down at the bottom. The people who are hands-on are actually leading the department. I try to encourage my technologists and leaders to go break something and see if you can make it better,” Allen says. “Radiology is a special field. A lot of people get into it for the technology. It is a lot about technology and physics and all of that, but it is also about caring. You have to have a caring heart and empathy and understanding,” Allen adds. “I think it takes a special person to want to do this.” Allen and her wife, Robin, qualify as special people. They have twin teenage daughters, Katie and Kasey, who keep them busy and have since their early arrival 13 years ago. “They were born at 27 weeks and at a year old they only weighed 12 pounds,” Allen recalls. Allen’s servant leadership approach is no doubt serving her well at work and at home. •

BECKY ALLEN

Enterprise Director of Radiology UC Health What book are you reading currently? “The Heart of Change” by John Kotter Favorite movie? “The Shawshank Redemption” What is something most of your coworkers don’t know about you? I’m scared of turtles. Who is your mentor? Andy Riddell What is one thing you do every morning to start your day? Pray to do and be my best. Best advice you ever received? There’s a reason why the windshield is larger than the rear view mirror. Where you’re going is so much better then where you’ve been. Who has had the biggest influence on your life? My mom; she’s my hero. What would your superpower be? To know the lottery numbers. What are your hobbies? Boating and hiking with the family. What is your perfect meal? Chicken, mashed potatoes, mustard greens and fried green tomatoes.

Away from work, Becky Allen enjoys spending time with her wife, Robin, and their twin daughters.

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ICEMAGAZINE

SPOTLIGHT

Rad idea ERIC KALLSTROM

CONTINUAL LEARNING

s a leader in noninvasive cardiovascular imaging, I have recognized the subjectivity that is intrinsic to our field and health care in general. To mitigate these challenges that chronically exist, standardization is key. As part of a service line, my reach is limited, yet expansive. Each week, I send out modality specific tips and tricks of the week titled “The (modality) Do and Don’t of the Week” to all my staff. I believe it is important to not only teach what is the correct way to do things, but also highlight improper techniques on a certain area, which is considered the Don’t. These Do’s and Don’ts cover topics such as best practice techniques, workflow, compliance and regulatory concerns, quality and patient safety.

mind our technologists of the system culture that employees and patients expect to encounter. A large database of Do’s and Don’ts has been created, which will eventually get cycled through to further remind everyone of past topics, while adding new concepts to keep the emails fresh and thought-provoking. At the end of the day, I am doing this for our staff and patients. An empowered and engaged imaging technologist pays dividends in the form of quality patient care, which is priceless. •

I have received satisfactory feedback on these weekly emails as they aim to teach and re-

Share your RAD IDEA via an email to

ICEMAGAZINE | MARCH 2020

ERIC KALLSTROM, MBA, ACS, RDCS, FACVP, FASE, is a manager of noninvasive cardiology within Baylor Scott&White Health. He promotes quality, education, standardization and patient safety as a leader of several imaging modalities. With a background in echocardiography, Kallstrom has held roles as sonographer, technical director, manager and educator.

editor@mdpublishing.com.

ADVANCING THE IMAGING PROFESSIONAL

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SPOTLIGHT

RISING

STAR

KERNESHA WEATHERLY

Kernesha Weatherly is pictured with an Agrarian tree goat just outside of Essaouria, Morocco, which she says was the main reason she wanted to visit Morocco.

ICEMAGAZINE | MARCH 2020

ADVANCING THE IMAGING PROFESSIONAL

BY ERIN REGISTER

ernesha Weatherly was born and raised in Montgomery, Alabama. In 2004, she went to Birmingham to begin her undergraduate studies at the University of Alabama at Birmingham and completed her degree in radiologic sciences with a specialty in molecular imaging. Kernesha went on to obtain a dual master’s in health administration and healthcare operations from Capella University. Additionally, she has successfully completed all coursework needed to obtain a doctorate in health care quality and analytics. Kernesha is in the process of completing her dissertation. After completing her bachelor’s degree, Kernesha became a certified nuclear medicine technologist (CNMT). However, jobs were not abundant, so she decided to continue her education and become ARRT certified in computed tomography (CT). Kernesha worked in CT for four years before she found a job in nuclear medicine. After working in nuclear medicine for a year and a half, she had the opportunity to become the clinical educator of the department of radiology. Due to her extensive work with the regulatory department to learn and ensure compliance with the CMS mandated conditions of participation, Kernesha was offered a job as the manager of breast imaging. She worked in that position for two years. Kernesha is currently the director of radiology for inpatient services and breast imaging for UAB Medicine. ICE Magazine learned more about this Rising Star in a questions-and-answer interview.

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: In high school, I loved to watch the show “Trauma, Life and Death in the ER,” and from then on, I knew I wanted to be in health care. However, I had no desire to be a nurse, as my grandmother was a nurse in the 1960s. Listening to her stories was enough to divert my attention elsewhere.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: I like the uncertainty of it all. I have found that I am good at expounding on and moderating collaborative efforts to get the job done. This position gives me the opportunity to continuously problem solve and the freedom to create innovative solutions that truly answer the questions at hand

Kernesha Weatherly Director of radiology for inpatient services and breast imaging for UAB Medicine

while simultaneously enhancing the quality of life for all, including patients, direct reports and indirect reports.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: Medical imaging is truly the eyes of health care. Unlike many health care professions, radiological technologists must be well-versed in multiple specialties in order to truly service the needs of an organization. Having the aptitude to effectively communicate what imaging modality is optimal based on the presented clinical indications is an art form that is amazing to see in action.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: Having inherited an area that had a series of opportunities for improvement, I was challenged with addressing the needs of all stakeholders, while learning a modality I have very little knowledge of. Being completely immersed into this multi-faceted structure positioned me to understand the need to become more expansive in my approach to the continuum of care. My ability to embrace change and challenges cultivated an atmosphere where I was able to truly transform the department into a premier imaging center. This transformation not only positively impacted a series of organizational metrics, but also impacted human metrics. Staff members once again felt heard and, through a series of collaborative process changes, our employee turnover rate diminished.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: It is one thing to have worked as a front-line employee, but it is another thing to navigate the world of administration. In five years, I would like to have cultivated an even greater platform of creating proactive processes that further advance the department and ultimately the organization. I am confident the access and exposure I am afforded will allow me to do just that. •

FUN FACTS Favorite Show to Binge Watch: “Chicago PD” and “Criminal Minds” Favorite Vacation Spot: Diana Beach, Kenya Favorite Food Combination: Acai bowls and peanut butter Secret Skill/Talent: Crocheting WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

SPOTLIGHT

Off Clock THE

JOE PHILLIPS, DIRECTOR OF CLINICAL SERVICES – DIAGNOSTICS AT CONNECTICUT CHILDREN’S HOSPITAL BY MATT SKOUFALOS

or all his life, Joe Phillips has been a lover of the outdoors, music and science. Growing up in Chicopee, Massachusetts with a dad who worked in the aerospace industry and moonlighted as a saxophone player on weekends, he got plenty of all three. “As a young guy, I always thought of myself as somebody who couldn’t get enough out of these experiences in life,” Phillips said. “Since I was little, if I could’ve worked in being a fisherman, I would have.” Indeed, his initial inclinations would have led Phillips to a career as a fish biologist, but after discovering the statistics-heavy nature of the job, he transitioned into nuclear medicine. He still kept up with his passions, however. “I’m from a Polish background: hard-working, 16

ICEMAGAZINE | MARCH 2020

blue-collar people,” Phillips said. “My parents pushed hard for me to have a better life than they did, and along the way, the culture of fishing and music was important to me.” Fishing holds special significance for Phillips because, even as a hobby, it’s “very technical and very artful,” he said. He enjoys fly fishing, a pursuit that requires hours of dedication, making tiny lures out of feathers and thread. Each is designed to appear and behave like an insect species native to the waterways he fishes, and to approximate the real thing, Phillips will study the bugs he’s approximating “at the Latin level,” he said. Tying flies for the upcoming season is one of Phillips’ favorite ways to pass the wintry hours. He’ll take them to Lake Ontario to fish for salmon and steelhead in the fall, or up to the Battenkill River in Vermont, studying the river and the fish to see what they’ll bite and what they won’t. Put the wrong fly over a fish, and it’ll stop eating and scatter. ADVANCING THE IMAGING PROFESSIONAL

Joe Phillips is seen with Stormtroopers at a conference.

“I can tell what that fish is doing based on how it’s feeding at the surface of the river,” he said. “There are seasonal patterns of the fish themselves. Water temperature affects what they do; every stream has its own insect life that’s slightly variable depending upon that. It’s very scientific.” As much as fly fishing is scientific, it also requires an artistic streak that Phillips also expresses through music. He started off as a drummer, and by 13 was filling in on weekend gigs with his dad’s cover act, The Inner Lite Band. It wasn’t quite the same as Phillips’ dream of ripping solos with Aerosmith, but the bookings kept everyone busy. “They’d play Friday night, twice on Saturday and twice on Sunday,” he said. “That was how my dad put food on the table.” Later, Phillips picked up the guitar “just because it’s not so loud” as percussion. He passed those talents on to his son, 19, and the two eventually formed an original act called The Woodstock Rail Line, named for their town of residence and love of train culture. They got enough momentum to land a local gig opening for country rock act Uncle Kracker, a highlight of their time onstage. However, Phillips considers the height of that band’s powers to have been a lesson to his son in what it takes to organize a group of musicians. “I basically built this band so he could understand how hard it is to get four guys in the same room and pointed in the same direction; having the same agreeable music direction,” he said. “If nothing else, that big [gig] was something to reflect on.” Today, Phillips is working to put together a blues and soul band that he said is almost ready to debut. In his 50th year, he’s got the experience behind him to know what the group will need to be; now it’s a matter of cultivating the musicians involved and WWW.THEICECOMMUNITY.COM

finding the right vibe. “We’re all adults, we’re all comfortable in our skins, we all have day jobs, but we all want to have fun,” he said. “We’re really picky and want to get the right personalities that will blend with us, and then see what happens.” “People want a show,” Phillips said. “Anybody can play music, but if you give them a show, they’ll come back.” Phillips describes himself as a local musician first. He’s never toured, and has no aspirations of making a second career from his experiences. But the opportunity to participate in making art with friends and family—in addition to his son’s talents, his wife, Sandy, can more than carry a tune—is the entire point of music, and to him, that’s more than enough. “Everybody needs some form of art in their life, and everybody has it in them,” Phillips said. “They just don’t explore it, or know that they do as much as they do.” “I think we all make our mark in the world,” he said. “Music is a different way to find peace in what you do. We can all be influential in our employees and families; there’s something about the creative experience of art.” Beyond the creative process of performing, playing with a group also emphasizes the ability to listen to the other players involved. Sometimes that extends beyond the members of the group internally to touring artists who come through town. Along the way, Phillips has formed “some great, intimate connections with musicians

Joe Phillips enjoys making his own lures for fly fishing.

we look up to,” including bands like Drive-By Truckers, from which Jason Isbell emerged as a solo artist. “[Isbell] was playing a show in New Haven, and at the end of the show, Amanda Shires, his wife, the fiddle player in his band, sees Sandy and I in the front row with all our kids,” Phillips said. “She points at us, folds up the set list into a tiny square, grabs Sandy’s hand, and puts that set list in her palm.” That set list is now on the wall in the music room in their home, joining photographs and memorabilia from other shows. It’s part of the moments of a lifetime spent appreciating and creating art; even hosting touring musicians when they come through town. “Music is part of everything we do,” Phillips said. “We’ve got this house and it’s open to everybody.” •

Joe Phillips and his wife, Sandy, love music, family and each other.

ICEMAGAZINE

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NEWS

Imaging News A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

DICOM SYSTEMS DEPLOYS ENTERPRISE MEDICAL IMAGING PLATFORM AT ORLANDO HEALTH Dicom Systems has delivered an enterprise-wide imaging platform to Orlando Health to support the management of medical imaging exams. Orlando Health, which is made up of eight hospitals and outpatient care centers serving over 2.6 million patients annually, was in search of an enterprise imaging system that could transfer workflow functions from their PACS and act as the command center for the transfer, normalization and optimization of a high volume of medical imaging exams. “In partnership with Orlando Health, we architected a solution that enables them to sustain their imaging growth and spikes in utilization for years to come without going back to the drawing board. Our intervention for this sensitive mission was carefully orchestrated in close collaboration with the Orlando Health team; imaging services remained 100% operational throughout the transition,” said Florent Saint-Clair, executive vice president of Dicom Systems.

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Dicom Systems Unifier features deployed include: • Advanced Intelligent Routing: Unifier routing enables customized workflows to automatically route images to multiple reading and archiving locations. • DICOM Load Balancer: Provides full configuration and management of DICOM image caching and compression for faster application delivery and scalability. Accurate, up-to-date health checks on application and server performance support the multisite enterprise and guarantee all the images route to the intended destination • Tag-morphing: Feature offloads all routing tasks from PACS to Unifier. The engine substantially improves the speed and performance of the enterprise by applying all transformations on data in flight. • High Availability Architecture: Incorporates multiple Unifier

appliance clusters across multiple data centers. “Dicom Systems is pleased to provide Orlando Health with the Unifier Enterprise Imaging platform to bolster the resilience of their workflows. The high-availability nodes span two data centers and load-balance imaging traffic to multiple PACS ingestion points,” said Dmitriy Tochilnik, president and CTO of Dicom Systems. “The complex technical environment at Orlando Health, along with the ingenuity and commitment of their IT teams to deliver the new platform under a tight deployment timeline, provided us with an opportunity to deliver value-added, real-world solutions.” Dicom Systems will showcase its Enterprise Imaging Unifier platform at HIMSS in Orlando, Florida at the Orange County Convention Center from March 10-12, 2020. • FOR MORE INFORMATION, visit www.dcmsys.com.

ICEMAGAZINE

NEWS

MINDRAY LAUNCHES TE7 ACE POINT-OF-CARE SOLUTION Mindray Medical has announced the release of a new point-of-care ultrasound system. The TE7 ACE is a new touch screen ultrasound system that provides targeted solutions to diverse point-of-care scenarios including: anesthesia, critical care and emergency. Featuring smart fluid management tools, safe needling toolkit, seamless data connectivity and a complete disinfection solution, TE7 ACE helps clinicians to deal with diagnostic challenges and make rapid decision. “Having identified the clinical challenges, Mindray developed this solution to empower clinicians with more confidence to focus on patient care,” said Xujin He, the general manager of medical imaging system business unit at Mindray. In terms of managing patient body fluid, quick assessment can help to work out the fluid therapy plan and save lives. Based on deep learning algorithms, the clinically proven advanced fluid measurement tools of TE7 ACE are offered to accelerate patient assessments accurately and efficiently: • Smart VTI: automatically calculates the Velocity Time Integral, Cardiac Output and Stroke Volume

ICEMAGAZINE | MARCH 2020

Variation. The trending graph helps for efficient recording and guides for the fluid therapy. • Smart IVC: automatically traces the IVC diameter change, and calculates the Collapsibility Index or Distensibility Index and IVC Variation, helps for the assessment of volume status and responsiveness. • Smart B-line: automatically calculates B-lines number, percentage and distance. It provides unique visual scoring map for intuitive overall lung water evaluation, guiding the fluid infusion and preventing pulmonary edema. To ensure safe, simple and convenient needle guidance, the newly launched L12-3VNs with 3 programmable buttons combines eSpacial Navi and remote control into one so that clinicians can perform puncture without touching the system. The connectivity solution eGateway also enables TE7 ACE to seamlessly fit into the existing hospital network, incorporating patient’s clinical data collected from both ultrasound equipment and patient monitors for wiser clinical decision making. This efficient and paperless process improves productivity while reducing the risk of transcription errors. •

ADVANCING THE IMAGING PROFESSIONAL

UNITED IMAGING PROVIDES DEVICES TO WUHAN EMERGENCY FIELD HOSPITAL To help front-line physicians, nurses and other health care professionals diagnose and treat the coronavirus, United Imaging has donated medical imaging equipment and protective medical gear worth more than $1.4 million to hospitals in Wuhan, China, at the center of the outbreak. On Feb. 1, United Imaging also finished installation of three high-end CT scanners – one uCT 780 (160-slice CT scanner) and two uCT 760s (128-slice CT scanners) – at the Huoshenshan Hospital, an emergency specialty field hospital with 1,000 beds built in less than 10 days in Wuhan. United Imaging accomplished the installation while the hospital was under construction, within half the time it usually takes to install this equipment. The company dispatched 15 service engineers to work in three continuous shifts, as well as a 25-person team that included project managers, clinical application professionals and operations to provide on-site support. At the same time, the company set up additional spare parts sites near the hospital to ensure a quick response in case of need. United Imaging also accelerated production to get more than 100 CT scanners and X-ray machines out quickly to hospitals in Wuhan, Shanghai, Beijing, Zhejiang, Inner Mongolia and other regions in China. With scanning workflow fully empowered by AI technology, United Imaging CT systems enable automatic patient positioning and scanning from the operation room. Because technologists don’t have to go into the scan room, this feature can help prevent cross infection between technologists and patients. Also, the ability to scan more than 300 patients daily provides a robust foundation for smooth and efficient hospital operations. United Imaging’s engineers are standing by 24 hours a day to respond to emergency calls from hospitals. Along with these engineers, hundreds of United Imaging employees have been contributing to this effort for more than 10 consecutive days, working through holidays and returning early, to support the health care professionals across China fighting the coronavirus. United Imaging also deployed its UIH CLOUD remote diagnosis platform in frontline hospitals as soon as the outbreak occurred. With this platform, patient images scanned at designated hospitals can be uploaded to the top hospitals in China in order to support remote, real-time diagnosis and guidance from doctors. According to reports, the platform achieved more than 1,000 diagnoses at one hospital in just one week. As a global company, United Imaging is committed to access for all to the best possible care worldwide and is proud to play a small part alongside so many who are going above and beyond in this moment. •

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NEWS CARESTREAM DIGITAL TOMOSYNTHESIS RECEIVES FDA CLEARANCE Carestream’s digital tomosynthesis (DT) functionality – a three-dimensional extension of general radiography – has received 510(k) clearance from the U.S. Food and Drug Administration. Simplifying workflow and reducing exam time, DT technology is an upgradable option on the Carestream DRX-Evolution Plus System, a versatile digital radiography system that can perform a wide range of general radiographic exams. Digital tomosynthesis uses a single sweep of X-ray exposures and streamlines operator workflow by separating the process of DT exposure acquisition from image volume formation. As a result, it can generate data from a series of low dose X-ray images of the same organ, taken at the same X-ray exposure, from different angles. “The images captured by digital tomosynthesis technology offer greater depth and enhanced visualization,” said Sarah Verna, worldwide marketing manager for global X-ray solutions at Carestream. “Doctors and radiologists will be able to perform scans quickly, providing valuable clinical information for further diagnosis while improving the workflow in an X-ray room.” Digital tomosynthesis, like a computed tomography (CT) scan, can produce cross-sectional images of an organ, allowing for increased visibility. This capability enhances the DRX-Evolution Plus in situations where physicians need quick answers.

“In trauma centers, CT rooms are always overbooked and there’s always a wait,” Verna said. “Now a doctor can further examine any body part, including the chest or lungs, with digital tomosynthesis because it generates many image slices, which helps sharpen diagnosis and make medical treatment more efficient. Digital tomosynthesis does not replace computed tomography and can be used in conjunction with it.” Carestream customers will now have the option to purchase the DT software for their DRX-Evolution Plus systems. Coupled with the company’s new ImageView Software that is powered by the Eclipse image processing engine, the DRX-Evolution Plus with digital tomosynthesis transforms into a powerful digital imaging tool for hospital systems. •

EOS IMAGING ANNOUNCES FIRST INSTALLATION OF EOSEDGE IN NORTH AMERICA EOS imaging has announced the first installation of its new EOSedge system in North America at CHU Sainte-Justine Mother and Child University Hospital Centre in Montreal, Quebec, Canada. This second EOSedge system installation worldwide follows the first system install in 2019 in Lyon, France. EOSedge is installed in Ste Justine hospital’s orthopedic department. A clinical research program with EOSedge led by Professor Carl-Éric Aubin and Dr. Stefan Parent at CHU Sainte-Justine will cover a wide range of areas such as multi-spectral imaging and biomechanical modeling in multiple clinical applications, as well as clinical studies

ICEMAGAZINE | MARCH 2020

on adolescent idiopathic scoliosis and bone metabolic conditions. “We are pleased that the first North American installation of our newly FDA and Health Canada cleared EOSedge system is at an institution with a dedicated value to advancing patient care. This installation marks another step in deploying, on a global scale a solution that not only further improves our dose reduction and whole-body imaging capabilities, but also adds new and unrivaled performance in image resolution and quality. We look forward to quick adoption of this outstanding imaging solution,” EOS imaging CEO Mike Lobinsky said. •

ADVANCING THE IMAGING PROFESSIONAL

EXPANDING COLLABORATIVE IMAGING PROMISES TO END RADIOLOGY CONSOLIDATION The $18 billion radiology industry continues to face a growing threat of consolidation, resulting in larger practices, higher medical costs, diminished patient care and increased physician burnout. In response, Collaborative Imaging has formed a business model to end radiology consolidation by ensuring practices can sustain autonomy while providing an investment vehicle that protects continued financial success. “Radiologists have faced tremendous pressures over the past decade that have drastically changed the industry’s landscape as a result of consolidation, reimbursement changes, sub-specialty and in-house night coverage in addition to the new complex billing and reporting requirements,” said Dhruv Chopra, CEO of Collaborative Imaging. “As a result, practices are being forced to make significant investments in technology, building administrative teams to handle non-clinical functions, purchase or develop additional applications and take a leap into operating their practice as a business if they are to continue to exist. However, many practices do not have the resources or capital available to make these investments, and

as such they are forced to throw in the towel and relinquish control of their practices to private-equity backed consolidators. These consolidators use their business acumen to capitalize on the inefficiencies the practices have and missed opportunities to realize additional revenues that do not get passed on to the physicians who are actually the ones performing the work. Collaborative Imaging is founded on the principal that we want our physicians to enjoy the upside that is theirs, and as such, we’re fighting to protect the practice of independent radiology.” As a national radiologist-owned alliance, Collaborative Imaging was conceived by radiologists in conjunction with financial and industry experts to combat the root causes of why an independent practice would sell to a consolidator. With more than 150 years of combined industry experience in technology, medical billing and workflow solutions, Collaborative Imaging offers an alternative to consolidation by providing the tools needed to help the practice remain independent and autonomous while drastically increasing revenue. •

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ICEMAGAZINE

NEWS HITACHI HEALTHCARE AMERICAS CREATES MEDICAL IMAGING INNOVATION CENTER

Hitachi Healthcare Americas has announced that it will create a new dedicated research and development facility within its North American headquarters facility in Twinsburg, Ohio. The move will result in the creation of approximately 40 new jobs, adding to the nearly 200 currently employed at the Twinsburg facility. Set to open this year, the Hitachi Healthcare Innovation Center of Excellence will leverage advancements in artificial intelligence and machine learning to bring about a new generation of imaging technology. “Being in the heart of a health care mecca with such prestigious facilities and educational institutions is the perfect location for us to develop innovative technologies and leverage the local knowledge and talent in Northeastern Ohio,” says Yasuhiko Taniguchi, CEO for Hitachi Healthcare Americas. Hitachi Healthcare Americas currently sells and supports medical imaging devices – including MRI, CT and ultrasound – at its Northeast Ohio facility. The creation of the R&D center will allow the Hitachi team to expand its scientific and engineering teams and more closely collaborate with industry key opinion leaders. When it opens, the facility will be Hitachi Healthcare Americas’ only health care R&D facility outside of Japan. In December, Hitachi Healthcare Americas announced that

ICEMAGAZINE | MARCH 2020

its healthcare division would be transferred to FUJIFILM later this year, but that move is not expected to impact the company’s presence in Northeast Ohio. BioEnterprise, the nonprofit accelerator that works to build Cleveland’s health care industry, collaborated with partners JobsOhio and Team NEO to help encourage Hitachi’s further investment in Northeast Ohio. Recognizing the value and impact of the new Innovation Center of Excellence, JobsOhio awarded Hitachi Healthcare Americas a Research & Development Grant that the company will spend on new prototyping equipment, software platforms and facility upgrades. Over the last 18 months, JobsOhio – in coordination with BioEnterprise and Team NEO – facilitated projects that attracted nearly 700 new jobs in Northeast Ohio, totaling close to $44 million in new payroll and $55 million in new capital expenditures committed. “Hitachi Healthcare’s new R&D Center will be its first in North America and builds on Cleveland’s global reputation as a medical imaging hub,” said J.P. Nauseef, JobsOhio president and chief investment officer. “This R&D investment further demonstrates Hitachi Healthcare’s commitment to design and build the next generation of medical devices, software and solutions to help improve the quality of care in Northeast Ohio.” •

ADVANCING THE IMAGING PROFESSIONAL

Because Quality Matters.

CONQUEST IMAGING EXPANDS SIMPLIFY PROGRAM Conquest Imaging has announced the expansion of SIMPLIFY, Conquest Imaging’s transducer repair program, featuring added TEE probe repair capabilities, flat rate repair pricing and a mobile probe testing program. The entire SIMPLIFY program is overseen by Vice President of Technical Operations Bob Broschart, a 30-year veteran in the ultrasound industry. Conquest Imaging, in addition to 3D/4D and standard probe repair, added many transesophageal (TEE) models to its repair capabilities list including: • Philips X7-2T • GE 6VT-D • Philips X8-2T • Siemens V5MS • GE 6T SIMPLIFY’s flat rate repair pricing enables sameday repair ordering. With the upfront pricing for minor, major and enhanced repairs, customers can provide payment and receive a return authorization the same day and their exchange or loaner probe the following business day. “Our onsite mobile probe testing is a revolutionary way of providing true probe management as a service to our customers that will save them tens of thousands to hundreds of thousands of dollars in their probe spend,” Broschart said. “We go in, evaluate their entire probe inventory and assess the state of each probe. Then, we begin planning and educating our customer on probe safety, wear-and-tear and why it matters. We partner with them to raise the quality of their inventory and reduce incidents, damage and replacements through better probe care.” The program includes periodic onsite evaluations and assessments, free training and repair scheduling. As a result, contract customers will experience significant probe spend savings while extending the life of each probe. “This enhancement of probe repair options and services is part of Conquest Imaging’s ongoing effort to strategically improve and expand ultrasound offerings, increasing the level of efficiency, excellence and savings to health care facilities and systems. SIMPLIFY continues to deliver free probe evaluations, exchanges, loaners and straight repairs,” according to a press release. •

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NEWS

ACCUMEN’S 3DR LABS PARTNERS WITH RESONANCE HEALTH Accumen Inc. has announced that its 3DR Labs LLC company is partnering with Resonance Health Limited to provide FerriSmart magnetic resonance imaging-based liver iron concentration reports for its clients. FerriSmart uses artificial intelligence (AI) to analyze magnetic resonance imaging (MRI) images and deliver a liver iron quantification result within seconds. This technology allows liver iron concentrations to be monitored effectively and efficiently for individuals with confirmed or suspected systemic iron overload, patients with thalassemia or sickle cell anemia who require regular blood transfusions, and recipients of artificial heart valves who may experience an increase in systemic iron levels over time. “We are excited to partner with Resonance Health to provide our clients with this additional resource for mining valuable diagnostic data from their MRI images,” said Accumen President and CEO Jeff Osborne. “3DR is already working with 900 hospitals in the United States, creating three-dimensional images from their MRI and computed tomography scans. We

consider FerriSmart Reports to be a natural extension to the comprehensive MRI analysis services that we already offer to our 3DR clients.” “We are delighted to partner with 3DR Laboratories and significantly increase the number of patients who can benefit from our non-invasive, MRI-based FerriSmart technology. This important liver iron concentration information can provide invaluable insights and help to guide their treatment options,” said Resonance Health CEO Alison Laws. “Iron deposition disorders, such as sickle cell disease and thalassemia, are a significant health problem not only in the U.S. but worldwide. 3DR is thrilled to partner with Resonance Health in delivering a safer, easier and less expensive AI-based technology to help care for these patients,” said 3DR Labs Chief Medical Officer Robert L Falk, MD. Resonance Health has received 510(k) clearance for FerriSmart from the U.S. Food and Drug Administration, a CE mark from the European Medicines Agency, and regulatory clearance from the Therapeutic Goods Administration in Australia. •

Ice Writer

INTRODUCING

K e l ly P r ay

Kelly Pray is the enterprise change management lead at Children’s Hospital of Los Angeles in California, as well as one of the writers for ICE magazine’s human resources column titled “Rad HR.” Kelly has a bachelor’s degree in political development and health from the University of California. She earned a master’s degree in health administration from the University of North Florida. Her background is in health care administration with a heavy focus on implementation science, and her certifications include Posci Change Practitioner and Prosci Train-the-Trainer. Kelly is responsible for building out change management as an organizational competency in order to ensure adoption and usage across enterprise initiatives. As a native Californian, she enjoys giving back to her local community and spending as much time outdoors as possible throughout the year. In her free time, Kelly is an indoor cycling instructor at Cyclebar in Los Angeles!

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NEWS

WEBINAR WEDNESDAY BY JOHN WALLACE

WEBINARS ADDRESS HOT TOPICS T

he successful and informative Webinar Wednesday series is back for its sixth season in 2020. The series saw growth throughout 2019 and continues to be a valuable resource for healthcare technology management professionals in the new decade. The first two sessions of 2020 touched on some hot topics including cybersecurity.

DEVICE SECURITY ADDRESSED The recent webinar “Steps to Build an Effective Medical Device Cybersecurity Program” provided information and attendees were eligible to receive 1 credit from the ACI. The session was sponsored by Asimily. The webinar featured Asimily CEO Shankar Somasundaram. He discussed the key elements needed to build an effective medical device cybersecurity program. His talk provided valuable information, both for organizations who are starting on the topic of medical device security as well as for organizations who are already deep into this topic. The webinar attracted 160 attendees for the live presentation. A recording of the webinar is also available for on-demand viewing. Attendees gave the session high marks in a post-webinar survey and answered the 28

ICEMAGAZINE | MARCH 2020

question “What did you like most about today’s webinar?” “I like learning about cybersecurity since I have limited experience with it,” said S. Sirois, BMET III. “Good points on security, I still need to work more with IT to establish what is acceptable without compromising security and still be able to take advantage of using advances in technology,” shared L. Munoz, BMET III. “A good broad-based overview on creating a cybersecurity plan for medical equipment management,” said C. Rodriguez, MSET II. “Easy-to-read slides with pertinent information, and the speaker was very knowledgeable on this topic,” said R. Sable, product manager. “The webinar presentation provided insight into what data is needed and how to gather that data to help reduce cyber risks,” Biomedical Systems Analyst L. Riley said. “It gave me more insight on the importance of cybersecurity and the need to have HTM get more involved,” said H. Hunter, owner. “Speaker was passionate and kept my interest during the description of each of the steps,” said C. Ramos, BESS. “Loved the nuts and bolts approach,” said R. Womack, CBET. ADVANCING THE IMAGING PROFESSIONAL

VENDOR CONTRACTS AND TRANSITIONS

development,” Biomedical Engineer E. Gonzales said. The first session of 2020 was sponsored by Nuvolo and “Hunger for new information. And yes it is always worth attendees were eligible to receive 1 CE credit from ACI. attending,” shared R. Mesropyan, CBET. “Evaluating Contract Transitions and Project ROI with a “I try to never miss a webinar if I’m not doing something Focus on Data Governance” was presented else over my lunch hour. It was worth seeing by Dustin Smith, director of central suphow other biomedical groups handle their port, clinical engineering at Intermountain data, and what steps would be if we were Healthcare, and Kyle Holetz, senior solution to go to a better system,” said Biomedical consultant at Nuvolo. They discussed what Technologist O. Stephen. is needed to evaluate the effectiveness of “I am now involved with maintaining vendor contracts and transition plans with a contracts, so it was worth my time,” said E. focus on data governance. This included the Bican, lead technician clinical engineering. setup of business processes and workflows “We are always balancing contracts with in and out of the CMMS to capture the in-house service and are always transitioning data elements needed to properly measure between the two with all our medical equipcontract effectiveness and a department’s ment constantly being moved around the success. U.S. This webinar helped tie some of these E. Gonzales, The webinar was popular with 153 atdetails together,” Field Service Engineer K. biomedical tendees for the live presentation and more Saager said. engineer have viewed a recording of the webinar “My boss invited me to this webinar and online. Attendees gave positive reviews in I accepted. I thought it was well worth my a post-webinar survey and answered the time. I got to see the other side of business questions “Why did you attend today’s webinar? And, was it applications from the business perspective rather than the worth your time?” technician side only,” Clinical Engineer G. Huber said. • “I wanted to hear their approach for contract decisions and how they arrive at that point. Definitely worth the FOR MORE INFORMATION about the Webinar Wednesday series, time, reinforced the need for good data,” said Biomed V. including a calendar of upcoming sessions and recordings of previous Schill-Mason. presentations, visit WebinarWednesday.Live. “VA is transitioning to Nuvolo, so I was interested in hearing how data could be used,” Clinical Engineer C. Mahoney said. THANK YOU TO OUR SPONSORS: “To keep current with trends in the industry and maintain certification CEUs,” said P. Graham, manager, IT clinical engineering. “It provides additional learning. Yes, since attending webinars will keep you updated with the latest trend of technology and also acquiring the continuous professional

“...attending webinars will keep you updated with the latest trend of technology...”

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WE BUILD

IMAGING ENGINEERS At Tri-Imaging Solutions, we strive to live up to our name and be a Solution for our Customers and ultimately, helping to Empower the EngineerTM

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PRODUCTS

Market Report Expect CT X-ray Tube Market Growth STAFF REPORT

CT X-ray tube market study formulated by Market Study Report LLC, presents a detailed analysis of the trends in this business space. This research report also offers information concerning the commercialization of this vertical, market size and revenue estimation of this industry. The CT X-ray tube market was valued at $420 million in 2018 and is projected to reach $570 million in 2025, according to the report. It forecasts a compound annual growth rate (CAGR) of 4.4% during the forecast period. In the study, 2018 was considered as the base year with 2019 to 2025 set as the forecast period to estimate the size of the CT X-ray tube market. According to Research and Markets, the global X-ray tube market was valued at $2.42 billion in 2017 and is expected to reach a value of $3.3 billion by 2023, registering a CAGR of about 5.21% from 2018-2023 (the forecast period). With an increase in medical cases and diagnostic equipment, the demand for X-ray tubes in medical imaging is growing, which is, in turn, driving the market growth, Research and Markets states. â&#x20AC;&#x153;However, the presence of stringent and strict regulations by FDA, across the globe, for manufacturing and designing X-ray tubes have created additional costs for manufacturers, while becoming a barrier for new entrants. These factors are restraining the market growth,â&#x20AC;? Research and Markets reports. According to a Azoth Analytics research report the global medical X-ray tube market is projected to display a subtle growth represented by a CAGR of 3.60% from 2019-2024. Azoth Analytics reports that, over recent years, the WWW.THEICECOMMUNITY.COM

global medical X-ray tube market has been witnessing growth on account of several driving factors including an increase in the global geriatric population and a surge in the incidence of chronic diseases due to sedentary lifestyle and unhealthy eating habits. Moreover, rising medical infrastructure developments with an increase in medical facilities is expected to propel the demand in the medical X-ray tube market. In the Azoth Analytics research report, the market is segmented on the basis of product type as well as application. By product type, the segment of rotatory anode medical X-ray tubes is predicted to hold its dominant position in the market. The report states that North America accounts for the largest regional share, by value in the global medical X-ray tube market in 2018. However, Asia Pacific is predicted to advance at the highest rate. The presence of a vast consumer base, particularly in emerging nations such as China and India, in addition to growing per capita expenditure on health care is likely to drive the regional market. According to MarketsandMarkets, the global diagnostic imaging market is projected to reach $33.5 billion by 2024 from $25.7 billion in 2019, at a CAGR of 5.5% from 2019 to 2024. The growth of this market is primarily driven by the increasing demand for early disease diagnosis and widening scope of clinical applications, rapidly growing geriatric population and the subsequent increase in the prevalence of associated diseases, technological advancements in diagnostic imaging industry, and increasing investments, funds, and grants by public-private organizations. The projected growth of the global diagnostic imaging market should have an impact on the replacement tube market. Some leaders in the replacement tube landscape include Dunlee, Richardson Electronics, Varex, Ray-Pac and others. â&#x20AC;˘ ICEMAGAZINE

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Product Focus

Replacement Tubes *Disclaimer: Products are listed in no particular order.

DUNLEE

DA200ULTRA CT Replacement Tube This OEM-equivalent, 6.3 MHU CT replacement tube can replace GE CT tubes in the BrightSpeed™*, Discovery™*, Lightspeed™* and Optima™* families. Dunlee used knowledge gained through its long history in tube development to optimize this tube, resulting in excellent quality. In fact, Dunlee is so certain of the tube’s reliability that it provides a 12-month, full warranty. The Dunlee DA200ULTRA replacement tube is manufactured in the USA. *The products listed may be trademarks of the OEM. For the latest information regarding the compatibility of CT tubes and scanners, please refer to our cross-reference guide at dunlee.com

ICEMAGAZINE | MARCH 2020

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2 GE HEALTHCARE Tube Watch

Tube Watch is GE Healthcare’s predictive solution that is designed to remotely monitor and predict tube failures before any disruption occurs. This insight enables proactive part delivery and service to be conducted at a convenient time. In some cases, CT systems can be repaired remotely. Tube Watch delivers peace of mind by converting potential unplanned downtime to planned events which helps to avoid patient and staff disruptions and associated revenue loss. If Tube Watch fails to predict a tube failure, GE provides a full credit of the annual Tube Watch premium as a guarantee.

RAY-PAC

Shimadzu Portable X-ray Tube Replacements Ray-Pac has extended it’s portable X-ray tube replacements product line to include the new Shimadzu single and dual focal spot models used in hospitals, emergency rooms, operating rooms and patient rooms. RayPac’s direct replacements for Shimadzu portable dual and single model with focal spots of 0.7/1.3, 14.5-degree target and 0.7, 14.5-degree target are available to ship today.

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PRODUCTS

RICHARDSON HEALTHCARE ALTA750

The ALTA750 is a form, fit and function replacement for the Toshiba/Canon Medical Systems CXB750D/4A CT tube, also known as the Varex Imaging MCS-7078 tube.* It is certified on OEM platforms from Toshiba Aquilion 4 through the PRIME (first generation). To optimize and increase the life of your ALTA750 tube, Richardson Healthcare includes a heat exchanger and new HV cable kit as a complete tube assembly.** Richardson Healthcare received CE Mark approval for the ALTA750 X-Ray Tube. The CE Mark confirms that the product meets the requirements of the European Medical Device Directive, and signals conformity to patient and user safety and device performance standards in the European Union. * All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of the trademarks is solely for identification purposes, and does not imply any affiliation with or endorsement by the trademark holders.

** All items must be replaced at the time of the installation in order to activate the ALTA750™ tube warranty.

ICEMAGAZINE | MARCH 2020

4 VAREX

GS-5172 and GS-5172B Varex GS-5172 is offered as a CT tube replacement for Philips CT scanners. There are two versions: GS-5172 is designed to replace the CTR2150CEPN in Philips MX-16 CT scanners and GS-5172B is designed to replace the CTR2150 in Philips Brilliance CT Scanners. Both versions are designed to match the original tube in form, fit and function with 200,000 scans second with a 12-month warranty.

ADVANCING THE IMAGING PROFESSIONAL

CT-20-NAM-648 The scientific overlay is not that of the individual pictured and is not from a device of Siemens Healthineers. It was modified for better visualization · 8369 1119

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Learn about our scholarships @ www.cbet.edu

The College of Biomedical Equipment Technology provides nationally recognized and accredited Healthcare Technology Management (HTM) education, training, and career services designed to meet the needs of our students and the high standards of our partners in the healthcare industry. CBET’s certiﬁcate and associate degree online programs include externships and job placement services supported by our international alliance of healthcare providers. Our instructors include AAMI award-winning educators and practitioners with decades of experience in HTM.

BMET Certification

The accelerated 6 month BMET Certiﬁcate Program is a nationally recognized credentialing source for entry-level biomedical equipment technicians. Cost: $5,500.00 Monthly Payments: $150 Interest-Free Duration: 6 Months

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BMET AAS Degree Program

The Associate of Applied Science Degree is an accredited and nationally recognized academic program designed to prepare students for a wide array of technical and managerial positions in healthcare technology management. Cost: $22,500.00 Monthly Payments: $250 Interest-Free Duration: 15 Months

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Leaders Share Tips, Tricks and Workarounds for Building a Successful Imaging Department

PEER

BY MATT SKOUFALOS

hat makes a successful imaging department often turns as much on the technology of the facility in which it’s housed as well as the staff within its walls. Critical to executing the missions of those departments are the people who lead them. Over years of holding positions of responsibility, their experiences comprise a wealth of significant information that can benefit colleagues doing the job in various environments. We asked a few of them to share their knowledge, the better to support others in similar roles. Husband and wife Joe and Sandy Phillips have been working in medical imaging all their professional lives. Joe is the Director of Clinical Services–Diagnostics at Connecticut Children’s Hospital, and Sandy is the Director of Radiology at Hartford Hospital. (Like the

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couple, both facilities are interconnected; the Phillipses even get to share a commute.) In more than a half-century of combined experience, they’ve gleaned a lot from working their way up the ranks, from technology to leadership roles. Along the way, Sandy Phillips said, she’s focused on a three-part credo: trust, transparency and teamwork. “As a manager, I really value those,” she said. “To motivate my team, I have to be transparent with them in order to earn their trust. That helps you build a solid foundation.” Transparency to Sandy is anchored in the ability to remain in the moment when speaking with colleagues: no cellphone usage, no cross-talking and listening actively during meetings. To cut back on distractions, she sets achievable boundaries, like prioritizing and organizing her workload. She tries to address email twice a day, once in the morning and again in the afternoon. “Otherwise, I think people get addicted to their email all day, and it gets hard to get any other work completed,” Sandy said. Hand in glove with making herself availADVANCING THE IMAGING PROFESSIONAL

PEER TO PEER “ The most important skill set is your own ability to be astute and learn from the mistakes of others.” Joe Phillips, director of clinical services - diagnostics at Connecticut Children’s Hospital

able and present for her peers is the value she places on follow-through. When asked for help or tasked with the responsibility of addressing issues that need to be looked into, there’s no greater priority for her than seeing things through once she’s committed to handling them. “Whether it’s a yes, a no, or a maybe, make sure you get back to your staff. Follow-up is extremely important,” Sandy said. “That’s the same for patient care: patients should not wait more than 15 minutes for delays in care. Communication is key.” To Sandy, it’s equally important to be sure staff are acknowledged for excellence. If a colleague’s name comes up in patient satisfaction surveys, she makes a habit of celebrating the good stuff instead of only focusing on things that need improvement. When it comes to rounding, “I don’t just round for patients,” she said; “I make sure that I’m rounding with my staff so I can keep a pulse check on my department. I find that in the morning, just going around to staff and touching base is huge.” When people go the extra mile – picking up an additional shift, staying late to support a peer – Sandy also believes that small notes and thank-you cards cement personal connections that can yield a big difference for their outlook. That’s especially true in a field where employees hold onto demanding roles for years. “I try to have a 10-and-five rule,” she said. “I have 244 employees, so it’s really hard for me to know everybody’s name, but I find that at 10 feet I smile, and at five feet, I always say hello. I always try really, really hard to get to know everybody’s name so I can say hi when they go by.” Given the intensity and pace of the job, Sandy said she always tries to incorporate opportunities for her WWW.THEICECOMMUNITY.COM

colleagues to de-stress, whether taking someone for a coffee break or setting up a mini putting session in the hallway. Ten- to fifteen-minute windows can be enough to help people refocus, she said. “I find that managers will go home and they’re constantly on their phone, doing emails, getting calls, and I tell them, ‘You need to learn that between your family and work life, there is a line,” Sandy said. “You need to be able to decompress. The work’s always going to be there; it’s like laundry.” The necessity of being “fair, consistent and standardized” with employees is another of Sandy’s leadership tenets, especially given the number who report to her. Critically, she also said that remembering her own background in imaging has informed her behavior in leadership roles. “You never forget where you came from,” she said. “I always still think of myself as a technologist, and I never forget what it’s like to be in those shoes and how hard the staff works.” Joe Phillips, who serves a key leadership role at Connecticut Children’s Hospital, said that to be a successful leader requires learning the technical aspects of management. As he’s risen in the ranks, Joe said he’s learned that the role of a leader is to “have a vision and allow your team to make mistakes and do the work.” “My job is to break down barriers,” he said. “All of us have gone to school to develop, but I don’t think that’s what gives you the tips and tricks to be a great manager. The most important skill set is your own ability to be astute and learn from the mistakes of others.” “Leaders often forget that the best answers to solving the problems are not in their brains and their desks,” Joe said. “It’s on the floor by the people who do the work. You have to involve your team in the thought process of

trying to solve your problems. You’d be amazed how many people make that mistake and then you’re back to ground zero because you have to rework the same problem.” Another critical aspect of leadership involves focusing on the issues to be resolved and not the people involved. Failure to do so can destroy relationships, Joe warned. He also advised that an engaged staff is what contributes to achieving the highest levels of customer satisfaction; therefore, supporting staff to connect with patients and with their work will yield dividends. “When you go to school to be an X-ray tech, they don’t really spend a lot of time on whether you asked the patient if they’ve had a comfortable experience, or if their privacy is being met,” he said. “How do you know that I’m a good X-ray tech? The tech will say, ‘Well, I’m certified.’ The only thing you can distinguish yourself with is that you’re competent.” Given the emphasis on patient experience, however, failing to make critical connections with the people being cared for means a huge opportunity missed, Joe said – particularly in the pediatric environment in which he operates. “The only thing patients can base their opinion or experience on is how you treat them,” he said. “It seems rudimentary, but you’d be amazed how people get jaded on the technical aspects. And in our world with kids, we’re not only managing the child’s experience, but the family’s experience. Making sure a family is treated to the best of your ability should be in your DNA.” “It boils down to hiring for personalities that are going to help you achieve what you want to achieve,” he said. “Where possible, you have to make your culture focused on these things, and make it OK to talk about them.” ICEMAGAZINE

PEER TO PEER

The migration of health care from a transactional, fee-for-service arrangement to accountable care systems that turn on larger efficiencies has also affected how work is approached in the imaging suite, Joe said. Given the institutional focus on how many covered lives an organization can cover, resources that support radiology are also divided among a broader pool of needs. Benchmarking forces facilities to measure themselves against other, similar organizations. Many variables influence the delivery of patient care, particularly the pace of change within a health system. Instead of being fodder for criticism, Joe said those broader metrics can actually help imaging departments advocate for additional resources as they need them. “Organizations benchmark their efficiencies against those of other hospitals, and it’ll tell us if we have opportunities to grow in other arenas,” he said. “That’s a way to see if you can expand your practice and add more staff or not.” “Most progressive institutions are looking to find a few minutes over the course of the day so they have time for one more patient,” Joe said. “As a leader, it’s important to understand your business at a tactical level, and find small areas for continuous quality improvement. There’s always another lever that you can pull to save a few seconds there, a few minutes here. Everything nowadays is about quality, safety and efficiency because it’s all tied to revenue at the end of the day. If your revenue doesn’t cover the needs of the organization and allow room to grow, you’re going the wrong way.” Jenilynn Porter, director of imaging services at UPMC Shadyside/Hillman in Pittsburgh, Pennsylvania, said collaboration is an essential aspect of leadership in the imaging suite, both among 40

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people in the department and those outside of it. She especially pointed out the need to have one-on-one meetings with professionals in hospital nursing units to help coordinate patient services.

“I wish people would understand the limits and what goes on in radiology,” Porter said. “You can get an X-ray within 10 minutes and a read within 20 minutes. But sometimes people will say, ‘I need this patient squeezed in for

“ We’ve done different tactics to make sure that the appropriate staff is involved, but communication is the biggest challenge.” Jennilynn Porter, director of imaging services at UPMC Shadyside/Hillman in Pittsburgh, Pennsylvania

“Sometimes we have a lot of challenges where patients have no idea when they’re getting their tests done,” she said. “We have to get it done in a timely manner, especially when they’re going to be discharged. We get staff input to make sure that the process is good for everybody.” Service coordination is critical in the high-volume environment at UPMC Shadyside/Hillman, where staffing presents another significant challenge. Teams organizing as one help to ensure that all shifts are covered as necessary, or that changes are made to the schedule otherwise. “We’ve done different tactics to make sure that the appropriate staff is involved,” Porter said, “but communication is the biggest challenge. Everybody’s so busy that it’s hard to take somebody away from patient care. We want to go in, one on one, and make sure that we’re able to implement [dialogue] for our patient care.” Another piece of that communication involves letting employees in other departments understand how yours works, Porter said. She’s dealt with requests for service that sometimes can’t be met simply for logical reasons. Given the size of her imaging department and the variety of modalities it manages, that can be a challenge to explain.

an MRI,’ and I can’t squeeze them in because that takes 45 minutes.” Before she became the director of professional practice for the American Society of Radiologic Technologists (ASRT), Becky Apodaca spent years in the medical imaging field as a registered radiographer and certified radiology administrator. On the strength of that experience, she recommends that good leaders focus on identifying victories as much as challenges, and celebrating the successes as they come. “When you leave for the day, what bothers you?” Apodaca said. “But also, when you leave for the day, what’s a really good thing that happened? Identify the wins and the challenges, and then share with others, as they may likely benefit from that sharing. In imaging, when we focused on wins, challenges, frustrations and victories as a way to identify projects, we opened our door for any other department to come in and take a look at the results.” Sharing what worked as well as what didn’t helped her departments avoid getting stuck in unproductive habits or taking unnecessary steps, and removed the stigma around trying something different – which is necessary in the ever-changing field of health care, Apodaca said. “It’s just being open to looking at how you do things, sharing that, and ADVANCING THE IMAGING PROFESSIONAL

then asking ‘Why?’ five times,” she said. “Don’t be afraid to have those crucial conversations that help you get better. Be open to new methods of doing things, and crossing department lines, because it’s so easy to get siloed. If you share your victories and concerns, the next guy may be having them too.” Conversations and communication can be productive – until they aren’t, Apodaca said. She cautioned that the best leaders give important issues their due, but they also don’t hold unnecessary meetings just to have them. “If you can share the information visually, or have a five-minute conversation as opposed to a scheduled staff meeting, that is fine,” she said. “One of my big A-ha! moments came when I was a director. I overheard one of the chief technologists say to a staff technologist, ‘If it’s OK with you, can we connect about this later? I want to be able to give you my full attention.’ ” “She wasn’t brushing the staff technologist off, she made sure it could wait, and she closed the loop later,” WWW.THEICECOMMUNITY.COM

Apodaca said. “It was such a respectful interchange.” Finally, Apodaca pointed out the value in taking time to make sure that things are done correctly. The old adage that “There’s never time to do it right, but there’s always time to do it twice,” underscores the resources sunk into course-correcting after a mistake. When things aren’t relatively consistent, quality can be affected, and that goes for staff as well, she said. Relationships can be preserved by good behavior and attention to interpersonal perspectives. “Growing relationships is a big deal,” Apodaca said. “Be respectful, break down the silos when you can; as these things can impact the caliber of care that one is able to provide for the patient. Be open to improvement. Welcome when concerns are shared with you, because you can’t make something better if you are unaware.” “Patients come to you at perhaps their most vulnerable point, and need their caregivers to be at their best,” she adds. •

“ Don’t be afraid to have those crucial conversations that help you get better. Be open to new methods of doing things, and crossing department lines, because it’s so easy to get siloed. If you share your victories and concerns, the next guy may be having them too.” Becky Apodaca, director of professional practice for the American Society of Radiologic Technologists

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INSIGHTS

RAD HR BY KELLY PRAY

MANAGEMENT: START WITH YOURSELF FIRST B urnout continues to permeate workplace environments. Across industries, over 50% of U.S. office workers say they are stressed at work on a daily basis – and that number is only increasing. In fact, the World Health Organization has declared burnout an “occupational phenomenon,” predicting it will become a global pandemic within the next 10 years. So, how can you as a leader best prepare staff for what seems to be inevitable? By starting with yourself first.

Burnout can exist when staff feel overworked, underappreciated and/or under-resourced. Signs of workplace burnout include exhaustion, low morale, anxiety, stress and lack of personal effectiveness. You may be feeling the effects of one or more of these signs right now – and research shows that more likely than not staff members are experiencing it too. It’s difficult to provide the necessary and appropriate support to those who are experiencing varying levels of 44

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burnout. It may seem near impossible when hoping to manage this through your own burnout as well. If you’re finding yourself overtired or disconnected – for the sake of both your health and your employees, it’s time to put yourself first. This may seem counterintuitive to those of us who aspire to be servant leaders, who put the needs of their staff before their own. It is important to understand that you can’t help your employees if you can’t first help yourself. When you fly on an airplane, the safety demonstration always instructs adults to put their oxygen mask on first before helping others. This is to best ensure the overall survival of everyone. Similarly, it is your imperative as a leader to best ensure the overall success of your organization. Not only will you leverage your abilities to best support your team, but you will set the example that personal health and well-being come first. So, where do you start? A low hanging fruit to putting your personal health first is to get enough sleep. Countless studies have shown the efficacy a good night’s sleep can have on one’s emoADVANCING THE IMAGING PROFESSIONAL

tional, physical and mental well-being. While certain constraints at work may feel beyond your control, your sleep schedule should not be one of them. Reframe the thought that rest and recovery equates to laziness and low work ethic. You want to be your most productive self, exhibiting optimal capacity for your leadership. Your most productive self is going to operate when you are at 100%. Additionally, you don’t need to face burnout alone. If you are struggling to find ways to combat burnout, invite your employees to participate in finding a solution that works best for the team. Engage with them in thought partnership to best get through tough times together. This will hopefully allow for options to successfully start re-engaging your teams and yourself. In partnering with your staff, reground yourselves in why you are putting in the work in the first place. Remember the Golden Circle from January’s article? Losing sight of the bigger picture can cause demotivation, especially to those who are at or above capacity. As a leader, remind yourself and your team the greater purpose to the work WWW.THEICECOMMUNITY.COM

you are putting in to highlight the significance of your combined efforts. In addition to engaging your staff, make sure your leader is aware of your workplace burnout. Communicate the consequences of burnout and, if possible, demonstrate the return on investment of allowing you to recover to a more optimal operating capacity. This may open the door for your leader to provide support and resources to you as well as your team. Burnout isn’t a choice, and it isn’t something to be belittled in the workplace environment. Burnout can feel overwhelming and, at times, like a failure. Anyone is susceptible to workplace burnout- regardless of expertise. Recognize the signs, press pause and put yourself first. •

Over 50% of U.S. office workers say they are stressed at work on a daily basis.

KELLY PRAY is the enterprise change management lead at Children’s Hospital Los Angeles.

REFERENCE https://www.shrm.org/resourcesandtools/hrtopics/employee-relations/pages/workplaceburnout-a-medical-condition.aspx.

ICEMAGAZINE

INSIGHTS

DIRECTOR’S CUT BY MARIO PISTILLI

WISDOM LEADING T

It is the leader’s job to interpret situations and provide context for their teams.

ICEMAGAZINE | MARCH 2020

here is a plethora of leadership theories and books on leadership out there. Most of you have probably heard of servant leadership, transformational leadership, adaptive leadership and strength-based leadership. I would like to introduce you to another, wisdom leading as introduced by Foster W. Mobley, Ed.D., in his book, “Leadersh*t: Rethinking the True Path to Great Leading.” I have had the honor and privilege of working directly with Mobley and his team at FMG Leading over the past year and have really started to change my focus as a leader. Wisdom leading posits that great leading “is less about what you do, and more about who you are.” The purest form of leadership to me is when people follow the leader because they want to, not because they feel they need to in promise of some reward or in avoidance of some negative consequence. In wisdom leading, the leader is very clear on what they believe in and lives that belief every day. One of my core beliefs is that the leader should be what I call “the chief believer” in whatever it is that you expect your team to buy in to. For me, that translates into one of my goals that every patient, regardless of their circumstance, is deserving of the very best care possible and that everything we do or consider doing is always rooted first in what serves the best interest of the patient. I try

to live this every day and role model this in every interaction. I preach this message at every opportunity. I never tolerate any other course and my team knows that they can expect this consistency from me. Leading then is “about how you show up.” Another trait of wisdom leading is that the leader goes first. The leader is the first person to take risks and test the waters of uncertainty. The leader is willing to take calculated gambles in support of who they are. The leader also is willing to take responsibility for their teams and ownership of any failures. A leader practicing wisdom leading defines meaning for their team and creates hope. It is the leader’s job to interpret situations and provide context for their teams. For example, most institutions have a strategic plan. Have you as a leader provided meaning and context to your team so that they understand how the strategic plan contributes to the organization’s mission and exactly what their role in it is? It is the leader who should provide that meaning into why we do what we do and what you expect the team to do to get there. One of the hardest concepts of wisdom leading for me has been the idea that a leader takes care of themselves first so that they can be better for their team. Just as the airline safety instructions tell you to place your own oxygen mask on first so that you can help others, the leader develops their own unique talents, passions and skills so that they are better equipped to share those with their team. This seems ADVANCING THE IMAGING PROFESSIONAL

contrary to many of us as health care leaders because it is an important tenet for us to take care of others, that is why most of us entered this profession in the first place. These two concepts do not have to be at odds. What I am saying is that you can most effectively help others when you first take care of yourself. This means making time for your own development and exercise to nourish your body and mind. Also, not neglecting the relationships in your life especially your family and friends. Find whatever those things are that nourish your being and spend quality focused time on those. Steven Covey, in his book “The 7 Habits of Highly Effective People” refers to this concept as “sharpening the saw.” If you, the saw, are not kept honed and sharpened you can not be an effective tool in the shaping and molding of others. This should not be a source of guilt for the leader, but a source of pride that they are devoting time for self-improvement and self-fulfillment so that they can be effective and impactful leaders. Mobley captures the concept in this phrase, “leading means building capacity in yourself and others to create breakthrough results.” Mobley uses the allegory of picturing your life in terms of a stream. In this stream are stones of various sizes from pebbles to boulders. These stones represent all of the obWWW.THEICECOMMUNITY.COM

stacles that prevent the waters of our stream from flowing freely. The leader challenges themselves to remove those obstacles from their stream and asks themselves, “What would be made possible if this stone was removed?” The most impactful leaders keep sight of the stones in their streams and actively work to remove these obstacles for themselves and others. Some of these stones may be deeply rooted in the ground and require great effort to move, but the bigger and deeper rooted the rock the larger the rewards once removed. So, I challenge you to reflect on what is blocking your stream and what would be made possible for yourself or others if it was removed. My journey in practicing wisdom leadership has been difficult but rewarding. I am sure it will be a lifelong pursuit to fully clear my stream. I highly recommend, “Leadersh*t, Rethinking the True Path to Great Leading” which is packed with many more valuable concepts and tools for self-reflection. • MARIO PISTILLI, CRA, MBA, FACHE, FAHRA, is administrative director for imaging and imaging research at Children’s Hospital Los Angeles. He is an active member and volunteers time for ACHE and HFMA organizations. He is currently serving on the AHRA national Board of Directors. He can be contacted at mpistiili@chla.usc.edu

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INSIGHTS

BETTY OR A PACS/IT BY MARK WATTS

CHATBOT?

t a conference table in a mid-sized west Texas hospital I sit down with the scheduling team. I have been working here less than a full month. “Mark, we have seen a sharp increase in patients rescheduled from your department.” “Why?” I ask. They reply “Lack of patient prep for the exam, not NPO, no full bladder, not clean colon are some of the reasons your technologists’ give.“ Well, who gives the pre-exam prep information? “Betty, she was on light duty as an RN due to back surgery so we assigned this work to her, she was great at it.” “OK,” I say. “Betty is better now and she went back to her regular job,” they say. This important step in radiology workflow was outsourced for months and then abruptly ended. A simple task being skipped doubled our rate of rescheduled exams. How do I get a dependable solution for this problem, increase patient satisfaction and control my costs? Could I automate this process of pre-exams prep instructions? Could Betty be replaced by a chatbot? “The advance of technology is based on making it fit in so that you don’t really even notice it, so it’s part of everyday life,” said Bill Gates while referring to the power of technology. This stands utterly accurate for advancements such as artificial intelligence-enabled chatbots, which foreshadow the future of technological advancements to come. Artificial intelligence (AI), also referred to as machine learning or machine intelligence, is an intricate innovation smoothly gearing up to revolutionize our lives forever. The stimulation of human intelligence using contemporary computers that imitates cognitive functions is changing problem-solving. And, with cutting-edge disciplines such as AI and chatbots, researchers are leading the way to a 50

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great transformation. Apart from all other ways of demonstrating an impact, the role of AI in health care is particularly groundbreaking.

INTRODUCTION OF AI IN HEALTH CARE Recently, the discussion has moved to a point where AI doctors replacing general physicians in the future is no longer startling. Even though the switch may not happen in the near future, AI in health care is definitely going to be assisting general physicians to make an evolved diagnosis. There will soon be a time when the dependency on the human mind in the health care industry will decline from its current percentage. So, it is about time we recognize and appreciate the benefits AI chatbots can bring to health care. Super-responsive AI-enabled chatbots are presenting us with an option of a computerized medical professional with human-like conversational skills. It is not just revolutionary; it is a paradigm shift. In the process of understanding the employment of this technology and its implications, we are sketching below a comprehensive study on how AI chatbots are revolutionizing health care.

ROLE OF CHATBOTS AND AI IN HEALTH CARE So, what is a chatbot? And, how exactly, can chatbots and health care be combined to save lives?A chatbot is a type of web-robotic application powered by AI that helps in running automated commands on the Internet. As the name suggests, these Internet bots are primarily used as communication tools and facilitate automated conversation by way of audio or textual messaging. Instead of depending on conversing with an individual, chatbots provide assistance in communicating between two sides with automated scripts. With low doctor-patient ratios all around the world, particularly in under-developed and developing ADVANCING THE IMAGING PROFESSIONAL

nations, chatbots are pitched to play a major role in basic health care. A recent study identified that, on average, a patient spends 60 minutes to reach the right doctor after arriving at a hospital. And, it takes almost 30 minutes to find the correct hospital or clinic. This is in regards to health care. A well-developed and advanced chatbot system can be used to answer any initial concerns and drastically reduce treatment time. Moreover, being mostly a service industry, health care business largely depends on customer satisfaction and the quality of services provided. Let’s understand how AI in health care can improve customer service: • Customer Service/Administration of Patient Engagement: Facilitating continuous interaction with patients, chatbots can drastically increase patient satisfaction and retention. Patients are provided with a tool for constant engagement resolving concerns and building confidence. • Research/Treatment: Research and suggestive treatment are the most crucial areas where chatbots can contribute. Some of the specialties currently involved in AI-powered chatbot research include radiology, health records, imaging and telemedicine. • Primary Care and Emergency First Aid: The main concern, above everything else, is the easy access to incorrect or misleading information, which today is just a click away. Moreover, lack of medical understanding can lead to a critical situation. Therefore, carefully developed and widely tested chatbots serve as a dependable way of providing primary care and emergency first aid. • Answering FAQs: Chatbots are good listeners with aptly programmed responses. So, the concern of not addressing any of the patient’s questions or even giving a halfbaked response is eliminated. Bots can be programmed to address different FAQs related to different medical conditions in a much more responsible way. WWW.THEICECOMMUNITY.COM

• Dispensers of Drug Information: Any medical professional can be missing out on the latest important drug information, which can be extremely crucial for deciding the treatment process. AI-enabled chatbots can be discreet in revealing significant drug information to doctors and work as a virtual junior resident. • Faithful Assistant in the Pocket: Most bots available for the general user are capable of working as a personal medical assistant. These bots can assist in scheduling medical appointments, send health reminders, administer test results and provide medication refill reminders. • Remote Patient Monitoring: Monitoring preoperative and postoperative patients is one of the trickiest parts of the recovery process. Although nothing can match human-like assistance, there are times that chatbots can be better at continued observation. These are some of the most noteworthy aspects of incorporating them in health care. WelTel Incorporated from Vancouver, Canada is doing some innovative work in this space. Dr. Richard Lester and his team are using AI to act as a health care force multiplier allowing four nurses the ability to monitor and service 500 AIDS patients. Keeping them on medication and allowing them to connect in a timely manner to caregivers. Betty and her back are better. I would urge you to investigate the options of AI-driven chatbots as a possible solution for pre-exam instructions and patient engagement. • MARK WATTS has over 20 years as an imaging professional with vast expertise in imaging informatics and IT issues. He has served in many roles in both hospitals and industry as a health care vice president, imaging director and IT consultant. His knowledge and experience in the convergence of IT and imaging has made him a sought after author, speaker and consultant. He has authored a textbook on informatics and was a pioneer in the adoption and development of PACS and VNA technologies.

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INSIGHTS

THE RISE OF DATA AND DECISION-MAKING

ou are likely workAs we look at analytics, we ing on an analytics must begin with a model that or business intelis informed by the outcome of ligence (BI) initiative. the data. Most successful projIt seems like we all are. ects begin with a design phase But how do we think that builds from preferred outabout this data we have comes backward. Knowing how been told is so importyou want to use data critically ant to capture, aggreinforms how you capture, modgate, synthesize, curate el and visualize those data. DEPARTMENT/ and display? When you Analytics and BI have beOPERATIONAL ISSUES come ubiquitous in health care consider the early days of net searches, it wasn’t as the technologies to aggreBY JEF WILLIAMS easy using those early gate, synthesize and report engines that brought limited results have increased. Several years ago, there were very and often required secondary searches few ways to gather disparate data elements and that were inefficient. The rise of Google bind them together (think modality utilization and brought a wave of information to our staffing levels) outside of hiring someone to build fingertips in ways that have changed spreadsheets and perform analysis. Now there are how we access that information. Howa large number of companies that can ingest data ever, the real value of Google was not in from multiple sources using a number of different how much information it could retrieve, formats and automate some level of analysis. This but in how it applies rules of relevance has given us ways to view our organizations and to the searcher. Just having access to their performance like never before. all of the data is almost useless unless Here is where leadership must provide the imit comes to us in a way that is indexed petus for change. Too often the ability to visualize by appropriateness, relevance and pritrends or report on key performance indicators oritization. (KPIs) sits on desktops, in inboxes, simply viewed Historically, much of the data we leverage within health care was limited. In recent years software solutions and platforms have emerged that are designed to retrieve and curate data points across devices, operations, technology, workflow, utilization and experience. But just “turning on” the faucet creates a waterfall of information that can create more problems that solutions. Useful data must be modeled, organized and curated for the user who needs the information. This requires effort in design that happens well before collecting data. 52

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and deleted. This can be due to apathy, mistrust or inertia. Apathy may be a strong word – but there are those who simply don’t care about the data. The move toward evidence-based decision-making is like any other transition in business – there are those who embrace and those who resist change. Some leaders believe their experience, their “gut” or their traditions are suitable for assessing and directing business strategy and management. It goes without saying that this type of leadership is nearly always shortsighted. We must always practice self-awareness to ensure we aren’t demonADVANCING THE IMAGING PROFESSIONAL

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er half is tactically delivering the necessary change to improve whichever KPI is being addressed. Governance does not get enough attention in analytics efforts. That is, providing the authority to both the decision-makers as well as the directors and managers, to implement change. Health care is a slow-moving industry and we must relearn some old habits to embrace agility and dexterity as organizations to overcome deficiencies and achieve better outcomes. We all believe data is important and well-informed leaders make decisions based on facts. But the implementation of technology and methodology also require our involvement. We must consider not only the data nor solely the technology. We must consider our leadership and our organizations that are dependent on action in designing, implementing and interpreting the information. • JEF WILLIAMS, MBA, PMP, CIIP, is a

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strating, supporting or encouraging this kind of behavior in our organizations. Mistrust is a by product of bad input, bad systems or bad methodology. Each of these can be remediated, albeit with some difficulty and specificity. When there is mistrust, there should be red flags that call attention to a fundamental problem that no amount of color coding or system promoting activity can remediate. Mistrust happens when the system’s design and build is not done carefully, when the data that is being ingesting and analyzed is not modeled correctly, or when the outputs and analysis do not accurately reflect the true nature of what is being measured. Leaders must call attention to mistrust as a critical concern in analytics. Without trust, the entire investment of time, resources and capital are wasted in an analytics initiative. Inertia is often driven by organizational structure. Having the right data, valuing that data and identifying how those data inform strategy and execution are barely half the work. The oth-

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Ice editorial board

INTRODUCING

Jef Williams

Meet our next member featured member of the ICE Editorial Board: Jef Williams. Jef is a Managing Partner and Imaging SME at Paragon Consulting Partners LLC. His certifications include Certified Imaging Informatics Professional (CIIP) and Project Management Professional (PMP). He also has a Master of Business Administration. Jef has worked in medical imaging for nearly 20 years. He started with a large IDN filmto-filmless project (first-generation PACS). After successfully completing the project, Jef spent five years at GE Healthcare as part of a large product development project. In 2009, he began consulting and has worked with clients of all types to assist with the design, selection and implementation of medical imaging infrastructure and technology. Jef has also worked with government agencies, large IDNs, physician groups and practices and innovative start-up health care service companies. Jef loves to travel with his wife to places they do not get to visit for work, including internationally. He is also an avid musician and guitar collector. In his free time, Jef is entertaining his adult children, playing with his golden retrievers and playing in his music room.

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For more information, go theicecommunity.com to view some of Jef’s columns.

ICEMAGAZINE

INSIGHTS

CODING/BILLING BY MELODY W. MULAIK

TO 3D OR NOT TO 3D W

hile the 3D procedures codes 76376 and 76377 have existed for a number of years, questions still arise as to their appropriate application. The answer depends upon the modality, whether a code exists that includes 3D by definition and/or if the documentation and medical necessity requirements are met. Letâ&#x20AC;&#x2122;s address the question as to whether or not the 3D codes may be assigned in addition to the base study by modality. Regular diagnostic studies: No. According to CPT Assistant (September 2019) 76376 is only applicable to advanced 3D rendering performed for the imaging modalities included in the code descriptors (CT, MRI, 56

ICEMAGAZINE | MARCH 2020

ultrasound or other tomographic modality). The use of the 3D codes necessitates 3D post-processing for advanced visualization and volumetric assessment derived from 2D tomographic images. Ultrasound: Yes. Code 76376 is used when 3D rendering is performed on the ultrasound console, and 76377 is used when 3D rendering is performed on an independent workstation (e.g., PACS workstation). The 3D rendering code should be reported in addition to the code for the ultrasound exam. The most frequently encountered studies are OB ultrasounds and breast ultrasound utilizing Automated Breast Ultrasound System (ABUS) technology. Mammography: No. Tomosynthesis is sometimes incorrectly referred to as 3D but it is a different technology. There are codes for breast tomosynethesis that should be ADVANCING THE IMAGING PROFESSIONAL

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utilized when performed so no 3D should be assigned for mammography services. CT/CTA: Yes, for regular CT scans. CTA requires and includes 3D angiographic rendering so it would not be appropriate to assign a 3D code in conjunction with a CTA exam. Two-dimensional reconstruction, such as reformatting an axial scan into the coronal plane, is included in the CT scan code and is not separately reportable. However, three-dimensional (3D) rendering can be coded in addition to CT scans and certain other procedures. MR/MRA: Yes. Codes 76376 and 76377 can be used in conjunction with MRI codes when 3D images are created unless 3D is already included in the code definition (e.g., breast MRI). 3D rendering is included in MRA and should not be reported together with the MRA codes. Nuclear Medicine (including PET): No. According to the CPT® manual, 3D rendering should not be reported in conjunction with any nuclear medicine study, including PET. The reason is that nuclear medicine procedures already have postprocessing work included in the value of the code. WWW.THEICECOMMUNITY.COM

If you are allowed to assign a code for 3D post processing services, the code assignment depends upon whether the 3D postprocessing was performed on the scanner workstation (76376) or an independent workstation (76377). If the 3D rendering is performed on the same workstation that processes 2D images, then code 76376 should be assigned. Code 76377 should not be assigned unless the radiology report indicates an independent workstation was used for the postprocessing. In addition to the term “3D,” other terms such a maximum intensity projections (MIPS), shaded surface rendering and volume rendering may also be used to describe 3D postprocessing. Multiplanar reconstruction (MPR) does not qualify as 3D. (See Clinical Examples in Radiology, Fall 2013). Finally, don’t forget that 3D rendering codes require concurrent physician supervision of image postprocessing 3D manipulation of volumetric data set and image rendering. •

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INSIGHTS

EMOTIONAL INTELLIGENCE BY DANIEL BOBINSKI

LEARNING TO SAY “NO” WHEN YOUR PLATE IS FULL

esearch shows that anywhere from 35 to 60 percent of people have difficulty saying “no” to others. Some people struggle with saying no because of behavioral style, others struggle because of how they were parented. Whatever the reason, if you’re feeling overloaded, overbooked, and overwhelmed, it might help to know that there are ways of saying “no” without saying the word, “no.” It’s refreshing for many to realize that we don’t have to be at the end of our rope before it’s OK to say no. Nor must we be belligerent or difficult. Learning to say no is a healthy part of managing our activities to maintain – or regain – a sense of sanity. And many of us learn that by saying no to certain things, we can be more productive and effective.

COGNITIVE LOAD THEORY In my masters and doctoral work, I studied cognitive load theory, which is the amount of mental resources we can use for working memory. In computer parlance, think “RAM,” or Random Access Memory. It’s a good analogy, because just like computers, humans have a limited capacity when it comes to working memory. Essentially, internal cognitive load has to do with A) how we think about things, and 58

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B) how we process them within our minds. External cognitive load has to do with how we mentally juggle things vying for our attention. When we get too much of either on our plates, our “RAM” gets full, which limits our productivity. As you might imagine, it’s the external things vying for our attention that overwhelm us the most. And, with today’s multiple communication channels, it’s easy for our cognitive load to get maxed out. For example, a quick phone call or text message asking for something is easy and makes us more productive, right? Maybe yes, maybe no. I know one administrative assistant whose boss thought nothing of calling or texting her at 10 p.m. so he could get a status update about something he forgot to bring up in a meeting. In essence, he expected his assistant to be available 24/7. Those calls and texts made the boss more productive, but left no time for the assistant’s brain to decompress. Rather than talk with her boss about this violation of boundaries, the assistant began leaving her cellphone home when she went out, which angered the boss and strained their relationship. Obviously, this was clearly a work-life boundary violation on the boss’s part, but it was also an example of an employee who didn’t know how to say no.

WHEN TO SAY “NO” Maybe what you’re experiencing isn’t as ADVANCING THE IMAGING PROFESSIONAL

extreme as what I just described, but maybe it is. Either way, if you’re like most people, your schedule may feel like it’s on the brink of spilling over and you may be experiencing guilt for not keeping up with everything people want you to do. To truly be effective, we need boundaries as well as good cognitive load management. Both of which require learning when and how to say no. But first, we must know why we are saying no. Perhaps the best tool in your self-management tool bag is a personal mission statement. This means taking time to reflect on your values and goals. In other words, what is important to you, and why? Creating a short, easily memoizable statement helps guide your decision making, and that includes recognizing when it’s necessary to say no. Said another way, we should lean toward saying no when something will take us off our intended course, or when the cost outweighs the benefit.

HOW TO SAY “NO” One problem with saying no is it can come across as abrupt, and that’s a common reason people won’t say it. With that in mind, let me share some alternative ways to say “no.” One of my favorite ways to say no without saying the word is, “I’m sorry, that’s not going to work for my schedule.” Why does it work? Because people have a difficult time arguing with your schedule. However, if they still apply pressure for you to say yes, you can always say “I’ll look at it a little closer, but right now I don’t think it’s going to work.” Other phrases include: • “I’m sorry, I can’t commit to that right now.” • “That is really a bad time for me. I have another priority that requires my attention.” • “You know, I’m probably not the best person for that. Have you thought about asking ____?” WWW.THEICECOMMUNITY.COM

• “Please understand that I’m honored, but can’t right now. Thanks for asking.” • “That sounds wonderful, I wish I could make it, but I can’t. Let me know how it works out.” Even the above phrases can be difficult, because most of us want to be helpful. Also, saying no to something can invoke a fear of missing out on a great opportunity. We might also fear burning a bridge. That’s why it’s important to have a personal mission statement.

EXTREME CASES In the past, I’ve coached clients whose bosses have no clue about how much they overload their employees. One technique I’ve suggested is very bold, and can actually backfire, but when clients are on the verge of quitting anyway because they’re so overworked, they’ve used it with success. The technique is to open your Day-Timer or take out your project list, then ask the boss which deadlines he or she thinks you should adjust to make time for the new task. As I said, it’s a bold move, but this technique has been successful in helping a boss see how busy someone is. One key to its success is doing it tactfully! It’s also not a technique that can be used too often. Bottom line, if people keep putting stuff on your plate and you’re getting overwhelmed, staying focused on your goals and familiarizing yourself with a few phrases can help you set boundaries to regain your sanity. • DANIEL BOBINSKI, M.Ed. is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach Daniel through his website, www. MyWorkplaceExcellence.com.

ICEMAGAZINE

“Continual cheerfulness is a sign of wisdom.” – Irish Proverb

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ICEMAGAZINE | MARCH 2020

ADVANCING THE IMAGING PROFESSIONAL

Science Matters

Does evening exercise make sleep worse? Many worry that evening exercise makes their sleep quality worse. A new survey of 23 studies found that moderate exercise in the evening is no problem at all. Sport physiciansâ&#x20AC;&#x2122; official recommendation: At least 150 minutes of moderate exercise each week

SCIENCE Poor sleep MATTERS

Effect on deep sleep phases (important for physical recovery) Healthy sleep Vigorous exercise

Unable to talk while exercising

Moderate exercise

Can talk but not sing*

Light exercise

Person can sing while exercising 4

These test subjects could not recover enough in the hour before going to bed Their pulse was more than 20 beats per minute faster than their resting heart rate

End of exercise (hours before bedtime)

Some evening exercise better than no exercise at all After doing some sport in evening:

21.2% of sleeping time spent in deep sleep

After an evening without exercise:

19.9% of time spent in deep sleep

Source: Institute of Human Movement Sciences and Sport at Swiss Federal Institute of Technology in Zurich; TNS Photos Graphic: Helen Lee McComas, Tribune News Service ÂŠ 2018 TNS

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ICEMAGAZINE

INDEX

ADVERTISER INDEX Ray-PacÂ® Agiliti p. 27

Ampronix, Inc. p. 4

Injector Support and Service p. 63

KEI Medical Imaging p. 25

Ray-Pac p. 3, 57

Richardson Electronics Healthcare p. 13

MarShield p. 25 Siemens Healthineers p. 35

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MedWrench p. 37 Technical Prospects p. 55 Chronos Imaging LLC p. 43

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PM Imaging Management p. 53

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Entech p. 23 Webinar Wednesday p. 48 Rad Rays LLC p. 42 GE Healthcare p. 18

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ADVANCING THE IMAGING PROFESSIONAL

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ICE Magazine - March 2020

Articles inside

ICE Break

Emotional Intelligence Learning to Say “No” When Your Plate is Full

Department/Operational Issues The Rise of Data and Decision-Making

Coding/Billing To 3D or Not to 3D

Director’s Cut Wisdom Leading

PACS/IT Betty or a Chatbot?

Peer to Peer Leaders Share Tips, Tricks and Workarounds for Building a Successful Imaging Department

Rad HR Management: Start With Yourself First

Imaging News A Look at What’s Changing in the Imaging Industry

Product Focus Replacement Tubes

Webinar Wednesday Webinars Address Hot Topics

In Focus Becky Allen, University of Cincinnati

Rising Star Kernesha Weatherly, UAB Medicine

Off the Clock Joe Phillips, Connecticut Children’s Hospital

Market Report Expect CT X-ray Tube Market Growth

Rad Idea Continual Learning