THEICECOMMUNITY.COM
AUGUST 2020 | VOLUME 4 | ISSUE 8
ADVANCING MAGAZINE
IMAGING PROFESSIONALS
Seizing the Moment
Rising Star Jose Montemayor
An Opportunity for Imaging to Embrace Diversity
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FEATURES AMSP MEMBER PROFILE
Medlink is part of one of the world’s largest award-winning manufacturers of digital radiographic panels and provides Viewords the ability to increase its U.S. market share.
DIRECTOR’S CUT
The issues of racism and intolerance are daily struggles that need to be addressed. It is not acceptable to say, well that’s not me, and do nothing.
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SEIZING THE MOMENT: AN OPPORTUNITY FOR IMAGING TO EMBRACE DIVERSITY
Imaging leaders and organizations, like AHRA, are doing their part to foster opportunities to increase the diversity of the diagnostic imaging workforce, from rank-and-file staff to leadership roles.
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ADVANCING THE IMAGING PROFESSIONAL
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AUGUST 2020
IMAGING NEWS
ICE shares news, trends and hot topics from throughout the diagnostic imaging community.
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IN FOCUS
Recent AHRA President Chris Tomlinson, CRA, FAHRA, thinks big and strives for success, but he is not afraid to fail.
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PRODUCT FOCUS
The global AIenabled medical imaging solutions market is anticipated to reach $9.61 billion by 2029.
OFF THE CLOCK
Virtual runners support Tyler’s Hope for a Dystonia Cure in 2020.
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MD Publishing 1015 Tyrone Rd. Ste. 120 Tyrone, GA 30290 Phone: 800-906-3373 Fax: 770-632-9090 Publisher
John M. Krieg john@mdpublishing.com
Vice President
Kristin Leavoy kristin@mdpublishing.com
CONTENTS SPOTLIGHT 10
Rising Star Jose Montemayor, University of California, San Francisco (UCSF) Medical Center’s Parnassus campus
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In Focus Chris Tomlinson, Jefferson Health
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Rad Idea Strategic Calendar Blocks
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Off the Clock Tyler’s Virtual Run for Hope
John Wallace Erin Register
NEWS
Art Department
Editorial
Jonathan Riley Karlee Gower Amanda Purser
Account Executives Jayme McKelvey Megan Cabot
Editorial Board
Laurie Schachtner Nicole T. Walton-Trujillo Mario Pistilli Jef Williams Christopher Nowak
Circulation
Lisa Lisle Jennifer Godwin
Digital Department Cindy Galindo Kennedy Krieg
Accounting Diane Costea
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Imaging News A Look at What’s Changing in the Imaging Industry
26
Webinar Wednesday Sessions Benefit Health Care Professionals
PRODUCTS 29
Market Report Report: AI-Enabled Medical Imaging Solutions Market to Reach $9.61 Billion
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Product Focus AI-Enabled Medical Imaging Solutions
INSIGHTS 38
Coding/Billing Time to Re-evaluate your E/M Options
40
Department/Operational Issues Leadership in Transition
42
Director’s Cut Workplace Diversity: What Can You Do?
44
Banner Imaging Marketing Before and After COVID-19
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Rad HR Trust starts with being trustworthy
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PACS/IT Black Box vs. Usefulness: Would you use something if you don’t know how it works?
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Emotional Intelligence Why You’re A Bad Boss
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AMSP Member Directory
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ICE Break
ICE Magazine (Vol. 4, Issue #8) August 2020 is published by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: Send address changes to ICE Magazine at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2020
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AMSP Member Profile Medlink Imaging Index
ADVANCING THE IMAGING PROFESSIONAL
WORKING AT THE SPEED OF LIFE H
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SPOTLIGHT
RISING
STAR
JOSE MONTEMAYOR
BY ERIN REGISTER
J
ose Montemayor is a former graphic designer from San Francisco, California. After 15 years, he began to burn out in the graphic design industry and was not sure what was next for him. “I just knew whatever I decided to pursue, I thought it would be great if I could be in a situation where I could help people,” said Montemayor. He received an associate degree in science in diagnostic medical imaging at the City College of San Francisco. Today, he is a radiologic technologist at the University of California, San Francisco (UCSF) Medical Center’s Parnassus campus. Montemayor was nominated to be featured as a Rising Star by UCSF Medical Center Principal Radiologic Technologist Supervisor David Poon, who said Montemayor has “already made a significant impact in our department addressing the needs of COVID-19.” ICE magazine learned more about Montemayor and his career in a question-and-answer interview.
Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: A friend of mine suggested X-ray. After doing some research into the field, I thought this might just be what I was looking for. It’s a huge risk to change your life and go back to school for something you may or may not end up enjoying as a career. As I progressed through taking all of my pre-reqs, getting into an X-ray program, taking classes and going through clinical rotations, I found that I really enjoyed everything about radiography. 10
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Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: I like the variety of what I do. I rotate to different parts of the hospital each day, so it’s never boring. I can be in the OR one day, the ER the next and portables after that. I feel like I’m always able to keep my skills up. I also really enjoy working with patients. It makes me feel good to know that I can have a part in helping someone out each day. This is truly a fulfilling career for me.
Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: While the process of taking an X-ray has fundamentally remained the same – exposing a body part with photons onto a treated plate – the equipment used to do this has evolved tremendously, well beyond anything Röntgen could’ve ever imagined! I like being able to use the latest and greatest tech at our disposal. I’m sure at some point in the future we’ll be taking X-ray from an app on our phones!
Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN THE FIELD THUS FAR? A: For me, just being able to successfully switch careers and finding something that I love to do is huge. Not everybody can say they love their jobs, but I’m in a great place, and I work with a group of wonderful, supportive people.
Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS? A: I feel like there is so much I can learn just being in diagnostic X-ray. I see myself continuing to learn and improve my skills. Maybe further down the line, I might consider MRI, but that will be closer to when I retire! • ADVANCING THE IMAGING PROFESSIONAL
Jose Montemayor pictured with his family.
FUN FACTS Favorite Hobby: Music, going to shows and playing my vinyl records
Favorite Show to Binge: “Game of Thrones” Favorite Vacation Spot: Paris One Thing on Your Bucket List: Skydiving - I want to conquer my fear of heights.
Any Secret Skills? I like to make funny cartoon voices. Our two-year-old loves it when Daddy does his silly voices.
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ICEMAGAZINE
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SPOTLIGHT
IN FOCUS CHRIS TOMLINSON
BY JOHN WALLACE
D
iversity is more than a hot topic for 2019-2020 AHRA President Chris Tomlinson, CRA, FAHRA, who is also enterprise vice president, radiology, clinical lab and pathology, emergency and hospital medicine service lines at Jefferson Health in Philadelphia.
Chris Tomlinson served as the 2019-2020 AHRA President.
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“I chose diversity and inclusion as my leadership platform for my presidency last summer,” Tomlinson reflects. “We noticed there wasn’t the same ratio of diverse leaders in the association as well as leadership positions in the industry versus our technical ranks which is the comparative ratio we look for.” He helped spearhead the work AHRA undertook to understand the issue within the association and the industry. “We had a number of talks on this at the annual meeting culminating in a keynote from one of the experts on unconscious bias, Yassmin Abdel-Magied, as well as a report out from our Diversity and Inclusion Task Force,” Tomlinson shares. Amid the COVID-19 pandemic, AHRA has had challenges to overcome in 2020. “This has been a difficult year for the AHRA as we were not able to deliver content through one of our channels; in-person
meetings,” Tomlinson says. “We did lean into our digital delivery models and I am proud to say that our resources were used extensively through the COVID-19 crisis; we saw some of the highest utilization rates ever for the AHRA’s COVID resources.” Addressing challenging topics is nothing new for Tomlinson. He thinks big and strives for success, but he is not afraid to fail. When asked to describe how he approaches leadership, Tomlinson says, “I value new ideas and risk taking to implement innovative concepts. I encourage my team to fail as you are not being bold if you never fail. I encourage my team to do the right thing and use their moral compass to guide them.” His leadership style is a direct reflection of the leaders who provided guidance and advice to him through the years. “My mentors taught me to be bold and take professional risks in order to grow; that you will learn the most when you are uncomfortable and faced with a project you don’t have background on and need to figure out the path to success,” he shares. “One of my favorite management authors is Russell Ackoff who taught systems and organization theory which I think is largely underappreciated in the field. I had the honor to meet him before he passed.” Tomlinson is also honored to serve others as they navigate their careers. ADVANCING THE IMAGING PROFESSIONAL
CHRIS TOMLINSON
Enterprise VP, Radiology, Lab & Pathology and ED/Hospital Medicine Jefferson Health What is the last book you read? Or, what book are you reading currently? “The Elephant Whisperer” Favorite movie? “Field of Dreams” What is something most of your coworkers don’t know about you? My favorite pet is a rabbit. I played rugby in college.
“I am a mentor to a number of folks in the imaging industry. I think there is no greater honor than to help someone develop and meet their full potential,” he says. A career in health care and imaging became a reality for Tomlinson after a successful stint as a consultant with Arthur Andersen Business Consulting. “I was recruited straight from college to this big five consulting firm’s health care practice area. After only two years, I received a promotion to senior consultant for my continuous demonstration of excellence in project management, client relations and solution development,” according to Tomlinson’s LinkedIn profile. His key projects as a consultant included management of 30-hospital ERP-supply chain installations at national and regional levels. After four years with Arthur Andersen Business Consulting, Tomlinson joined the staff at the Children’s Hospital of Philadelphia (CHOP) as senior client solutions executive, information services department. After five years in that role, Tomlinson became CHOP’s senior director, radiology and executive director, radiology associates. In 2017, Tomlinson moved to his current role as enterprise vice president, radiology, clinical lab and pathology, emergency and hospital medicine service lines at Jefferson Health. “My job allows me to help design a large health system and care delivery model made up of a number of WWW.THEICECOMMUNITY.COM
What is one thing you do every morning to start your day? Drink coffee.
What would your superpower be? Time travel.
Best advice you ever received? “Our ability to solve a problem is limited by our conception of what is feasible,” from Russell Ackoff.
What are your hobbies? Barbecuing (pellet smoker), sports (Notre Dame, Philadelphia Eagles/Phillies/ Sixers/Flyers), music (Sublime, Reel Big Fish; ska)
Who has had the biggest influence on your life? My grandmother.
What is your perfect meal? Brisket with coleslaw and cornbread.
When not at work, Chris Tomlinson enjoys spending time with his wife, Vanessa, and their two sons - Zachary and Shane.
acquisitions of smaller health systems,” Tomlinson explains. “To be able to deliver care at scale is the model for an efficient and cost-effective future where health care costs come under control.” When asked about his greatest professional accomplishment, Tomlinson says “advancing industry concepts around enterprise imaging concepts, VNAs and hospital-practice alignments.” Tomlinson said he expects the COVID-19 pandemic to have a lasting impression on diagnostic imaging and health care delivery in the United States.
“I think there will be more patient interaction and customer intimacy coming out of the COVID crisis. Imaging will need to move toward retail interactions with patients as well as mobile platforms to further increase patient satisfaction and service recovery,” Tomlinson says. “I think consolidation will continue and innovation in modality-based AI and radiologist reading algorithms (radiologist work distribution) will make great strides.” Away from work, Tomlinson and his wife, Vanessa, recently celebrated their 20th wedding anniversary. The couple has two sons, Zachary and Shane, a dog and a pet rabbit. • ICEMAGAZINE
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SPOTLIGHT
Rad idea
BY BRENDA DEBASTIANI
STRATEGIC CALENDAR BLOCKS
B
eing a busy leader sometimes makes it very difficult to “stay on top of everything” and keep a good work-life balance. Conflicting priorities, emails and meetings are my biggest challenges to control. Placing blocks on my calendar to complete required tasks helps me better manage my time. I have 30 minutes blocked daily to make rounds with my team and 30 minutes blocked daily to complete charge audits. I have 8 hours blocked on the first Monday of every month to complete regulatory mandated audits (critical result TAT, etc.), and various other blocks as needed. Yes, there are sometimes projects or unplanned situations that require me to work 12-hour days or work 60-hour weeks, but that is now the anomaly, thanks to me using my calendar strategically. • BRENDA DEBASTIANI, MBA, CRA, FAHRA, RT(R), is Director of Imaging at Mon Health Medical Center. Share your RAD IDEA via an email to editor@mdpublishing.com.
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ADVANCING THE IMAGING PROFESSIONAL
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SPOTLIGHT
Off Clock THE
TYLER’S VIRTUAL RUN FOR HOPE BY MATT SKOUFALOS
T
he novel coronavirus (COVID-19) pandemic put on hold nearly every segment of business and kind of activity in communities the world over. The virus has sickened millions of people and resulted in hundreds of thousands of deaths. COVID-19 also forced those who have been fortunate enough to have been spared the infection to change the way they do most everything, from working to accessing essential services, to interacting with neighbors. Especially for those in the health research space, the pandemic has meant finding ways to continue to perform studies vital to the advancement of 16
ICEMAGAZINE | AUGUST 2020
scientific understanding of a variety of ailments, including the rare neurological condition known as dystonia. Dystonia is a movement disorder that causes involuntary and uncontrolled muscle spasms. It can force those afflicted with the condition into painful and abnormal contortions or movements. Dystonia sufferers are typically capable of normal cognition, sensory awareness and strength, but their speech can be impaired by the chronic disorder. It’s not fatal by itself, but prognoses are widely varied and difficult to anticipate; perhaps most cruelly, one-third of all patients are children. Two of those patients are Tyler and Samantha, the son and daughter of Rick Staab, CEO of The Intermed Group of Alachua, Florida. Both Tyler and Samantha were born with dystonia, and have been affected by
the disorder from young ages. Staab established the nonprofit Tyler’s Hope for a Dystonia Cure when his son was diagnosed with the condition in 2005. In the years since the foundation was created, Tyler’s Hope has generated more than $35 million in funding for dystonia research and led collaboration among researchers at multiple universities around the world. Of every dollar raised by the charity, only 2 cents goes to defraying overhead costs. Rick Staab believes that’s the level of commitment that is required to discover a cure for dystonia in his lifetime – and that of his children. “Finding a cure is like a needle in a haystack, but I’ve always been pretty lucky,” he said. “It could happen tomorrow, but I believe it’s going to happen in my lifetime, and I know it’s going to happen. We do high-risk, high-reward ADVANCING THE IMAGING PROFESSIONAL
Craig and Mercedes Petrus participated in a virtual 5K to support Tyler’s Hope.
research, but most of the time it’s paid dividends.” However, in the course of battling the pandemic, Tyler’s Hope has been forced to cancel its normal charity events. Although the foundation only hosts a few such events annually, they are critical to raising the funds necessary to sustain its operations and keep moving forward with vital research for a dystonia cure. “When you don’t have income, you still have bills,” Staab said. “We have commitments for research grants that we as a board have decided to pay because we have tremendous momentum built up.” “We’ve got to keep going until we cross that finish line,” he said. “We have so much opportunity to cure this relative to most other diseases and disorders that we face.” One of the events to have been cancelled was Tyler’s Run for Hope, a 5K that typically draws participants from throughout the Gainesville, Florida metro area. With participants homebound amid concerns for their safety and limits on social gatherings intended to stifle the spread of COVID-19, the organization switched its plans to an ongoing, freestyle, virtual 5K in which participants can take part from across the country and the world. “Through fiscal diligence, we have enough money to operate for a while and do some creative things virtually,” Staab said. “It’s just not as easy, but we have to do it.” Since May, the virtual Run for Hope has garnered support from 127 participants and their families, having raised nearly $3,500 (and still going) with minimum contributions of $25 apiece. Everyone is invited to complete the 3.1mile event in his or her own way. Some jogged, ran or walked; others rode stationary or road bikes. Some kayaked, and some even completed the distance on stand-up paddleboards. “You name it, people participated in all different ways,” Staab said. After they completed their disWWW.THEICECOMMUNITY.COM
tances, participants then sent along photographs for the charity to publish in solidarity. They were issued a pair of commemorative flip-flops as a thankyou for supporting the charity in these challenging times. For some, the run offered a welcome respite from stayat-home orders and a chance to get some much-needed physical activity. It will continue through August 2020. “It also puts the focus on health during a time when people weren’t really able to get out of the house,” Staab said. “I’ve heard from a number of people that said they were thankful that they’d done it. They had a sense of achievement just for participating.” Importantly to the foundation, the virtual 5K also helped keep the focus on its efforts at a time when people’s attentions and finances are fragmented in any number of ways. Staab hopes it will help continue to keep Tyler’s Hope on their radar amid uncertainty surrounding its largest event, the Hope Weekend, a charity golf tournament held every October. “Things are up in the air,” Staab said, noting that if the event can’t proceed as planned, not only does the charity miss out on its revenues, but the sponsorships and third-party donations that supported it as well. That’s why Tyler’s Hope is asking its regulars to pledge
their contributions to the event months ahead of time to establish a floor for its revenues. “We sell out, usually with the same people coming,” he said. “If we open things back up, all the events are going to happen around the same time. We’re asking them to get it in the budget so if things get crazy again, it’s not an afterthought.” Tyler and Samantha are both working through their conditions with resolve and resilience, and their brother, Luke, remains symptom-free. Staab is hopeful that the grassroots momentum of Tyler’s Hope for a Dystonia Cure will enable every child suffering from the disorder to live a normal life. “When you look at your kids or anybody else’s [with this ailment], you’ve got two choices,” he said. “One: do nothing and feel sorry for yourself, or two: do everything you can to change that.” “We realize we aren’t the only ones hurting in this time, and if we do what we think is right, people will remember us on the other side,” Staab said. “Every day we make even more progress and more promise. The more we do, the faster that speeds up.” • For more information, and to donate, visit TylersHope.org.
The Ocala Turtles Running Group supports Tyler’s Hope.
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NEWS
Imaging News A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY
DETECTION TECHNOLOGY RELEASES X-PANEL 1615 Detection Technology has released the X-Panel 1615 to increase image-guided surgery and dental scan capabilities. The X-Panel 1615 is a CMOS (complementary metal oxide semiconductor) X-ray flat panel detector series that powers stringent medical imaging solutions. It has extra features that are application-fitted for X-ray systems with slender form-factors and state-of-the-art imaging performance. “The X-Panel 1615 enhances both patients’ and health care professionals’ experience and safety, and eases the system design for faster time-to-market and notable total cost savings. The X-Panel 1615 provides X-rays with the largest active area in its class. It realizes high-quality, lowdose imaging at fast scanning speeds. Moreover, all this added value comes with compact, lightweight mechanics for flexibility and ease of use. The X-Panel 1615 can be easily integrated into small system form factors,” says Jyri Tolonen, product manager at medical business unit. For greater digital imaging, the X-Panel 1615 is available in two models that are optimized to application-specific requirements, and offer use-case-driven add-on features. The X-Panel 1615s, which features in-built functions for extra image stability in long fluoroscopic scans, is a perfect fit for mini C-arms systems used in the surgical field. In turn, the X-Panel 1615d comes with the capability to scan full frames at record speeds, up to 66 fps, yet the data transmission is secured through the GigE data interface. This is made possible by a specific scan-to-buffer mode, which offers completely new scanning options for dental cone beam computed tomography (CBCT) and panoramic imaging.
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Both models come with a large active area of 161-by-150 mm. This improves diagnosis by allowing full-sized and detailed images of clinically relevant anatomy to be viewed, minimizes the required scanning time and overall radiation dose, and streamlines workflows during surgical operations and dental treatments. “We have built the solution on a reliable and easily scalable CMOS platform, which allows for uncompromised designs. Our CMOS imaging sensor (CIS) design sets a new golden standard for high scanning speed and superior image quality, even with ultra-low radiation doses. The solution is powered by a 100-micrometer dual range pixel, and a programmable 14-bit ADC for fast, low noise, high-resolution analog-to-digital conversion. We are especially proud of our solution’s Detective Quantum Efficiency (DQE) performance at higher spatial frequencies and ultra-low doses. 70% DQE(0) and over can be easily measured with regular frame doses that need no compromises, even with ultra-low frame doses.” The X-Panel 1615 has an in-built pixel correction functionality that frees up the system resources for actual image construction. For improved image stability, the detector solution has a correlated double sampling (CDS) functionality to remove the effects of undesired offset. •
ADVANCING THE IMAGING PROFESSIONAL
DIGIRAD CELEBRATES AN ANNIVERSARY Digirad, a provider of nuclear imaging and diagnostic expertise, is celebrating the 20th anniversary of the first commercially performed solid-state nuclear medicine image being scanned. The image was captured in June of 2000 using a Digirad 2020tc and ushered in a new era of imaging to cardiology and nuclear medicine. The development of the solid-state camera began years before when Dr. Bill Ashburn, a leader and pioneer in nuclear medicine, read an article in the San Diego Union-Tribune about solid-state technology being developed by San Diego Semiconductor. Ashburn formed what would become Digirad and began the creation of the first solid-state detector head. Throughout the mid to late 1990s Digirad developed the technology, was awarded patents and continued to refine the manufacturing process. The result of this effort was the Digirad 2020tc. This imager was a single head, general-purpose nuclear medi-
cine camera featuring an articulating arm and a unique, rotating SPECTour chair for cardiac SPECT imaging. Digirad received its 510(k) clearance from the Food and Drug Administration in June of 1997 for the 2020tc imager. After continued trials and purchase commitments, the first Digirad 2020tc cameras were delivered in late May of 2000, and the first commercial scans using solid-state in the history of nuclear medicine took place in June. “The 20th anniversary of the first solid-state scan is a significant milestone for nuclear imaging, and we’re proud of the role Digirad has played in the development of this technology,” said Matt Molchan, Digirad CEO. “Our team has built off that legacy, and we feel that the X-ACT+ and Ergo represent the future of solid-state nuclear medicine.” • For more information, visit www.digirad.com.
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NEWS
AMBRA HEALTH OFFERS ACCESS TO MEDICAL IMAGING WITH EPIC INTEGRATIONS Ambra Health has announced further integration with Epic to enable medical imaging in desktop, mobile and web applications. These new capabilities utilize interoperability across platforms and enable patients, physicians and administrators to instantly access medical imaging, when and where they need it. Ambra Health showcased its medical image management solutions via daily online demonstrations and presentations at the Society for Imaging Informatics (SIIM) virtual conference in June. Ambra’s integration with MyChart makes secure, electronic sharing of imaging with patients easier than ever. Whether enabling patients to upload their imaging themselves – ensuring it’s immediately available to physicians for their first exam – or eliminating the need to distribute imaging to them via CDs, Ambra provides a positive experience for providers and patients alike. It’s easier for patients to store their medical images together with their personal health record, and access their imaging anytime to view, download or share their images from MyChart. “Our new integrations with Epic power more complete access. Providing patients with access to the images in their own health record allows them to be the owners of their own health care journeys,” says Ambra Health CEO Morris Panner. Ambra has also developed integrations with other Epic applications to offer image exchange across platforms. •
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CARESTREAM HEALTH TAPS PRESIDENT OF AMERICAS REGION Kristin Dietzler has been appointed president of Carestream Health’s Americas Region, effective immediately. In this role, she will be responsible for leading and growing Carestream’s medical imaging, NDT and dental traditional businesses in the United States, Canada and Latin American markets, and will lead the organization for these geographic areas. Dietzler will report to David C. Westgate, chairman, president and CEO of Carestream Health, and she is a member of the company’s executive leadership team. With a 25-year track record, Dietzler is a recognized leader in the medical device and supplies industry. Most recently, she was general manager and global commercial lead at Medtronic, a medical device company. “Kristin is a teamwork-focused leader with valuable experience managing large sales and marketing teams, and her customer-focused approach to doing business has enabled her to successfully meet aggressive sales targets year over year,” said Westgate. “We welcome Kristin to our leadership team as we look to expand our market presence and build on the trust we have earned with customers based on our radiology expertise.” Prior to her previous role at Medtronic, she served as vice president and general manager where she led the North America team that included a large direct sales organization in addition to indirect channels, national accounts and marketing teams. Dietzler holds a bachelor’s degree in business administration-marketing and management from Saint Mary’s College in Notre Dame, Indiana. She has served on the board of directors for the New Hope Foundation, and has held leadership positions on multiple corporate committees supporting diversity and inclusion. •
ADVANCING THE IMAGING PROFESSIONAL
LJVC LAUNCHES NEW MOBILE ULTRASOUND SERVICE La Jolla Vein Care (LJVC), a leader in vein treatment serving the Southern California community for more than a decade, is actively working to enhance its traditional service offerings to assist new and existing clients amid the unprecedented times brought forth by COVID-19. In a world of social distancing and self-quarantine, many individuals are postponing medical care in a bid to reduce virus exposure levels – a move many health care experts anticipate may lead to worsening symptoms and potentially dangerous complications down the line. To offset the concern that underlying vein diseases will go unchecked to the detriment of patient well-being while also addressing the public desire to avoid unnecessary outings while under shelter-in-place orders; LJVC has deepened its commitment to best-in-class telemedicine offerings and has recently launched a new mobile ultrasound service. “House calls are something many people see as a thing of the past, but with the inactivity of self-quarantine potentially exacerbating underlying vein diseases combined with an overall reluctance to venture out to
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visit a doctor, we knew something needed to be done,” said Dr. Nisha Bunke, MD, FACPh, RPhS, venous disease specialist and vein clinic medical director at LJVC. “We’re proud to roll out these new service offerings to meet patient needs and adapt to changing preferences during this difficult time.” While varicose veins may be unsightly, they are not simply surface-level ailments and an ultrasound exam is required to diagnose the underlying venous diseases that cause these issues. As the first company of its kind to offer direct care to patients in their homes, LJVC has adopted the use of both telemedicine and state-of-the-art mobile ultrasound services via Terason uSmart 3300 NextGen technology. While telemedicine was quickly made available for consultations, pre-procedure assessments and post-procedure follow up appointments, the treatment center is advancing its accessibility initiative through new in-home mobile ultrasound diagnostics conducted by certified technicians – ushering in a new era of vein care.•
ICEMAGAZINE
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NEWS
GE HEALTHCARE LAUNCHES AI SUITE TO DETECT CHEST X-RAY ABNORMALITIES GE Healthcare has introduced its Thoracic Care Suite, a collection of eight artificial intelligence (AI) algorithms from Lunit Insight CXR to help alleviate clinical strain due to COVID-19. The AI suite quickly analyzes chest X-ray findings and flags abnormalities to radiologists for review, including pneumonia, which may be indicative of COVID-19 as well as tuberculosis, lung nodules and other radiological findings. “The launch of our Thoracic Care Suite is a part of GE Healthcare’s larger effort to help ensure clinicians and partners on the front lines have the equipment they need to quickly diagnose and effectively treat COVID-19 patients,” says Kieran Murphy, president and CEO, GE Healthcare. “The pandemic has proven that data, analytics, AI and connectivity will only become more central to delivering care. For GE Healthcare, that means continuing to advance intelligent health and providing innovative technologies. This new offering is the latest example of how X-ray and AI can uphold the highest standard of patient care amidst the most modern of disease threats.” Millions of COVID-19 cases have been confirmed worldwide – overwhelming radiologists, technologists and physicians. As the spread of the virus stabilizes, clinicians continue to need tools to help manage new cases and complications caused by the virus – including pneumonia and acute respiratory distress – which have further increased pressure on radiologists to quickly read chest X-ray exams. With approximately 1.44 billion chest X-ray exams taking place each year, radiologists are overwhelmed, especially as they may be looking for multiple indications per exam. Thoracic Care Suite harnesses the power of AI to help alleviate these pressures by automatically analyzing images for the presence of eight abnormal radiologic findings, including suspected tuberculosis and pneumonia findings, which can be indicative of
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COVID-19. Upon reading the flagged report in picture archiving and communication systems (PACS), radiologists can quickly find the abnormality score for each of the eight possible abnormalities, an image overlay and a written location description to help expedite diagnosis and treatment. “Clinicians are looking for clinically proven methods to help identify symptoms early and determine which patients are at higher risk of complications and need to be actively monitored,” explains Professor Fergus Gleeson, consultant radiologist, professor of radiology at the University of Oxford, and the 2020 president of the European Society of Thoracic Imaging. “AI can help identify these distinctions and enable hospital resources to be targeted to those that will need them whilst in hospital and following discharge.” Thoracic Care Suite provides much needed support to help quickly identify high-risk cases as well as monitor patients showing the progression and regression of mild respiratory symptoms. With 97-99% accuracy rate (Area Under the Curve - AUC), the powerful algorithms behind the AI suite have been trained to detect radiologic findings within seconds. In one study, results showed a 34% reduction in reading time per case. In addition to detecting pneumonia, Thoracic Care Suite also supports tuberculosis, atelectasis, calcification, cardiomegaly, fibrosis, mediastinal widening, lung nodule and pleural effusion detection. Thoracic Care Suite is available to GE Healthcare’s thousands of global fixed, mobile and R&F X-ray customers at point of sale, meaning the technology can more quickly be deployed in market and in hospital without the fear of annual fees – an important consideration if a second wave of COVID-19 were to occur. Furthermore, installation of the technology does not require customers to engage with any enterprise IT projects, helping to lower the barrier for entry in adopting AI. •
ADVANCING THE IMAGING PROFESSIONAL
RADLOGICS EXPANDS LEADERSHIP TEAM RADLogics has announced that Linda McManus has joined the company’s growing executive team as executive vice president and general manager for U.S., Canada and the Americas. With over 25 years of healthcare technology experience including several high-profile roles with Nuance, she will lead RADLogics’ efforts to scale the company’s medical imaging AI platform and applications user base with particular emphasis on the U.S. market. RADLogics recently announced the company’s novel AI-Powered applications supporting the evaluation of COVID-19 patients are available on the Nuance AI Marketplace for Diagnostic Imaging. “We are delighted to have Linda join our executive team during this critical and exciting time for RADLogics,” said Moshe Becker, CEO and co-founder of RADLogics. “In response to the pandemic, we have successfully deployed our AI-powered medical imaging analysis solutions globally, and we have seen significant interest in the U.S. market and throughout the Americas. Building on our long-standing strategic relationship
with Nuance, Linda will work closely with their customer engagement and marketing teams to rapidly expand access to our AI-Powered solutions that are now available to thousands of U.S. clinicians and radiology teams at connected health care facilities through the Nuance AI Marketplace.” “I’m thrilled to join the RADLogics team to help the company chart a path for success in North America and South America,” said McManus. “Not only is there a pressing need for our AI-Powered solutions to help manage and treat symptomatic COVID-19 patients, but AI tools are poised to help meet the high demand on radiology providers and practices due to a dramatic increase of scans that were postponed due to the influx of COVID-19 patients. To help support radiologists as they respond to this new ‘surge,’ our solutions will help alleviate the increased burden on U.S. health care providers and support better outcomes.”.• For more information, visit www.radlogics.com.
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ICEMAGAZINE
23
NEWS
RSNA SHARES INTERNATIONAL COVID-19 DATABASE The Radiological Society of North America (RSNA) and the RSNA COVID-19 AI Task Force has announced the launch of the RSNA International COVID-19 Open Radiology Database (RICORD). RICORD is envisioned as the largest open database of anonymized COVID-19 medical images in the world. More than 200 institutions around the world have expressed interest in participating. The database will include supporting clinical information and expert annotations. It will be freely available to the global research and education communities. “The strong positive reaction speaks to the determination of the global radiology community to contribute its resources and expertise to addressing the pandemic,” said RSNA COVID-19 AI Task Force chair Matthew P. Lungren, M.D., M.P.H., assistant professor of radiology at Stanford University and associate director of the Stanford Center for Artificial Intelligence in Medicine and Imaging. “This effort is the result of countless hours by volunteer task force members and a broad community of radiologist annotators led by our close partners at the Society of Thoracic Radiology.” Shortly after the first news of the pandemic, scientists isolated the virus and quickly sequenced the genome. The sequenced genome was immediately made available to the entire worldwide research community and became the inspiration for RICORD. “This unprecedented spirit of collaboration accelerated clinical testing, therapeutic drug discovery, epidemiologic tracking and vaccine development,” Lungren said. “All of these advancements were completed in weeks to months, rather than the typical pace of months to years, and were catalyzed by this act of open-source scientific collaboration. This is perhaps one of the most dramatic examples of an open source research effort saving countless lives.” RICORD aims to save lives via an open imaging database that can be used by the global research and education communities to gain new insights, apply new tools such as artificial intelligence and deep learning, and accelerate clinical recognition of this novel disease. Radiologists and imaging departments in many countries have already found themselves on the front lines of
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this pandemic, particularly when other testing methods have fallen short or when clinicians seek imaging cues to guide therapy. The RSNA COVID-19 AI Task Force hopes that RICORD will serve as a definitive source for COVID-19 imaging data by combining the contributions and experiences from radiologists around the world who have encountered the disease and gained invaluable clinical imaging experience that may also, if shared with others, save lives. RSNA has also developed data sharing agreements and tools to organize, de-identify and transfer data. The RICORD data collection pathway enables radiology organizations to contribute data to RICORD safely and conveniently. It provides sites with guidance for data sharing and serves to standardize exam parameters, disease annotation terminology and clinical variables across these global efforts. In addition, it connects to sustainable storage infrastructure via the U.S. National Institutes of Health. Substantial datasets have already been contributed to RICORD and are being used for education and research projects, including one that will develop a detailed annotation schema for COVID-19 imaging on CT. RICORD v1.0 is the first annotated core dataset consisting of a subset of chest radiography and CT examinations in DICOM format with expert radiologist annotation labels. Over time, as data are ingested, curated and annotated, the RSNA COVID-19 AI Task Force will continue to update and expand both the volume and variety of data available in RICORD, including adding clinical variables and expanding to other imaging modalities. “More than ever, this pandemic is showing us that we can rally together toward a common purpose,” Lungren said. “Rather than siloing data and pursuing fractured efforts, we can instead choose to collaborate through efforts like RICORD to accelerate an end to this pandemic as a united global imaging community.” Sites interested in learning more or contributing data should visit the RICORD resources page. • For more information, visit RSNA.org/COVID-19.
ADVANCING THE IMAGING PROFESSIONAL
SIEMENS HEALTHINEERS RELOCATES ULTRASOUND HEADQUARTERS
SAMSUNG INTRODUCES LATEST ULTRASOUND SYSTEM FOR ADVANCED DIAGNOSTICS Samsung has announced the immediate availability of the RS85 Prestige, the latest addition to the company’s portfolio of ultrasound systems. The RS85 Prestige was designed for scanning performance and delivers consistent image clarity, depth of penetration and sensitivity to perfusion of blood flow. “Health systems are under increasing pressure to deliver high-quality care, and the RS85 Prestige is a perfect example of a technology that can help meet the high expectations of patients, providers and administrators,” said Dan Monaghan, senior director, ultrasound at NeuroLogica. “The combination of processing speed, leading software and Advanced Intelligence features and performance makes the RS85 Prestige a beneficial addition to a hospital’s radiology suite.” At the core of the image quality of the RS85 Prestige is Crystal Architecture, which combines advanced beamforming (CrystalBeam), sophisticated image processing (CrystalPure) and advanced S-Vue Transducers to produce clear, uniform, high-resolution images. Additional features include: • ShadowHDR: Designed to suppress shadows and enhance the clarity of detailed grayscale images. • TAI, TSI: Provides quantitative tissue attenuation measurement and tissue scatter distribution measurement to assess steatotic liver changes. • LumiFlow: Displays a “3D-like” appearance to 2D color Doppler, enhancing spatial comprehension of blood vessels and aiding in the understanding of vessel boundaries. • MV-Flow: An advanced Doppler technology providing detailed documentation of microvascular perfusion into tissues and organs. • S-Shearwave Imaging: Allows for non-invasive assessment of the stiffness for tissue/lesions in various applications such as breast, liver, MSK and prostate. •
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Siemens Healthineers has announced the establishment of manufacturing operations in the United States at its Issaquah site to supplement its existing overseas manufacturing operations. The company’s recently renovated Issaquah, Washington site will complete high-level assembly of its ultra-premium ACUSON Sequoia ultrasound system with the capability of supporting other products in its portfolio. Effective May 11, the Siemens Medical Solutions USA Inc., Ultrasound business has changed its headquarters/legal manufacturer site from its current location in Mountain View, California to its existing facility located at 22010 S.E. 51st Street, Issaquah, WA, 98029. The Silicon Valley office in Mountain View remains in operation and will become a satellite office to continue leveraging local talent. “Establishing manufacturing capacity will benefit our customers through enhanced responsiveness, additional production flexibility and improved order to customer delivery time,” said Bob Thompson, head of ultrasound, Siemens Healthineers. “Moving the headquarters to Issaquah is an important step in the growth and evolution of our ultrasound business, and an opportunity to expand solutions to deliver precision medicine.” In other news, Siemens Healthineers and Geisinger have established a 10-year value partnership to advance and support elements of Geisinger’s strategic priorities related to continually improving care for their patients, communities and the region. Geisinger is a nationally recognized regional health care system that provides highly effective care delivery. As a leader in transforming delivery of health care, Geisinger has pioneered a high-performance digital care environment. A global pioneer in medical technology, Siemens Healthineers will provide Geisinger access to its latest digital health innovations, diagnostic imaging equipment and on-site staff to support improvements during the life of the agreement. Education and workflow resources will also be available, which will provide Geisinger staff with the ability to efficiently make decisions and continually optimize workflows. Building on a successful history of mutual research collaboration and technology enablement, Siemens Healthineers is dedicated to this long-term alliance producing impactful benefits for the patients who trust Geisinger for their care and the community. •
ICEMAGAZINE
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NEWS
WEBINAR WEDNESDAY STAFF REPORT
SESSIONS BENEFIT HEALTH CARE PROFESSIONALS STAFF REPORT
T
he wildly popular Webinar Wednesday Series continues to provide top-notch education and valuable ACI-approved credits. The most recent sessions included a variety of topics of interest to health care professionals.
CONTACT TRACING ESSENTIALS
“Great blend of practical use of everything included in the webinar.” K. Saager, Field Service Engineer
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The June 17 Sonitor-sponsored presentation “Contact Tracing Essentials: RTLS Provides Critical Data to Help Regain Confidence & Safety by Automating Contact Tracing” was eligible for 1 credit from the ACI. In a world where contact tracing is now essential, Real-Time Location Systems (RTLS) can provide the necessary insights and data needed to seamlessly trace the path and reduce the spread of infection. Teams from Sonitor, Infor Location Based Intelligence (formerly Intelligent InSites) and Sanford Health focused on how RTLS can automate contact tracing and the value it is bringing to Sanford Health to help ensure staff and patient safety. The webinar was popular with 245 registrations and 167 attendees for the live presentation. Attendees shared feedback via a post-webinar survey that included the question “How well did the content that was delivered match what you were promised when you registered?” “I learned more about the technology trends in the industry,” Biomedical Engineer M. Mappes said. “It was as stated, but information started me thinking in a direction that I had
not considered before which was good,” Project Manager M. Coker said. “Interesting to learn about the technology used in contact tracing,” shared Biomedical Engineer O. Canna. “The presenters were well prepared and informative,” said Biomed II J. Clark. “Informative especially now, as it’s really useful to trace those affected by the pandemic,” said Biomedical Engineer E. Gonzales. “Great blend of practical use of everything included in the webinar,” Field Service Engineer K. Saager said. “Good insight on using tracking for COVID/staff tracking,” said F. Yasnowski, CE quality analyst.
MEDICAL DEVICE RISK SCORING The presentation “Don’t Take Risks With Medical Device Risk Scoring” made 255 individual eligible to receive 1 credit from the ACI. The webinar, sponsored by Nuvolo, pushed Webinar Wednesday past the 5,000 mark for registration in 2020! In the webinar, industry experts Matt Baretich, PE, PhD, and Carol Davis-Smith, CCE, FACCE, AAMIF, discussed the need for an industry-wide methodology to accurately determine the risk of medical devices. Determining the risk a medical device poses to patients or staff should it malfunction is not only a regulatory requirement. It can be used to determine work order prioritization, hazard alert response, AEM eligibility and equipment replacement needs. With so many medical equipment management plan decisions being based on this important safety metric, it’s necessary for HTM organizations to use a risk scoring ADVANCING THE IMAGING PROFESSIONAL
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Demtruk
“We are migrating to a new CMMS right now. This will help me assess the way we’ve been assigning risk to devices and decide if we should do something new.” M. Van Donsil, Clinical Engineer
method that accurately determines risk at a point in time as it tracks changes in risk over time. The presenters also discussed the need for organizations to standardize how they determine risk so that there is a universal understanding of the safety implications of classes of devices, and improved ability to audit and benchmark. The winner of a Webinar Wednesday T-shirt given away during the live webinar was Scott Gillett of Baylor, Scott & White in Texas. Another lucky attendee, Kevin Davis of ERD LLC, won a gift card. The 255 attendees provided feedback via a post-webinar survey that included the question, “How will today’s webinar help you improve in your role?” “It was interesting to get a different take on risk scoring,” said M. Hoffman, CBET. “We are migrating to a new CMMS right now. This will help me assess the way we’ve been assigning risk to devices and decide if we should do something new,” Clinical Engineer M. Van Donsil said. “I agree that we need to be constantly evaluating all equipment for current risk assessment levels. Many merits, as mentioned, are still based on a 30-year-old system. We need to rethink potential risk and hazards on not only the older machines, but the newer technology that is constantly changing is very important. The presentation was an eye opener for sure, and I liked the simple format used as an example that we all can use. I personally feel that if we do not step WWW.THEICECOMMUNITY.COM
up that things will eventually bite us,” said B. Hayes, CBET III. “It will provide a good introductory resource to help explain our AEM and risk assessment policies to team members,” said J. Walsh, operations manager. “It is very important that everyone in our industry stays up to date with ever-evolving guidelines, standards and best practices. This webinar covered some key elements regarding risk and AEM programs,” Owner/ BMET K. Davis said. “It gave me a better understanding of the challenges that HTM faces, and the logic that is used regarding risk factors and PM completion rates,” said H. Tucker, principal FES Technical Services. “Puts many things in perspective as related to risk assessing our medical equipment. I always enjoy hearing the visionary perspective of Matt and Carol. They have a way to find gems that I can take back and apply in my position,” Clinical Engineering Director G. Schneider said. •
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Market Report Report: AI-Enabled Medical Imaging Solutions Market to Reach $9.61 Billion STAFF REPORT
A
ccording to a market intelligence report by BIS Research, titled “Global AI-Enabled Medical Imaging Solutions Market – Analysis and Forecast, 2019-2029,” the global AI-enabled medical imaging solutions market was valued at $404.0 million in 2018 and is anticipated to reach $9.61 billion by 2029. The global market is expected to grow at a compound annual growth rate (CAGR) of 30.95% during the forecast period from 2019 to 2029. This growth of the market is aided primarily by the expected launch of novel artificial intelligence (AI) algorithms for use in medical imaging. The plenitude of medical imaging modalities available at present has increased the complexities of clinical decision-making. As a result, the integration of AI in medical imaging has become a crucial requirement. AI has the potential to transfigure the medical imaging industry in terms of accuracy and productivity. In the field of medical imaging, the AI-based solutions are used for various applications including image analysis, detection, diagnosis and decision support, image acquisition, reporting and communication, triage, equipment maintenance, and predictive analysis and risk assessment, among others. Moreover, the novel deep learning algorithms have paved the way for the expansion of the scope of AI application in medical imaging. Owing to these advancements, numerous manufacturers in the market are developing and offering innovative solutions for use in medical imaging. Hence, the market is expected to witness exponential growth over the coming 10 years. WWW.THEICECOMMUNITY.COM
According to Manu Kaushik, lead analyst at BIS Research, “North America is the leading contributor in the global AI-enabled medical imaging solutions market and contributed approximately 53.81% to the global market value in 2018. This region is anticipated to grow at a double digit CAGR during the forecast period 2019-2029 and is expected to dominate the global market in 2029 as well. However, the Asia-Pacific region is projected to grow at the highest CAGR during the forecast period 2019-2029. The Europe region also contributed a significant share of 26.63% to the global market.” The specialty imaging segment is expected to witness a robust CAGR during the forecast period 2019-2029. Moreover, the oncology sub-segment under specialty imaging is also expected to witness an impressive growth during the forecast period 2019-2028. The autonomous software providers are currently the largest shareholders in the global AI-enabled medical imaging solutions market. This market dominance is attributed to the presence of numerous established as well as emerging players. Transparency Market Research (TMR) also predicts market growth. “Artificial intelligence is expected to revolutionize medical imaging in the upcoming years and is increasingly being used in cardiology, pathology, ophthalmology, etc. It is projected that artificial intelligence-based systems will eventually replace physicians in certain medical specializations in the forthcoming years,” according to TMR. “The AI in medical imaging market is expected to grow at a staggering pace during the forecast period, due to a range of factors, including improvement in computing power, learning algorithms, and availability of huge data sets, which are sourced from wearable health monitors and medical devices. Due to these factors, the global AI in medical imaging market is expected to reach a value of $7.4 billion by the end of 2027.” • ICEMAGAZINE
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PRODUCTS
Product Focus AI-Enabled Medical Imaging Solutions QURE.AI qER
Imaging Artificial Intelligence (AI) provider Qure.ai announced its first FDA 510(k) clearance for its head CT scan product qER. The FDA’s decision covers four critical abnormalities identified by Qure.ai’s emergency room product. Now the AI tool can be used to triage radiology scans with intracranial bleeds, mass effect, midline shift and cranial fractures. Two of these capabilities – cranial fractures and midline shift – are exclusive to Qure.ai’s product. This means that the newly cleared qER suite will be able to triage nearly all critical abnormalities visible on routine head CT scans. The qER suite plugs directly into the radiology workflow and prioritizes critical cases on the worklist. This triage drastically reduces the time taken to open critical scans, so those with time-sensitive abnormalities get to be read and reported faster, leading to better patient outcomes. •
*Disclaimer: Products are listed in no particular order.
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ADVANCING THE IMAGING PROFESSIONAL
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AFTER
AIR Recon DL
3 LAUREL BRIDGE
AI Workflow Suite WWW.THEICECOMMUNITY.COM
2
AIR Recon DL is the MR industry’s first 510(k)-cleared, deep learning-based image reconstruction technology that works across all anatomies. This pioneering technology, using a deep learning-based neural network, improves the patient experience through shorter scan times while also increasing diagnostic confidence with better image quality across all anatomies. Now with AIR Recon DL, clinicians and technologists will no longer have to choose between image quality and scan time. AIR Recon DL seamlessly integrates into the clinical workflow to generate AIR Recon DL images in real-time at the operator’s console. •
AI algorithm clinical utility will rely upon their seamless and reliable integration into existing clinical reading workflows. Organizations implementing AI algorithms must consider how they will automatically identify, fetch, anonymize and deliver current and relevant prior studies to AI algorithms, as well as how to reidentify and store algorithm results in a clinical archive. The Laurel Bridge AI Workflow Suite manages these tasks automatically. In addition, it can integrate on-premises and cloud-based AI algorithms into existing clinical workflows, is HIPAA-compliant and supports the DICOM standard. It also enables the delivery of AI algorithm results to a PACS, VNA and EMR. • ICEMAGAZINE
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PRODUCTS
AIDOC
Artificial Intelligence Solutions
5
Aidoc is a leading provider of artificial intelligence solutions that support and enhance the impact of radiologist diagnostic power – helping them with the prioritization of time-sensitive, and potentially life-threatening cases and improving quality of care. The company has four FDA clearances, six CE marked solutions (for flagging and prioritizing ICH, C-spine fractures, vessel occlusion and pulmonary embolism) and FDA permission was granted for the detection of findings associated with COVID-19. Aidoc has commercially deployed its solutions at a mix of hospitals, health networks and radiology groups including Montefiore Nyack Hospital, LifeBridge Health, LucidHealth, Yale New Haven, Cedars-Sinai, University of Rochester, Christiana Health in the U.S. Additionally, Aidoc has also partnered with the American College of Radiology Data Science Institute, the University of Rochester Medicine and Nuance Healthcare for an industry-first AI validation initiative aimed at showing the usability of AI in clinical practice. •
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SIEMENS HEALTHINEERS
AIDAN Artificial Intelligence Technologies Siemens Healthineers offers AIDAN artificial intelligence technologies on its Biograph family of PET/ CT systems, which includes the Biograph Horizon, Biograph mCT and Biograph Vision. AIDAN is built on a foundation of patient-focused bed design and proprietary AI deep-learning technology to enable four new features. AIDAN’s FlowMotion AI uses continuous bed motion with ALPHA proprietary AI technology, which automatically detects anatomical structures, to recognize patient anatomy and automatically apply disease-specific protocol parameters based on individual requirements. AIDAN’s PET FAST WorkFlow AI automates and simplifies post-scan tasks. It automatically performs fast image transfer and auto data export, and creates PACS-ready data ranges. AIDAN’s OncoFreeze AI allows acquisition of PET/CT images that are virtually free of respiratory motion utilizing 100 percent of the acquired PET counts, with no additional time added to the exam and no respiratory belt. Finally, AIDAN’s Multiparametric PET Suite AI offers a fully automated workflow that extracts the arterial input function automatically from acquired PET/CT images. In addition to the standard SUV image, Multiparametric PET Suite AI provides clinical information for the patient report in the form of metabolic rate and distribution volume. • ADVANCING THE IMAGING PROFESSIONAL
HOLOGIC
3DQuorum Imaging Technology, powered by Genius AI 3DQuorum Imaging Technology, powered by Genius AI, works in tandem with Hologic’s Clarity HD high-resolution imaging technology to reduce tomosynthesis image volume for radiologists by 66 percent. The technology utilizes Genius AI-powered analytics to generate 6mm SmartSlices from the original high-resolution 3D data. The Genius AI powered software also identifies clinically relevant regions of interest and preserves important features during the creation of SmartSlices. SmartSlices are designed to expedite reading time by reducing the number of images to review, without compromising image quality, sensitivity or accuracy. With 3DQuorum technology, the number of 3D images to review is reduced by two-thirds, saving an average of one hour per eight hours of daily image interpretation time. •
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Seizing the Moment An Opportunity for Imaging to Embrace Diversity BY MATT SKOUFALOS
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or Verlon E. Salley, medical imaging is essentially the family business. His father was a radiologic technologist who advanced to become a nuclear medicine technologist. Growing up, Verlon would volunteer to help him in the summer in Fort Lauderdale, Florida, which means, “radiology has been on my resume since middle school,” he said. Today, Salley is the senior director of radiology at UAB Medicine in Birmingham, Alabama. But Salley’s rise to his current position wasn’t without its challenges, and not all of them were related to his career. Growing up in Florida as a Black man, Salley said he has experienced overt racial bias, as well as “things that were more subtle.” During his second day of a fellowship, he recalled how the hospital president stopped him from entering a meeting he was required to attend, suggesting, “Maybe you’re looking for a patient’s room? That’s on the other side of the hospital.” “I’ve got a briefcase, I’ve got a suit and tie, and he says, ‘Oh sir, I don’t know what you’re looking for, but this is the boardroom,’ ” Salley recalled. “I point at my name badge. I said, ‘I’m the fellow. My preceptor is that guy there.’ I’m standing at the door, and he whispers something in my preceptor’s ear to allow me to come into a board meeting that I’m supposed to be at.” “I was educated, raised, trained to expect this,” Salley said. “It doesn’t shock me, all the different things; what I’ve become is cerebral to it. I recognize that I can help by talking to the individuals in my environment.” Sadly, experiences like those are all too common among people of color in the United States, and not just in the imaging field. Making them less common – or eliminating them altogether – means fostering opportunities to increase the diversity of today’s
workforce, from rank-and-file staff to leadership roles. That can’t happen without a deep dive into human resources and demographic data at all levels of employment in the health care system, which requires buy-in from the uppermost ranks of several institutions. From senior management to front-line employees in settings from hospitals to professional organizations, Salley said he’d like to see efforts made to identify baseline diversity numbers, the better to grasp the degree of the gaps in the field. “They more than likely have that information, but I guarantee you nobody’s ever asked,” he said. “It’s one thing to measure your organization, it’s another thing to know what the denominator is. And don’t stop just at ethnic numbers: look at gender, education; all of that matters, because once people have the opportunity to move up in management, some job descriptions require advanced degrees.” Having the diversity mix of an organization on hand allows institutions to define and meet expectations, Salley said, which is useful when hiring managers, directors and other senior leadership. But if the imaging field is to advance beyond merely addressing a shortfall in its diversity calculus, it must do more than reinvent something like the NFL’s “Rooney Rule,” which requires teams to interview external minority and female candidates for
high-ranking jobs. Such regulations can amount to little more than “checking the boxes” if organizations don’t hold themselves accountable to a higher standard, and commit to seeking qualified employees of all types, Salley said. “Not a lot of companies look for diverse candidates,” he said, “therefore, institutions are not diverse at the higher levels because they hire from within. There’s favoritism and nepotism; individuals get hired and never leave. The organization never trains you from within.” Salley said this kind of institutional self-examination should be accelerated by professional organizations in the imaging space, including the American College of Radiology (ACR), American Registry of Radiologic Technologists (ARRT) and the Association for Medical Imaging Management (AHRA). He’d like to see professional groups like those make themselves a part of the national conversation on the issue of diversity in the workforce. “Even med schools where these radiologists train should consider a curriculum on health care disparities and what’s going on in the nation,” he said. For his part, Salley is gathering data from his local chapter of the National Association of Health Service Executives (NAHSE), a non-profit association of Black health care executives on the experiences of Certified Biomedical Equipment Technicians (CBETs) who
“If somebody says they need to hire more people of color, and they do, and those people are not included in what happens in the organization, then all you have is diversity, and not inclusion.” – Vernon Salley
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have faced discrimination in the workforce. In polling the 46 members of his local NAHSE chapter on their attitudes about discrimination in the workplace – “does it exist, have you endured it, what do you suggest” – Salley is collecting information that he believes will help him “to have a smart conversation with my upper administration.” “I’m trying to get real data,” he said, the better to anticipate questions about the impact of his findings. Documenting instances of maltreatment is one thing, and commitments to cultivating diversity another; however, Salley said what’s even more important than either is inclusion. “If somebody says they need to hire more people of color, and they do, and those people are not included in what happens in the organization, then all you have is diversity, and not inclusion,” he said. “If people’s hearts are not changed, if empathy is not adopted, it won’t make a difference.” Ernie Cerdena, president of the Medical Technology Management Institute (MTMI Global), can recall arriving in the United States from the Philippines at 23. He had a limited command of the English language, and as the newest technologist on his team, was given a lot of extra work. “I was put on difficult shifts, the 3-to-11,” Cerdena said. “If nobody showed up for the third shift, I had to do it. I always had to double-shift. I was only making $12 an hour, and my coworkers were making more than me.” The extra obstacles Cerdena encountered weren’t just at work, either. Newly married, when he and his wife were apartment hunting, they discovered that a landlord to whom they’d already given a security deposit mysteriously and suddenly gave the place to a different tenant. When they asked why their money had been accepted if that was the case, the rental agent was evasive, Cerdena said. It took a lot of follow-up with the city housing depart36
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“For some people who’ve never experienced this, they’re never going to be able to relate to it. You question your worth, your value and your role in society. Are you a burden, or are you a contributor?” – Ernie Cerdena ment to get some answers. “For some people who’ve never experienced this, they’re never going to be able to relate to it,” Cerdena said. “It’s hard. You question your worth, your value and your role in society. Are you a burden, or are you a contributor? I work very hard to make sure that I pay my taxes; to make sure that I take care of my patients.” Cerdena said that he’s experienced other, similar moments of prejudice throughout his career, but described himself as non-confrontational, and “tending to be silent about my own experiences.” “So personally, I just accept it,” he said. “But at the same time, what can you do so that doesn’t happen again in the future? That’s the reality.” Today, Cerdena is an AHRA Past President who chairs its Diversity and Inclusion Task Force. The committee aims to create awareness of diversity issues throughout the imaging field, including leadership, starting by educating AHRA members and critiquing its own processes. “AHRA is meant to be a catalytic force in the development of imaging leadership,” Cerdena said. “Part of that know-how is to be able to recognize sensitivity to cultural diversity, ethnicity, gender, socioeconomic standards, sexual orientation, age and disability.” Established in 2019 by current AHRA President Chris Tomlinson, the task force seeks to fulfill that mission of catalytic change by addressing the day-to-day challenges that its mem-
bers face – and about which they might not speak up. “You cannot measure the level of negative impact of that to us, because we experience it,” Cerdena said. “We were victimized by it; the ammunition to overcome those issues is education.” When Cerdena’s committee surveyed AHRA members about their attitudes toward the concept of diversity within the organization, a vast majority said they believed that the organization cultivates a diverse membership, and that doing so is important. Similarly, respondents thought the association offers equal opportunities for all members to participate, volunteer and gain awards and recognition. Eighty-three percent said AHRA is doing enough to address diversity and inclusion within the organization, and 78 percent said they feel comfortable voicing contrary opinions without fear of negative consequences, and can share “ideas or other aspects of their authentic self, while also feeling valued and respected by fellow members.” Respondents also indicated, however, that they would like AHRA leadership to reflect the diversity of the organization, and that AHRA should create a scholarship program for minority demographics. The fact that 82 percent of respondents are white reflects the challenges the association has in promoting diversity internally and in the external interactions of membership. Tomlinson, who is also the enterprise vice-president for radiology ADVANCING THE IMAGING PROFESSIONAL
imaging, clinical lab and pathology for the emergency and hospital medicine service lines at Jefferson Health in Philadelphia, Pennsylvania, said respondents’ attitudes varied significantly by geography. AHRA members in the northeastern United States found diversity to be “top-of-mind,” he said, while some AHRA members in the middle of the country “weren’t as sensitive to the issue, and questioned the need for the agency to focus on diversity at all.” “They felt it was out of the scope of what a professional association should be doing,” Tomlinson said. “What the AHRA survey showed us was we really didn’t have the awareness we would have liked.” The medical imaging industry tends to reflect its diversity most among its technical ranks, and least among those in supervisory roles. But Tomlinson noted that medical imaging leadership industry-wide is “definitely less than representative from where we feel it should be from an industry perspective.” “We think it has to do with mentoring and unconscious bias,” he said. “If you have diversity in your community, but not in your management team, you’ve got to ask, ‘Why is that not there?’” “Why wouldn’t the makeup of our community be the makeup of that health system across all layers, including leadership?” he asked. Addressing gaps in mentorship and accounting for unconscious bias re-
quires education and sustained effort, but AHRA is intended to be “the indispensible resource for imaging leaders,” and a lack of diversity among its own leadership, is “definitely a problem,” Tomlinson said. “It’s something we need to address, and they’ve elected me president not to make them feel comfortable, but to deal with tough issues, and that’s what I’m doing,” Tomlinson said. As a Black woman working in the medical imaging field, Chris Harris said she’s had experiences similar to those Salley and Cerdena underwent. Today, Harris is the operational manager for MRI at Children’s National Hospital in Washington, D.C., but when rising through the ranks, she didn’t have any mentors of color to guide her path. “It’s very hard to be in a position where there’s no other people of color in leadership,” Harris said. “Working day to day, you come across situations where you need somebody to talk to. Sometimes there’s things that white people don’t understand about me and my background, and it’s hard for me to express myself to them.” At the Children’s Hospital of Philadelphia, where Harris worked before taking the position in Washington, D.C., she said she always had to work “harder and more” than her white counterparts to be noticed, “and if you’re noticed, it still might not be enough” to advance. “Every day, I’ve got to work 10 times as much, 10 times as hard,” Harris said. “On top of it, I’m very boisterous, and
“If you have diversity in your community, but not in your management team, you’ve got to ask, ‘Why is that not there?’” – Chris Tomlinson WWW.THEICECOMMUNITY.COM
“It’s very hard to be in a position where there’s no other people of color in leadership. Working day to day, you come across situations where you need somebody to talk to.” – Chris Harris I’m looked at as aggressive. I have to sit a certain way, I have to look a certain way; I have to show a poker face. But my heart is about the patient and the process.” Until the imaging space can work through its process and diversify its leadership more greatly and consistently, Harris thinks those in the space may have to look elsewhere for diverse mentorship, whether in educational or community institutions. As a way of setting the tone, she volunteers with high school students in blue-collar communities who may not have professional mentors in their lives. “It’s hard because there’s not enough people of color to reach out and talk to move people of color forward,” Harris said. “I feel like the generations coming up want to support. It’s how do we get the people of color to move themselves forward?” “We’re starting to work together as a nation,” she said. “If we keep that momentum, it can happen. If we don’t move it, it’s not going anywhere.” • ICEMAGAZINE
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INSIGHTS
TIME TO RE-EVALUATE YOUR E/M OPTIONS S CODING/BILLING BY MELODY W. MULAIK
weeping changes are coming for Evaluation & Management (E/M) guidelines in 2021 and this is causing many radiology practices to re-evaluate their coding and billing practices. Historically ensuring the performance and necessary time to document the required components for these services has been challenging for many practices so the return on investment was not always present to justify coding and billing. In some practices, interventional radiologists not only provide requested treatments but they also directly manage the care of certain patients. In these circumstances, it is many times appropriate to bill for an E/M service.
The specific changes for 2021 are for new and established outpatient visits. They do not relate to inpatient visits or consultations. Some of the changes by the American Medical Association (AMA) include the following: • Only the choice to use time or medical decision making (MDM) in determination of the code level; • Deletion of code 99201 effective January 1, 2021; • Time values assigned to the code levels; • Inclusion of all the time spent on the date of the visit; and • Eliminating the ability to use the history and exam or time in combination with the MDM to select the final code level. In addition to the AMA updates, the Centers for Medicare and Medicaid Services (CMS) proposed and finalized the following items of potential interest for radiology practices for CY 2021: 38
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• Recognition and reimbursement for the new prolonged visit add-on code (CPT code 99XXX, still to be revealed by AMA) and allow for it to be used with levels 2-4 as well as level 5. • CMS will no longer recognize prolonged services codes 99358 and 99359 for separate reimbursement when associated with outpatient E/M visits. • Elimination of history and/or physical exam in determining billable code level • Choice of either time or MDM to decide level of outpatient new or established patient visit, using the AMA CPT guidelines for MDM. By CMS adopting these new guidelines, the history and exam will no longer affect the level of code. The visit will only include the history and exam as it was pertinent to the visit and when performed. The number of body systems reviewed will no longer be documented and again would only be included as pertinent to the visit itself. Level 1 visits (99211) would describe or include those visits performed by clinical staff for established patients and will not include medical decision making. This streamlining will encourage more practices to re-evaluate their opportunities to bill for these services and potentially increase revenue opportunities. It is worth having discussions with appropriate stakeholders now, and not waiting until January 2021, so that you can be adequately prepared for any required system, process and/ or billing changes needed to ensure that E/M services are successfully captured at the beginning of the year. • MELODY W. MULAIK, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle and Coding Strategies Inc.
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INSIGHTS
LEADERSHIP IN TRANSITION DEPARTMENT/ OPERATIONAL ISSUES BY JEF WILLIAMS
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e are being tasked to deal with levels of uncertainty many of us have never had to face in our careers. The impact of 2020 is putting stress on our jobs, positions and organizations. To deal with the crisis at hand most have had to shift leadership styles toward crisis management. Making decisions in real time based on urgency and criticality means less communication and putting aside the non-urgent items and tasks leaders are expected to address. The internal values and mission of investing in people and culture are temporarily suspended to simply keep the organization functioning and meeting the greatest mission of health care – caring for and treating patients. I’ve talked with many leaders over the past few months and none enjoy the part of their job related to downsizing, furloughing, reducing patient access and asking support staff to work extra shifts to cover for positions that were laid off. But in times of crisis, this is the job. However, we must be careful to remember that crisis management is a temporary
leadership model and is not sustainable over long periods. While we are not over the multiple layers of 2020’s difficulties, I believe it’s time to reintroduce ourselves to the better model of leadership that emphasizes communication, promotes greater team performance and positively impacts the organization. There are many ways leadership can transition. Three I am finding common in recent days are differentiating urgency from importance, focusing on long-term solutions and communicating and engaging our teams successfully. Recent events have required focusing on urgency. In crisis what is urgent is also what is important. While this serves well in making quick decisions and acting decisively to address the problems immediately in front of us, long-term efficacy in leadership differentiates urgency from importance. As Stephen Covey famously stated in his book “7 Habits of Highly Effective People,” we cannot fall into a pattern of the tyranny of the urgent. Furloughs and layoffs have been required to manage revenue downturns and right-size operations. As we bring people back to work, we must consider the value of providing some level of security and
Crisis management is a temporary leadership model and is not sustainable over long periods.
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a vision of the future (albeit still uncertain for many). The urgency of ramping up operations must also include the important work of investing into the people and teams we manage. It has been impressive to see the agility of health care in adjusting to meet an unexpected situation. From pop-up care facilities in parking garages to shifting to parked car waiting rooms we have seen the best in doing what is needed at an expedited pace. These stop-gap decisions are necessary in a crisis. But much like stopping a leak in your floating boat, the repair isn’t designed to be permanent. As life transitions to the new normal, leaders will need to identify those stop-gap measures and restructure to meet long-term solutions. Getting a leaky boat to shore with a T-shirt is success – but you are not taking it out again until permanent repairs are made. Consider cars replacing waiting rooms; will this WWW.THEICECOMMUNITY.COM
work in states with extreme temperatures or with people using public transportation? Shifting to long-term lasting improvement will only strengthen our organizations. Top down leadership is the most effective form of leadership in a crisis. There is no time to build consensus or share information other than what is needed at that point in time. Pulling in control from others to centralize decision-making is natural, even necessary, when managing a crisis. While this is the most efficient model in performing well during that period, it is difficult to sustain while looking to build strong, empowered, engaged and high-performing teams. We are not through this period of challenge but consider the impact this has had on the people we lead. Emphasizing communication that is transparent and allows for questions and feedback may be the best path toward reducing personnel anxiety and
frustration. We may not have all the answers, but we can share what is being done by executive leadership. Good leadership engages. Most have not had the time to do so amid the COVID-19 pandemic, many still are running at accelerated paces, but as things begin to normalize consider ways to engage your teams and organization. I suspect we will be talking about this into 2021 as there is currently no end in sight. The task of leading and making decisions never goes away. The process and systems we follow may change due to circumstances and forces beyond our control, the role does not go away. Let us continue to strive to self-assess our positions, situations and decisions in light of the people and teams we lead. • JEF WILLIAMS, MBA, PMP, CIIP, is a managing partner at Paragon Consulting Partners. ICEMAGAZINE
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WORKPLACE DIVERSITY: WHAT CAN YOU DO?
T DIRECTOR’S CUT BY MARIO PISTILLI
his issue of ICE with the cover story of diversity in the workplace was planned in late 2019, long before these most recent events including the murder of Mr. George Floyd. This has served as yet another reminder that racism is still real and pervasive in our society, and if we are honest, also in our workplaces. It is sad and shameful that it took such a tragic act to once again shock many into actions that we should have been doing all along. This cycle has been on perpetual repeat for far too long. The focus of this article is on Black, Indigenous, and People of Color (BIPOC) issues, that does not discount the experience or lessen the importance of any other impacted groups. The BIPOC community, and in particular the Black community, is particularly impacted as I write this, but the strategies described can be applied to any situations of discrimination. The issues of racism and intolerance are daily struggles that, regardless of the focus of the news cycle, need to be addressed. It is not acceptable to say, well that’s not me, and do nothing. I admit publicly that I have not done enough to support, empower and defend diversity in my workplace and in my community. I come to this as a beneficiary of white privilege and can never understand what it is like to suffer because of the color of my skin, my ethnicity or my sexual orientation. I can, however, be better and do better to be an ally and make a positive difference for those around me. I must lead change at creating and maintaining an anti-racist and anti-discriminatory culture. My hope is that
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sharing my personal journey to become better will resonate with others and spur action in their lives. • Learn to be uncomfortable and do not avoid it. It does not feel great to confront your own failures and inadequacies. The level of discomfort you might feel as you engage regarding these issues is of no comparison to the pain and hurt visited upon victims of intolerance on a daily basis. That is no excuse for inaction or avoidance. Those we lead deserve that we confront and overcome these feelings. • Listen, listen and then listen some more. Respect that every person, no matter their background, has their own truth. Allow people to express whatever their particular truth is and listen with the intent to understand and empathize not to solve. • Take steps to educate yourself. This is your responsibility and there should not be an expectation of anyone else to be your teacher. We each need to own our ignorance and seek the resources to fill that knowledge gap. I have a lengthy list of resources that is by no means all inclusive, but I have found many of these very helpful. You may access the list of resources via the online version of this column at https://theicecommunity.com/ workplacediversity. • Have courage. Call out others, regardless of their position, when you hear or see words or behaviors that are inconsistent with a just culture. I strongly encourage that your learning include how to recognize aggressions and micro-aggressions. Also, it is not always about overt words or actions it is also the unsaid. Be vigilant in ensuring that everyone you engage with is participating and encouraged to contribute. ADVANCING THE IMAGING PROFESSIONAL
• Don’t use excuses. I have heard others say, “I am afraid to talk to people about this, because I might say the wrong thing.” Speak from the heart and with empathy and if you do “say the wrong thing,” then sincerely apologize. I am not afraid, because I am not trying to strategize and tailor what I say to what I think the person wants to hear. I speak from my heart and with empathy and if what I say lands wrong, then I say that I am sorry and ask for a clearer understanding of what the impact of my words were. I am not a big fan of asking permission to make a mistake in advance. I have heard people start out by saying, “I might say the wrong thing, but … .” The person you are speaking to has no obligation to allow you permission to misspeak and has every right to any reaction that your words may evoke in them. I know that I will say the wrong thing, and you probably will also, but take responsibility for it and learn from it. I also feel it is very important to let the other person know that their feelings and emotional safety are important to you. • Don’t force it. If your team member is not in a frame of mind to talk or open up, then don’t push to make it happen. Give others the time and WWW.THEICECOMMUNITY.COM
space to process whatever they are going through and invite them to talk when they are ready. This does not mean to ignore issues, but to try again later to check if it is a better time. • Know your team. I previously wrote about the importance of rounding and getting to know your employees. This includes their feelings or challenges around race, sexual orientation, disabilities or any other issues that may be impacting them or their families. Make it clear that whatever those impactful issues are that it is safe to talk about them. • Advocate for change. Encourage everyone to report any instances of unjust culture that they have been subjected to or witnessed. You can encourage them, by making sure that the response is not disciplinary or retaliatory to the reporter. Also, be a role model by reporting these things yourself. I have placed many risk management reports when I have learned of something that should be reported. If you know the person that filed or placed the report, let them know that you appreciate them bringing this issue forward and are happy that they reported it. • Be willing to explore your own
biases. We all have certain biases regardless of how well intentioned you think you are. You can take a bias test at: https://implicit.harvard.edu/ implicit/takeatest.html. It is a good place to start to begin to recognize the biases that you have so you can start to address them. This is not a quick fix issue; this is a lifelong commitment to engage in personal growth. It is about being a better human and forming better connections with everyone around you – regardless of their personal truth. I am, and will continue to be, a flawed person. However, I can strive to do better. There is no way that in the space of this article, I have even scratched the surface of the complexities and nuances of these issues. I challenge each of you to embark on your own journey of self-improvement, be kind to each other and support others in their journeys. Our individual uniqueness and our diversity are strengths that make us all better. • 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. ICEMAGAZINE
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INSIGHTS SPONSORED CONTENT
BEST PRACTICES BY PATRICK KNAUER
MARKETING BEFORE AND AFTER COVID-19 B efore COVID-19, Banner Imaging used a two-pronged approach to consumer marketing. Our primary marketing goal was to help consumers easily find address and contact information for Banner Imaging’s 23 locations. This not only helped create frictionless experiences for patients, it also helped to reduce missed appointments and volume loss due to error and confusion.
Secondly, we created the term “shoppable modalities” to describe when consumers invest their time seeking an imaging service or provider. Because today’s health care consumer is shopping online, this enables many opportunities for digital marketers. Digital tactics like search, social media, email and retargeting are tools that can be used in a performance campaign designed to increase volumes. But when COVID-19 hit, consumer behavior changed. Our approach to marketing needed to transform as well. Prior to stay-at-home orders in our service area, analytics clearly indicated the most common action patients preferred were visits to our clinic webpages. However, after stay-at-home orders were given, website visits dramatically decreased while clinic phone calls rose to prominence. This change in behavior illustrated a couple of central patient needs. 44
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First, there was a big need for information from the basic (hours of operation) to the complex (services for high-risk individuals). Beyond the requests for information, however, we realized a common theme – patients were seeking guidance from trusted health care professionals. The need for guidance included: how to access imaging and radiology services, feeling safe in a health care environment and staying healthy outside of the health care environment.
DIGITAL TRANSFORMATIONS For digital tactics, we rely on our website bannerhealth.com as the source of truth. This approach enables us to focus on content and information at one end point – and broadcast that information through channels that are fed by our data. The Banner Health website contains location, services and contact information for all Banner Imaging locations. We use clinic webpages to feed information through our business listings vendor, Yext, which automatically updates hundreds of Internet directories and listings. Most importantly, ADVANCING THE IMAGING PROFESSIONAL
this includes Google My Business. Google My Business is considered the “homepage” for our Banner Imaging clinics as the number of views and actions taken on Google My Business far exceed our own website. Utilizing Google My Business is the easiest and most effective method of communicating business changes to consumers. Google My Business also created new categories specifically to alert consumers how COVID-19 impacted operations. Between our website and Google My Business we had an effective reach on communicating business changes and access instructions. Additionally, we relied on the Banner Health Blog to offer guidance during COVID-19. This included articles on staying safe and advice from our thought leaders on mental and physical health during the pandemic. The articles were promoted on multiple channels to help reach our audiences. These channels included email, social media and Google My Business. The viewership and engagement on COVID-19 guidance was tremendous. Although volumes were down in Banner Imaging locations, our relationships and trust with our patients was growing thanks to content marketing efforts. It’s our belief that the lasting effects of building trust with consumers will ultimately generate a positive impact to volumes.
BRICK AND MORTAR TRANSFORMATIONS Banner Imaging also made many changes inside the clinics. The campaign, “A Safe Place for Care” was created which enacted cleaning, safe distancing and masking protocols to make the environment safe and reassuring for patients and providers. Posters, i-frames, table tents, floor and window stickers were created and placed within the clinics to reinforce WWW.THEICECOMMUNITY.COM
instructions and the efforts Banner Imaging took to safeguard patients. The signage also encouraged patients to visit the website for a deeper dive into the COVID guidance content we generated. Finally, Banner Imaging transitioned clinics across disparate geographic regions to serve patients who had no respiratory symptoms. These locations were labeled “Non-Respiratory” to inform patients that they were intended to serve individuals who were not symptomatic for COVID-19. These locations were also imaging destinations for high-risk patients. The marketing team then built awareness of Non-Respiratory locations through advertisements on social media, search, as well as on bannerhealth.com and email.
THE RESULTS ARE NOT YET IN The overall financial and business impact of the efforts made by Banner Imaging will not be understood for some time to come. However, by listening to the needs of the patient and involving teams across content, branding, operations and marketing to reach our consumers, the end result was holistic and patient centered. Trust and rapport with our patients is one of the most valuable assets we can nurture in a time of volatility and uncertainty. In the past weeks we have seen a trending lift in patient confidence reflected through volumes – although the environment remains fluid. We believe our marketing efforts have helped contribute to these positive indicators and we will continue to listen and respond to the needs of our patients in the days ahead. • For more information, visit bannerhealth.com. PATRICK KNAUER, MBA, is a service line marketing program director-ambulatory for Banner Health. ICEMAGAZINE
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TRUST STARTS WITH BEING TRUSTWORTHY W RAD HR BY JANEL BYRNE
hile the word “trust” is only 5 letters, it’s a BIG word. A quick google search reveals trust means a “firm belief in the reliability, truth, ability, or strength of someone or something.” Think of the relationships with people in your personal life where trust does and does not exist. What’s the difference in the quality of those relationships? Now think about your work relationships – those with the team you lead, your peers, your leader and so on. What’s the difference you notice there? When I think about this question, the first thing that comes to my mind is how a lack of trust slows true progress – not only in what we can be achieved but literal speed … as trust wavers, a sprint can turn into a crawl. What do I mean by all of this? Have you ever gone around someone to get the job done
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because you didn’t trust their ability to do it? Or you knew they were able to do it but their lack of follow-through will result in you having to do it anyway? How about a meeting where you needed to say something crucial but it went against what the majority of participants thought or, worse, against your leader’s opinion? In cases like these, i.e., going around others that should do the work or meetings where people don’t share their true opinions because of a lack of trust, there is a lot of wasted time with not-so-productive outcomes. There’s a reason Stephen M.R. Covey titled one of his best-selling books, “The Speed of Trust.” When there’s trust, people have more open conversations where honest opinions are shared, folks can hold one another accountable to what they said they were going to do, and results can be achieved in half the time because there are less “meetings after the meeting” (i.e., the water cooler chats where people share what they really think).
ADVANCING THE IMAGING PROFESSIONAL
I can like you but if you don’t do what you say you’re going to do, I won’t trust you. While I don’t need to spend a significant amount of time convincing you that trust is important, I often get asked by leaders, “So, really, how do I build trust throughout my team?” To which I say, “Well, first you need to be trustworthy.” Pulling from the practical teachings within “The Speed of Trust,” one’s trustworthiness is their character and competence. Simply, I can like you but if you don’t do what you say you’re going to do, I won’t trust you. Same is true for the opposite – you may deliver what you say you will, but if you’re a jerk about it I’m not going to trust you either. Covey, and subsequent learning experiences available through the FranklinCovey Group, breaks down character and competence further and includes simple definitions for behaviors within each, and how to bring them to life to increase one’s own trustworthiness. For our purposes in this article, I’ll share a sample behavior within each to give you a flavor for how to you can improve your character and competence, aka – your overall trustworthiness. Character is your intent and integrity. Intent means your genuine concern and caring for others. It’s your fundamental motive or agenda where you seek mutual benefit and act in the best interest of everyone. A behavior within intent to improve your trustworthiness is to “declare your intent.” Choose the intent that will serve everyone best, including yourself. State it, signal it, clarify it and discuss it – especially when your intent is unclear. Share the “why” behind the “what” you are asking, requesting, recommending, etc. wherever possible. Integrity is the congruence of values, beliefs and behavior. It is deep honesty, humility and courage. A behavior that demonstrates integrity is the ability to be open. When you are speaking with others and asking questions, are you formulating your responses while they respond (i.e., not really listening) or are you genuinely listening to hear WWW.THEICECOMMUNITY.COM
their perspective? Are you truly open to having your mind changed or are you defaulting to saying “no” before you fully consider something new or different? Competence is a combination of capability and results. Capability is the capacity we have to produce and accomplish tasks. These are our talents, attitudes, skills, knowledge and style. A behavior that supports capability is running with your strengths. It’s important for us to all be able to identify our strengths and our weaknesses. And in the areas in which you can grow – how are you working toward filling this gap? We can’t be strong at everything, so this is an opportunity to maximize our strengths and partner with others where we are not as strong. Results means your track record – past, present and anticipated. Getting the right things done while not taking away from the trust others have in you (instead, adding to it!). A behavior that comes to mind is taking responsibility for results which means adopting a “results” mindset rather than an “activity” mindset. This is where you define outcomes and move toward achieving those. Ask yourself, am I just doing this because we have always done it this way? Will what I’m doing now lead to the results I want, or am I just staying busy? Bringing us back to the original question, “How can I build trust?” or, even, “How can I re-build trust?” Take a look in the mirror and ask yourself if you truly walk the talk of trustworthiness – do you regularly demonstrate that you are someone of character and competence? Trustworthiness is a life-long journey that requires ongoing commitment to improve and sustain in all of your relationships. This is not a sprint – it’s a marathon. • JANEL BYRNE, MSW, SHRM-CP, is an organizational effectiveness manager at
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INSIGHTS
BLACK BOX VS. USEFULNESS WOULD YOU USE SOMETHING IF YOU DON’T KNOW HOW IT WORKS?
M PACS/IT BY MARK WATTS
y wife calls me in a panic, match the diagnostic capacities of a team of “the mechanic said our car 21 board-certified dermatologists in classifycould have blown up!” It ing skin lesions as cancerous or benign. The was the five-year checkup for our Stanford computer science creators of that Honda hybrid. It gets 45 miles to algorithm still don’t know exactly what feathe gallon, gets me from point A tures account for its success. A third examto point B and starts every time I ple, also in medicine, comes from Joel Dudpush the button on the dash. These ley at Mount Sinai’s Icahn Institute. Dudley useful criteria are how I judge a car. led his team on a project called Deep Patient I had replaced the battery, Arizo(I met Joel at a genetics conference in New na’s extreme heat drains the life York and asked for a picture with him, I said, out of them. I must have used the “It is not every day you meet the Henry Ford “wrong battery” or of genetics.”) to see whethnot a factory soluer the data from electronic It’s fair to tion. Cars are a black medical records could be used box to me. I cannot to predict the occurrence of 78 predict that service it or change diseases. When the neural netthere will be the oil. I just want to work was used on more than use them. 700,000 Mount Sinai patients, many more it was able to predict using unsupervised learning from raw medical record data. Dudley said something that sums up the AI black box problem. “We can build these models, but we don’t know how they work.” We already accept black boxes in medicine. For example, electroconvulsive therapy is highly effective for severe depression, but we have no idea how it works. Likewise, there are many drugs that seem to work even though no one can explain how. As patients we willingly accept this human type of black box, so long as we feel better or have good outcomes. Should we do the same for
intense efforts to understand the inner workings of AI neural networks.
Artificial Intelligence has a black box issue too, as does the human brain. If there’s one thing that the human brain and AI certainly share, it’s opacity. Much of a neural network’s learning ability is poorly understood, and we don’t have a way to interrogate an AI system to figure out how it reached its output. Move 37 in the historic AlphaGo match against Lee Sodol is a case in point: the creators of the algorithm can’t explain how it happened. The same phenomenon comes up in medical AI. One example is the capacity for deep learning to 48
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AI algorithms? Pedro Domingos would, telling me that he’d prefer one that’s 99 percent accurate but is a black box over one that gives explanation information but is only 80% accurate. But that is not the prevailing view. The AI Now Institute, launched in 2017 at New York University, is dedicated to understanding the social implications of AI. The number one recommendation of its AI Now report was that any “high stakes” matters, such as criminal justice, health care, welfare and education, should not rely on black-box AI. The AI Now report is not alone. In 2018, the European Union General Data Protection Regulation went into effect, requiring companies to give users an explanation for decisions that automated systems make. That gets to the heart of the problem in medicine. Doctors, hospitals and health systems would be held accountable for decisions that machines might make, even if the algorithms used were rigorously tested and considered fully validated. The EU’s “right to explanation” would, in the case of patients, give them agency to understand critical issues about their health or disease management. Moreover, machines can get sick or be hacked. Just imagine a diabetes algorithm that ingests and processes multilayered data of glucose levels, physical activity, sleep, nutrition and stress levels, and a glitch or a hack in the algorithm develops that recommends the wrong dose of insulin. If a human made this mistake, it could lead to a hypoglycemic coma or death in one patient. If an AI system WWW.THEICECOMMUNITY.COM
made the error, it could injure or kill hundreds or even thousands. Any time a machine results in a decision in medicine, it should ideally be clearly defined and explainable. Moreover, extensive simulations are required to probe vulnerabilities of algorithms for hacking or dysfunction. Transparency about the extent of and results from simulation testing will be important, too, for acceptance by the medical community. Yet there are many commercialized medical algorithms already being used in practice today, such as for scan interpretation, for which we lack explanation of how they work. Each scan is supposed to be over read by a radiologist as a checkpoint, providing reassurance. What if a radiologist is rushed, distracted or complacent and skips that oversight, and an adverse patient outcome results? There’s even an initiative called explainable artificial intelligence that seeks to understand why an algorithm reaches the conclusions that it does. Perhaps unsurprisingly, computer scientists have turned to using neural networks to explain how neural networks work. For example, Deep Dream, a Google project, was essentially a reverse deep learning algorithm. Instead of recognizing images, it generated them to determine the key features. It’s a bit funny that AI experts systematically propose using AI to fix all of its liabilities, not unlike the surgeons who say, “When it doubt, cut it out.” There are some examples in medicine of unraveling the algorithmic black box. A 2015 study used machine
learning to predict which hospitalized patients with pneumonia were at high risk of serious complications. The algorithm wrongly predicted that asthmatics do better with pneumonia, potentially instructing doctors to send the patients with asthma home. Subsequent efforts to understand the unintelligible aspects of the algorithm led to defining each input variable’s effect and led to a fix. It’s fair to predict that there will be many more intense efforts to understand the inner workings of AI neural networks. Even though we are used to accepting trade-offs in medicine for net benefit, weighing the therapeutic efficacy and the risks, a machine black box is not one that most will accept. Yet, as AI becomes an integral part of medicine. Soon enough we’ll have randomized trials in medicine that validate strong benefit of an algorithm over standard of care without knowing why. Our tolerance for machines with black boxes will undoubtedly be put to the test. I personally am OK with not knowing how the iPhone works inside or how an internal combustion engine works. The black box of AI will gain acceptance with usefulness and once we know it is safe and tested. By the way, the right battery cost $275 plus installation. My wife feels safe now. • MARK A. WATTS is the director informatics, technology and artificial intelligence and sales at Medical Technology Management Institute. ICEMAGAZINE
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INSIGHTS
WHY YOU’RE A BAD BOSS EMOTIONAL INTELLIGENCE BY DANIEL BOBINSKI
E
ver hear the statement that people don’t quit their job, they quit their boss? Yet we also hear that the most common reason people quit a job is because they don’t feel useful or challenged. Could both be true?
I’ll answer that question with a question. “Who is responsible for helping employees feeling useful and challenged?” If your answer is, “the boss,” we’re on the same page. And so, I find myself agreeing with the adage that most people don’t quit their job, they quit their boss. However, instead of simply outlining the characteristics of a good boss, let’s take a different tack and consider why you might be bad as a boss. After all, if you’re a boss and you’ve read this far, I’ll assume you want to know what 50
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you’re doing that’s bad. And that’s good. In all recorded history, we know of only two people who walked on water, and one of them was bad at it. Rare is the boss who isn’t bad at something. As you read, I’d like to suggest all bosses contemplate two things. • How you’re bad as a boss • Why you might be bad in those areas But you can’t stop there. If that’s all you do, you might remain bad. To get better, you’ll need to become a student and learn to do a few things differently. So, with the hope that you want to get better, let’s jump in.
You’re a bad boss when your employees don’t know what’s expected of them. Have you ever met anyone who successfully passed a telepathy class? Me either. If you, the boss, don’t clearly communicate to each employee what ADVANCING THE IMAGING PROFESSIONAL
you want from them, they won’t know. Communication is a two-way process. If you say something and another person hears it, that doesn’t mean they understand it. If your employees can’t explain back what you expect of them, then you haven’t communicated. This isn’t a one-and-done, either. It can’t be like the wife who, after 20 years of marriage, asks her husband why he never says, “I love you,” and the husband says, “I told you once on our wedding day; if I change my mind, I’ll let you know.” How to be better? For good performance management to occur, bosses need to connect with each direct report about once a quarter to discuss the high-priority job responsibilities and what results are expected. As I said, those conversations should flow both ways, and that means bosses need to listen at least as much as they talk. And that leads me to my next point:
You’re a bad boss when you don’t listen to your employees. Seriously. If you don’t listen to your employees, they won’t feel heard, and people who don’t feel heard don’t feel valued. You should also know that people who don’t feel valued rarely engage, and employees who aren’t engaged aren’t all that profitable to your team. How to be better? TRULY listen to your direct reports. This doesn’t mean just letting them talk and saying, “Yeah, I hear you.” A good boss comprehends the thoughts and feelings behind each employee’s words. And the following is important: While you don’t have to agree with what people tell you, immediately indicating you disagree WWW.THEICECOMMUNITY.COM
can be a bad thing. What’s important is that you indicate that you understand what’s being told you. That’s what makes employees feel heard. If they don’t feel heard, they don’t think you care and, in short order, they stop caring. Here’s another way to look at this. There’s a difference between “effective” and “efficient.” Effective means doing the right thing, efficient means doing something quickly. As management guru Stephen Covey used to say, you can’t be efficient with people. True listening is an effective skill, but trying to be efficient about it often backfires.
You’re a bad boss if you don’t compliment or encourage your employees. A maxim often attributed to Mark Twain is, “I can live for two months on one good compliment.” If you never compliment people on the work they do, they’ll think you don’t care. See my previous comments for the ripple effects of that. The words, “good job” are like currency. Saying those words is like handing someone a dollar. But even better are specific compliments, such as, “I really like the way you thought through that production problem and found a workable solution. That’s going to make everyone’s job easier.” The latter is more like handing someone a $100 note. How to be better? Make it a daily habit to identify at least one action from people on your team that deserves a compliment, then give it. Knowing your people is valuable here, because some people enjoy public compliments, while others prefer to receive compliments privately. Either way, all people enjoy receiving compliments.
You’re a bad boss when you say what you think people want to hear, then do something different. If you lack the courage to talk truth with people, you probably shouldn’t be a boss. Once people find out you’ve lied to them, their trust in you goes out the window. And with it, their commitment to the team. Psychologists tell us most people lie for one of two reasons. First, because they’re afraid something bad will happen if they tell the truth. Second, because they hope to gain something from the lie. Either way, if you’re lying to employees, know that at some point your lies will get exposed. When that happens, trust evaporates and people won’t cooperate with you. How to be better? First, determine why you lie. Then, I strongly recommend getting a coach or a counselor to discuss the issue. No one can change this behavior but you, but having an accountability partner in some capacity will help you break the habit. Humans are flawed creatures, so nobody is the perfect boss. But by identifying our weak spots and working to correct them, we increase the likelihood that good employees will hang around and stay engaged. • 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 on his office phone, 208-375-7606, or through his website, www.MyWorkplaceExcellence.com. ICEMAGAZINE
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MEDLINK IMAGING BY ERIN REGISTER
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edlink Imaging LLC, founded nearly 26 years ago, was formed to address the distribution needs of the medical X-ray film industry. “Growing to become one of the largest master distributors of medical X-ray film and imaging supplies, Medlink Imaging has successfully been a guiding force in supporting channel partners, even as the diagnostic imaging marketplace began to evolve,” said Medlink President Richard Owen. During this evolution, Medlink expanded from being an analog company to also supplying digital imaging products. “As a company looking to embrace evolution, make improvements and continually expand our product line, Medlink began distributing the VIVIX DR panel, manufactured by Vieworks, in 2012,” Owen stated. “It soon became apparent that the VIVIX brand was one of the superior DR panel products available in the marketplace. With a stronger belief in the VIVIX brand, Medlink and Vieworks moved forward and created a permanent relationship in 2018 when Vieworks acquired Medlink.” This acquisition allowed Medlink to become part of one of the world’s largest award-winning manufacturers of digital radiographic panels and gave WWW.THEICECOMMUNITY.COM
Vieworks the ability to increase its U.S. market share. ICE learned more about Medlink Imaging in a question-and-answer interview.
Q:
How does Medlink stand out in the medical imaging field?
Owen: Medlink, a Vieworks company, is one of the largest providers of digital radiography systems with a presence in all diagnostic imaging marketplaces as one of the largest manufacturers worldwide. Our solutions are in all market segments in diagnostic imaging, including hospitals, imaging centers, orthopedic and mobile imaging solutions
Q:
What has been Medlink’s biggest achievement?
Owen: We have expanded our sales support with proven results in helping our channel partners achieve success in all regions.
Q:
What is on the horizon for Medlink? Do you have any goals you would like to achieve in the near future? Owen: Medlink is continuing to diversify in adding radiographic equipment to our portfolio to enhance our presence in the marketplace. Our goal is to establish Vieworks’ brand identity in hospitals nationwide, as well as market segments in the diagnostic imaging marketplace.
Q:
Is there anything else you would like ICE readers to know? Owen: We at Medlink Imaging are committed to Richard Owen, standing strong President together, esMedlink Imaging pecially during these uncertain and trying times. We recognize the evolving needs of our channel partners, especially when it comes to facing the recent challenges in our country. To address those needs, we have been focusing on putting together a portable X-ray solution that combines innovation, power and versatility with one of the top-rated DR panels available. We succeeded with the portable Jade unit. This unit is an unparalleled, user-friendly, mobile digital diagnostic system that is also one of the most affordable in today’s market. It is ideal for hospitals, field hospitals and alternate offsite facilities. While we do not know what the future holds, we will continue to listen to the needs of our customers and are committed to providing exceptional products and services to the diagnostic imaging industry. • For more information about Medlink Imaging - A Vieworks Company, visit www.medlinkimaging.com. ICEMAGAZINE
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“Management is, above all, a practice where art, science, and craft meet.” – Henry Mintzberg
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Noble (inert) gases Halogens
1: Hydrogen 26: Iron
Periodic table of the elements
6: Carbon
Displays the chemical elements, arranged by atomic number from top to bottom; shows remarkable patterns in the elements The columns put elements of similar chemical properties together
92: Uranium
Metals
Non-metals
Chemical properties are the result of how the elements’ electrons behave
Science Matters
New periodic table looks into atom A new table, inspired by the classic periodic table based on the elements’ electrons, shows how an element’s inner structure – its nucleus – also has repeating, periodic patterns. Neutrons
ATOM NUCLEUS
Protons
Electrons
Nuclear reactions happen here
A nuclear periodic table
arranges the elements according to the pattern of “shells” within their nuclei; it shows symmetrical groups simiar to – but different from – the standard periodic table’s
“Magic” numbers are the numbers of protons in stable nuclei
Chemical reactions involve electrons Wrapped nuclear periodic table puts elements in a continuous sequence
Two special sequences outside the main table
Two more views of the wrapped table
Source: Yoshiteru Maeno and Kouichi Hagino of Kyoto University; Foundations of Chemistry journal Graphic: Helen Lee McComas, Tribune News Service
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INDEX
ADVERTISER INDEX Ampronix, Inc. p. 3
KEI Medical Imaging p. 57 SalesMaker Carts p.27
MedWrench p. IBC Association of Medical Service Providers (AMSP) p. 52
Summit Imaging, Inc. p. 2
MW Imaging Corp. p. 5 SOLUTIONS
TriImaging Solutions p. 28, BC
Diagnostic Solutions p. 47
iMed Biomedical
Leading the Industry in Biomedical Solutions
PM Imaging Management p. 57 W7 Global LLC p. 39
iMed Biomedical p. 23
Injector Support and Service p. 4
Richardson Electronics Healthcare p. 19
Webinar Wednesday p. 15
Innovatus Imaging p. 9 RTI Group North America p. 39
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