ICE Magazine January 2021 by MD Publishing

THEICECOMMUNITY.COM

JANUARY 2021 | VOLUME 5 | ISSUE 1

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

ICE 2021 Education is Heating Up this Winter! PAGE 18

PRODUCT FOCUS

POCUS PAGE 35

The New

Normal The Imaging Landscape in Late-Stage Pandemic Days

PAGE 38

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FEATURES

RISING STAR

Aletha Ewing works as a medical imaging manager and the DXA modality lead for Banner Imaging.

ROMAN REVIEW

The procrastinator’s brain is different. It contains a monkey - The Instant Gratification Monkey.

COVER STORY

While the global scientific community worked as one to solve a huge, new problem in real-time, their efforts and discoveries were also frequently undermined by an equally virulent “infodemic.”

OFF THE CLOCK

Paul Dubiel shares his unique adoption experience.

ICEMAGAZINE | JANUARY 2021

16 ADVANCING THE IMAGING PROFESSIONAL

JANUARY 2021

ICE 2021

The ICE 2021 Conference is set for February 10-12, 2021, with a top-notch education lineup.

RAD HR

Diversity, equity and inclusion are more than hot topics.

35 WWW.THEICECOMMUNITY.COM

PRODUCT FOCUS

Powerful AI-enabled tools and user-centric interfaces improve workflow efficiency, allowing clinicians to to focus more on their patients.

ICEMAGAZINE

MD Publishing 1015 Tyrone Rd. Ste. 120 Tyrone, GA 30290 Phone: 800-906-3373 Fax: 770-632-9090 Publisher

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Editorial

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ICE Magazine (Vol. 5, Issue #1) January 2021 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

ICEMAGAZINE | JANUARY 2021

CONTENTS SPOTLIGHT 10

Rising Star Aletha Ewing, Banner Imaging In Focus Lydia Kleinschnitz, UPMC Presbyterian Shadyside Rad Idea Smart Goals Off the Clock Paul Dubiel, UT Health Austin

NEWS 18

ICE 2021 ICE Education is Heating Up this Winter! Imaging News A Look at What’s Changing in the Imaging Industry ICE Webinars ICE Webinar Series Ends 2020 on Positive Note

PRODUCTS 34

Market Report POCUS Market to Reach New Highs 35 Product Focus POCUS

INSIGHTS 42

44 46

58 59

60 62

Coding/Billing Order Up! 5 Steps to Becoming and Expert at Ultrasound Sponsored by Avante Rad HR A Tribe Called Change Emotional Intelligence What’s the Value of Your Employees? MarShield Radiation Shielding Sponsored by MarShield PACS/IT Fog and Health Care at Home Roman Review Procrastination is Good AMSP Member Directory AMSP Member Profile Pro Diagnostic Imaging Systems ICE Break Index

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SPOTLIGHT

RISING

STAR

ALETHA EWING

Aletha Ewing with her sons on a desert trail hike.

BY ERIN REGISTER

letha Ewing, 36, was raised in Varna, Illinois, where the population is 200 residents. She attended college at Illinois Central College in Peoria, Illinois and graduated with an associate degree in applied science in radiology. Right after her college graduation, Ewing moved across the country to Phoenix, Arizona, where she began her career in X-ray and quickly cross-trained into DEXA. Shortly after that, she cross-trained into CT and worked as a CT technologist for 10 years before being awarded a promotion into leadership. For the last five years, Ewing has worked as a medical imaging manager and as the DXA modality lead for Banner Imaging. ICE learned more about Ewing in a question-and-answer interview.

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: I always knew I wanted to be in the medical field, but I was not sure what route to take. During my senior year of high school, I had some minor medical issues. This opened my eyes to the radiology world, and it was so fascinating to me. I loved how it was constantly changing and offered so many areas of advancement.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: I love the camaraderie of the leadership team. I honestly have the best support system. Each member of the leadership team has different strengths. We all come together to accomplish one goal. I also enjoy mentoring staff and encouraging them to grow in their career. I will always do whatever I can to help them flourish and succeed. I am currently a leader in our engagement team for Banner Imaging. I take pride in encouraging employees to be engaged in their career and love to see employees grow and stay involved in their work.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: There is always more to learn! Whether we like it or not,

Aletha Ewing Medical imaging manager and the DXA modality lead for Banner Imaging

this field is constantly changing, and it keeps my interest. There is always something new to learn, whether it is new upgrades or entirely new systems all together. The medical imaging field is constantly developing and growing. In the 15 years I have been in the medical imaging field, it amazes me what has changed and how much it has improved!

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: I would have to say being involved in the implementation of our current company. There were many details. So much had to be prepared and planned out precisely in order to succeed on our go live date. This was a big accomplishment for many people, and we all had a specific role in order to succeed. I, along with many others, were pushed to our limits to get everything up and going. We closed on a Friday and opened the following Monday, full force. Were there issues to fix along the way? Absolutely! Did we succeed? Absolutely! I learned more than I ever thought possible. This really opened my eyes to all the moving parts of the company and gave me more appreciation for all members of the team.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: I have recently started studying for the CRA exam. I would love to continue to grow as a leader and continue to mentor others like I have been mentored over the years. My mentor continues to challenge me and always pushes me to do more than I thought possible. With each assignment, I continue to learn and grow into a better leader. •

FUN FACTS Favorite Hobby: family time riding our RZR on desert trails Favorite Vacations Spot: anywhere there is a beach Favorite Food: tacos Secret Skills or Talents: DIY, I always say you can YouTube anything! WWW.THEICECOMMUNITY.COM

ICEMAGAZINE

SPOTLIGHT

IN FOCUS LYDIA KLEINSCHNITZ

BY JOHN WALLACE

ydia Kleinschnitz, MHA, BSN, RN, is the senior director of imaging services for UPMC Presbyterian Shadyside Hospital. However, she did not grow up thinking about a career in imaging. In fact, her tenure in imaging services started thanks to a no show.

Lydia Kleinschnitz, MHA, BSN, RN, is the senior director of imaging services for UPMC Presbyterian Shadyside.

ICEMAGAZINE | JANUARY 2021

“A career in radiology was not what I had planned,” Kleinschnitz explains. “I went to nursing school as I was inspired by my stepfather who was a corpsman in the Navy attached to a MASH unit during the Korean war. When I graduated nursing school my plan was to work in a coronary care unit, obtain my BSN, get married and have some kids. Once all those things happened, I thought, now what?” “I then stepped through doors as they opened,” she adds. “I worked as an office manager for a cardiologist, a director of care management at a health plan and then a nursing unit director in radiology. As a nursing leader in radiology, I was offered the opportunity to apply for the overall imaging director position. I was originally the second choice but when the candidate didn’t show up on his start date, I got the job as imaging services director at UPMC Shadyside Hospital. In radiology, I have remained for

the past 15 years and I am currently the senior director of imaging services for UPMC Presbyterian Shadyside Hospital.” The no show may be one of the best things to ever happen in her professional life. It opened a door to a rewarding career that blends a few of Kleinschnitz’s interests. “I love my job because it is always evolving. Technology continually advances so it is never boring! Even more, I enjoy the people I work with. I admire their compassion and focus on patient care,” she says. She has been fortunate to cross paths with some amazing leaders who helped her excel and become a gifted manager in her own right. “One of my first professional mentors was my director at the health plan. Working for the insurance company was my first foray outside of a hospital and into a business setting. Colleen Walsh taught me how to really manage others and helped me understand the ‘big picture.’ She helped me learn to never be a barrier, but to have an open mind and be open to change,” Kleinschnitz says. “The other important mentor was my previous imaging services director Verlon Salley. He taught me about staff engagement and tactics to improve staff morale. He really encouraged staff collaboration and input.” Salley worked with Kleinschnitz in a hospital setting and also as a researcher and ADVANCING THE IMAGING PROFESSIONAL

writer. Their work has led to more writing as Kleinschnitz continues to share her experiences and knowledge with colleagues. “I was a co-author along with Verlon Salley and Marlon Johnson on an article featured in AHRA magazine about staff engagement,” she explains. “I am currently working on an article with Jenilynn Porter and Marlon Johnson on tech quality assurance. We really want to feature all the hard work our teams do to maintain image quality and staff skills.” A desire to share and watch others succeed is a big part of the way Kleinschnitz sees herself helping those she works with at UPMC Presbyterian Shadyside Hospital. “My approach to leadership is to provide the vision and to be an example but also act as a facilitator, a collaborator and, when and if needed, an authoritarian,” she says. “That last one is not often needed!” Away from work, Kleinschnitz loves spending time with her two adult daughters and seeing the world with her husband, Andrew. She also likes that she has extended family members living nearby. “My husband and I enjoy traveling and have visited approximately 10 countries. I particularly enjoyed Scotland and Germany,” she says. “We hope to travel again once we are through the current pandemic.” “My greatest accomplishment must be that I have been able to balance a career while along with my husband, raise our family,” she adds. “I have a great work/life balance and I can’t imagine doing anything else.” •

Lydia Kleinschnitz enjoys travelling with her family. Here she is seen in a selfie she took with one of her daughters, Anna, and her husband, Scott, while visiting Colorado.

LYDIA KLEINSCHNITZ

Senior Director, Imaging Services, UPMC Presbyterian Shadyside hospitals What book are you reading currently? “The Pioneers” by David McCullough, and just finished “Valley of the Shadow” by Ralph Peters. Favorite movie? “Rocky” Not for the boxing but for the story of resilience and when opportunities present, taking chances. What is something most of your coworkers don’t know about you? I love reading newspapers especially the local ones when we travel. Who is your mentor? I’ve had few including my high school swim coach and former bosses at UPMC – Colleen Walsh and Verlon Salley. What would your superpower be? Flying, would love to avoid traffic.

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What is one thing you do every morning to start your day? Start my day with a prayer. Best advice you ever received? In business never be the roadblock or be the builder of walls. Who has had the biggest influence on your life? My parents. Both are deceased now. They helped to instill strong values and love of family. What are your hobbies? Making homemade candles, reading (especially anything history related), traveling, hiking, watching baseball. What is your perfect meal? Love steak and potatoes, especially when it is a family meal.

ICEMAGAZINE

SPOTLIGHT

Rad idea

JOHN WALLACE

SMART GOALS

elieve it or not, 2020 is over and 2021 is here. And, what comes with every new year? That’s right … goals!

At MD Publishing we use SMART goals and I recommend that approach to anyone who is serious about meeting their goals. The use of SMART goals is a popular approach. SMART is an acronym that stands for Specific, Measurable, Achievable, Relevant and Time-based. Each ingredient in the SMART recipe works with the other ingredients to create a goal that is carefully planned, clear and trackable. The following is information from Indeed.com that explains more about the SMART goals approach and how to craft goals for 2021. S = Specific Be as clear and specific as possible with what you want to achieve. The more narrow your goal, the more you’ll understand the steps necessary to achieve it. M = Measurable What evidence will prove you’re making progress toward your goal? For example, if your goal is to earn a position managing a development team for a startup tech company, you might measure progress by the number of management positions you’ve applied for and the number of interviews you’ve completed. Setting milestones along the way will give you the opportunity to re-evaluate and course-correct as needed. When you achieve your milestones, remember to reward yourself in small but meaningful ways.

ICEMAGAZINE | JANUARY 2021

A = Achievable Have you set an achievable goal? Setting goals you can reasonably accomplish within a certain timeframe will help keep you motivated and focused. Using the above example of earning a job managing a development team, you should know the credentials, experience and skills necessary to earn a leadership position. Before you begin working toward a goal, decide whether it’s something you can achieve now or whether there are additional preliminary steps you should take to become better prepared. R = Relevant When setting goals for yourself, consider whether or not they are relevant. Each of your goals should align with your values and larger, long-term goals. If a goal doesn’t contribute toward your broader objectives, you might rethink it. Ask yourself why the goal is important to you, how achieving it will help you and how it will contribute toward your long-term goals. T = Time-based What is your goal timeframe? An end-date can help provide motivation and help you prioritize. For example, if your goal is to earn a promotion to a more senior position, you might give yourself six months. If you haven’t achieved your goal in that timeframe, take time to consider why. Your timeframe might have been unrealistic, you might have run into unexpected roadblocks or your goal might have been unachievable. • JOHN WALLACE is the editor at MD Publishing. Share your RAD IDEA via an email to editor@mdpublishing.com.

ADVANCING THE IMAGING PROFESSIONAL

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SPOTLIGHT

Off Clock THE

PAUL DUBIEL, CRA, AHRA, RT(R), ARRT ASSISTANT DIRECTOR OF SHARED SERVICES, UT HEALTH AUSTIN BY MATT SKOUFALOS

t 34 and a half, Paul Dubiel got the disappointing news that he wasn’t old enough to become a father.

It was 1997, and Dubiel and his wife had begun the process of petitioning the Chinese government to adopt a child. Their application had been delayed as the country reeled from the effects of avian flu, but then the wait was further extended because the law required him to be at least 35 years old before he could welcome the baby. “It never worked out for us to have kids ourselves,” Dubiel said. “We wanted a child, and we thought about adoption. We just decided to look internationally, and we happened upon China. “China says under 35 is too young to adopt, and in the United States, 35 is almost too old to adopt, depending on how everything goes,” he said. “We 16

ICEMAGAZINE | JANUARY 2021

were in a holding pattern.” With another six months to go before they would be allowed to meet their daughter, the Dubiels traveled to Seattle for a vacation. While they were out sight-seeing there, they popped into a store with a display of colorful kites, including a traditional Chinese dragon kite. It seemed to be another signifier of the path that they had chosen. “We thought, ‘Well, we may not have the baby yet, but this kite will remind us of it,’” Dubiel said. “That was our first kite, so since then, every time we see an interesting kite, we collect it.” Kites originated in China; historians believe generals used the technology to aid in troop deployments and gathering logistical information. Today, they are a cultural signifier, often shaped in the forms of mythological or symbolic figures. In Chinese culture, the dragon is believed to be an auspicious totem, bringing luck and wealth, and associated with nobility and power. ADVANCING THE IMAGING PROFESSIONAL

Paul Dubiel and his family visited China with their adopted daughter.

The dragon kite has never been flown (“We don’t fly them because I know I would crash them,” Dubiel said), but at eight feet long, it is vibrant, colorful, and commands attention. Its three-dimensional, abstract, sectional body has provided conversation for years, perhaps never more than during the novel coronavirus (COVID-19) pandemic of 2020, when the kite became the most interesting detail of teleconferencing backgrounds in their household. “It turned four, boring, blank, white walls and made the space interesting,” Dubiel said. “It goes from one end of the ceiling to another; it’s how it looks in the room and how it makes the room feel.” A few years after the Dubiels eventually welcomed their daughter, Claire, home from China, they adopted a second baby, Leah, via the same process – and they kept collecting kites. By now, the girls have grown into young women, and the kite collection has hit double-digits. “It’s things that caught our eye when we walked by and saw them in a store or a street fair,” Dubiel said. In the beginning, Claire (now a college graduate) and Leah (now a college freshman) purchased some of the kites from a store, and made others; all of them were added to the collection. Many are from trips to the West Coast of the United States; some were bought on a visit the family made to China. They’ve all been selected purely for their aesthetic qualities, whether they matched another piece of décor in the home, or took the form of an animal in which the girls were interested. There are butterflies, dragonflies, bats, and moths; one’s a turtle, and of course, there are several dragons. For the Dubiels, a collection that started as a way to keep their promised baby close to their hearts while they waited to hold her in their arms became a touchstone for the family. WWW.THEICECOMMUNITY.COM

In the years that followed, they took a deeper dive into Chinese culture, the better to help their daughters bridge the country of their birth and the one that had become their home. The parent-run agency Families with Children from China played a big part in helping the Dubiel family keep their children in touch with their ancestry. The group hosted social events through which parents supported one another during the adoption process, and connected families in Central Texas with children half a world away in China. “Asian culture in general is very strong here in Austin,” where Dubiel, a 27-year fellow of the Association for Medical Imaging Management (AHRA) and current AHRA Director, works as the Assistant Director of Shared Services at UT Health Austin. “There’s an active group of families that adopted from China here. When we adopted our oldest, we used to go to meetings in people’s backyards; by the time our second daughter came along, they had to rent out school cafeterias for any big meetings or parties.” When they were old enough, the Dubiels traveled to China with their daughters so that the girls could visit the cities of their birth, speak to the officials who managed the orphanages where they were first cared for, and take in a sense of their heritage. “They wanted to see the places where they started their lives, and we did that for them,” Dubiel said. “I think both of them had some closure; I know we did.” The Dubiels still enjoy traveling, and

Paul Dubiel’s two daughters are seen at a graduation.

although the COVID-19 pandemic put a halt to this year’s plans, they’re likely to set out again here and there as their daughters begin their adult lives. The lessons they hope they’ve imparted on their children have more to do with the family they’ve created together than any innate expectations of the cultures they’ve traveled through in the process of getting there. “We always try to blend both American and Chinese cultures,” Dubiel said. “You’ve just got to let the kids learn what they want and how much they want to be involved in it. You need to be there to help them, but you can’t push them into anything. “We’re their parents, and they’re our kids,” he said. “We’ve always been a family from the beginning.” •

Some of Paul Dubiel’s kites are seen in his house.

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ICE 2021 Education is Heating Up this Winter! REGISTER NOW!

“I like learning new things and also the networking. We’re meeting people from

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different parts of the United States and seeing what they’re doing and building relationships with them.” D. Jaramillo, Manager, Imaging Services Director

ADVANCING THE IMAGING PROFESSIONAL

he 2021 Imaging Conference and Expo (ICE 2021) is set for February 10-12, 2021. It is the only conference dedicated to imaging directors, radiology administrators and imaging engineers from hospital imaging departments, freestanding imaging centers and group practices. ICE offers valuable CE credits from the ASRT and ACI (pending approval) and, keeping in line with successful conferences in the past, offers comprehensive educational opportunities for attendees. Attendees will have the opportunity to earn several hours of CE credit from top-notch speakers from across the country. The conference will kick off with a CRES Prep Course, presented by Brian Wilson, Trimedx Imaging Service Engineer 3. The next two days of the conference are packed with valuable educational sessions that cover a wide range of topics from interdepartmental communication to MRI safety standards and recommendations. In addition to the classes, ICE 2021 will include a special panel discussion titled “A Look Back at 2020 and the Lessons Learned.” Nicole Walton-Trujillo, Nicole Dhanraj, Jason Theodre, Jason Scott and John Bell will be the panelists for this one-of-a-kind session. ICE spoke with some of the conference presenters about why they chose to attend, as well as present on their designated topic, providing great insight. Riley Tasker, Intermed Group Imaging Equipment Specialist, said she hopes her presentation “Creating an Efficient Radiology Value Stream” will allow imaging centers and decision makers to learn about opportunities to grow their business while saving revenue. Nicole Dhanraj, Northern Arizona Healthcare Systems Director, says she is presenting “Leading with Cultural Sensitivity” because health care itself has a very diverse workforce. “To help leaders be more impactful, we need to lead through a culture lens versus a narrow myopic view,” said Dhanraj. “Even though leaders are aware of the differences in culture, at times, we do not realize our unconscious behaviors and perceptions that can affect our effectiveness as a leader with a diverse team. Understanding the influences of culture on operations will help leaders build stronger teams and lead more effectively.” For his presentation titled “Inspire, Encourage and Empower,” Kenneth Fazzino, director at Envision Physician Services, stated, “this presentation is from the realization of how much a leader can impact a team and individual. I have worked with some very good and some not so good leaders.

It takes a blend of styles and approaches to be successful. Many leaders are promoted from within with no formal training for such an important role.” Banner Imaging’s Perry Kirwan and Jason Theodre are presenting “5 Simple Steps to Develop Better Action Planning – A Medical Imaging Capital Case Study.” Perry stated, “It’s easy in the medical field profession to let confirmation bias sometimes drive important decisions that have long term implications. Hopefully this presentation will provide some insight on how not to fall into typical traps that we often do when stretched for time over multiple competing priorities.” Theodre added to Kirwan’s response by mentioning, “When things become difficult, it is easy for all of us to go on autopilot. Our normal behaviors are filled with bias. Being deliberate in our actions, including strategic thinking, always leads to better outcomes.” When asked why they decided to participate in an in-person meeting in 2021, the speakers used the terms “opportunity” and “professional development.” Dr. Nicole Walton-Trujillo, imaging director at Intermountain HealthCare, said ICE 2021 is “a great opportunity to connect to vendors face-to-face when preparing a project or rounding the curve on a project internally.” John Beall, administrative officer at Madigan Army Medical Center, added, “I believe it has a lot to do with my desire to meet colleagues from throughout the nation and learn from them in person. It has been a long and trying period for all of us as we have attempted to care for our patients and families. When I saw that the event was being planned, it was an opportunity to mix professional development with a few days of being somewhere that wasn’t within the parameters of my home-to-work bubble.” Whether it’s invaluable continuing education, productive networking or the exclusive exhibit hall, attendees have the perfect opportunity to enhance their careers and spend time with colleagues at ICE 2021. As an added incentive, ICE conference admission is complimentary for all hospital employees, imaging center employees, members of the military and students. ICE continues to be the only conference to combine leaders in imaging management with imaging engineers, providing an exclusive and unique community of key decision makers and influential imaging professionals. ICE is the perfect resource to grow and prosper, personally and professionally. • For additional information, visit AttendICE.com.

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ICEMAGAZINE

ICE 2021 EDUCATION WEDNESDAY, FEBRUARY 10 1-5 PM CRES Study Group and Prep Class (Part I)*

situations that leaders undergo, and how to

of when the referring provider orders an

use those events to be stronger and more

imaging test to the time the results are given

approachable with your team. Being resilient

can be very worrisome for the patient, as the

is an attainable goal that we must achieve!

patient experiences a high level of uneasiness of what the results might indicate. It is up

Brian Wilson, CBET, CRES,

to us, as imaging professionals, to decrease

Trimedx

Creating an Efficient Radiology Value Stream

Healthcare technology management (HTM)

Riley Tasker, R.T. (R), BA,

display to help minimize the fears that are

professionals that desire a Certified Radiolo-

Equipment Imaging Specialist

felt by our patients. It is important to be em-

gy Equipment Specialist (CRES) certification

and Scott Nudelman, CHTM,

pathetic towards our patient’s needs in order

are expected to have experience in a wide

COO, The Intermed Group

for them to have a more positive experience.

Imaging Service Engineer 3,

range of medical imaging modalities. This

the scanxiety level of our patients. There are many behaviors that technologists can

Many times it is the “little things” like smiling,

two-part session will review the major topics

This session will address several topics,

providing a gentle touch or sitting with a

for the AAMI CRES Certification test. Stu-

including partnering with a multi-vendor,

patient that make the biggest impression

dents will have a good understanding of the

multi-modality-trusted and collaborative

upon our patients. However, it is up to leaders

objectives and subjects covered on the CRES

service providers, reducing downtime on ser-

to portray a culture based upon delivering

examination.

vice contracts, eliminating redundancies and

positive patient experiences.

THURSDAY, FEBRUARY 11 8 AM – 12 PM CRES Study Group and Prep Class (Part II)*

streamlining workflow, such as leveraging

strategies to ensure appointments are kept

Verifying Image Quality ‑ How to use an Ultrasound Phantom

and minimize ‘no-shows.’

James Rickner, Director of

technology, HTM and optimizing protocols and, lastly, implementing effective schedule

Brian Wilson, CBET, CRES, Imaging Service

Technical Services, MXR Imaging

Kenneth Fazzino, CRA, PMP,

1 – 2:30 PM Interdepartmental Communication with Respect to Workplace Trauma to Imaging Clinicians

Director, Envision Physician

Dr. Nicole T. Walton-Trujillo, R.T.(R)(CT),

Services

Imaging Director, Intermountain HealthCare

By the end of this session, attendees should

This session will review how current work

have an understanding of different leadership

processes around interdepartmental com-

styles, characteristics and actions that can

munication can engage a work process

3 – 4:30 PM Developing Your In-House Service Capabilities: Executing a Multi-Year Plan

impact teams. We will discuss the charac-

change to improve the safety of the team in

Dustin Telford, CRES, CHTM, CBET, CLES,

teristics of a successful leader, and how they

workplace trauma situations.

Clinical Engineering Manager, Children’s

Engineer 3, Trimedx

10:30 AM – 12 PM Inspire, Encourage and Empower

translate within our world. Empowerment is critical but must be done properly, and we will review what makes it work.

How to be Resilient During Stressful Times Brenda DeBastiani, MBA, BA,

This session will show how to use a phantom to verify and troubleshoot difficult problems with respect to image quality and show attendees how to use their skills to complete accredited PMs to OEM specifications.

Hospital & Medical Center Omaha

The Importance of Imaging’s Role in the Patient Experience

Developing and maintaining a capable work-

Jason Scott, FAHRA, CRA, CPXP,

and those hoping to bring some services

Chief Patient Experience Officer, Witham

in-house, are challenged to manage to build

Health Services

a successful service program. During this

force is only one area that in-house programs,

presentation, the presenter will discuss how

CRA, RT(R), FAHRA, Director of Scanxiety is a relatively new term in medical

to develop a plan that incorporates contract

imaging but one that plays a huge role in

negotiations, customer relationship manage-

All of us are experiencing more stress than

a patient’s experience. Scanxiety is anxiety

ment and the quality to manage either a fully

ever, but why is it that some leaders thrive

and worry that accompanies a period of time

in-house program or a hybrid solution with

while others struggle? This presentation

before undergoing or receiving the results

business partners. Content includes work-

will talk about some of the most stressful

of a radiology examination. The time period

sheets and project planning resources.

Imaging, Mon Health Medical Center

*Additional charge applies for CRES Prep class.

ICEMAGAZINE | JANUARY 2021

ADVANCING THE IMAGING PROFESSIONAL

MRI Safety Standards and Recommendations Susan MacIntyre, ARRT (R),

Survival Guide for Imaging Engineers in the Cath Lab

ARRT (MR), MRSO (MRSC), CRA,

Brian Wilson, CBET, CRES,

MRI Supervisor, UPMC

Imaging Service Engineer 3, Trimedx

This session will review basic MRI principles

This course will cover the various technolo-

along with safety and discussion of the ACR

gies found in the cath lab, EP lab, IR lab and

recommendations for MR safety based on

vascular and hybrid ORs. Imaging service

the 2020 ACR Manual on MR Safety.

engineers will receive a basic understanding

contribute the minimum required while always on the lookout for better employment opportunities. During this session, we will learn how to improve and model engagement, so you can inculcate your team members that fall in the

of the differences and similarities between

Digital Mammography – Quality Control and Medical Physics Checks

the different modalities and how to safely work in each environment.

“not engaged” category.

5 Simple Steps to Develop Better Action Planning – A Medical Imaging Capital Case Study Perry Kirwan, CCE, VP Technology Management and Jason Theadore, CRA, CEO,

what tests are performed during an annual

Medical Imaging Modalities Introduction for Managers and Service Engineers

PM and by a medical physicist. We will review

Dale Cover, RSTI

mation around various principles. This allows

Dale Cover, RSTI This course will teach the service engineer

the digital detector technology and perfor-

Banner Imaging Services An expert, in any field, learns to group inforthe expert to quickly draw information when

mance characteristics from the major digital

This presentation will delve into the various

needed. A beginner organizes information in

mammography OEMs. We will review the

imaging systems used in today’s medical

a more random and error-prone fashion. A

quality-control tests and cover how tests and

imaging field. Basic operational principles,

thinking model, like a playbook for a game or

checks are performed, what tools and test

major subsystems and use and primary main-

recipe for a meal, helps the leader learn more

equipment are required to perform system

tenance issues for each imaging modality will

quickly and efficiently. Five simple steps can

tests and checks, what the tests are attempt-

be the main focus of this discussion. At the

help any leader develop the proper plan of

ing to quantify and, lastly, corrective actions

conclusion of this presentation, attendees will

action for both strategic and tactical consid-

needed, such as component replacement,

have a better understanding of the medical

erations: Stop & Think, Identify Assumptions,

calibration, etc., when tests fail.

imaging systems in their facilities and how

Evaluate Information, Draw Conclusions and

they affect patient outcomes and hospital

Develop the Plan for Action.

FRIDAY, FEBRUARY 12 9 – 10:30 AM Leading with Cultural Sensitivity

Nicole Dhanraj, Systems Director, Northern Arizona Healthcare Within our health care industry, there is an em-

operations.

11 AM – 12:30 PM You Say Your Staff Is Not Actively Engaged… Are You?

The Magic 7 Triggers to Yes Manny Roman, Business Operations Manager, AMSP

John Beall, Administrative Officer,

We are not thinking machines, we are feeling

Madigan Army Medical Center

machines that think. Modern real-time brain

phasis on increasing workplace diversity. As a

imaging techniques demonstrate what parts

result of the changes in the workplace demo-

In 2020, Gallup released that the percentage

of the brain are activated under varying con-

graphics, radiology leaders have to be able to

of “engaged” workers in the U.S. — those

ditions. These imaging techniques prove that

lead and influence persons with varying values

who are highly involved in, enthusiastic

the part of our brains that control emotions is

and beliefs. An individual’s culture has a pow-

about and committed to their work and

first to react to all input. It will make decisions

erful influence on how they form relationships,

workplace — reached 35%, which is the

based on emotions before presenting the

perceive and process information, their work

highest level since the organization started

information to the logical thinking part of

ethic, learning styles and their willingness to

tracking the metric in 2000. On the flip side,

the brain. We will explore 7 triggers that influ-

speak up. In this session, we will explore diver-

the report identified that the percentage

ence others to a “Yes” decision.

sity in health care and discuss the challenges

of workers who are “actively disengaged”

associated with leading a diverse workforce.

— those who have miserable work expe-

In addition, there will be a discussion on the

riences and spread their unhappiness to

impact of being ethnocentric, especially as

their colleagues — was at 13%. This means

2:30 – 5 PM Panel Discussion: A Look Back at 2020 and the Lessons Learned

it relates to hiring practices and fostering an

that a little over 50% of our staff falls under

This general session will provide viewpoints

inclusive environment. Finally, the session

the “not engaged” category — those who

from a variety of esteemed representatives

will conclude with strategies on leading with

are psychologically unattached to their

of the imaging profession on lessons learned

cultural sensitivity with the intent of increasing

work and company and who put time, but

from 2020. How they overcame the challeng-

awareness of bias and other pitfalls radiology

not energy or passion, into their work. This

es faced and also highlighting the successes

leaders often unconsciously fall victim to.

population will usually show up to work and

achieved.

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ICEMAGAZINE

• • • • • • • • • • • •

Lead Lined Cabinets Radiation Barriers Modular Booths/Walls Lead Curtains Lead Bricks & Sheet Lead Borated Polyethylene Leaded Glass & Acrylic Lead Lined Storage Containers X-Ray Rooms Design & Construction Tungsten Vials & Syringe Shields Lead Pig Vials & Waste Containers Design & Consultation Services

NEWS

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

CANON MEDICAL OFFERS NEW LIVER REPORTING TOOL FOR ULTRASOUND Liver disease is one of the major challenges in imaging today, and accurately determining compensated advanced chronic liver disease (cACLD) is extremely important in order to define the right treatment path. The recently updated guidelines from Society of Radiologists in Ultrasound (SRU) introduced the “Rule of Four,” a standardized method of using four different levels of shear wave elastography-based liver stiffness to assess the probability of cACLD. To help easily and accurately determine cut off values, Canon Medical Systems USA Inc.’s premium Aplio i-series

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ultrasound platform is now available with software to display the calculated measurement averages from multiple samples of the liver, customizable based on the “Rule of Four.” The program uses measurements obtained with Shear Wave Elastography, Canon Medical’s technology that provides a quantitative measure and dynamic visual display of tissue stiffness in the liver. In addition, the system provides standard deviation and interquartile range (IQR) data, as well as a simple visual propagation map, to ensure accurate and confident application

of the “Rule of Four” to determine cACLD and for the assessment of other liver pathologies. “The new guidelines from SRU reinforce the importance of quickly and accurately determining cACLD, so that clinicians can chart the right course for patient care,” said Dan Skyba, managing director, ultrasound business unit, Canon Medical Systems USA Inc. “At Canon Medical, it doesn’t get much easier than automatically calculating that average measurement of tissue stiffness, with our Shear Wave Elastography plus this new liver reporting tool.” •

ICEMAGAZINE

NEWS

PHILIPS HIGHLIGHTS EXPANDING ENTERPRISE IMAGING INFORMATICS PORTFOLIO AT RSNA 2020 Royal Philips highlighted its expanding enterprise imaging informatics portfolio at RSNA 2020. Informatics solutions play an important role in diagnosis and treatment, as well as the management of patient data across the health care enterprise. At RSNA 2020, Philips announced a series of informatics innovations. The latest version of Philips Advanced Visualization Workspace (IntelliSpace Portal 12) features a robust set of new AI-assisted quantitative assessment and automatic results generation features to support the diagnostic workflow, including follow-up and communication across cardiology, pulmonology, oncology and neurology. New features include AI algorithms for lung nodule detection, cardiac functional analysis and quantification of pulmonary infiltrates, associated with COVID-19 patients. The intelligent, automated and connected multi-modality, multi-vendor suite of applications supports follow-up and communication across clinical care pathways. Industry-first vendor-agnostic Philips Radiology Operations Command Center enables virtualized imaging operations via a private, secure and auditable telepres-

ICEMAGAZINE | JANUARY 2021

ence platform. Philips is the first company to market a radiology command center that can integrate with existing technologies and systems outside Philips. As a multimodality (MR and CT), vendor-agnostic digital hub, the Radiology Operations Command Center connects imaging experts at a central command center with technologists and onsite staff in locations across an entire enterprise for real-time, over-the-shoulder collaboration and support. Powered by Philips’ proprietary, patented operational performance management technology, the Radiology Operations Command Center enables remote access to scanners across an imaging network. Patients anxious about a potentially serious diagnosis can receive support even before arriving for their exams, with personalized instructions and reminders delivered via SMS-based communications from Philips Patient Management Solution. The solution sends personalized reminders and helpful information about upcoming telehealth consults, helping patients to prepare for their virtual appointments. Before in-person appointments, health care providers can use Patient Management to screen patients using a digital survey to identify possible COVID-19 symptoms. •

ADVANCING THE IMAGING PROFESSIONAL

FDA APPROVES PSMA-TARGETED PET IMAGING DRUG On December 1, 2020, the U.S. Food and Drug Administration approved Gallium 68 PSMA-11 (Ga 68 PSMA-11) – the first drug for positron emission tomography (PET) imaging of prostate-specific membrane antigen (PSMA) positive lesions in men with prostate cancer. Ga 68 PSMA-11 is indicated for patients with suspected prostate cancer metastasis (when cancer cells spread from the place where they first formed to another part of the body) who are potentially curable by surgery or radiation therapy. Ga 68 PSMA-11 is also indicated for patients with suspected prostate cancer recurrence based on elevated serum prostate-specific antigen (PSA) levels. Ga 68 PSMA-11 is a radioactive diagnostic agent that is administered in the form of an intravenous injection. “Ga 68 PSMA-11 is an important tool that can aid health care providers in assessing prostate cancer,” said Alex Gorovets, M.D., acting deputy director of the

Office of Specialty Medicine in FDA’s Center for Drug Evaluation and Research. “With this first approval of a PSMA-targeted PET imaging drug for men with prostate cancer, providers now have a new imaging approach to detect whether or not the cancer has spread to other parts of the body.” Once administered via injection, Ga 68 PSMA-11 binds to PSMA, which is an important pharmacologic target for prostate cancer imaging because prostate cancer cells usually contain elevated levels of the antigen. As a radioactive drug that emits positrons, Ga 68 PSMA11 can be imaged by PET to indicate the presence of PSMA-positive prostate cancer lesions in the tissues of the body. The FDA granted approval to the University of California, Los Angeles and the University of California, San Francisco. •

SAMSUNG INTRODUCED INNOVATIONS AT RSNA 2020 Samsung Electronics Co. Ltd. showcased its diagnostic imaging solutions in ultrasound, digital radiography and mobile computed tomography at RSNA 2020. In ultrasound, Samsung showcased the RS85 Prestige. It is designed to deliver outstanding scanning performance with consistent image clarity, depth of penetration and sensitivity to perfusion of blood flow to enhance abdominal and breast examination functionality. Above all, the RS85 Prestige delivers real-time images to clinicians, which is essential in ultrasound imaging. Samsung also featured its premium digital mobile X-ray, the AccE GM85, which delivers unparalleled performance by improving diagnostic confidence and workflow. The AccE GM85, powered by a lithium-ion battery, in particular has demonstrated unprecedented performance during the recent pandemic. The AccE GM85 is suited to general imaging needs, and its practicality during the COVID-19 pandemic is highlighted through its unique feature set. Samsung also introduced two new enhanced software options for its line of DR equipment. In computed tomography, Samsung featured Body-

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Tom Elite and OmniTom – mobile whole-body and head CTs. These mobile CTs can be used at the point of care, whenever imaging is needed to determine the ideal treatment strategy for a patient – without restrictions of physical space and power. Samsung’s NeuroLogica mobile CT devices are used by numerous leading institutions in intensive care units, emergency rooms, orthopedic and neurosurgery rooms, brachytherapy suites and ambulances. In addition, Samsung presented a Photon Counting Detector (PCD) – technology that measures photons emitted by X-rays. The PCD, currently under development, has the potential to allow for dose optimization, allowing the user to reduce exposure while maintaining image quality, or increase the image quality by keeping dose equivalence compared to currently used CT detectors. The PCD is expected to deliver increased data mining capabilities from multiple-energy detection and contribute to the improved utility and efficacy of AI applications. Expanding from this, Samsung is closely collaborating with a major university hospital in the United States. •

ICEMAGAZINE

NEWS

CARESTREAM HIGHLIGHTS PEDIATRIC IMAGING Carestream Health’s DRX-Revolution Nano was in the spotlight as the company showcased its advances in pediatric imaging at RSNA 2020. The Carestream DRX-Revolution Nano Mobile X-ray System effectively and noninvasively examines and aids in the treatment of pediatric patients. Neonatal intensive care units (NICUs) are able to conduct chest, intensive care and orthopedic exams quickly, at the patient’s bedside. “This system is ideal for chest X-rays and other pediatric exams,” said Sarah Verna, worldwide marketing manager for global X-ray solutions. “The DRX-Revolution Nano is ideally suited to serve as a dedicated system in an intensive care unit and the NICU.” The portable, nonmotorized X-ray system uses carbon nano tube technology and features an ultra-lightweight design for easy maneuverability and arm positioning. It quietly and carefully moves around equipment that

ICEMAGAZINE | JANUARY 2021

typically surrounds babies in critical care. The DRX Plus 2530C small-format detector provides greater positioning flexibility, especially in bassinets. “It has no motors, which allows the system to be quiet,” Verna said. “It is small, lightweight and easy to transport even in tight environments like the NICU.” The DRX-Revolution Nano addresses concerns over the level of radiation received by pediatric patients during imaging. With its Cesium iodide design for dose-sensitive pediatric applications, the system balances low radiation dose with high image quality, resulting in patient safety and accurate exams. Radiation exposure time is automatically determined to use the shortest exposure possible for effective results. As with other Carestream imaging solutions, the DRX-Revolution Nano has the X-Factor platform that enables the sharing of detectors across the DRX product suite.•

ADVANCING THE IMAGING PROFESSIONAL

ALPHA SOURCE GROUP NAMES NEW CEO Alpha Source Group (ASG) named Allan Klotsche to the position of CEO. Klotsche is charged with heading the reinvention of the service, repair and parts provider for OEMs and health care providers. “The company is known for its capabilities to support a vast array of diagnostic imaging (DI) equipment modalities including CT, MR, ultrasound, nuclear medicine, BMD, PET, PET CT and SPECT CT across multiple OEMs,” a press release states. “In the last two years, the company has expanded its product offerings, enhanced its capabilities and grown its geographic footprint to support customers’ service and repair needs. Since assuming the leadership role, Klotsche continues to refine an innovative new strategic initiative to expand the company’s new service offerings by partnering with OEMs to support their field service repair needs. These first-of-their-kind industry partnerships give OEMs the ability to more quickly and cost-effectively meet the service repair and maintenance needs of health care pro-

viders across the country,” according to a news release. Formerly, Klotsche served in multiple executive and CEO roles in the manufacturing industry. He earned his executive master’s degree in business administration from the University of Wisconsin-Milwaukee where he currently serves as an executive-in-residence at the Lubar School of Business. He is also a former board member of Alpha Source Group from 2015 until July of this year. Rich Springer remains in the role of president of Alpha Source Group. “Alpha Source Group’s full spectrum of service offerings combined with our exceptional national field service team is well positioned to meet the demands of OEMs in need of a partner that can provide essential maintenance and repair with the highest standards of excellence. Our ability to scale rapidly gives OEMs peace of mind knowing that their customers will be serviced quickly, cost-effectively and that the job will be done right and on time,” says Klotsche. •

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NEWS

ICAD REPORTS OVER 1,000 LICENSES SOLD AS PART OF PROFOUND AI SALES

HOLOGIC ANNOUNCES CE MARK FOR CERVICAL CANCER SCREENING TOOL Hologic Inc. announced that its Genius Digital Diagnostics System is now CE marked in Europe. Genius Digital Diagnostics is the first digital cytology platform to combine a new artificial intelligence (AI) algorithm with advanced digital imaging to help cytotechnologists and pathologists identify pre-cancerous lesions and cancer cells in women. Hologic is redefining cervical cancer screening by introducing Genius Digital Diagnostics for laboratories. The system can rapidly analyze all cells on a ThinPrep Pap test slide, narrowing tens of thousands of cells down to a gallery view of the most diagnostically relevant images. This will help provide health care providers with the critical information they need to guide earlier detection and better treatment decisions for the patients they serve. “Application of AI requires digital images that are of exceptional quality,” said Kevin Thornal, president, diagnostic solutions division at Hologic. “Our teams developed a breakthrough imaging technology that converts physical

ICEMAGAZINE | JANUARY 2021

glass cytology slides into digital images with superior clarity. From this digitalization, advanced image analysis and improved standardization are now achievable.” Genius Digital Diagnostics enables a more seamless and dynamic collaboration across laboratories within a network, connecting pathologists with remote review so each patient can benefit from the collective knowledge of geographically dispersed experts when needed. Digital case review promises to enhance the experience for lab partners by improving workflow and accelerating review time. Hologic now offers the first CE-marked comprehensive cervical cancer screening portfolio from sample collection to digital diagnosis. Genius Digital Diagnostics consists of a digital imager for image acquisition, an AI algorithm for analyzing images, an image management server for storing images, and a review station for case review. The complete system is scalable, designed to fit the present and future needs of laboratories. •

iCAD Inc. has reported that over 1,000 licenses have been sold as part of ProFound AI sales since the products were launched, signaling the rapid and wide-spread adoption of the cancer detection software solution built on artificial intelligence (AI). The sales have been distributed across all major mammography system vendors and enterprise-wide viewing applications with a significant percentage to date sold to hospitals and imaging centers with GE and Siemens, as well as facilities with more than one imaging system vendor, including Hologic and Fuji. “The solid momentum is led by the company’s growing customer base and demand for its expanded suite of leading breast health AI solutions, including ProFound AI for both Digital Breast Tomosynthesis (DBT) and 2D mammography, and interest in the recently introduced ProFound AI Risk, which is helping to transform breast cancer screening from agebased screening to risk-adapted precision screening, individualized for each woman,” according to a news release. ProFound AI Risk is the first and only commercially available clinical decision support tool to provide an accurate two-year breast cancer risk estimation based solely on a screening mammogram, the release adds. •

ADVANCING THE IMAGING PROFESSIONAL

SANJEEV BHALLA JOINS RSNA BOARD OF DIRECTORS Sanjeev Bhalla, M.D., a highly regarded educator and clinical leader in cardiothoracic and pulmonary imaging, has joined the Radiological Society of North America (RSNA) Board of Directors as liaison for education. “I am beyond excited to serve the RSNA in this new role,” Bhalla said. “I have always thought of RSNA as a leader in science, education, workflow and technology, because it is on the forefront of what is new and exciting in our field. This year has created new challenges that have forced us all into reflection on our core principles. The essence of RSNA has always been the sense of community. I look forward to helping to build on our sense of community, as we explore the novel ways we learn and grow in the post-COVID world.” Bhalla is section chief of the Cardiothoracic Imaging

Section at Mallinckrodt Institute of Radiology (MIR) in St. Louis, Missouri, a position he has held since 2007. He is a professor of radiology in the Cardiothoracic Imaging Section, and assistant residency program director and vice chair for education at MIR. He is co-director of Body CT at Barnes-Jewish Hospital and clinical radiologist at Barnes-Jewish Hospital, Barnes-Jewish West County Hospital and St. Louis Children’s Hospital. After receiving his undergraduate degree from Yale University in 1990, Dr. Bhalla earned his medical degree from Columbia University College of Physicians and Surgeons in 1994 and completed his internship at Columbia-Presbyterian Hospital Department of Internal Medicine. He moved to MIR for his residency in diagnostic radiology, serving as chief resident, followed by a fellowship in cardiac and thoracic imaging. •

SIEMENS HEALTHINEERS UNVEILS NEW MOBILE C-ARM SYSTEM AND MORE Siemens Healthineers introduced the Cios Flow, a mobile C-arm designed to increase the ease and efficiency of everyday imaging workflows for surgical interventions, and more at RSNA 2020. The Cios Flow can be used by multiple medical disciplines in the operating room (OR), including orthopedics, trauma surgery, spinal surgery, vascular surgery and pain therapy. This wide range of applications helps ensure high-capacity system utilization, making the Cios Flow cost-effective. Additionally, its features are designed for easier and more efficient operation to help improve patient care in the OR. The Cios Flow’s low weight, maneuverability, and intuitive touch-gesture interface simplify operation, even for new users. The new SpotAdapt function helps the user to visualize challenging anatomical areas. The user simply taps the anatomical area on the preview image of the Touch User Interface, and SpotAdapt automatically optimizes relevant imaging and post-processing parameters such as brightness and contrast. Siemens Healthineers also presented the MULTIX

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Impact C, a new ceiling-mounted digital radiography (DR) system. RSNA also marked the launch of the MULTIX Impact VA20, a new version of the established floor-mounted parent DR system. Both systems are affordably priced to expand access to high-quality imaging and enhance the patient experience. The MULTIX Impact C and the MULTIX Impact VA20 each possess an intuitive operating system, versatile wireless detectors, motorized tube heads, and a free-floating, flat tabletop, which enables easy patient access. The touch user interface on the X-ray tube permits the radiologic technologist to remain by the patient’s side for longer periods of time. And when in the control room, the technologist can use the patient positioning camera to continuously monitor the patient. Siemens Healthineers in addition introduced the LUMINOS Lotus Max, a premium 2-in-1 remote-controlled imaging system that seamlessly integrates fluoroscopy and radiography for increased productivity and optimized clinical operations. In this manner, the LUMINOS Lotus Max transforms the delivery of patient care. •

ICEMAGAZINE

NEWS

FDA CLEARS POWERFUL MRI DEVICE GE Healthcare has announced U.S. FDA 510(k) clearance of SIGNA 7.0T magnetic resonance imaging (MRI) scanner, the world’s most powerful FDA-cleared MRI device available. With a magnet approximately five times more powerful than most clinical systems, SIGNA 7.0T can image anatomy, function, metabolism and microvasculature in the brain and joints with incredible resolution and detail. This new system can be used for research and clinical purposes to support a broad range of investigations across neurologic and musculoskeletal diseases. With a powerful 7.0 tesla magnet at its core, SIGNA 7.0T combines a broad range of advanced technology, imaging methods and years of GE Healthcare experience into a new imaging tool. The completely new SIGNA 7.0T features UltraG gradient technology, GE’s

ICEMAGAZINE | JANUARY 2021

most powerful whole-body gradient coil, to meet the demands of ultra-high field imaging speed and resolution, advanced diffusion and functional brain imaging. This system also features GE’s latest SIGNAWorks software platform with state-of-the-art applications such as deep learning-based tools like AIR x brain for automated slice positioning and Silent MR imaging, enabling seamless protocol translation between GE MR systems. In addition, SIGNA 7.0T is equipped with Precision RF transmit and receive architecture to enable improved image quality and enable development in parallel transmit. This system also provides a unique platform for advanced knee and cartilage imaging, allowing for ultra-high-resolution anatomical visualization as well as research capabilities to measure quantitative changes in anatomy due to disease. •

ADVANCING THE IMAGING PROFESSIONAL

INTALERE, UNITED IMAGING ANNOUNCE AGREEMENT Intalere, a health care leader in delivering solutions designed for improved financial, operational and clinical health for partners, recently announced a new agreement for diagnostic imaging solutions from United Imaging. Through this agreement Intalere members will receive negotiated pricing on United Imaging’s advanced medical products, digital health care solutions and intelligent solutions, including PET-CT, CT and MRI products, that cover the entire process of imaging diagnosis and treatment. The United Imaging All-in approach will potentially allow Intalere members to expand their services and offerings to the community and patients they serve. Specifically, it means that United Imaging

provides its machines fully loaded, enabled with protocols that healthcare providers may use now and may need in the future. This helps give them flexibility and control and get more from their investment. Members will have access to the Flex Cap Warranty program that enables warranty extension at point of sale, which significantly reduces capital outlay and total lifecycle cost. Finally, members receive the company’s Software Upgrades for Life offer, meaning that United Imaging keeps their systems modern by installing the latest software upgrades in most cases at no cost. This contract is currently effective through November 30, 2025. •

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NEWS

ICE WEBINARS STAFF REPORT

ICE WEBINAR SERIES ENDS 2020 ON POSITIVE NOTE

he December 1, 2020, ICE webinar “How to Have Effective Conversations, Especially When It’s Difficult” presented by Janel Byrne was approved for 1 ARRT Category A CE credit by AHRA (Ref. LEC11051) and approved for 1 CRA credit. Byrne, organizational effectiveness manager at Children’s Hospital Los Angeles (CHLA), provided a 60-minute webinar focused on how to have effective communication with peers and co-workers, especially when it’s difficult. We face difficult conversations every day and handling them poorly impacts our quality of life, productivity, success and relationships. The webinar provided simple tools to transform difficult conversations into effective, respectful conversations where honest ideas are exchanged, positive intent is present, action results from the dialogue and the quality of the relationship grows. More than 60 individuals registered for the webinar. It received high marks in a post-webinar survey with a 4.5 rating on a 5-point scaled with 5 being the best possible rating. The survey also included the question, “Overall, how satisfied were you with today’s webinar?” “Very much – I liked the worksheet and 32

ICEMAGAZINE | JANUARY 2021

the work that she had us participate in throughout the session,” said J. Beall, U.S. Army retired. “I like how she was positive in responding to conflict,” shared C. Cadieux, imaging clinic manager. “Very good webinar – great speaker and excellent information,” said J. LeRose, interim director, radiology. The ICE webinar series grew in 2020 with an average of 45 registrations per session. Growth is expected to continue in 2021.

REVENUE TIPS The ICE Webinar series presentation of “E/M for Radiology – 2021 and Beyond!” was sponsored by Revenue Cycle Coding Strategies. The session was approved for 1 ARRT Category A CE credit by AHRA (Ref. END2903) and was approved for 1 CRA credit. Teri Bedard presented a 60-minute webinar focused on interactions between radiologists and patients. Not each of these qualifies as a billable evaluation and management (E/M) service. However, if you are not billing for any E/M services, you may be leaving money on the table. This session helped determine whether an encounter is billable or whether it’s included in other services the radiologist performed. Bedard shared real-life examples of billable radiology E/M services. She also ADVANCING THE IMAGING PROFESSIONAL

provided important E/M coding guidelines to help ensure that professionals select the correct E/M category and level of service. New outpatient and office E/M guidelines were reviewed and how these changes could potentially impact reimbursements was discussed. Attendees shared feedback via. Post-webinar survey that included the question, “Finish this sentence: ICE webinars are ... “ “ … a great way to get CEs and learn about updates,” Radiology Manager M. Chambless said. “ … interesting and informative,” Clinical Manager E. Camargo said. “ … fantastic,” RIS/PACS Manager A. Kirkendall said. • FOR MORE INFORMATION, visit icewebinars.live

Knowledge. Experience. Integrity. < / ŚĞůƉƐ ǇŽƵ ĚĞůŝǀĞƌ DZ/ ĂŶĚ d /ŵĂŐŝŶŐ ^ĞƌǀŝĐĞƐ ƚŽ ǇŽƵƌ ƉĂƚŝĞŶƚƐ͘ KEI helps you deliver MRI and CT Imaging Services to your tŝƚŚ ŽƵƌ ƚĞĂŵ ŽĨ ƐĞƌǀŝĐĞ ĞŶŐŝŶĞĞƌƐ ĂŶĚ ŝŶǀĞŶƚŽƌǇ ƐƉĞĐŝĂůŝƐƚƐ͕ < / ŝƐ ǇŽƵƌ WŚŝůŝƉƐ ƌĞƐŽƵƌĐĞ patients. With our team of service engineers and inventory ĨŽƌ ƐǇƐƚĞŵ ƉĂƌƚƐ ĂŶĚ ĨŝĞůĚ ƐĞƌǀŝĐĞ͘ < / ƌĞĂĐŚĞƐ ĞǀĞƌǇ ƚŝŵĞ ǌŽŶĞ ĂŶĚ ǁŽƌŬƐ ƚŽ ŵŝŶŝŵŝǌĞ ĚŽǁŶ ƚŝŵĞ ĂŶĚ ĐŽƐƚůǇ ĚŝƐƌƵƉƚŝŽŶƐ ƚŽ ǇŽƵƌ ǁŽƌŬĨůŽǁ͘ WĂƌƚŶĞƌ ǁŝƚŚ < /͕ ĐĂůů ƚŽĚĂǇ͘ specialists, KEI is your Philips resource for system parts and

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PRODUCTS

Market Report POCUS Market to Reach New Highs STAFF REPORT

he global point-of-care ultrasound systems (POCUS) market size was valued at $721.4 million in 2018 and is projected to expand at a compound annual growth rate (CAGR) of 5.7% by 2026, according to Grand View Research (GVR). Rapid technological advancements in health care services and increasing number of patient admissions in emergency care are some of the major factors driving the demand for point of care ultrasound devices, GVR reports. This change has led to the adoption of speedy and accurate diagnostics technology in emergency department (ED), especially in the case of “point-of-care devices” to reduce the delay between the onset of symptoms and decision on a definitive therapy to reduce mortality and morbidity in critically ill patients. The global point-of-care ultrasound devices market size was $2.09 billion in 2019, and it is predicted to progress at a CAGR of 7.4% during the forecast period (2020–2030), according to Prescient & Strategic Intelligence. The growth is contributed to rising health care expenditure, surging geriatric population, developing health care infrastructure and the increasing prevalence of chronic diseases. For instance, in the U.S., according to the Centers for Disease Control and Prevention (CDC), six in 10 people have at least one chronic disease, such as a cardiovascular disease (CVD), stroke, cancer or diabetes. The ongoing COVID-19 pandemic across the world is expected to have a tremendous impact on different spectra of society, the point-of-care ultrasound devices market be34

ICEMAGAZINE | JANUARY 2021

ing no less, according to according to Prescient & Strategic Intelligence. The production of POCUS devices and related goods has been impacted negatively due to COVID-19 and imposition of lockdowns, which have resulted in a reduced workforce, constraints in producing goods with proper sanitization, surge in the unemployment rate and affected import and export services. Globally, the Asia-Pacific region is expected to advance at the highest CAGR during the forecast period in the pointof-care ultrasound devices market. Some of the factors leading to the market growth include the improving health care infrastructure, increasing need for point-of-care diagnosis and treatment, and growing prevalence of chronic and lifestyle-related diseases. In addition, POCUS devices are increasingly being used for the scanning of osteoarthritis in the aging population, as there is a high risk of this disease in the elderly. Global Market Insights Inc. also forecasts POCUS growth in globally and in the Asia-Pacific region. Global Market Insights reports that the global market is set to surpass $3 billion by 2025. The Asia-Pacific point of care ultrasound market was valued at $625 million in 2018 and is expected to boost exponentially over the forecast period, according to Global Market Insights Inc. A growing need for point-of-care in emergency departments and rising prevalence of chronic diseases in this region will boost the regional growth. Increasing health expenditure in China and Japan will prove beneficial for POC ultrasound devices market growth. Moreover, increasing demand for point-of-care ultrasound in Japan coupled with technological advancements in POCUS is expected to foster business growth over the coming years. • ADVANCING THE IMAGING PROFESSIONAL

Product Focus

BUTTERFLY NETWORK Butterfly iQ+

The Butterfly Network Inc. recently announced the new Butterfly iQ+, featuring the world’s only Ultrasound-on-Chip technology. Butterfly iQ+ offers new capabilities, such as faster frame rates, Needle VizTM technology, a longer battery life and industry-leading durability. Butterfly iQ+ features an optimized manufacturing process in partnership with TSMC, the largest and most advanced dedicated IC foundry in the world. TSMC’s MEMS (microelectromechanical systems) manufacturing technology enables the ultrasound transducer to seamlessly integrate with CMOS (complementary metal-oxide semiconductor) technology. *Disclaimer: Products are listed in no particular order.

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POCUS

SIEMENS HEALTHINEERS

ACUSON Sequoia with BioAcoustic Technology With patient-centric technology and applications at the core of its DNA, the ACUSON Sequoia ultrasound system with BioAcoustic technology can adapt to patient’s unique characteristics. Built from the ground up with input from users around the world, the ACUSON Sequoia system was created with users and patients in mind. An unmatched list of advanced applications offerings allows clinicians to personalize ultrasound to a patient’s specific needs. Powerful AI-enabled tools and user-centric interfaces improve workflow efficiency allowing clinicians to focus more on their patients.

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3 PRODUCTS

CLARIUS MOBILE HEALTH Clarius PA HD

The Clarius PA HD is now available for high resolution cardiac imaging with the release of the Clarius Ultrasound App 7.3.0, available for download on the Apple App Store and Google Play. Clarius PA HD is a wireless handheld scanner that offers clear cardiac ultrasound imaging and fast frame rates comparable to traditional hospital ultrasound systems, made possible by advanced 8 beamformer processing. Designed for cardiac and lung imaging, it enables physicians to access the power of high-definition imaging using most iOS and Android smart phones and tablets. In addition to excellent cardiac and lung imaging, the Clarius PA HD is suitable for FAST exams, superficial and transcranial imaging. Its

no-subscription pricing includes unlimited cloud storage and image management for unlimited users, a 3-year warranty and forever-free software updates. Reimbursements for cardiac exams using ultrasound are available in the United States to help offset the cost of ultrasound systems. Plans vary by state and provider. A guide to reimbursements is available at http://clarius.com/cpt. Clarius scanners come with free access to the HIPPA-compliant Clarius Cloud, which has a built-in, customizable PDF tool, making it easy to print, archive and share professional reports. Users save images on their device or the Cloud. An option to connect to any DICOM-compliant server is also available.

ECHONOUS

KOSMOS Platform Developed by EchoNous, KOSMOS is a handheld POCUS device that makes AI-driven guidance a reality for the first time in the handheld space. KOSMOS produces scan resolutions that rival cart-based and standalone ultrasound machines. The device offers automatic systolic heart function capabilities (ejection fraction, cardiac output, stroke volume), high-quality ultrasound imaging, ECG and auscultation features all in a single diagnostic tool that can be carried from bedside to bedside in physicians’ hands. The artificial intelligence built into the platform was trained on thousands of heart scans from all over the world and can map out heart structures while guiding users for improved scans; simultaneously rating scans to determine diagnostic quality. 36

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ADVANCING THE IMAGING PROFESSIONAL

GE HEALTHCARE Venue Go

As the latest member of the Venue family of point-of-care ultrasound systems, Venue Go features an adaptable take-anywhere design and powerful AI-enabled auto tools that simplify complicated workflows to help the clinician diagnose, treat and monitor patients at the point of care. From fast and automated assessments used in the diagnosis of shock and dyspnea to fluid management and monitoring of pulmonary conditions, Venue Go can help support the patient across all point of care areas and clinical spaces – from the ED to the ICU to the OR.

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5 KNOICA MINOLTA SONIMAGE HS2 The Konica Minolta Healthcare Americas Inc. next-generation, compact ultrasound system SONIMAGE HS2 features advanced image clarity and innovative functionality optimized for point-of-care environments. Building on the company’s advanced ultrasound technology, the HS2 System delivers superior image quality and simplified operation to help clinicians address an array of clinical applications in musculoskeletal, vascular, pain management, interventional and orthobiologics. The new SONIMAGE HS2 provides enhanced needle guidance, superior image quality, high-resolution blood flow imaging and an intuitive, wide view touchscreen monitor. Konica Minolta’s Dual Sonic technology utilizes a unique algorithm that transmits two

waveforms depending on the focal length, providing the clarity and high signal needed for deep tissue imaging. Improved Tissue Harmonics technology suppresses acoustic noise and increases both frequency and sensitivity for deep tissue and superficial imaging. When coupled with the company’s wide bandwidth L18-4 probe, users achieve exceptional image quality with improved fine details and contrast resolution for precision in diagnostic and interventional procedures. Additional enhancements include higher resolution and faster frame rates, enabling more clear visualization of small vessels and slow blood flow. Simple Needle Visualization (SNV) software is optimized for confident needle guidance. ICEMAGAZINE

COVER STORY

The New

Normal The Imaging Landscape in Late-Stage Pandemic Days 38

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ADVANCING THE IMAGING PROFESSIONAL

COVER STORY BY MATT SKOUFALOS

he novel coronavirus (COVID-19) pandemic has upended most of society the world over, particularly revealing fault lines in health care, economics, access to valuable social services and disaster preparedness in the United States. While the global scientific community worked as one to solve a huge, new problem in real-time, their efforts and discoveries were also frequently undermined by an equally virulent “infodemic,” as political operatives of no lesser station than the American president sought to manipulate what was known about the virus for their own ends. (In October, researchers at Cornell University analyzing 38 million English-language articles about the pandemic found that President Donald Trump was the single largest driver of COVID-19 misinformation.) With the promise of antiviral vaccines from pharmaceutical giants Pfizer and Moderna expected to hit cold-chain storage facilities as 2021 unfolds, the country has its first glimpse at being able to stem the tide of the virus. But the havoc it will have wreaked with the national health care infrastructure will not soon be undone. Like COVID-19 itself, the effects of the pandemic are likely to linger for months and years after it is under control. The losses that will have been sustained as a result may never be recovered. Mike Klein, CEO of the Nashua, New Hampshire-based radiation therapy and cancer detection device-maker iCAD Inc. believes that the world of breast imaging is “clearly at an inflection point” that the pandemic has accelerated at “a double-time rate.” That point, as Klein sees it, is the departure from an age-based to a risk-adaptive screening model, triggered by the gap in care brought about by months of inactivity that many hospitals and imaging centers endured in the spring and early summer of 2020. Roughly 40 million American women undergo breast cancer screening annually, making breast imaging “the canary in the coal mine” of broader imaging trends, Klein said. That breaks down to somewhere around 3.3 million women per month, or 10 million per WWW.THEICECOMMUNITY.COM

“ A woman may show up today with no indication of cancer, but with AI, we pull apart images, pixel by pixel, and look at asymmetries, architectural distortions and anomalies.” Mike Klein, CEO of iCAD Inc.

quarter; from late March to late June 2020, they were unable to undergo routine mammograms when health care facilities were closed to all but essential procedures across much of the country. “Fundamentally, 90 days was taken out of the cycle,” Klein said. “We now have to screen 40 million women in 25 percent less time.” In addition to the lost opportunities of booking those patients, capacity limits and sanitization measures have reduced the number of patients seen in a given day by as much as half. Organizations may seek to offset the impact of those depleted revenues by extending hours and working weekends, but as Klein sees it, “We’re still lagging by 25 percent, and we also have missed 25 percent.” “The net effect is we have a pipeline capacity of 20 million women and 40 million women who need to be screened,” he said. “This is not going to be changed until perhaps into the summer or well into the fall.” Klein sees an opportunity to regain that lost ground by making broader changes. His solution: bringing patients in for imaging studies based on their unique biological profiles rather than on a calendar basis. By leveraging artificial intelligence (AI), the iCAD ProFound AI Risk clinical decision support tool can help physicians inform patients about their individual cancer risk months before studies present visually identifiable abnormalities. “A woman may show up today with no indication of cancer, but with AI, we pull apart images, pixel by pixel, and look at asymmetries, architectural distortions and anomalies,” he said. “That gives a tremendous amount of information; we’re talking about 300 slices just from X-ray mammography,” Klein said. “With the tools, they can get a probability score today that they’re now able to see their risk profile going forward. Existing models on the market offer a lifetime risk, whereas ProFound AI Risk gives you a two-year risk.” As clinicians work to make up for lost time, lost revenues, and patients who’ve missed routine screenings, “they can prioritize whom to call in first by running historic studies through ICEMAGAZINE

COVER STORY

the algorithms,” Klein said. “This becomes a prioritization and scheduling tool for who to see now, but also who to follow up with on a more consistent basis,” he said. Under traditional screening paradigms, patients are classified as being of either average or high risk, along a 90-10 split, respectively. “It’s ‘I’ll see you in a year,’ or ‘I’ll see you in two weeks for supplemental imaging,’ ” Klein said. “But with this information, you now make decisions based on where the patient is. If risk is high, the patient moves to a different regimen of personalized care. Suddenly, everything changes: you screen more frequently, and you screen on supplemental technology, while you see lower-risk cases less frequently.” Individualized risk stratification supports clinicians pursuing additional advanced imaging studies for those patients who need them while also allowing for earlier interventions in the treatment of a disease the survival rate of which improves dramatically the earlier it’s diagnosed. Klein believes the early detection information yielded by AI-enhanced imaging algorithms will lead to physicians treating breast cancer in a similar fashion as they treat heart disease: with pharmaceutical interventions and more frequent monitoring. The deferral of breast cancer screenings because of pandemic-related shutdowns has also dragged down detection rates, Klein said. Prior to the pandemic, the bulk of cancers found through screening were detected at Stage One, the minority in later stages of development. Since the shortfall of that missing second quarter of cases, clinicians are diagnosing more later-stage cancers through the same screening opportunities. That demonstrable difference in early detection also has an impact on imaging professionals, as they will 40

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be seeing fewer patients who will likely be farther along in the development of their diseases, Klein said. “The stress of not knowing, of being able to say it’s 95 percent curable versus 75 percent, for example; the psychological impact of having to tell patients, ‘I could have done something six-to-nine months ago but we’re not there,’ is really challenging,” he said. “This phase between radiology and patients becomes far more intimate now,” Klein said. “You can be part of a care management program with that woman instead of a bearer of bad news. We’re going to be in for a really tough time, and even though the patient workload will be at a more moderate pace, the qualitative dimension of the news that has to be given will be better than it is now.” Staffing challenges have been another dimension of the pandemic, as health care workers of every stripe battle the anxiety of possibly contracting the virus in the normal course of their duties, change up their protocols to cohort sick patients, and face extra precautions to keep their families safe as well. Klein believes that pandemic fatigue coupled with treating patients in more advanced stages of their illnesses may even affect hiring decisions going forward. “You’re going to need people that are going to be able to interact more with patients,” he said. “This high-throughput, assembly-line nature of health care is going to give way to more quality time, more telehealth, more triaging of who needs to be seen and not seen.” If the earliest days of the pandemic presented issues of coping with the shutdown in non-emergency operations, the challenge of late-stage pandemic health care involves adapting to greater hospital utilization, as record numbers of Americans check into intensive and critical care units with complaints related to COVID-19 symptoms. To Kevin Goodwin, CEO and founder of the Redmond, Washington-based portable ultrasound manufacturer EchoNous Inc., that means finding ways for doctors and imaging specialists to work faster, offer telehealth options and hold on until a vaccine is widely available. “We see lung ultrasound and hand-carried ultrasound get-

“ I think the whole health care model has a pronounced shift towards telehealth and telecare: keep revenue going by seeing patients remotely, because in-person is just not as easy.” Kevin Goodwin, CEO of EchoNouse Inc.

ADVANCING THE IMAGING PROFESSIONAL

COVER STORY ting a big lift because of the size of the unit and the value of ultrasound,” Goodwin said. “You can look at the lung and see how things are changing in real-time. It’s lower-cost, better for patients and you get more information.” Goodwin believes EchoNous can fill a specific niche in COVID-19 diagnoses with its portable ultrasound device, which offers specific advantages over stationary ultrasound units as well as X-ray technology. Since ultrasound imaging is performed in real-time, technicians can see the impact of the virus in terms of observable change, identify scarring and develop cardiopulmonary information without the use of ionizing radiation. Like Klein, Goodwin believes the value of the imaging modality can also be enhanced with the application of AI and machine-learning processes to imaging studies, the better to unpack more information from the results of the scans via object classification tools. He also believes the uptick in usage will lead to more technicians pursuing ultrasound training, particularly as at-home care increases and practitioners and caregivers visit patients where they live. “I think the whole health care model has a pronounced shift towards telehealth and telecare: keep revenue going by seeing patients remotely, because in-person is just not as easy,” Goodwin said. “You have a combination of people who are afraid, unwilling, or unable to come in, and how many people can be in the room at one time?” “Expectations for ultrasound are positive; the economics will loosen up if we have legitimate vaccines,” Goodwin said. “It’s just a matter of scaling it and pointing it where it’s needed.” “Hospitals lost a lot of money on an operating basis [in the early days of the pandemic],” he said. “This time around, people are able to better manage it.” As a technology vendor, Goodwin also believes that the imaging trade show sector is on a slower path to recovery amid the pandemic. He didn’t enjoy the virtual substitutes that sprang up to replace and supplement those in-person events canceled due to the risks of in-person gathering, and wondered whether the convention business itself could be more deeply at risk until the virus is brought under heel. “We’ve been through several of them; the platforms are not ready, and they don’t give the vendor quality access,” he said. “I don’t know if trade shows come back the way that they did. It’s been a bad year for them.” WWW.THEICECOMMUNITY.COM

Pediatric critical care specialist Arup Roy-Burman, MD, founder and CEO of Elemeno Health of Oakland, California, believes virtual connections have greater value in a socially distanced future. With pandemic-related protocols changing on the fly, and especially when depleted staff may not have a full roster of colleagues on hand to consult, technologies that replace face-to-face interactions allow valuable information to be shared in a chaotic time without compromising safety. “We’ve had pressures on staff like we have not seen in generations,” Roy-Burman said. “Staff need to be able to do more, learn more, handle personal protective equipment (PPE), and practices and workflows that are constantly changing. How do I keep myself safe, and how do I keep my team members safe when we no longer get everybody together for training?” The very real likelihood of missing employees during the pandemic, whether for reasons of illness, workforce reductions, scheduling irregularities, or capacity limitations doesn’t mean that those staffers on the clock must lose access to their collective wisdom, however. Elemeno Health offers a technological solution to what Roy-Burman describes as “the knowledge-practice gap,” i.e., the shortfall between institutional knowledge and bedside manner: on-demand videos comprising the accumulated learning of the organization’s “best and brightest.” He calls it “bite-sized micro-learning at the point of care.” “In a setting where we’re limiting the number of people, it’s harder to find somebody to ask, and in so many situations, you’ll get a different answer depending upon who you ask,” Roy-Burman said. “If I’m a frontline staffer, I need a multiplier to access the information I need when I need it, in a format that is nice, short, and easy to digest. With that virtual coaching, I can do more.” “We’re now recognizing that our frontline staff are under tremendous duress, and we need to look at technologies that will support them, equip them and enable them to be their better selves,” he said. Along the same lines, Roy-Burman believes U.S. health care will enjoy “a greater de-siloing” as institutions begin to collaborate more in a communal sense, a trend that follows the same path of consolidation most institutions are currently walking. “Twenty years ago, there was this intense idea of everything we do in our hospital is proprietary,” he said. “For American health care to thrive in this economic climate, we’re going to have to help one another.” • ICEMAGAZINE

INSIGHTS

ORDER UP! CODING/BILLING BY MELODY W. MULAIK

good new year’s resolution is to ensure that all your current processes are compliant and reviewing orders is a great place to stary. Understanding when and how diagnostic imaging services are ordered is critical to ensuring compliance and appropriate reimbursement. When discussing orders and their restrictions and requirements, Medicare services should be considered separately from non-Medicare. These two categories have very different requirements, and it is important to understand their differences and the associated operational and financial impact. Most large commercial payers require preauthorization for high-cost studies such as CT, MRI or PET. It is the referring physician’s responsibility to obtain this prior approval by contacting the payer and providing the medical reason for the exam. If the facility

ICEMAGAZINE | JANUARY 2021

and physician do not submit the exact code (or range of codes) that was approved, the claim will usually not be paid. If the incorrect exam was requested by the referring physician, no changes can be made without first contacting the referring physician’s office and obtaining a new preauthorization. Failure to do so could result in loss of reimbursement for both the facility and the physician. At the present time, Medicare does not have a prior approval process like commercial payers. Instead, providers must determine whether the exam will be covered by reviewing the National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs) and issuing Advance Beneficiary Notices (ABNs) as appropriate. In the non-hospital setting, Medicare pays for diagnostic tests, including imaging studies, only when the tests are ordered by the patient’s treating physician or nonphysician practitioner (NPP) and the treating physician/NPP is using the result in the management of the patient’s specific medical problem. The testADVANCING THE IMAGING PROFESSIONAL

ing facility is not permitted to perform a different exam or an additional exam without obtaining a new order. However, this restriction does not apply to diagnostic tests furnished to hospital inpatients or outpatients. Hospital diagnostic studies are governed by two separate provisions, and in those regulations, there is no statement restricting ordering authority to treating physicians. However, many Medicare contractors have taken the position that only treating physicians, even in hospitals, may order diagnostic X-ray tests. Providers should review their contractor’s published guidance. CMS has published specific rules for the ordering of diagnostic tests in the Medicare Benefit Policy Manual, Chapter 15, Section 80.6. The treating physician/NPP may conditionally request an additional exam to be performed if the initial exam “yields to a certain value” determined by the treating physician/NPP (eg, perform breast ultrasound following mammogram, if clinical indicated). Conditional orders must be written for a specific patient. A treating physiWWW.THEICECOMMUNITY.COM

cian/NPP cannot issue a blanket order. CMS does allow three important exceptions to the ordering rules. The first relates to “test design,” which is the specific exam protocol –—for example, number of views, use or non-use of contrast, SPECT versus planar, etc. The second exception occurs when there is a clear and obvious error in the order “that would be apparent to a reasonable layperson.” The third exception involves the patient’s condition. If the patient’s physical condition will not allow the performance of the exam that was ordered, the radiologist may cancel the exam. For example, the treating physician orders a barium enema, but the initial scout film shows stool in the colon. In this situation the radiologist may cancel the barium enema without notifying the ordering physician. The imaging facility and the radiologist may bill for any medically necessary preliminary testing (like the scout film in the example). • 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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Steps to Becoming an Expert at

BY LYLE CMEREK

ULTRASOUND MAINTENANCE, SERVICE AND REPAIR

o you want to become an expert at maintaining, servicing and repairing ultrasound machines? Like all things in life, you have to start at the beginning! There are many important steps to take in order to consistently and efficiently diagnose ultrasound issues.

STEP 1: LEARN HOW TO OPERATE THE MACHINE. It’s difficult to learn a machine when it’s broken, so learn the machine when it’s working! Take advantage of your full access to the machine during PMs and service calls. I always tell customers to learn how to “drive your ultrasound machine.” Create a test exam and save an image or cine loop of every mode (2D, Color Doppler, PW, CW, M-Mode, 3D/4D, etc.). Do this for every probe. Press every button on the control panel and touchscreen in every mode. Learn how each button affects the image, and do this for every mode. If you do not know what the button is or how it works, use the help button which is a user and/or reference manual. Learn where this help button is on all of your ultrasound machines.

STEP 2: LEARN HOW THE MACHINE WORKS. Most ultrasound machines follow this acoustic architecture: 44

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• • • • •

Front-end Back-end Power Control Display Learn what your specific machine calls each sub-component and learn what each circuit board or part does in each sub-component. This is vital if you ever want to become proficient at interpreting error logs. Scroll through the error logs during PMs to learn what they look like in an operational and problem-free state. Learn what it would take to install each part. Do you have to reload software, reinstall embedded software, remove and reinstall an options dongle or chip, or do a calibration? Extra credit: Learn the difference between 2D and B-Mode. Learn the difference between Crossbeam and SonoCT.

STEP 3: HAVE A DETAILED UNDERSTANDING OF WHAT THE SYMPTOM IS. Now that you know how the machine works and how to operate it, you should be confident in having a knowledgeable ultrasound conversation with a sonographer reporting a problem with their machine. • What are the specific details and symptoms of its inoperability? • Are you able to replicate the issue now and is it an all-the-time symptom, or is it intermittent? ADVANCING THE IMAGING PROFESSIONAL

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STEP 4: DIAGNOSE THE IMPEDING ISSUE.

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• If it’s intermittent, have you seen a picture or video of the issue? • Is the issue only happening on a certain probe, or a certain port, or in a certain area of the hospital? • Are you getting any error messages or error codes? On most machines, if there is an error message or error code, the error logs will typically steer you in the right direction. I’ve received many technical support calls in which a customer is looking for answers on how to resolve an issue, and they can’t describe what the problem is. How can you implement a resolution, when you don’t even know the problem?

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At this point, you have asked the sonographer all of the questions and have all of the answers. If the issue isn’t intermittent, replicate the issue yourself. It’s important to have a good grasp of the failure point. Run diagnostics and interpret the results. Scroll through the error logs or send the error logs to have them interpreted. Scroll through your manuals (service, reference and user) to help guide you. If you need help, reach out to your ultrasound expert that is willing to assist you, interpret your error logs and guide you in the right direction. After you have done a thorough job of researching and studying the issue, it is not uncommon to have to reach back out to the department to ask any new and additional questions. Don’t be hesitant to gather more information. The more the better!

STEP 5: IMPLEMENT THE RESOLUTION. So let’s reflect on what you’ve done; you’ve learned how to operate the machine, you’ve learned how the machine works, you have a detailed understanding of the current symptom, and because of the hard work done on these first three steps, you were able to diagnose the issue in Step 4. Now, it’s time to grab your tool bag, get out there, and go fix your ultrasound machine! • LYLE CMEREK is an Ultrasound Customer Service Engineer

for Avante Health Solutions. For more information about comprehensive ultrasound solutions from Avante, visit us

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INSIGHTS

RAD HR BY KIAHNNA D. PATTON

A TRIBE CALLED CHANGE D

iversity, equity and inclusion are more than hot topics. They are the reality of this big, colorful and what we hope to be nutritious and delicious salad bowl representative of the United States. Not long after George Floyd was killed by police officers, many people were moved to mobilize and get active. For some it was protesting, educating themselves about racism and perhaps their unwitting complicity in upholding inequitable systems, and they began to support businesses they had not known about or considered in the past. For others it was speaking out against injustice whether to family and friends or to strangers online, and then there were folks who activated entire communities of people. Two such people are the wife and husband team of Jennifer and Norman Anthony Coulter Jr. Norman is founder of 6ixth Man Leadership (www.6thmanleadership.com). He is also an educator, author, minister, philanthropist and an intellectual pursuing a doctorate in leadership studies 46

ICEMAGAZINE | JANUARY 2021

with an emphasis on authentic leadership, self-leadership and solutions to systemic racism. Norman and Jennifer, who is also an accomplished educator, are visionaries of “A Tribe Called Change,” an online community of multigenerational, multiracial people from government, nonprofits and private sectors; parents, students and more, who meet biweekly via video conference to discuss tough topics that many have a hard time broaching, let alone getting past the surface of. From a position of listening with empathy and understanding, they engage in “courageous dialogue and direct action” on topics including: • What are you doing in your world with respect to equality, equity, understanding between hostiles, etc.? • How to diffuse the tension inwardly and outwardly as the election approaches. • How do we feel post-election? • How do you see things and people you don’t understand? • Restorative practices and positive deviance. • Medicine and systemic racism: a view from the front lines. • Solutions to system racism in education and the church. • The “how” of destroying systemic racism. ADVANCING THE IMAGING PROFESSIONAL

“The divisive nature of racism usually makes people pick teams. Seems the challenge of our age is to build the community by eliminating ignorance, but that requires discourse and most lack the skills for it.” Norman A. Coulter

I submit that one of those skills is to create transformational change – the kind that happens when going from a caterpillar to a butterfly. Build your chrysalis, and as the work happens internally to form organs, antennae, wings and legs, you’re preparing to be born anew. But you have to do a bit of work to emerge from the chrysalis, to push through this barrier that has been your protection. Like caterpillars, I suggest that we, barring any genetic predispositions that would situate us otherwise, are largely born with all we need to become beautiful butterflies capable of transformational change and boundless flight. How can you build and sustain a community to address diversity, equity and inclusion topics and make a meaningful transformational change in yourself and your organizations? I offer the following, certainly not exhaustive, list to get started: • Build your discourse muscles so that you become proficient at having productive exchanges of thoughts. This concept leans heavily on Steven Covey’s “7 Habits of Highly Effective People,” wherein he encourages us in the fifth habit to “Seek first to understand, then to be understood.” Empathic listening certainly should not be underrated. WWW.THEICECOMMUNITY.COM

• Open your mind and reserve judgment. As an educator myself, one of the most important concepts I reinforce with our youth is to foster a nonjudgment atmosphere and be open to acknowledge the whole of an individual as they are, and get to know the person’s story and how it impacts the way they show up. • Invest in intentional healing. Mobilize your mind and body and take personal responsibility for your own healing process. This is similar to Norman’s concept of Lead Self First (www.6thmanleadership.com/self-leadership-humility-empathy/), in which you come to terms with your own moments of truth, and become your truest self. This is an individual journey, as one may need to heal from generational or situational trauma, others may need to heal from a new realization that our society has benefited some and intentionally downtrod others. Many company leaders have lent their voices and committed on behalf of their organizations to eliminate systemic and systematic discriminatory practices. Public statements have been made, and those words rely on individual action. Companies are entities composed of people, who at an individual level make changes that affect the collective. Ask yourself, “What’s my individual responsibility as part of my tribe?” We all can do something to make the lives of our fellow humans a little bit better. One of your steps might be getting actively involved in the conversation. Start somewhere, and end somewhere better. • KIAHNNA D. PATTON is senior human resources business partner at Children’s Hospital Los Angeles (CHLA) and nonprofit founder. Visit A Tribe Called Change Facebook Page. This is a private group that requires acceptance of one’s request to join. “A diversely mobilized initiative rooted in a consensus understanding that the severe effects of systemic racial hatred in America persist. Through courageous dialogue and direct action, this group intends to compose strategic solutions and gather momentum that leads to communities inhospitable to racially discriminatory attitudes and violence.”

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INSIGHTS

EMOTIONAL INTELLIGENCE BY DANIEL BOBINSKI

WHAT’S THE VALUE OF YOUR EMPLOYEES?

efore I get too far, let me state that my title for this column started out as, “Obstacles in the Organizational Chart.” You’ll understand why in a moment. Let me tell you the story about someone we’ll call Jim. After 14 years with his company, Jim supervised his department, but his own supervisor didn’t give Jim much freedom to make improvements. An atmosphere of micromanagement squelched all initiative. This frustrated Jim. He and the members of his team had many ideas for how to improve efficiency and effectiveness, but every time he suggested something, his boss told him to just keep doing what they were doing. One day Jim was talking with a regular customer, and during the conversation, the customer revealed that he was a supplier for some of the equipment used at Jim’s place of work. He said he could tell Jim was familiar and confident with the products and was curious why Jim’s company wasn’t using them to their full potential. Since Jim trusted this customer, he discretely mentioned the restrictions being placed on him from above. A week later that same customer came back to Jim’s place of business and offered Jim a job. He wanted Jim to be a product rep, which included visiting companies that

ICEMAGAZINE | JANUARY 2021

used the product and making recommendations for how the products could be used more effectively. He also offered Jim 50 percent more money than he was currently making. Suffice it to say Jim didn’t have to think too long about it. He took the job and excelled at it. As Jim related this story to me, he noted how strange it was that his prior company wouldn’t listen to anything he had to say, even after being loyal to that company for 14 years. However, once he became a consultant and product rep, that same company implemented his advice! “A year ago, I was offering my input for free,” he said, “but because I was just another face who’d been there forever, they just took me for granted. Now they actually listen to what I have to say, and I make more money at the same time!” The problem of letting invisible obstacles appear in the organizational chart is more common than you may think. As I write this, I’m reminded of some work I did with a food processing plant. Many of the supervisors were hired out of college, and it was their job to manage the production workers. These supervisors regularly conversed among themselves, brainstorming different ways to improve production speed as well as quality. Since I was facilitating a training course for the supervisors, I suggested they bring in some seasoned employees, tell them they ADVANCING THE IMAGING PROFESSIONAL

valued their opinion, and ask for ideas on how to improve production. It amazed me they said no. “Too awkward” was their reason for not doing it. To this day, I have a tough time understanding why people let pride get in the way of learning how to get things done better or faster. Just because people work at a “lower” level on the organizational chart doesn’t mean they don’t have valuable insights. Allow me to offer five suggestion for developing a cooperative and collaborative workplace that leads to better employee engagement and workplace effectiveness. • Hire good people. This ought to be a no-brainer, but everything starts here. I’ve seen supervisors make it a habit to hire people barely qualified to do a job, just so they could pay them less. This almost always backfires. As the late advertising mastermind David Ogilvy once said, “If we hire people smaller than we are, we become a company of dwarfs. But if we hire people who are bigger than we are, we shall become a company of giants.” • Believe in your employees’ capabilities. In my master’s program I learned about a 1964 study in which children were given a standard IQ test, but the researcher repackaged the test with the title, “The Harvard Test of Inflected Acquisition.” He told the teachers it would identify students likely to experience a dramatic increase in their IQ. Of course, it did no such thing, but the researcher chose children at random and told their teachers that these students would experience dramatic IQ growth. And wouldn’t you know, because their teachers set high expectations, over the course of two years, those students actually did increase their IQ. • Ask questions. Too many supervisors think they need to do the telling and have all the answers. It’s not true! It’s been my experience that the best supervisors are the ones who ask good questions. The key here is to be WWW.THEICECOMMUNITY.COM

genuinely curious about what people think and ask questions to draw that out. Conversely, “gotcha” questions designed to make an employee feel stupid will certainly backfire. • Seek to understand. I borrow this phrase from Stephen Covey’s best-selling book, “7 Habits of Highly Effective People,” because it’s a much better action to recommend than simply, “listen.” I can listen to someone rattling on about something that doesn’t interest me, and I won’t retain much. But if I “seek to understand,” then I’m absorbing data in a way so that I can restate it later in my own words. When we understand something, it’s easier to see its inherent value. • Recognize everyone operates differently. Whether its behavioral styles, cognitive styles, or motivational preferences, every person is unique. Again, to quote Stephen Covey, we treat people the same by treating them differently. This sounds like an oxymoron, but it simply means knowing someone’s style and communicating according to that person’s style. For example, a strong driver prefers direct communication with little chit chat, whereas a non-confrontational supporting style prefers low-key conversations and also time to think. Bottom line, every employee brings value to a team. It’s the job of every supervisor to identify each person’s value and ensure each person is given an opportunity to contribute. Without that, motivation is usually minimal, and productivity – as well as profitability – can suffer. • 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, 208-3757606, or through his website, www.MyWorkplaceExcellence.com.

ICEMAGAZINE

INSIGHTS

SPONSORED CONTENT

MARSHIELD RADIATION SHIELDING

M “MarShield’s biggest achievement is our longevity and stellar reputation in the industry.” Jim Chesla, Vice President, MarShield Radiation Shielding

arShield Radiation Shielding is a custom manufacturer of radiation shielding products and supplier of shielding materials. Imaging Community Exchange (ICE) recently interviewed MarShield Radiation Shielding Vice President Jim Chesla to find out more about the company.

shielding materials including interlocking and straight lead bricks, high-density concrete block, sheet lead, lead-lined drywall and plywood, lead lined doors, leaded glass and acrylic windows, non-lead alternative shielding material options, and RF shielding materials and install services. MarShield manufacturing capabilities include fabrication, machining, coating, engineering, testing and more.

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Chesla: The benefit of “custom” is that we offer solutions to make our customers more efficient. We often say “buy what you need, not what is available and off the shelf. Customization can also improve radiation protection and assist in meeting ALARA goals. Our slogan is “Challenge Us!” We’ve seen a lot and work with everyone from engineers, architects, health physics/safety managers, contractors and purchasing staff to understand your challenges and get to a solution that maximizes the value of your purchase. Value extends well beyond the initial purchase of your equipment!

Chesla: MarShield’s biggest achievement is our longevity and stellar reputation in the industry. MarShield has been providing radiation shielding solutions to the diagnostic imaging, nuclear medicine, nuclear energy and non-destructive testing markets for over 40 years.

Q: WHAT ARE SOME OF THE SERVICES AND PRODUCTS YOU OFFER? Chesla: MarShield offers products for use in existing settings and in construction of new procedural rooms and settings. Shielding material options include lead, heavy tungsten, non-lead alternative and borated polyethylene. For operational settings, MarShield manufactures X-ray modular shielding rooms, wall panels and control booths, radioactive storage vaults and cabinets, lead curtains, mobile and stationary barriers and portable shields. For sites under constructions we offer 50

ICEMAGAZINE | JANUARY 2021

Q: WHAT IS ON THE HORIZON FOR YOUR COMPANY? Chesla: Oddly enough, not knowing what challenges lurk around the corner is most exiting for us! MarShield continues to come up with new shielding concepts, shielding materials including non-lead alternatives, and new designs and manufacturing technics to improve on the value that we bring to our customers.

Q: IS THERE ANYTHING ELSE YOU WOULD LIKE OUR READERS TO KNOW? Chesla: Don’t contact us in the middle of designing or planning your shielding requirements. Contact MarShield from the beginning. We’ll assist in getting the project underway quicker, more efficiently, and most economically; and at the lowest cost possible. • For more information, visit www.marshield.com. ADVANCING THE IMAGING PROFESSIONAL

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FOG AND HEALTH CARE AT HOME PACS/IT/AI BY MARK WATTS

ealth Care can be stressful! “Hey Bob, can you come to my office please?” Bob was not just my employee, but a trusted friend. When Bob arrived, I told/ asked him to drive me to the hospital, I was having chest pain! After the emergency room visit, (labs came back negative) the doctor said I should consider leaving that place of work to lower my stress level. I was sent home with a Halter 24-hour heart monitor and a documentation device to track my heart rhythm. I thought to myself, “Is this 12-pound system hanging around my neck the best we can do?” I resigned from that position as my doctor said, “No job is worth dying for.” Bob stayed. “The future of health care is in the home, we are building the hospital of the future, less inpatient beds and more reaching IoT (Internet of Things) monitoring from home.” This was the proclamation made by a CIO of a large health care system at a health information conference. The logic and compassion of providing care at home as appropriate could control cost and improve patient satisfaction. I understood some features of system design and the application of new technology in health care, but what magic combination would it take to make this vision a reality. Can we build this much trust?! 1. Secure data transfer 2. Trusted IoT monitors and communication systems 3. Bandwidth (5G) 4. System training of doctors and nurses (Electric ICU) 5. Edge (Fog) computing The term “Edge computing” refers to computing as a distributed paradigm. It brings data storage and compute power closer to the monitoring device or data

ICEMAGAZINE | JANUARY 2021

source where it is most needed. Information is not processed on the cloud filtered through distant data centers; instead, the cloud comes to you. This distribution eliminates lag-time and saves bandwidth. For example, if an echocardiogram machine in the home is collecting a stream of real time data and notes an abnormal heart rhythm. A report is sent stating an elevated ST wave form based on data received directly from the sensors. The computer performing that action is called an Edge computing device or simply an “edge device.” The product “Report” is the meaningful edge result for the health care organization. Because of this change in data sourcing and management, we will compare the two technologies and examine the benefits each has to offer.

EDGE COMPUTING AND REAL-TIME DATA PROCESSING What is edge computing, exactly? To find out, we first need to look at the growth of the Internet of Things (IoT) and IoT devices. Cloud computing revolves around large, centralized servers stored in data centers. After data is created on an end device, that data travels to that central server for processing. This architecture becomes cumbersome for processes that require intensive computations. Latency becomes the main problem here. Edge computing allows computing resources and application services to be distributed along the communication path, via decentralized computing infrastructure. Computational needs are more efficiently met when using edge computing. Wherever there is a requirement of collecting data or where a user performs a particular action, it can be completed in real-time. Typically, the two main benefits associated with edge computing are improved performance and reduced operational costs, which are described in brief below. ADVANCING THE IMAGING PROFESSIONAL

• Improved Performance: Besides collecting data for transmission to the cloud, edge computing also processes, analyses and performs necessary actions on the collected data locally. Since these processes are completed in milliseconds, it has become essential in optimizing technical data, no matter what the operations may be. Transferring large quantities of data in real-time in a cost-effective way can be a challenge, primarily when conducted from remote health care sites. This problem is remedied by adding intelligence to devices present at the edge of the network. Edge computing brings analytics capabilities closer to the machine, which cuts out the middleman. This setup provides for less expensive options for optimizing asset performance. • Reducing Operational Costs: In the cloud computing model, connectivity, data migration, bandwidth, and latency features are expensive. This inefficiency is remedied by edge computing, which has a significantly lower bandwidth requirement and less latency. By applying edge computing, a valuable continuum from the device to the cloud is created, which can handle the massive amounts of data generated. Costly bandwidth additions are no longer required as there is no need to transfer gigabytes of data to the cloud. It also analyses sensitive IoT data within a private network, thereby protecting sensitive data. Enterprises now tend to prefer edge computing. This is because of its optimizable operational performance, address compliance and security protocols, alongside lower costs.

BUILDING TRUST: EXAMPLES OF EDGE COMPUTING The best way to demonstrate the use of this method is through some key edge computing examples. Here are a WWW.THEICECOMMUNITY.COM

few scenarios where edge computing is most useful: • Autonomous Vehicles: Self-driven or AI-powered cars and other vehicles require a massive volume of data from their surroundings to work correctly in real-time. A delay would occur if cloud computing were used. • Streaming Services: Services like Netflix, Hulu, Amazon Prime, and Disney+ all create a heavy load on network infrastructure. Edge computing helps create a smoother experience via edge caching. This is when popular content is cached in facilities located closer to end-users for easier and quicker access. • Smart Homes: Like streaming services, the growing popularity of smart homes poses a problem. It is now too much of a network load to rely on conventional cloud computing alone. Processing information closer to the source means less latency and quicker response times in emergency scenarios. Examples include medical teams, fire or police deployment. Accepting change in health care is not easy. To understand the health care of tomorrow we must teach our doctors and nurses to trust the information they are using to make decisions. To trust the data, they must have confidence that the reports are accurate and timely. To lift the fog of doubt in these remotely generated reports, we may need to explain the source and method of collection. IoT, 5G and edge computing will be the new fax machine. Bob called me recently to let me know that my replacement at that large for-profit health care provider died of a heart attack in my old office. Health care can be stressful. • MARK WATTS is the enterprise imaging director at Fountain Hills Medical Center.

ICEMAGAZINE

INSIGHTS

PROCRASTINATION IS GOOD

received an email from the editor asking that I submit this column “tomorrow” a full two days ahead of the deadline. This caused a small sense of anxiety since I have been procrastinating writing the column for a full month. He graciously allowed for the previous deadline.

be done. No matter the reason for procrastinating, there is value in putting things off if we do it right. As an example, I was avoiding writing this column until the deadline. So, I put my mind’s back burner to work on coming up with what to write. Then, I began to complete other tasks that I had been avoiding. I drained and flushed the ROMAN REVIEW water heater, a very unpleasBY MANNY ROMAN ant task. I finally changed the I rarely have an idea what I HVAC air filters, a dangerous will write about until the day task due to their height in the the column is due. I am a master procrastinator. I ceiling. I performed some of the other items on have learned that the “line” is often not as dead Ruth’s long list. My point is that procrastination is as it appears. I put off doing almost everya good thing because in the process of avoiding thing until the very last minute, or later. I have one task, we can justify getting others done. convinced myself that I work better under the For this column, I spent time researching propressure of expiring time constraints. My focus crastination and ran across the most entertaining is sharper and clearer. This drives some people and informative Ted Talk ever: “Inside the Mind of mad, my lovely wife, Ruth, for example. a Master Procrastinator” by Tim Urban. Mr. Urban Procrastination is good. It is the art of putfinally has defined why procrastinators procrastiting things off for a later time. Procrastination is nate. The culprit is a monkey. always leaving for tomorrow what we don’t feel According to Mr. Urban, we all have a master like doing today. With practice you get over the controller in our brains, a Rational Decision-Makanxiety caused by putting important things off. er. This guy makes sure that we spend our time, So, why do people procrastinate? Sometimes talent and tools wisely in the endeavor to accomthe task is unpleasant. Sometimes we just don’t plish all the necessary tasks on time and correctwant to do it. We may expect it to be a diffily. He is the captain and driver of the boat. He is cult process to complete, requiring extra effort. at the helm fully in control of the direction. Sometimes we hesitate to engage the task due to The procrastinator’s brain is different. It cona lack of confidence in our ability to complete it tains a monkey. The Instant Gratification Monkey properly. Sometimes it just is an irritation we wish insinuates himself into control of the helm. When to avoid. Sometimes it is fear of failure. the Rational Decision-Maker says it is time to get Good procrastination is not a sign of laziness. some work done, the Monkey says, “No. There is It is a purposeful manner of organizing work to time for all the boring stuff later. Let’s search ted. 54

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ADVANCING THE IMAGING PROFESSIONAL

com for interesting stuff and then we will go get ice cream and then go to a movie and then …” So, you see the Monkey provides a full schedule. There is no room for the work. We enter a dark playground filled with guilt and anxiety in the Rational Decision-Maker. The Monkey does not care. So, the work is delayed until the deadline is upon us. We wanted to do it and even planned to get it done early or at least start working on it. Then, the Monkey took over. There is hope, however. Procrastinators have another entity in their brains. The normally dormant Panic Monster awakens when a deadline, a career disaster, a danger of public embarrassment or some other scary consequence is imminent. The Monkey is terrified of the Panic Monster and runs and hides in a nearby tree, which we apparently also have in our brains. The Rational Decision-Maker can then take over and implement damage control. This system works for one type of procrastinator. The real problem is the procrastination where there is WWW.THEICECOMMUNITY.COM

no deadline such as entrepreneurial endeavors, exercising, eating right, working on relationships. The Panic Monster remains asleep and the Monkey continues happily in control. The Rational Decision-Maker never gains control and we suffer the attendant consequences such as regrets and unhappiness. It can feel as if we are spectators in our own lives. I believe this is where having well-defined value systems, goals and objectives can help to keep that Monkey at bay and the Panic Monster asleep. Goals and objectives should always have a time element so that at a minimum, the Panic Monster can come to our aid. All that said, anyone who knows me knows that I love monkeys including my own personal Instant Gratification Monkey. He and I are not afraid of the Panic Monster. We are afraid of Ruth, however. • MANNY ROMAN, CRES is the AMSP Business Operation Manager.

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MEMBER PROFILE

PRO DIAGNOSTIC IMAGING SYSTEMS BY ERIN REGISTER

fter 25 years of technical training with top OEMs, Steve Hurley founded Pro Diagnostic Imaging Systems (by PTSI) in 2000. His goal was to address a need to serve the underserved markets, such as Orthopedics and Veterinarians, as well as delivering a cost-effective alternative to OEMs. Pro Diagnostic Imaging Systems is a member of the Association Medical Service Providers (AMSP), the premier national association of independent service and products providers to the healthcare technology industry. ICE magazine learned more about Pro Diagnostic Imaging Systems in a recent question-and-answer interview. WWW.THEICECOMMUNITY.COM

What are some of the services and products PTSI offers? Is there a specific one you are excited about right now? A: We provide medical imaging, biomedical and security scanning equipment and service. We are excited to represent many great brands and some terrific innovative items, including the Smart C mini C-arm by Turner and the Omniscope DReam C-arm from NIR Medical.

How does PTSI stand out in the medical imaging field?

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What has been PTSI’s biggest achievement?

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ICEMAGAZINE

INDEX

ADVERTISER INDEX AlParts Medical p. 4

Ampronix, Inc. p. 57

KEI Medical Imaging p. 33

MarShield p. 22

Richardson Electronics Healthcare p. 27

SOLUTIONS

TriImaging Solutions p. 9

MedWrench p. 56 Banner Imaging p. 3 UMAC p. 2

MW Imaging Corp. p. 5 Diagnostic Solutions p. 43 W7 Global LLC p. 31

PartsSource, Inc. Back Cover Injector Support and Service p. 63

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Innovatus Imaging p. 15

PM Imaging Management p. 33

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