ICE Magazine June 2021 by MD Publishing

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JUNE 2021 | VOLUME 5 | ISSUE 6

ADVANCING

IMAGING PROFESSIONALS

MAGAZINE

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TAKE IT WITH YOU Trends in Imaging storage & access

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FEATURES

14 18 RAD IDEA

Experts share advice on how to reduce stress.

GUIDE TO AHRA

AHRA will host its 49th annual Meeting and Exposition in downtown Nashville, Tennessee.

COVER STORY

In the era of high-speed Internet, cloud computing and data storage, the networks that support on-demand sharing of high-resolution medical images span the globe.

42 DIRECTOR’S CUT

Mentorships benefit the protégé and mentor.

ICEMAGAZINE | JUNE 2021

ADVANCING THE IMAGING PROFESSIONAL

JUNE 2021

20 PRODUCT FOCUS

Check out the latest PACS and RIS devices.

10 WWW.THEICECOMMUNITY.COM

IMAGING NEWS

The latest medical imaging news from around North America.

RISING STAR

Hilary Russell “is an outstanding leader with the potential to one day become an imaging director.”

ICEMAGAZINE

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

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editorial

John Wallace Erin Register

Art Department Jonathan Riley Karlee Gower Taylor Powers

Webinars

SPOTLIGHT 10

Rising Star Hilary Russell, OhioHealth Marion General Hospital (MGH)

In Focus Wanda Mangum Biokua, BSHA, R.T., (R) (M) (ARRT), King’s Daughters Medical Center

Rad Idea Stress Relief

Off the Clock Curt Bush, U.S. Radiology Specialists of Houston, Texas

Guide to AHRA

NEWS 20

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

27 28

ICE 2021 Recap

Account Executives

PRODUCTS

Jayme McKelvey Megan Cabot

Editorial Board

Manny Roman Christopher Nowak Jef Williams Josh Laberee Jason Theadore Nicole Walton-Trujillo

Events

Lisa Lisle

Digital Department Cindy Galindo Kennedy Krieg

Accounting

Diane Costea

Market Report Firms Predict PACS, RIS Market Growth

Product Focus PACS & RIS

INSIGHTS 38

Coding/Billing ABNs are Still in Style

PACS/IT Market Forces and AI in Imaging

Director’s Cut Continuing Education

Emotional Intelligence Is It Time for a Mid-Year Tune-Up?

Roman Review A Strained Tethered Life

Department/Operational Issues Future State of Image Access

50 52 53 54

ICE Break

ICE Magazine (Vol. 5, Issue #6) June 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. © 2021

ICE Webinars Imaging Service Program Advice

Jennifer Godwin

ICEMAGAZINE | JUNE 2021

AMSP Member Directory ICE 2021 Scrapbook

Index

ADVANCING THE IMAGING PROFESSIONAL

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SPOTLIGHT

RISING

STAR HILARY RUSSELL BY ERIN REGISTER

FUN FACTS: Favorite Hobby: Stand up paddle boarding

Favorite Show to Binge Watch: Topsail Island, North Carolina

Favorite Food: Ben & Jerry’s Chubby Hubby ice cream

Any Secret Skills or Talents?: I used to run half marathons, and I can play the piano.

ilary Russell, radiology team leader at OhioHealth Marion General Hospital (MGH), has spent almost two decades in the imaging field - all at the same hospital. An Upper Sandusky, Ohio-native Russell, 39, began her career at MGH as a transporter while she was in X-ray school. “My first role at MGH as a radiology technician (RT) was on night shift for 13 years,” said Russell. “I then moved to the diagnostic X-ray team lead position and have been in that role for the last four years. I am registered in CT, and I am currently pursuing my bachelor’s degree in healthcare administration.” Russell, who earned an associate degree in radiologic technology from Marion Technical College in 2003, plans to graduate with a healthcare administration degree in August of this year. Kimlyn Queen-Weis, a director of operations at MGH, nominated Russell, stating, “She is an outstanding leader with the potential to one day become an imaging director.” ICE learned more about this rising star in a recent interview.

Q: WHY DID YOU CHOOSE TO GET INTO THE IMAGING FIELD? A: I chose radiology because I love to help people. The satisfaction of 10

ICEMAGAZINE | JUNE 2021

ADVANCING THE IMAGING PROFESSIONAL

making a difference in a patient’s life is what I love most!

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION?

Hilary Russell, center, is seen with colleagues at the MütterMuseum at the College of Physicians of Philedelphia.

A: I really enjoy leading and mentoring my co-workers in my team lead position. I want to be a good example of a leader to them.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: The advancing technology is amazing. The ability to use a much lower dose of radiation when we made the transition from computed radiography (CR) to digital radiography (DR) is a wonderful thing. I am also very interested in the management side of the imaging field, which is why I chose to pursue my degree in healthcare administration.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT THUS FAR? A: I helped champion the Lean Daily Management (LDM) process at my facility. This has been a great asset to all departments. We use key performance indicators (KPIs) to solve what we call “pebbles in our shoes.” The LDM process has helped improve patient and employee satisfaction.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: My personal and professional goals include obtaining my master’s in healthcare administration, volunteering more in my community, such as running for a spot on the board of education, learning to cross-stitch and traveling to Belize for a paddle boarding trip. •

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ICEMAGAZINE

SPOTLIGHT

IN FOCUS WANDA MANGUM BIOKUA

BY JOHN WALLACE

ing’s Daughters Medical Center Imaging Director Wanda Mangum Biokua, BSHA, R.T., (R) (M) (ARRT), was reluctant to become a leader at the Brookhaven, Mississippi facility. “My journey into radiology leadership began when my director was promoted to a COO position,” Biokua explains. “She asked me to move into her position, I was young and had no interest in being a leader at the time. She finally convinced me to take the position as an interim. I discovered I loved the work and began to thrive. I had found my calling. I became a sponge. I absorbed everything I could and began to educate myself to become a leader. I have worked

for some great organizations and great people that have afforded me wonderful opportunities to grow as a leader over my career.” Now, Biokua has her own signature style when it comes to leadership. “Building relationships is so important. Trust and honesty – I try to make a difference in people’s lives,” is how she describes her approach to leadership. “The decisions we make can affect our employees’ ability to provide patient care and the patient’s experience. Some in small ways, others in larger ways. We should always keep this in mind when making decisions.” “Good to Great” is one of Biokua’s favorite books and it provides one aspect of her leadership goal.

“I really feel that my greatest professional accomplishment has been paying it forward – helping others move into leadership roles.” – Wanda Mangum Biokua, Imaging Director, King’s Daughters Medical Center, Brookhaven, MS 12

ICEMAGAZINE | JUNE 2021

ADVANCING THE IMAGING PROFESSIONAL

“The principle we need the ‘right people on the bus’ – it is so important to recruit the right people. The ability to adapt and perform in an everchanging field is so important. These individuals have high expectations for themselves and others. They may not be in a leadership position, but they are leaders nonetheless,” she adds. “As leaders, we must be open to learning every day. I look for team members who have strengths that balance my weaknesses.” Leadership also means helping others. “I really feel that my greatest professional accomplishment has been paying it forward – helping others move into leadership roles,” Biokua says. “Over the years, I have been honored to work with those who I felt would make great supervisors, chief technologists or managers. Mentoring those individuals and working closely with them I have witnessed their growth. It has helped me understand how different people are motivated and this has helped me grow as well.” Biokua’s career success can be traced to mentors who helped her along the way. “Dr. Mark Geller was a great mentor to me and taught me many valuable lessons. Dr. Geller was my radiology medical director and is now president and CEO of Montefiore Nyack Hospital in New York,” she says. “He encouraged me to use data and analytics to make sound decisions. He taught me to dive deep into the data and interpret the numbers to make improvements. It was under his leadership that I developed the ‘Imaging Scorecard’ I still use today.” “Tim Moore, president and CEO of the Mississippi Hospital Association,

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is a leader I watch closely today. He started his career in radiology,” she adds. “Tim is a sterling example that a radiology background can influence public policy and make positive change in health care. He is working tirelessly to bring change and create better access to care for our state through Medicaid expansion.” Diagnostic imaging is not for everyone. However, Biokua says it is a dream job for her. “I love science and numbers. Radiology is a great field for me to apply the application of these two areas,” she says when asked why she loves her job. “Patient care is a vital piece of our work, but we must also have strong analytical skills. We have to be able to manage large volumes of expensive equipment and be strong in project management. I enjoy educating myself on the latest news and technology as it helps me keep up with the constant changes in protocols, regulations and requirements in the field.” She echoes what many in the field say when asked about the future of diagnostic imaging. “Artificial intelligence (AI) is the latest advancement for radiology. AI is complex, challenging and can be cost prohibitive for smaller and rural health care systems. It is important to stay abreast of the latest technology and opportunities so we can make the right decisions as it pertains to patient care and diagnostics,” Biokua says. Away from work, Biokua creates time to stay connected with family. “This goes back to a healthy balance of work and family. My greatest joy comes from my two children and three grandchildren. We make the time we have together as meaningful as possible,” she says. •

WANDA MANGUM BIOKUA Imaging Director, King’s Daughters Medical Center, Brookhaven, MS

What is the last book you read? I am currently building a bucket list from the book “1000 Places to See in The United States and Canada Before You Die.” Favorite movie? “How to Make an American Quilt.” I loved seeing how the things that happen throughout our life affect who we become as we grow older. What is something most of your coworkers don’t know about you? Most are surprised that I spent most of my free time crappie fishing. Who is your mentor? Dr. Mark Geller was a great mentor to me and taught me many valuable lessons. Dr. Geller was my radiology medical director and is now president and CEO of Montefiore Nyack Hospital in New York. What is one thing you do every morning to start your day? I cook my little Pomeranian a piece of toast for breakfast. She’s living her best life. Best advice you ever received? Watch your image. People are watching you and what you do at work and outside of work. They hold you to higher standard. Who has had the biggest influence on your life? My big brother, George has always been one of my greatest supporters. He makes me feel like Wonder Women even on my worst day. What would your superpower be? Being able to ease suffering. What are your hobbies? Reading, beach trips, fishing and spending time visiting my family. What is your perfect meal? A big steak cooked over charcoal.

ICEMAGAZINE

SPOTLIGHT

Rad idea STRESS RELIEF

r. John Chuback a cardiovascular surgeon, personal development and success training expert, and author of “The Straight A Handbook: The 50 Most Powerful Secrets for Ultimate Success In and Out of the Classroom” shares advice on how to reduce stress. Control your mind. As a cardiovascular surgeon, I have performed countless, highly technical, high-risk surgical procedures. Such operations would be intensely stress provoking for any individual who had not spent many years training for such experiences. However, in the same operating room, an observer – a medical student for example – feels no stress during cardiac surgery because they bear no responsibility. So, we see that stress as an actual entity doesn’t really exist. Stress is only experienced in the mind of the individual. Stress is a feeling. It’s a perception of a situation; it’s not the situation itself. Once one masters one’s mind, stress begins to gradually dissipate and be replaced with self-confidence, self-control and

ICEMAGAZINE | JUNE 2021

tranquility. It is essential that we understand the workings of our mind in order to take control of how we will respond to the challenging situations life has to offer. This is perhaps the most empowering skill one can acquire, develop and perfect – the ability to control one’s mind. Seme Eroh, author of “When the Fog Lifts: Gaining Clarity After Chaos and Confusion,” shares more advice. “Identify your triggers so you can avoid them. Our lives are so busy and we get many things that add to stress but there are only a few things that really cause stress,” Eroh says. “Learn to peel the onions slowly (pace yourself) and identify the real cause of your stress so you can learn how to deal with it. Ignoring or hiding stressors under layers harms you in the long run.” “Formulate a plan. Develop a system or community to relieve stress – take a walk in the park, meditate, go out with friends, check in with a close friend, watch a movie or whatever makes you feel less stressed.” • Share your RAD IDEA via an email to editor@mdpublishing.com.

ADVANCING THE IMAGING PROFESSIONAL

AHRA's 49th Annual Meeting and Exposition

August 1-4 Nashville, TN

Sounds Like Music to Our Ears! Don't miss this opportunity to network with medical imaging leaders and leading industry exhibitors, as well as gain insight into healthcare services, tools, and trends that will impact your patients and facility for the better.

SPOTLIGHT

Off Clock THE

CURT BUSH,

VICE PRESIDENT OF OUTPATIENT IMAGING SERVICES FOR U.S. RADIOLOGY SPECIALISTS, TEXAS BY MATT SKOUFALOS

ots of folks picked up new hobbies during the novel coronavirus (COVID-19) pandemic, from baking to gardening to home renovation. For Curt Bush, vice president of outpatient imaging services for U.S. Radiology Specialists of Houston, Texas, it was scuba diving.

Curt Bush enjoys scuba diving with family and friends.

ICEMAGAZINE | JUNE 2021

Bush, who has worked in medical imaging for more than 25 years across assignments in Florida, Wisconsin, and Texas, has always loved being around water. He owned his first boat at 22, and lives near a canal on Tiki Island, just outside of Galveston, Texas; Bush likes to fish off the boat in Galveston, and his wife, Angie, enjoys fishing off the canal. During the lockdowns that accompanied

the pandemic, the couple found themselves for want of hobbies, their travel plans having been curtailed. They decided it would be a good time to certify as divers “because there wasn’t a lot else to do, and it’s COVID-free under the sea.” “I thought it would be cool to do; then we found out that a lot of our neighbors were certified divers, and they’d tell stories,” Curt Bush said. “My brother was in the Navy; he got certified 20 years ago. It just sounded like something cool to do, and so we thought we’d give it a shot.” “I think the marine life is cool,” he said; “especially since we live on the water, it’s fun to see what’s underneath it.” The couple completed its first dive “the weekend before the world shut down,” Curt Bush said, and then had to wait until June 2020 to get certifying dives done. The first dive was done in a pool; a controlled environADVANCING THE IMAGING PROFESSIONAL

Curt Bush picked up scuba diving as a hobby during the Covid-19 pandemic.

ment that helps novice divers get used to the water and the equipment that accompanies the experience. But there was an added wrinkle: Angie, whose “biggest fear is to drown,” Curt said, had a bit more anxiety to overcome. “Getting her in the water was quite an accomplishment,” he said. “We do most things together and she decided, ‘I’ll try it.’ ” Gamely, Angie pressed on after the initial diving experience when the couple went for their second dive at Mammoth Lake, in Clute, Texas. Popular among area diving clubs, the lake sits upon a retired sand pit, and caters to recreational swimmers with sunken artifacts to swim in and around, including planes, buses, fire trucks and pieces of old amusement parks. At depths of 40 to 60 feet, the lake is large enough for divers to learn how to orient themselves by compass, with enough ephemera to take in that make it a memorable experience. “There are interesting things to look at while you’re down there,” Curt Bush said. In the pool, the bubbles from the respirator had made Angie uncomfortable; in the lake, the water was cloudy, which added a new hurdle of limited visibility. But by the time the couple made it to Key West, Florida, later in the summer, she’d fully acclimated to the experience, Curt said.

“As soon as we got into the water, she was just gone,” he said. “It’s a lot different when you’re looking at fish and stingrays.” “Since you’re underwater, any noise is very exaggerated,” Curt Bush said. “We get each other’s attention by clanking a piece of metal on our tank. Because you don’t have the red lights down there, everything looks a lot more blue. You can attain perfect buoyancy a foot off the bottom.” The trip to Key West was Curt’s “birthday do-over,” he said, and the couple got the opportunity to enter the water off a couple different reefs. Curt Bush described the experience as relaxing and calming. It was their first dive around marine life, and they saw sharks and grouper, among other fish. For a pair who enjoys vacationing in warmer climates, it was the first big step into a burgeoning passion. “We’ve already been to Cabo and Cancun and Cozumel; we’re going to go back to Cabo in June, and Key Largo in May,” Curt Bush said. “Cabo was colder water; we saw a bunch of stingrays. On the Pacific side, the reefs are a little deeper, so they’re not as colorful as they are in the Caribbean. In Cancun and Cozumel, we saw sea turtles and a yellow ribbon eel; just his head was probably four feet long.” In Playa del Carmen, the couple dove with bull sharks, once on a guided ex-

cursion and a second time for a feeding. Curt Bush recalled a moment of hesitancy when his divemates were wearing chainmail mesh to ward off shark bites, but he soon overcame it while the attendant warded off any sharks who got too close with a stick. Nonetheless, he had his own close encounter of the fish kind during the experience. “That was fun,” Curt Bush said. “We were at the bottom, holding onto a rope. One of the sharks hit me in the back of the head with his tailfin as he went by; I thought it was Angie tapping me on the back of the head. I don’t think he saw me.” The couple’s wish list includes Fiji, Belize, and Grand Cayman, but it’s a trip to the Galapagos Islands in December that they next have their eyes on. Curt Bush said he’s planning two days of diving, during which they’ll hope to swim with penguins and sea lions, and observe migrating whales making their way back to the Pacific Ocean. Even though the underwater experiences are capped around 45 to 50 minutes, the quality of the trips are so singular that each one stands out in the mind, he said. “I think it’s cool,” Curt Bush said. “It’s probably not for everybody, but it’s fun just to be down there. It’s amazing that it’s this completely different world that you never get to see otherwise.” •

Curt Bush enjoys seeing sharks and other marine life on his dives.

ICEMAGAZINE

GUIDE TO AHRA

AHRA INVITES MEMBERS TO MUSIC CITY STAFF REPORT

A AHRA: The Association for Medical Imaging Management is a professional organization representing management at all levels of hospital imaging departments, freestanding imaging centers and group practices. Founded in 1973, AHRA’s 5,000 members reach across the country and around the world. AHRA offers a complete slate of professional development programs including a comprehensive selection of educational conferences and seminars, networking opportunities, award winning publications and the Certified Radiology Administrator (CRA) credential. 18

ICEMAGAZINE | JUNE 2021

HRA, the Association for Medical Imaging Management, hosts its 49th annual Meeting and Exposition at the Music City Center on August 1-4 in downtown Nashville, Tennessee. “This is your best opportunity to network with medical imaging professionals and leading industry exhibitors with amazing knowledge and expertise. Gain insight from informative, thought-provoking educational sessions on health care services, tools and trends that will impact your patients and facility for the better,” according to the event’s homepage. AHRA President Jacqui Rose, MBA, CRA, FAHRA, RT(R), is excited about the opportunity to meet with peers, especially after the COVID-19 pandemic put everything on hold for over a year. “I am truly excited because we are planning an in-person meeting,” Rose said. “It has been so long since we have been together, and we are all looking forward to doing something non-virtually!”

She added that those who are not AHRA members should consider joining and attending the annual meeting in Nashville. “This is an amazing family, once you become a member, you will find the greatest value and your home for imaging leadership,” Rose said. “AHRA is my solo go-to location for all the information I need to be successful and bring the best outcomes to my customers. If you’re unsure, just give it a try and I guarantee that you will be impressed.” Attendees benefit from continuing education opportunities and an exhibit hall packed with companies offering a range of products and solutions that will make their jobs easier. ARRT Category A Continuing Education (CE) credit will be available at the AHRA Annual Meeting and Exposition. CE credit for states with licensure for radiologic technologists will also be available. The number of credits per session will be listed in the onsite program book. AHRA will be using an electronic tracking system for CE credits at the meeting. The bar code on each individual’s badge will be scanned as individuals en-

ADVANCING THE IMAGING PROFESSIONAL

ter a session and as they leave the session. Attendees must get both scans to receive CE credit. Each night attendees will receive an e-mail listing the sessions they attended and the number of credits they received that day. This email will also include links to online session evaluations. Attendees are encouraged to complete the evaluations. After the conference, each attendee will receive an email with a complete attendance history and number of credits earned. More details about the CE tracking system will be provided in the onsite program book. A CRA Exam Workshop is among the educational offerings in 2021. There is also an “Executive Leadership Workshop” presented by David J. Waldron, BSc, ACIB, CDipAF, chief executive officer, Traction Business Development LLC. A separate fee is required for the executive leadership workshop. “The annual meeting achieves many of the goals we all share as imaging leaders. We have the opportunity to learn new information and best practices to optimize the outcomes for our customers,” Rose said. “There is an endless network of imaging knowledge leaders to meet and connect with to build your network and enhance your success.” The 2021 meeting and exposition’s line-up includes three keynote addresses. Two motivational speakers will be on stage for the first two days of keynote speeches. The third and final keynote is “The Promise: Become a Legendary Leader and Discover Your Signature Moves” presented by Jason Hewlett. “In 2021 our world is different, but foundational values remain the same: To deliver on our promises, to be accountable to expectations and exceed them, and to always give 100% in every interaction,” a description about the keynote states. “In Jason’s entertaining and educational presentation, utilizing the legends of stage for establishing what a promise looks like from a performance level, participants will be enlightened, energized and entertained in a keynote unlike any other. Music, comedy, stories

WWW.THEICECOMMUNITY.COM

and powerful insights will leave attendees talking about ‘The Promise’ in their own lives, business, and how everyone can up their game in 2021.” Attendees will learn about confidence in skills and talents, team unity and the ICM process – Identify, Clarify, Magnify. They will also discover signature moves and personal branding. The event offers exciting and productive opportunities for companies to showcase products and services to some of the most influential decision-makers in medical imaging. Booth personnel will visit face-to-face with current customers and meet prospective ones. AHRA also provides a venue to launch new products and gain real visibility. “AHRA’s Annual Meeting and Exposition is just the right size for attendees to spend quality time with exhibitors,” the website states. “AHRA goes the extra mile to ensure that attendees come into the exhibit hall by providing complimentary lunch in the hall for attendees each day. Raffles and other incentives ensure that you have the best opportunity to connect with lots of attendees.

“Connecting with many customers all in one place,” Rose said when asked how exhibitors benefit from attendance. “This is the place imaging leaders go to get the most information in the most conducive environment. We all have very busy schedules, and in one location, over three days, we can hear from many customers at one time. There are great opportunities to enhance the experience through symposiums and hot spots.” When asked what else imaging leaders should know regarding the event, Rose said AHRA and the city of Nashville are working to host a safe annual meeting. “Nashville is designated as a safe destination regarding COVID and they are ready for our team with the best plans to keep all of us safe in this environment while enabling us to get back together again,” Rose said. “We are all excited about the 2021 annual meeting, 2020 took a toll on all of us and we need to figure out what our new normal looks like,” Rose added. “Please join us in reshaping our AHRA normal!” •

ICEMAGAZINE

NEWS

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

MTMI GLOBAL WELCOMES NEW PRESIDENT The Medical Technology Management Institute (MTMI Global), an internationally recognized continuing education provider for medical imaging and healthcare technology employees, has announced Jay Mazurowski, MS, FAHRA, CRA, as its new president. Mazurowski most recently served as deputy executive director at AHRA: The Association for Medical Imaging Management, a professional development program for international leaders in medical imaging management, where he also served as president of the board of directors. He also spent 15 years as the director of radiology services for Concord Hospital and Concord Imaging Centers. “Over the past three decades, I’ve seen firsthand the dedication and resilience of our nation’s health care professionals.” said Mazurowski. “Our nation is in need of qualified health care professionals now more than ever. We intend to continue increasing access to the resources and technology necessary to support them and their patients, by providing flexible training in new and innovative modalities.” MTMI Global continues to expand into new healthcare technology training, including biomedical equipment technician training and offers online competency tests, virtual conferences and live-streams seminar hybrids. During the pandemic, MTMI’s virtual seminar attendance has increased by 300 percent. • For more information, visit MTMI.net.

ICEMAGAZINE | JUNE 2021

CANON MEDICAL RECEIVES FDA CLEARANCE ON ONEBEAT SPECTRAL CARDIAC CTSUBHEAD NEWS Meeting the Vitisquibusa growing cardiovascular provitate explacc needs ullupta of health care providers, Canon quis renisquas Medical sitatusSystems nostiis eos USA etur Inc. anrest, nounced that natur itsalist, Deep simendanim Learning Spectral aut dis ad CT quam has ut received 510(k) faciuntclearance estiandam foraut expanded utent que capabilities consenimi, into cardiovascular voluptas is applications. num re volupta Available quassitio on the que company’s Aquilion occuptaerum ONE/PRISM ut es esequis Edition CT idelia cuptass system, health care inctate providers qui ut can aut now omnis acquire soloreces whole-heart ma spectral images nonsend in one aesequa beat thanks estrum to vendandit the system’s fugiam 16 cm wide area est hiliqua detector, testrum 0.275 voluptatem second whole-heart harcipistiacquisition with numquias rapid kVp quat. switching and Deep Learning Spectral Reconstruction. Offic tem. Mintiunducia nos volestiusam, Designed sit ipienduciam for deep intelligence, aut ommo the idipsum Aquilion atent ONE/ PRISM Edition etumintegrates il is et, intis artificial is aliquam intelligence quist, sinctum (AI) technology faceat to maximize dis rercid conventional min repremand fugiae spectral alit, CT capabilities nosapedios while providing santiis ium deep fugitclinical re, odis insights necea to assist physicians con poriatas in making rehendunt more assitaes informed volorio decisions across optatem the patient’s quasped care quae. cycle. Nequi To make reptatiis it even pos easier for clinicians, dolessi ut the ut esecab fully integrated idende volorporat. end-to-end workflow is easy Faceaquam to use and amcan nis nonsed be incorporated maximodiinto routine protocols. one quis pra vento beruptatur? Sed magni “By integrating cora pro AI berspere into spectral nullamus imaging, modiat Canon apis Medical is estorrovid bringing innovative ma cum voloris technology que nianti to theide market that can eos make maxim an endandis immediateeliquatum impact for aspeditis clinicians, empowering incit them et, offictistio to make definitive doluptis andanto diagnoses,” beaqui said Erin Angel,seque managing veriasdirector, ad et odit CTvolesci business moloribus, unit, Canon Medicalautate Systems natium USAquat Inc. “With quodignis Deepnus Learning etur as Spectral CT, molupta we have tiberum leveraged ut rem thequamet, power of santescit AI to overcome ea several core sectiur? of the barriers • that are otherwise associated with dual energy and spectral imaging.” •

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ZIEHM IMAGING AMERICAS, CARESTREAM ANNOUNCE PARTNERSHIP In partnership with Ziehm Imaging, Carestream Health is announcing the addition of a mobile C-arm into its growing product portfolio. Known as the Ziehm Vision RFD C-arm, this surgical imaging system will further enhance Carestream’s mobile and fluoroscopic product offerings to benefit even more health care providers. The system will be available in the U.S. and Canada in 2021. The Vision RFD C-arm offers a 25kw generator, in either a 20.5 x 20.5 cm or 31 x 31 cm field of view flat-panel CMOS digital detector, allowing for broad procedural

work including vascular, cardiac, spine ortho-trauma and pain management, in addition to many general surgical applications. The system’s Advanced Active Cooling enables extended case times beyond traditional air-cooled systems. It also provides an intuitive graphical interface that benefits technologists with reduced training time as well as improved productivity. •

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NEWS GE HEALTHCARE UNVEILS NEW POCUS, AI (POCUS), GE Healthcare has unveiled Venue Fit, a streamlined and compact POCUS system, alongside an industry-first AI offering for cardiac imaging on the Venue and Venue Go. The Venue Fit is the smallest system in GE Healthcare’s Venue Family, featuring an easy-to-clean touchscreen, intuitive scanning tools and a small footprint designed to fit in tight spaces often found in point-of-care settings. The Venue Fit and associated AI come at a time where clinicians are relying on point of care ultrasound to combat COVID-19 cases. Offering portability, real-time images, cleanability and workflow efficiency, POCUS has become an essential tool enabling clinicians to quickly triage and monitor patients in and outside of COVID wards. Accordingly, GE Healthcare saw orders for its existing Venue Go system increase more than fivefold in 2020 compared to the year prior. The new Venue Fit ultrasound system helps meet the needs of providers in tight spaces needing quick imaging insights. It is smaller in size, but still provides the same Venue Family image quality, touchscreen, intuitive interface and real-time documentation software that can save time and boost clinical confidence. In addition to the release of the Venue Fit, the existing Venue Go and Venue ultrasound systems will now offer an industry-first AI tool for cardiac scanning with an

integrated quality indicator, RealTime EF, alongside new software applications: • RealTime EF, the industry’s first AI tool that continuously calculates the heart’s real-time ejection fraction, a measurement of the heart’s ability to pump blood effectively, during live scanning with an integrated quality indicator that helps users know when they have an adequate view to generate accurate measurements of this critical cardiac measurement. The tool can help reduce the need for ECGs and support clinical confidence. • Lung Sweep, a rapid visualization tool that provides a dynamic panoramic view of the entire lung. This tool automatically activates at the start of each sweep when the probe is tapped on the body and deactivates at the end of each sweep when the probe is lifted, so there’s no need to touch the screen. The Auto B-lines tool can be used in conjunction with Lung Sweep to highlight B-lines over the entire panoramic view and display the frame with the most B-lines per rib space. • Renal Diagram, a simplified, intelligent documentation tool that allows clinicians to select labels from a prepopulated list that correlates with the images captured, making it easy for other clinicians to follow up on patients with suspected kidney infection. •

NANOX.ARC DIGITAL X-RAY EARNS 510(K) CLEARANCE Nano-X Imaging Ltd. announced that its single-source Nanox.ARC digital X-ray technology has received 510(k) clearance from the U.S. Food and Drug Administration. “Obtaining 510(k) clearance from the FDA for our single-source Nanox.ARC digital X-ray is a significant step forward along our U.S. regulatory pathway,” stated Ran Poliakine, chairman and chief executive officer of Nanox. “We remain on track to commence system shipments in the fourth quarter of 2021 and the first quarter of 2022 with the goal of finalizing deployment of the initial 15,000 Nanox.ARC systems by the end of 2024.” “We believe we are well positioned to achieve our goal

ICEMAGAZINE | JUNE 2021

of democratizing medical imaging and expanding the market to the roughly two-thirds of the world’s population who currently have limited or no meaningful access to imaging or the preventative screening that it offers,” Poliakine concluded. The company remains on track and expects to submit a 510(k) application to the FDA for its multi-source Nanox.ARC and the Nanox.CLOUD in 2021. If cleared, the multi-source Nanox.ARC will be the company’s commercial imaging system that it expects to deploy broadly across the globe. •

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LG EXPANDS DIAGNOSTIC MEDICAL MONITOR LINE Spurred by the pandemic and the larger trend toward remote work, radiologists have started seeking display solutions that allow them to read critical medical images from anywhere. To support their work, LG Business Solutions USA has announced the latest in LG’s full line of professional, medical-grade diagnostic monitors, the 31-inch, 12-megapixel 31HN713D, which can be used for multiple modes of diagnostic study, including 3D mammography. “More and more, radiologists and tele-radiologists working remotely have embraced the high performance and cost-effectiveness of LG medical monitors to do their jobs more efficiently,” said Stephen K. Hu, head of medical monitors at LG Business Solutions USA. “With this new model, they have a diagnostic monitor capable of even the most challenging studies, plus features to help maximize their productivity. Its multimodality capabilities allow physicians to read studies from all modalities making it a perfect choice for use in health care facilities and home offices alike.” Traditionally, mammography has represented a challenge to digital imaging and diagnostics, requiring high brightness and resolution to discern subtle details in the human breast. Hu said the new model is optimized for breast imaging, with an ultrafine 4200x2800 IPS panel capable of up to 1080cd/m2 of brightness. In addition, its 31-inch screen size and 12MP resolution allow the monitor to take the place of two 5MP medical monitors commonly used for diagnostic mammography. LG’s IPS technology supports wide viewing angles, helping to ensure more accurate viewing of multiple images laid out on the same monitor.

The FDA 510(k)-certified and DICOM-compliant LG 31HN713D diagnostic monitor meets parameters set by the American College of Radiology for image quality in digital mammography. It comes with an integrated front sensor for automated self-calibration to ensure accurate, consistent imagery without requiring additional calibration equipment. It also has a built-in presence sensor that turns off the display when not being used, as well as an auto-luminance sensor to optimize screen brightness for ambient lighting conditions. Helping radiologists perform better readings, the new monitor features a pair of special diagnostic modes. The Focus View mode allows radiologists to review sections of a medical image by adjusting brightness and grayscale tones in the area of focus while darkening the rest of the screen. The Pathology mode emulates the level of detail and color viewable under a microscope for diagnoses. The LG 31HN713D also includes built-in down and wall lighting to help improve contrast and better illuminate radiologists’ work surfaces when viewing images in dark spaces. •

SIEMENS HEALTHINEERS ACQUIRES VARIAN Siemens Healthineers AG has successfully completed the acquisition of Varian Medical Systems Inc. The acquisition was previously announced on August 2, 2020. The combined company is creating a unique, highly integrated portfolio of imaging, laboratory diagnostics, artificial intelligence and treatment for the global fight against cancer with significant potential for increased value creation. Varian and Siemens Healthineers are building on the long-standing strategic partnership called “EnVision” to establish a comprehensive digital, diagnostic and

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therapeutic ecosystem that includes treatment management. With Varian, Siemens Healthineers will leverage AI-assisted analytics to advance the development and delivery of data-driven precision care and redefine cancer diagnosis, care delivery and post-treatment survivorship. Through early and accurate detection as well as more efficient diagnosis, increased treatment quality and access, Siemens Healthineers will support and accelerate Varian’s mission to reduce uncertainty for cancer patients and increase the level of cancer survivorship. •

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NEWS

PHILIPS SMARTCT 3D SOFTWARE RECEIVES 510(K) CLEARANCE Royal Philips has announced U.S. Food and Drug Administration 510 (k) clearance for its Philips SmartCT application software. SmartCT is a key component of Philips Image Guided Therapy System – Azurion – providing interventionalists with CT-like 3D images (Cone Beam CT) to support diagnosis, therapy planning, treatment and follow-up for interventional radiology procedures. Bringing intuitive touchscreen control of advanced 3D image acquisition, visualization, vessel/organ segmentation, and quantitative measurements to the table-side, within the interventional lab’s sterile zone, SmartCT helps enhance clinical confidence, smooths workflows and increases productivity. It includes software applications for angiography, neurology, soft-tissue imaging and guidewire/catheter navigation, supporting a wide range of procedures such as the treatment of aneurysms, vascular diseases and liver tumors. Philips’ latest Azurion image-guided therapy platform integrates essential lab systems and tools needed for complex interventional procedures into an uncluttered laboratory environment in which interventionalists can focus on treating the patient rather than being distracted by the technology. SmartCT brings total control of the Azurion platform to a touchscreen tablet situated alongside the interventional radiology table. This eliminates the need for clinicians to leave the sterile field and step into an adjacent control room, as well as supporting faster and better-informed decision making. “A key part of our image-guided therapy strategy is to combine high-quality, low X-ray dose imaging with

ICEMAGAZINE | JUNE 2021

a superior user experience that allows interventional radiologists to diagnose and treat patients as part of smoother, safer and less interrupted workflows,” said Ronald Tabaksblat, general manager image guided therapy systems at Philips. “Philips SmartCT is a major step forward in 3D imaging, enhancing confidence in the interventional suite and supporting key elements of the quadruple aim of better patient outcomes, enhanced patient and staff experiences and lower cost of care.” With SmartCT, users are guided through the image acquisition process and can review and interact with the acquired CT-like 3D images on the system’s table-side touch screen module using 3D visualization and measurement tools. These tools have been designed to support procedures in a range of clinical domains, including neurology, oncology and cardiovascular procedures, and feature intuitive two-point distance measurements on 3D images, the ability to remove structures from the images that obstruct the region of interest, and the ability to select and store optimum projection angles for recall during procedures. Philips SmartCT image acquisition, visualization and measurement software is an integral part of the next-generation Philips Image Guided Therapy System – Azurion – which was launched in September 2020. •

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Konica Minolta Healthcare Americas Inc. announced a new version of the Exa Platform, which includes RIS, PACS, billing and specialty viewers, that improves radiology workflow efficiency through the use of automated software. The new capabilities are the result of both planned product development and in response to customer feedback and needs. Resource scheduling is a key enhancement to the Exa platform, enabling sites to schedule patients based on the availability of a radiologist to interpret a specific exam or a technologist to perform a particular exam. This feature provides the necessary information to the scheduling staff, allowing patients to be scheduled in the right room at the right facility at the right time, potentially reducing delays in the imaging services being provided. Another important new feature is the ability to schedule appointments by region or market. This functionality is required for enterprise hospital systems or larger imaging center chains with facilities spanning multiple states or cities that utilize centralized scheduling. Additional new capabilities include an automated collections process for the Exa Billing module that delivers robust tools so radiology departments and practices can manage accounts with outstanding balances. Enhanced web-based portals allow patients to upload insurance cards and referring physicians to upload prior exams. To improve productivity, third-party software can now be launched from the Exa worklist while the Exa viewer with the full toolset can be launched from within an EMR. Security improvements including two-factor authentication, DICOM print capabilities accessible on the Exa viewer and multiple panels in the Exa viewer providing all relevant content on one screen for radiologists, schedulers and billing staff to round out the new automated software enhancements. •

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NEWS ECHONOUS LAUNCHES ONLINE PORTAL TO STREAMLINE ULTRASOUND EDUCATION EchoNous has announced the launch of Kosmos Universal Platform (UP), a specialized software platform that helps educators streamline and automate the process of teaching POCUS, specifically ultrasound scanning – an emerging and critical skill for modern-day medicine. Kosmos UP assists educator faculty to help their students master using ultrasound relying on modern-day algorithms and workflow related software. The platform integrates EchoNous’s Kosmos handheld device with the online portal, leveraging innovative AI applications built within the tools. Kosmos UP manages educational workflow, reduces grading time and streamlines feedback for the students as well as facilitating research. Designed by ultrasound expert educators, Kosmos UP enables medical students to build ultrasound skills more efficiently. The platform also helps prepare students for clinical environments in an industry that increasingly requires ultrasound proficiency. Over the past several years, medical students have begun training earlier to better prepare themselves for emerging expectations during residency. The recent

pandemic has thrown additional challenges into this mix, with schools now facing faculty shortages within a remote learning environment. Focused on ultrasound education and distance learning, the Kosmos UP platform makes it easier for educators to catch up and exceed expectations. Kosmos UP focuses on three core benefits. First, streamlining the feedback process between teachers and students. Through the platform, instructors can annotate reports seamlessly, allowing for more time spent mentoring and less on document review and grading scans. Second, Kosmos UP allows educators to easily track students’ quantity of acquired images and facilitate interpretation of scans at individual and group levels. This feature enhances the ability to assess students with intelligent performance analytics, allowing curricula programs to be tailored to specific students’ needs. Finally, students can use Kosmos UP to submit their assignments and generate clinical reports for faculty to review. In turn, faculty can organize educational materials in the content hub and leverage built-in templates to provide quick quality assurance reviews. •

CANON MEDICAL EXPANDS RAYSEARCH PARTNERSHIP Canon Medical Systems USA Inc. and RaySearch Laboratories AB are expanding their partnership to enable RaySearch’s U.S. salesforce to distribute Canon Medical’s Aquilion Large Bore CT and Celesteion PET/CT products. Together, the companies will bring their integrated radiation oncology portfolio to more U.S. customers to further enhance care for cancer patients. “Over the last two years, our partnership with RaySearch has helped us deliver on our Made for Life philosophy by providing a comprehensive oncology solution that has brought together the tools for optimal treatment planning for our customers,” said Yuji Hamada, president and CEO, Canon Medical Systems USA. “In this new phase of our collaboration, we look forward to working with RaySearch so that more customers and patients can benefit from our combined solution.”

ICEMAGAZINE | JUNE 2021

Since 2018, Canon Medical and RaySearch have collaborated to offer Canon Medical’s imaging systems with RaySearch’s treatment planning product, RayStation. Together, the companies have been able to deliver accuracy and workflow-focused solutions to customers and patients, gaining positive traction in the market. “RaySearch’s primary goal is to provide innovative software to clinics, independently or together with our industrial partners,” said Johan Löf, founder and CEO, RaySearch. “A part of this is to make sure that we not only have products that integrate well with our partners’ systems, but that we also have efficient sales processes. The partnership with Canon is an excellent example of this. This expansion allows us to provide our joint solutions to customers in the most efficient way possible.” •

ADVANCING THE IMAGING PROFESSIONAL

ICE 2021

UNITES IMAGING PROFESSIONALS BY JOHN WALLACE

ort Lauderdale Beach, Florida turned out to be an ideal spot for ICE in 2021.

The 2021 Imaging Conference & Expo (ICE) brought together 357 imaging professionals from throughout the United States on May 11 and 12. The conference was a huge success and described as a “class reunion” by many who were last able to interact with each other at the 2020 ICE conference held in Arizona. The COVID-19 pandemic ramped up in the U.S. shortly after the 2020 ICE concluded in February of last year. Travel restrictions and other limitations mandated by companies and health care facilities as well as local and federal government resulted in virtual events and the cancellation of many imaging conferences. MD Publishing, the parent company of ICE magazine and the ICE conference, decided to move its 2021 event to May. It proved to be an excellent decision. MD Publishing President and Founder John Krieg said ICE 2021 was an opportunity for members of the diagnostic imaging community to reconnect. “What we have proved is people can still meet in a safe and clean environment, continue doing business together and help our industry grow and prosper,” Krieg said. “It was like a reunion. It was wonderful to see everyone after a long hiatus.” “I love that events are back stronger than ever,” he added. MD Publishing Vice President Kristin Leavoy shared in the excitement of attendees and exhibitors when asked about the ICE 2021. “ICE 2021 was such a refreshing event! It was great for our vendors and attendees to be able to come together WWW.THEICECOMMUNITY.COM

after over a year of being apart,” Leavoy said. “Also, there were a lot of new faces who got a glimpse at all that the ICE conference and magazine have to offer. It’s wonderful to see the ICE name becoming a resource people know and trust!” ICE 2021 included a packed exhibit hall, well-attended classes and festive networking events. Jay Mazurowski, MS, CRA, FAHRA, is the new president of the Medical Technology Management Institution (MTMI). He was attending his first ICE and found it “very enjoyable.” “I’m having a good conference,” he said. “The exhibit hall was great last night. I think the education was top notch. I made a lot of connections in the exhibit hall.” “I was surprised with how many vendor partners you had for a show this size,” he added. Advanced Ultrasound Systems’ Scott Heggie was also attending his first ICE. “It’s been a really nice conference,” Heggie said. “The quality of the traffic has been good with a lot of inter-vendor communication – which has been nice.” Amber Sportsman from MW Imaging said it was “nice to see people out and about again.” Sportsman said she was able to meet one MW Imaging customer in person at the conference and spoke with some companies about vendor-to-vendor sales. A few hours later, Sportsman was excited to talk about ICE some more. “It’s been a great Day 2. We are very pleased with the conference. We’ve had a lot of good traffic,” she added. Brian Wilson works for TRIMEDX and was a presenter at the conference. “I’ve had a fantastic time,” Wilson said

about ICE 2021. “I think it has been very well put together and very informative. I highly recommend it to anyone in the imaging field.” “The education, exhibit hall and networking have all been top notch,” he added. International X-ray Brokers President Bob Feldman was blown away by the conference, especially the amount of exhibit hall traffic on the last day of the event. “It has been a very good show,” Feldman said. “It is probably one of the best ones for us. I’m surprised at the turnout for the second day.” Eric Cunningham from AdventHealth said this was his first ICE, and he enjoyed the “great speakers” and “good networking.” “I feel like they are my colleagues and it’s nice to see what’s going on outside of your own organization,” Cunningham said. AdventHealth’s Patricia Pitterman said, “I’ve had a great conference.” She stressed the quality of the presentations and some takeaways she will be able to use upon her return to work. “I think the presentations are meaningful,” Pitterman said. “One of those that didn’t really occur to me is that end of life doesn’t mean it’s dead. There are other options for service.” ICE returns to February next year. Imaging professionals are invited to ICE 2022 at The Meritage Resort & Spa in Napa, California. The conference is slated for February 2022. For more information, visit AttendICE.com.

ICEMAGAZINE

NEWS

IMAGING SERVICE PROGRAM ADVICE T

he 2021 ICE webinar series continued on April 13 with “How to Develop the Ultimate Imaging Service Program.” It was sponsored by Accruent. STAFF REPORT

ICEMAGAZINE | JUNE 2021

In this 60-minute webinar, expert Al Gresch discussed where the majority of service expense lies for any hospital or health care system – the maintenance of high-end imaging equipment. Annual costs to maintain this equipment typically fall in the range of 10-15% of the device’s acquisition cost. This session covered strategies on how to reduce that annual expense to 5% or less, while at the same time increasing equipment uptime and customer satisfaction. Participants learned how imaging service is different than biomed service, what imaging customers need, how to increase equipment uptime, how to minimize the cost-of-service ratio on imaging modalities and how to continually raise the bar via service delivery. Gresch also discussed six steps to success. Additional information was shared via a question-and-answer session following Gresch’s presentation. One question asked about a good way to start implementing in-house imaging service. “I think ultrasound is a great place to start. It’s not an incredibly complicated modality to service,” Gresch said. “And, you know, we made great strides in saving money, but providing a higher level of service in that modality. The next step was that we started out doing things like portables and C-arms and general rad rooms and RNS.”

He said that approach helped build confidence with radiology leaders that they could perform the service and “that we’re committed to providing the highest level of service possible.” Gresch answered other questions and his answers are included in a recording of the webinar available at ICEwebinars.live. The webinar drew 81 attendees for the live presentation and received positive reviews in a post-webinar survey. The survey also asked, “Overall, how satisfied were you with today’s webinar?” “The theoretical and practical/technical aspects were well presented, having a close connection between them. The involvement of statistical elements was welcome for an overview,” said C. Corciova, associate professor/medical bioengineer. “This topic is one that, as a company, we have been interested in learning about,” Regional Operations Manager I. Salazar said. “Al always does a great job with describing what needs to be done at a high-performing organization,” Professor D. Braeutigam said. “Very interesting program,” Imaging Director D. McGill said. • For more information, visit ICEwebinars.live.

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Market Report Firms Predict PACS, RIS Market Growth STAFF REPORT

picture archiving and communication system (PACS) refers to a medical imaging technology which offers convenient access to and economical storage of images from multiple modalities whereas, radiology information system (RIS) refers to a computerized database used by radiology departments in order to store, manipulate and distribute patient radiological data and imagery. These technologies provide cost-effective and manageable access to images from multiple source modalities such as computed tomography (CT), ultrasound, X-ray and magnetic resonance imaging (MRI) among others. The PACS and RIS market is expected to witness market growth at a rate of 6.61% in the forecast period of 2021 to 2028 and is expected to reach $10.4 billion by 2028, according to a Data Bridge Market Research report. The report provides analysis and insights regarding the various factors expected to be prevalent throughout the forecast period while providing their impacts on the market’s growth. The rapid digitization in the health care industry is escalating the growth of PACS and RIS market. The increasing popularity of PACS as they assist in reducing the physical and time barriers associated with traditional film30

ICEMAGAZINE | JUNE 2021

based image retrieval, distribution and display and the rising number of health care facilities and high-value products such as cardiology PACS, orthopedic PACS and oncology PACS are major factors driving the PACS and RIS market. The increase in the total number of diagnostic procedures performed across the globe, due to increased awareness regarding early diagnosis of diseases, is accelerating the PACS and RIS market. The increasing need for storing, interpreting and consultation by many medical experts regarding patient diagnostic images is also a reason for market growth. Additionally, the integration of patient images with electronic medical records and health information exchange platforms and a surge in health care expenditure are positively impacting the PACS and RIS market. Furthermore, the adoption of cloud-based solutions and technological advancements extend profitable opportunities to the PACS and RIS market players in the forecast period of 2021 to 2028. Acumen Research and Consulting also predicts market growth. A report by the research firm states that the PACS and RIS market is expected to reach a market value of approximately $5.1 billion by 2027. A Transparency Market Research report states that the global PACS and RIS market was valued at $2.6 billion in 2018 and is projected to expand at a compound annual growth rate of abour 5.3% from 2019 to 2027. • ADVANCING THE IMAGING PROFESSIONAL

Product Focus

PACS & RIS

FUJIFILM Synapse 7X

Powered by Fujifilm’s pioneering server-side technology, the Synapse 7x is a next-generation image visualization platform which unites the comprehensive functionalities of Synapse Radiology PACS and Synapse Cardiology PACS, VNA, 3D. The platform is also supported by REiLI, Fujifilm’s AI-enabled platform, to bring AI-driven workflows to providers across imaging specialties for more collaborative, accurate and efficient clinical decision making. With the Synapse 7x, IT personnel can focus on management of a single enterprise imaging system, while providers can experience unobstructed enterprise imaging access, helping to improve care coordination and standardize clinical workflows. •

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PRODUCTS

GE HEALTHCARE Centricity Universal Viewer

Backed by the breadth of GE Healthcare and the Edison Ecosystem, GE Healthcare’s PACS solution and the Edison Open AI Orchestrator bring together image visualization, workflow, artificial intelligence, 3D post processing and archiving in a single platform to provide enterprise functionality at an affordable cost. Its modular design allows for deconstructed and distributed radiology deployments to support remote reading, distributed reading workloads and collaboration. By natively incorporating AI-based decision support and intelligent workflow automation, it helps support your clinicians in achieving new levels of productivity and diagnostic accuracy. •

ICEMAGAZINE | JUNE 2021

INTELERAD IntelePACS

IntelePACS is a highly scalable, distributed radiology solution that drives performance for various health care organizations. Awarded Best in KLAS Recognition for PACS Asia/Oceania in the 2020 Best in KLAS Global Report, IntelePACS brings simplicity to complex environments, providing hospitals, imaging centers and teleradiology organizations with a robust platform for storing, retrieving and routing medical images. Combining secure communications and compression technology, IntelePACS maximizes productivity and security, enabling greater patient care. Highly customizable and known for its interoperability, IntelePACS is available as a cloud-hosted solution through the nuage Cloud Imaging Platform. •

ADVANCING THE IMAGING PROFESSIONAL

PHILIPS

Philips Diagnostic Informatics Suite Philips elevates enterprise imaging to a new level of power and usability, creating an even stronger workspace designed around the radiologist and the recurring needs of optimizing efficiency. The radiology workspace combines information management, viewer capabilities with native reporting assistant, and advanced visualization into a single common suite to present at the fingertips of the radiologist all the tools required. All radiology modules have been updated with a new diagnostic viewer to support multi-disciplinary collaborations, brand new radiology information system completely zero-footprint and the next generation advanced visualization that received the award EuroMinnie award for Best New Radiology Software. •

KONICA MINOLTA HEALTHCARE Exa Platform

Konica Minolta Healthcare Americas Inc. and nVoq Inc. recently announced an agreement to embed nVoq’s cloud-based speech recognition and automation solution in the Exa Platform. nVoq’s enterprise-ready solution will integrate with Konica Minolta’s cloud-based Exa Platform, which requires no workstation installation and includes the diagnostic-quality Zero Footprint Viewer with Server-Side Rendering for fast access to images anywhere, on any device. Now, Exa users will have the same capabilities, enhanced with voice-enabled reporting utilizing nVoq’s flexible, highly accurate, speech recognition APIs (nVoq.SPS) to deliver a unified experience for Exa users. Exa is an integrated RIS, PACS, billing platform with a unified patient chart across all modules. •

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COVER STORY

YOU

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TAKE IT WITH YOU Trends in Imaging storage & ACCESS

BY MATT SKOUFALOS

ICEMAGAZINE | JUNE 2021

ADVANCING THE IMAGING PROFESSIONAL

rior to the proliferation of picture archiving and communication system (PACS) technologies, which enabled the digital archiving and distribution of medical images, physicians were reliant upon physical media to store and share patient imaging studies. Even after the imaging industry converted to digital image acquisition, sharing those digital images still required transferring physical media like CDs, DVDs and portable hard drives. With the rollout of broadband Internet came virtual private network (VPN) peer-to-peer connections that could support the electronic transfer of large digital image files. Now, in the era of high-speed, wireless Internet, cloud computing, and data storage, the networks that support on-demand sharing and viewing of large, high-resolution medical images span the globe. Tim Carrigan, regional sales manager for the Midwest and North Atlantic United States for MXR Imaging of Detroit, Michigan described current market conditions for the portability of medical images as “a pretty exciting time” in the history of the various technologies that underpin the process. If, as Carrigan said, the old ways based in physical media were “cumbersome and very limiting,” then the newest batch of technologies “has opened doors to millions of different uses and workflow enhancements regarding the sharing of patient data.” “It’s an amazing time to be able to talk about the ways of eliminating what was printed on film, printed on paper and burned to CD,” he said. “The difficulty now is getting patients and health care providers to see and use those advancements.” When cloud-based computing was first available, hospitals and health systems were apprehensive about opening their facilities to the Internet, Carrigan said. Nowadays, amid increased demand for the ease of use and efficiency that such systems facilitate, they can be found throughout the imaging department, from radiology information systems (RIS) to electronic medical records (EMR). By their very nature, distributed computing systems thrive on ubiquity. “There’s a reduction in the level of maintenance that’s associated with managing and archiving images for facilities because the images aren’t living on servers in their IT departments,” Carrigan said. “There’s advantages to not investing in obsolescence. The ability to share reports and access the imaging-related data is fantastic.” WWW.THEICECOMMUNITY.COM

“That’s helped drive the customer’s comfort level relative to getting that stuff offsite, stored in the cloud securely, and knowing that, in the event of a disaster, it’s better that it’s not in their building,” he said. “Being able to access that data in multiple locations is becoming more attractive as the physician base gets more comfortable with using that technology.” His colleague, Stuart Birkinbine, regional sales manager for the Western United States at MRX Imaging, notes

making that data more mobile.” As Carrigan notes, “HIPAA requirements are no joke,” and neither are the consequences for violating them. At that point, concerns about data integrity are as much tied in with concerns about liability, and upon whose shoulders the penalties for failing to secure patients’ and hospitals’ data should fall. It’s a question that becomes more complicated as broader digital networks are established to expand the portability of patients’ personal data among various

“It’s not uncommon for us to be talking about a PACS and RIS system and have to answer hundreds of questions about data security.” – Stuart Birkinbine that amid the push for greater system interoperability, different challenges emerge; most notably, ensuring the security of the various forms of sensitive data that are shared among various health networks and across various hospital systems. “From a healthcare information technology (HIT) perspective, you will run into a lot of groups that are very concerned over the transmission of that data,” Birkinbine said. “It’s not uncommon for us to be talking about a PACS and RIS system and have to answer hundreds of questions about data security, and how that information is able to be accessed without being stolen or hacked into. All of those things are hindrances to

health care practitioners, insurers, and payers, not to mention the patients themselves. “It really is, more or less, a system of liability, and who, ultimately, is accepting that liability,” Birkinbine said. “If you as a patient have access to that information, you accept that liability. Education on that comes from a lot of different sources, but ultimately, the education is all the way down the line to understand the reason you need to make that data safe and secure.” Carrigan points out that the same patient-level security risks have existed since the age of physical media, be it digital or analog: patients could misplace their physical exams as easily ICEMAGAZINE

COVER STORY as they could find them compromised virtually across a storage network. To health care practitioners, the higher-order question is how much more can be achieved for the quality of patient health outcomes in a cloudbased system. “The fact that stuff is more mobile and portable and secure, and that it can get to patients’ hands right in a portal, is important,” Carrigan said. “These health systems are also working in concert with other health systems regionally to develop secure methods of sharing their imaging data. That’s why VNA (vendor-neutral archives) and AI (artificial intelligence) have become the hot topics in imaging; all of that has been facilitated to a huge degree just by the different architecture that’s come to the PACS environment.” “It’s on a lightning-strike type of trajectory in terms of the pace at which things continue to evolve,” he said. “These systems are amazing in terms of how quickly they’re able to deliver a huge study over the Internet to somebody who wants to review them at another hospital or at their home, and has permission to do so. You could be in the south of France and the department is in Manhattan. We’re there now. Imagine how much better that could get.” To Mark Watts, enterprise imaging director at Fountain Hills Medical

improved by more closely connecting patients at general-purpose, point-ofcare facilities with specialists equipped to treat their specific conditions. By way of illustration, he offers the following hypothetical: “You’re in the hospital; there’s a trauma that occurred,” Watts said. “It turns out that there isn’t a neurologist who can decompress a cervical spine fracture. The patient is seen in the emergency room, they have a CT, and it turns out that yes, they have a fracture, and in that hospital, they don’t have the capability of helping that patient.” “How do I take that image and get it to the right physician so they can utilize that data set and plan surgery in another location?” Watts said. “What if that location is out of network? They have to create some means of transferring it from one place to another.” The ability to digitally, rapidly and securely transfer images from one location to another while that patient is in transit via helicopter or ambulance, gives the surgery team at that second location a chance to view those images, decide what’s necessary for the treatment of that patient, and then determine a course of action. “You don’t want them to have to send the patient over, get the CD, put it in their PACS system, take time to upload it, and have the surgeon see

“ The fact that stuff is more mobile and portable and secure, and that it can get to patients’ hands right in a portal, is important.” – Tim Carrigan Center in Fountain Hills, Arizona, things can get a lot better for patients and the clinicians who treat them if more facilities would cooperate to establish image-enabled healthcare information exchanges (HIEs). The reason many haven’t done so, he said, is fear of losing business from a competitor, and in an environment where it’s clear that patient care can be 36

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it for the first time in the operating room, instead of having an hour or so to plan it,” Watts said. “Time is of the essence; seconds matter for brain and heart tissue.” The ability to share that patient data with specialists across different health care institutions also cuts back on the number of unnecessary imaging studies performed. In a 2016 study

published in the Journal of Digital Imaging, lead author Amy Vreeland of the Waban, Massachusetts-based Imaging Strategies points out that diagnostic imaging accounts for 10 percent of total annual health care costs ($100 billion in 2016 numbers), of which an estimated 9 percent may be unnecessary or redundant. The authors of that study also note that an HIE based in New York cut down on the adjusted odds of repeat imaging by 25 percent; it stands to reason that greater participation in such arrangements can certainly drive even greater efficiencies in this area. However, in some parts of the country, health systems have begrudgingly participated in inter-agency image-sharing networks under only the most exigent circumstances. According to Watts, it took a fear of being crushed by novel coronavirus (COVID-19) patients to connect hospitals in Arizona in the past year of the pandemic. “From the advent of COVID, the idea of a hospital being overwhelmed by patients has really forced there to be a bond between hospitals,” Watts said. “When the native American population was hit by COVID, the hospitals on the reservations were hit very hard. They had to set up a way to take an X-ray at the reservation hospital and send it to Flagstaff, where Northern Arizona Healthcare had another hospital set up to take care of it.” To facilitate these connections, participating hospitals established VPNs that connected fully one-third of the state of Arizona to enable medical imaging studies to be sent to one another. With just a single level one trauma center in the northern third of the state, these connections were especially important as health care resources were stretched razor thin during the early stages of the pandemic. As Watts notes, “Traditionally, this would not have occurred because people want to take the X-ray and get paid for the X-ray, and they don’t care if they take it again somewhere else.” “It’s an interesting thing that COVID forced their hands as far as making this happen,” he said. “They had collaboADVANCING THE IMAGING PROFESSIONAL

ration because they had this sense of urgency of their hospital being overwhelmed.” Every patient in need of specialty care that’s unavailable – or not commonly delivered – at their current location would want their medical imaging studies to be forwarded to a specialist in another location. The only reason hospitals wouldn’t automatically do so, Watts reasoned, is a fear of losing that patient for return business. “To do it honestly would be to treat the patient to the highest level and capabilities of the facility, transfer them to a subspecialty as needed, and then care for them when they return home,” he said. “Meet all your patients’ needs within their community, and build that level of trust that you’re doing everything in their best interests.” “You should do what’s best for the patient, and that ultimately will be the best for your institution,” Watts said. “Facilitate the exchange so that when the patient is well and comes back, you can do whatever you can do in your community to the highest level. But don’t impinge on the level of health care that you can provide for the patient.” Watts knows that some of the anxiety around losing patients is a regional concern that doesn’t exist everywhere; in areas of the country where rural and community hospitals routinely refer patients for specialty procedures, fear of losing patients may be less pronounced WWW.THEICECOMMUNITY.COM

“ Meet all your patients’ needs within their community, and build that level of trust that you’re doing everything in their best interests.” – Mark Watts than in denser, urban areas, where teaching hospitals vie for position among other institutions whose in-house centers of excellence represent a gauntlet thrown down amid ongoing competition. He is hopeful that the idea of more widespread HIEs will get its due, particularly among larger, national institutions, which Watts says are instrumental to driving greater adoption of these models. “If you have a certain amount of mass, then you can move the market and make progressive ideas come through,” he said. “Intermountain Healthcare dominates the state of Utah, so if we have a Utah imaging exchange, you just connect all of Intermountain up and you have Utah covered. They have the altruistic view of wanting their patients to have the best standard of care, and so they fund this imaging exchange. But when you’re in the Northeast and you have turf battles with somebody right across the street, their trade secrets may be something that keeps them alive and viable, even though the technology is there for an imaging exchange.” Ultimately, Watts believes that the only way in which the idea of an HIE

will become more broadly adopted must come through federal intervention, as was done with mammography rules, and private-sector technological advancements. That’s in addition to the advocacy push that’s come from professional organizations like the Healthcare Information and Management Systems Society (HIMSS) and the Society for Imaging Informatics in Medicine (SIIM), the work of which laid out foundational technologies and building blocks for sharing medical images, and which continue to pioneer ways to provide better interaction among agencies. Watts also points to vendors like Nuance, Merge, GE Healthcare and Life Image as potential leaders in a vision for image sharing that he describes as “streaming” images, but added, “it’s going to take someone who’s a disruptor, who has that clout,” to change things. “We could get over the hurdle of having to send CDs from one location to another if we all just agree that, if we have an image at our facility, that we’ll share it with the requesting facility,” Watts said. • ICEMAGAZINE

INSIGHTS

CODING/BILLING

BY MELODY W. MULAIK

ABNS ARE STILL IN STYLE M ost commercial payers require prior approval before the performance of an advanced imaging study in order to provide payment. At the present time, Medicare does not follow this same process. Instead, they continue to instruct providers to issue an Advance Beneficiary Notice (ABN) to inform patients of their known or potential financial responsibility. The ABN is a written notice you should issue to a fee-for-service beneficiary before furnishing items or services that are usually covered by Medicare but are not expected to be paid in a specific instance for certain reasons, such as lack of medical necessity.

The ABN gives the patient the opportunity to choose whether to receive the service. If the patient chooses to receive the service and Medicare does not pay, the patient is responsible for payment. On the other hand, if the provider does not give the patient an ABN, the provider cannot bill the patient for any services that are denied by Medicare due to medical necessity. The proper use of ABNs is very important in radiology since many radiology claims are denied for medical necessity – specifically, the lack of a covered diagnosis. CMS has instructed providers to use ABNs only for 38

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patients enrolled in original (fee-for-service) Medicare, not Medicare Advantage (Medicare managed care). Unless the patient’s payer instructs otherwise, providers should not issue ABNs to non-Medicare patients. Briefly, the provider must issue a mandatory ABN when Medicare usually covers the item or service, but the provider believes Medicare may deny payment because the item or service is not considered medically reasonable and necessary for this patient in this particular instance. For example, if the exam is not covered for headaches, Medicare will not pay for an exam ordered due to headaches unless the radiologist identifies a covered condition that caused the headaches. ABNs can be issued on a voluntary basis for services that are excluded from Medicare coverage by law. Examples of these statutorily excluded services include routine physical exams, most screening tests (other than covered tests like screening mammograms), cosmetic services, routine dental and vision services, etc. An ABN should not be issued if the provider does not have a specific reason to believe the service will be denied. Providers are not permitted to issue routine or “blanket” ABNs to all of their Medicare patients. An ABN cannot be issued after the exam has already been performed, or when the patient has already been prepped and is about to begin the exam. The ABN must be ADVANCING THE IMAGING PROFESSIONAL

provided far enough in advance that the patient has time to consider the options. Also, an ABN cannot be used to make the patient pay for a bundled service or for services in excess of the Medically Unlikely Edit (MUE) limits. Payments for bundled services are already included in the Medicare payments for other associated services, so the provider cannot collect an additional payment. For example, it would be inappropriate to ask a patient to sign an ABN for intravenous injection of a radiopharmaceutical for a bone scan, since the injection is included in the scan code. Finally, a patient cannot be asked to sign an ABN if the patient is unable to read and understand the form. For this reason, ABNs should not be given to patients who are blind,

illiterate or demented. The imaging facility can issue an ABN that covers both the technical component and the professional component of the imaging exam. This means that a hospital can issue an ABN that also covers the radiologist, even though the hospital does not bill for the radiologist’s professional services. In this situation the radiologist’s contact information should be included on the ABN. An ABN can also be issued by the ordering physician if the physician is aware that the exam is likely to be noncovered though it would be rare to see this occur.• MELODY W. MULAIK, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle and Coding Strategies Inc.

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INSIGHTS

MARKET FORCES AND AI IN IMAGING PACS/IT/AI

BY MARK WATTS

Useful, adaptive technology, innovative change management processes, value added in stream workflow will lead to a breakdown of the current antiquated power structures and unleash an AI imaging revolution.

ICEMAGAZINE | JUNE 2021

sat at a Society for Imaging informatics (SIIM) conference years ago listening to a consultant telling the audience that a Picture Archive and Communication System (PACS) implementation is too complex for an imaging director to understand and complete. He then offered up an 18-month project plan that he would be willing to lead a hospital though for a large fee. Fast forward a couple of years and with a talented motivated team, I was able to install PACS for 19 hospitals in 17 months. This was the result of educational offering at SIIM, “Standardization of Implementation Practices and Other Market Forces.” Market forces changed the music industry, during my lifetime. Records, cassettes, CDs, MP3, streaming. Who will be the market disruptor in AI for imaging? Do we have a Steve Jobs yet? Steve Jobs used a combination of technology and innovation to disrupt the music industry. It was his ability to create “useful” and user-friendly music solutions that toppled the status quo. He did not go to Capital Records, RCA or Virgin Atlantic executives and ask permission to change their world. Goody and Tower Records did not go out of business because Steve Jobs told customers not to go there. The Internet, customer choice, MP3 players and other market forces did it. A better value proposition and lifestyle opportunity was presented. The consumer market rewarded this innovation. As I review the efforts to introduce artifi-

cial intelligence (AI) into imaging, I do not see the “killer app” yet. I do see the demos from IBM Watson, Zebra Technologies and Aidoc. They offer the technical, MP3 solution for imaging AI solutions. Prioritization, scheduling and reminder notifications are like the beeper, cellphone and day planner. We are still looking for the smartphone of imaging AI, a well-designed user-friendly technical platform that offers just-in-time, in workflow value added assistance. I choose the word assistance intentionally. I see AI in imaging best applied as a value add and not as a replacement. The market forces that will usher in the fourth industrial revolution in imaging are: 1. Radiology practice consolidation 2. 5G networks 3. Improved algorithms with bias awareness 4. Institutional IT infrastructure to support “learning organizations” like Johns Hopkins 5. Team-based care, Mayo Clinic model 6. Health care inequalities 7. CMS policies All these factors will push the current radiology workflow to a place where efficiency will displace personal preferences. The radiologist at your hospital will not be asked, “Do you want to partner with an AI assistance?” It will be mandated like the conversion from film to PACS. The psychological aspect of the symbiotic working relationship between a trained radiologist and AI must be part of the solution creation. The Mayo Clinic model of team care places the patient at the center of the care wheel. This change in system design allows ADVANCING THE IMAGING PROFESSIONAL

multiple doctors to contribute to the optimized diagnosis and treatment. The pie is evenly distributed and egos/ financial gain are removed from the decision-making process. On my list of must reads is Dr. Felipe Kitamura, head of innovation in diagnostic operations at Dasa. He says, “A good AI algorithm is an algorithm that is used. When we start thinking about testing a model, one important step is providing the AI result to the radiologist in a timely manner. Sending the AI result back to PACS in an automated way is key.” Useful, adaptive technology, inno-

vative change management processes, value added in stream workflow will lead to a breakdown of the current antiquated power structures and unleash an AI imaging revolution. I think one day soon a reader of this article will write an article on the time he read about the way AI adoption was too complex for an imaging director and how he worked with SIIM educational offerings and got it done. • MARK WATTS is the enterprise imaging director at Fountain Hills Medical Center. He can be reached at markwattscra@gmail.com

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CONTINUING EDUCATION DIRECTOR’S CUT BY BETH ALLEN

s imaging professionals, we have continuing education requirements tied to our licenses. It is pretty easy to obtain those credits through the AHRA, ASRT, conferences, training, webinars and articles. I would like to consider the valuable continuing education that is possible through mentorship. Although we cannot earn CE credits for it, this type of experience and education can change your life. I recently spoke with Banner Imaging CEO Jason Theadore about this subject. BA: So, let’s get right to it, what are some of your thoughts on what mentorship is? JT: Mentor is a term taken from Greek mythology with a general meaning of a “trusted counselor to a hero.” This sets up the relationship perfectly by defining the protégé as the hero and that the mentor must become a trusted advisor. It takes time to become a worthy advisor. In the best relationships, there is mutual gain and benefit to maturing both the mentor and protégé. BA: That sounds like this could be a great experience for everyone. JT: People who are self-satisfied have no need for mentoring. Mentoring is for people that want more, have clear personal and professional goals and want help reaching them. Being mentored is difficult for adults. Most people do not want advice, even when they ask for it. BA: If people do not really want advice, what principles can be useful in mentorship? JT: The relationship recognizes that adults learn differently than children:

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•

Adult learners expect to be respected • Adults are self-directed, motivated and goal oriented • Adults bring both life and learning experiences • It is never a one size fits all when providing mentorship Knowing that, there needs to be a certain equality between the mentor and protégé in a real adult learning relationship. BA: Have you been part of a mentorship relationship and is there one that sticks out as the best? JT: I have been fortunate enough to be in both the mentor and the protégé seat so to speak. Much of how I think about mentorship is from one specific mentor. The relationship started with sincere mutual respect between us. I was impressed that it was not a resume builder for this mentor. It was a relationship based on the fact that he wanted me to be successful. Period. To help me, he always treated me as a colleague even when he shared what some would think was tough love or a difficult message. He had a way of always being explicit about any action he suggested I take. That always helped me see the relevance of the ideas and actions he suggested. Maybe the most important aspect is that the relationship never ended, and we became good friends. That really reinforced, to me, that there is something for both the mentor and protégé. BA: At Banner Imaging, we have accountability partners since one of our key values is to foster accountability. How is that different than mentorship? JT: From my perspective, it is different. Accountability partners are not always mutually exclusive and are best when the ADVANCING THE IMAGING PROFESSIONAL

partners, or group, knows exactly what needs done. I think about the Four Disciplines of Execution (4DX). Narrow the focus, act on lead measures, keep score and drive accountability. The accountability partner relationship is more tactical. Both relationships help the individuals involved become accountable. When we are accountable, we stop deflecting responsibility and come to realize that our decisions drive the outcome. We can truly create the future when we are accountable. BA: I appreciate this discussion on mentorship and the positive effect it has on both the mentor and the protégé. My hope is that this will inspire someone to seek a mentor to propel themselves forward or to become a mentor for a new leader. It will make a difference for both. Thank you. •

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INSIGHTS

EMOTIONAL INTELLIGENCE BY DANIEL BOBINSKI

IS IT TIME FOR A MID-YEAR TUNE-UP? I

t’s good for managers and leaders to periodically review how well they’re doing in the core responsibilities for their role. I’m not talking about trade-specific duties or tasks, but rather the central responsibilities required of every manager and every leader, no matter the industry. A good framework for doing this is to first consider responsibilities of a front-line worker. Every front-line worker is given materials and taught a process to achieve an outcome. If the worker is trained well, he or she learns how to assess the outcome and make whatever adjustments are necessary in either the materials or the process so an optimal outcome can be achieved. This same process applies for people in management and leadership roles.

A MANAGER’S MATERIALS The “materials” given to front-line supervisors and mid-level managers are not what one would normally think of as materials. Managers must oversee the front-line workers themselves and the processes those front-line workers use. And, just like a front-line worker must become a student of the quality and capability of the materials he or she is given, managers must learn specific things about the people they manage. What are each person’s strengths? What are their weaknesses? What are their preferred behavioral styles? What motivates each person? How does each person perceive and process information? In addition to each person’s behavioral, cognitive and motivational preferences, a 44

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manager should know each person’s skill set. That is, what does each team member know about the tasks assigned them and to what level can each of them perform? If managers are unaware of these things, then those managers are not able to adequately operate in the rest of their core responsibilities. The other major subset of what managers must oversee is the processes used by front-line workers. Supervisors and managers do not need to understand the intricacies of every front-line position, but they must have a solid grasp of the overarching process the team uses to achieve its objectives. They should have a good understanding of what each team is supposed to accomplish, and how the various positions interact with each other.

A MANAGER’S PROCESS If “front-line workers” and “processes” are the core materials assigned to a supervisor or manager, the next responsibility is to answer the question, “What do we do with that information?” The core responsibilities for managers are to ensure that all front-line workers are well-trained, and that processes are examined and improved upon. Just like front-line workers must assess and adjust based on what they observe in their finished products, supervisors and managers must assess their employees and adjust (improve) their knowledge and skill sets as needed. They must also do the same for the processes used by each team. Too often I hear managers say that training is not their responsibility. I say, “au contraire!” It’s when managers learn to think like trainers that a workplace becomes the ADVANCING THE IMAGING PROFESSIONAL

thriving hub of productivity it wants to be. Shifting into a supervisory role after being a front-line worker for many years can be difficult. It’s a new level in the organization, and it requires a new level of thinking.

THE LEADERSHIP LEVEL Similarly, moving into a senior management or leadership role can be equally difficult. It is yet another level in the organization and working at that level requires a totally different way of thinking. Picture a 10,000-acre farm. At the front line are people working in the soil and operating the various machines. At the supervisory and management level, people are making sure that the front-line workers are trained appropriately and that all the different teams and departments are working together for optimal productivity. Supervisors and managers rarely do the physical labor, they train and coordinate those that do. It’s a different kind of work. Responsibilities at the leadership level are yet a different kind of work altogether. Leaders on a farm must pay attention to economic forecasts and shifts in consumer demand. They must also pay attention to the capabilities of their vendors and suppliers (all external factors) as well as the internal capabilities of the various departments on the farm. Leaders must also be the central repository for the ideas people have about how to make the farm better. Consider that list to be the materials for which a leader is responsible. The next question is, “What does the leader do with that information?”

THE LEADER’S PROCESSES Good leaders take the information listed above and use it to ensure their company is as effective and as profitable as it can be. That usually means communicating throughout the entire organization the various ideas that have been WWW.THEICECOMMUNITY.COM

presented on how to make the farm better. From there, they collect and synthesize the feedback so the best decisions can be made on when, where and how to invest time, talent and/or resources. The success of that process depends on the quality of listening that occurs. One common misunderstanding among leaders is that they need to have all the answers. Again, I say, “au contraire!” A leader does not need to have all the answers. A good leader needs to ask effective questions and weigh what is learned. The other core responsibility that leaders often overlook is enabling the capability of their organization. Knowing when and where to do this does not happen by osmosis. Again, a leader must ask questions of his or her managers to learn where gaps exist in making the various processes more productive. All this requires transparent communication from everyone involved. And so, just as managers must understand the behavioral, cognitive and motivational preferences of their people on the frontline, leaders must know the same about their managers. In other words, leaders must also be able to manage their managers. When was the last time you took inventory of your management and/or leadership capabilities? If all we do is produce and never take time to conduct a tune-up, eventually our engines are not as effective and we run the risk of burnout. We’re already about halfway through 2021. Is it time for a tune-up? • 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 him on his office phone at 208-375-760, or through his website at www.MyWorkplaceExcellence.com.

ICEMAGAZINE

INSIGHTS

A STRAINED TETHERED LIFE A

long time ago, I wrote about the fact that our lives are highly influenced by our tethers, our bonds to other humans and things. Some bonds are very strong and have a large influence and causative effect, such as the bonds to loved ones. Others are weak influences that can be ignored with minimal consideration, such as an article of clothing.

and other family members. We bond with friends at school and we are even bonded, in a weird way, to the bully who takes our lunch money. We become liberated by adulthood yet retain bonds to those close to us and add tethers to government through driver’s license, taxes, etc. We ROMAN REVIEW get jobs with the attendant bonds and tethers. We fall in BY MANNY ROMAN love and repeat the entire process for our progeny. So, in fact, we really do live our lives tethered to other lives. The bonding is sometimes by nature, someSome would say that our lives are not fully ours times by nurture, sometimes by choice, somedue to the tethers to other lives from conception times by chance, yet always tethered. We are until death. We all want to be in total control over sometimes pulled together and sometimes pulled our lives and our situations. To suggest that our apart. Some bonds are strong and some are weak lives are not completely our own could mean that and some are unbreakable and some are unsuswe may not, in fact, be able to control our lives. tainable. First, let’s check the validity of the statement All decisions and actions must take the bonds that our lives are not our own because we are and tethers into consideration. When someone tethered and bonded to others. From conceptakes an action that jeopardizes a desired bond, tion to birth we are indeed tethered, no question marriage for example, the rest of the world about that. After birth, all the books speak on wonders what that individual was thinking at the the bonding between children, parents, siblings time. When someone takes no action to break an 46

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ADVANCING THE IMAGING PROFESSIONAL

The bonds and tethers to family, friends, authority, coworkers, money, etc., are what make our lives interesting, rich, rewarding, challenging and worth living.

undesirable bond, an abusive relationship for example, the world wonders why. The bonds and tethers to family, friends, authority, coworkers, money, etc., are what make our lives interesting, rich, rewarding, challenging and worth living. The wise among us can differentiate between the types of bonds we have. We can take actions to strengthen the desirable ones and disengage from the undesirable ones. During the past year of the pandemic, many bonds were threatened or broken. Families were forced into separation by quarantine. Children were deprived the in-person interaction with classmates and teachers. People lost their jobs, lost businesses, their independence. Essentially, many of us lost control over our daily lives as well as access to the things that brought us happiness and comfort. An unimaginable number lost their lives. So yes, we are tethered from conception to demise. This huge interruption of our daily lives has made this fact abundantly clear. Our bonds were stretched. Some were completely broken. Some revealed themselves to be of greater significance than we thought. Others proved of lesser value than anticipated. I am confident that the majority of us have conducted an assessment of our bonds, even if at the unconscious level. I’m not saying that this pandemic has been good. I’m saying this pandemic has caused most of us to put greater value on our strong bonds and lesser value on the weak ones. As we move toward whatever a new normal is, we should work to reattach the desired broken and stretched tethers and break the unwanted bonds. I’m going to conduct this evaluation right now, well, maybe after one poker game. • MANNY ROMAN, CRES, is the AMSP Business Operation Manager.

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INSIGHTS

FUTURE STATE OF IMAGE ACCESS M

DEPARTMENT/ OPERATIONAL ISSUES BY JEF WILLIAMS

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anaging the users of your imaging platform is an ongoing challenge as the use and access of patient medical images continues to expand across the enterprise. In early iterations of PACS, the original digital imaging management platform, user groups were defined. The largest share of users was within radiology including both radiologists and technologists with a small subset of peripheral departments accessing PACS for the purpose of treatment planning and patient care. As imaging has expanded within the enterprise so has the complexity associated with defining user groups. Not only has user group management become more complex but so has the entire strategy of managing the digital imaging objects created from many different modalities and devices. Going forward, the industry will have to think differently about how it defines a user profile.

PATIENT ACCESS While the number of user profiles within our imaging platforms will continue to be driven primarily by provider groups within our organizations, there is now a push to provide patients access to their images from their patient portal. As the industry continues to move toward improved patient experience and consumer centric models for sharing patient medical information, it will require an equal investment in the necessary technology to make it functional and usable for patients. For some organizations, the goal is simply to image-enable the patient portal so that patients can view and, in some cases, download their medical imaging. This is a great first step in giving patients access to all their medical information in a way that is convenient and an improvement on using hard media.

MACHINE ACCESS Perhaps one of the fastest growing user profiles with imaging solutions is not human at all, but rather the artificial intelligence (AI) platforms and ADVANCING THE IMAGING PROFESSIONAL

machines that are interpreting images and providing results back to the radiologist. The challenge with developing these user profiles is in designing the technology to ensure that the use cases driving these peripheral image analysis tools enhances and does not detract from the workflow. Simply adding a module to your PACS may directly or indirectly negatively impact some of the critical key performance indicators (KPIs) identified within the department, especially turnaround times. But at that same time, deployment of AI may potentially improve quality and outcomes. As organizations expand their AI footprint an eye toward KPIs is going to be an important component of the program’s success. Having both clinical and technical teams work collaboratively in designing, deploying and supporting a complex set of machine users should be embedded into the organization’s strategy and roadmap related to machine users.

RESEARCH ACCESS Data has become an important commodity in health care just as it has in every other field. Organizations are leveraging their data to achieve outcomes related to population health and other strategic objectives. The researchers using large data sets in research WWW.THEICECOMMUNITY.COM

projects have become another important user in imaging management platforms. Because of the size and scope of many research projects the manipulation of data for the purpose of research can impact system performance which is why many organizations choose to use a separate research platform for their projects. In order to populate these research platforms, organizations require resources and tools to manipulate data including de-identification which should be an important consideration in defining new user profiles. All these things are important to consider as you build your strategy and roadmap for the future of how imaging will be managed and accessed. Where user access to imaging in large organizations can be counted in the thousands per day, it is conceivable that access over the next decade will increase tenfold when considering the number of net new user profiles accessing image information. This will have an impact on how systems are designed and deployed and should be a discussion topic with your key imaging vendors. •

“While the number of user profiles within our imaging platforms will continue to be driven primarily by provider groups within our organizations, there is now a push to provide patients access to their images from their patient portal.”

JEF WILLIAMS, MBA, PMP, CIIP, is a managing partner at Paragon Consulting Partners.

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Secondary rainbow: Light takes a second refraction inside water drops and emerges at a different angle

Science Matters

A stage for spectacular rainbows Hawaii has the right combination of sunlight, rain and atmosphere to produce vivid and complex rainbows.

Rainbow over east Oahu

Steven Businger photos

Four favorable factors

A rainbow on flat ground

Warm sea surface at night and radiation to

Sun must be within 42° of horizon

space cools cloud tops, producing morning rains – and rainbows

Mountains push up wind, forming rain

As sun rises during the morning, top of rainbow lowers and disappears

clouds; without mountains, Hawaii would be a desert with little rainfall

Daytime warming drives air circulation;

showers form over Oahu and Kauai ridges, with frequent sunset rainbows

Hawaii’s remotness gves it clean air free of pollution, dust and pollen from mainland Supernumerary rainbows, caused by interacting light waves, sometimes appear below the primary rainbow

The pattern reverses with as sun sinks in afternoon; rainbows rise in the east, with the tallest just before sunset

Rainbows in Hawaii’s culture

Hawaiian language has 24 words for rainbow phenomena, including earth-clinging rainbows (uakoko), standing rainbow shafts (kāhili), barely visible rainbows (punakea) and moonbows (ā nuenue kau pō)

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