ICE Magazine July 2021 by MD Publishing

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JULY 2021 | VOLUME 5 | ISSUE 7

ADVANCING MAGAZINE

IMAGING PROFESSIONALS Pathways to

EDUCATION AND ADVANCEMENT in Medical Imaging PAGE 30

PRODUCT FOCUS

X-RAY DEVICES

PAGE 27

In Focus

Jordan anaokar PAGE 10

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FEATURES

EMOTIONAL INTELLIGENCE

RAD IDEA

The introduction of a new oral contrast product that patients can pick up and drink in their home.

A team is more productive when it has a strong leader.

30 COVER STORY

Imaging leaders can distinguish themselves from peers by seeking opportunities to build skills that supplement, but are not necessarily established in, the medical field.

OFF THE CLOCK

Dave Angel is a man of two worlds: music and imaging.

ICEMAGAZINE | JULY 2021

ADVANCING THE IMAGING PROFESSIONAL

JULY 2021

18 PRODUCT FOCUS

The medical X-ray equipment and imaging software market is predicted to eclipse $21 billion by 2026.

12 WWW.THEICECOMMUNITY.COM

IMAGING NEWS

The latest medical imaging news from around North America.

RISING STAR

Bryan Burnside is a patient experience champion.

ICEMAGAZINE

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

CONTENTS SPOTLIGHT 10

In Focus Jordan Anaokar, MD, Fox Chase Cancer Center

Rising Star Bryan Burnside, Merit Health Madison in Canton, Mississippi

Rad Idea New oral contrast product

Off the Clock Dave Angel

Publisher

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editorial

John Wallace Erin Register

Art Department

NEWS 18

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

ICE Webinars In house staff among most valuable assets

Jonathan Riley Karlee Gower Taylor Powers

Account Executives

PRODUCTS

Jayme McKelvey Megan Cabot

Events

Lisa Lisle

Circulation

Product Focus X-Ray

Jennifer Godwin

Digital Department Cindy Galindo Kennedy Krieg

Accounting Diane Costea

Editorial Board

Laurie Schachtner Nicole T. Walton-Trujillo Mario Pistilli Jef Williams Christopher Nowak

INSIGHTS

Coding/Billing CT and CTA increases continue

Banner Imaging Vision Becomes Reality: Building a Customer Obsessed Culture with Voice of The Customer

Director’s Cut Genuine Communication

RAD HR Death is Normal: Supporting Colleagues Through Loss

PACS/IT AI results drift 10x10=105?

Emotional Intelligence Team Building 101

ICE Magazine (Vol. 5, Issue #7) July 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

Market Report Global X-ray Market Growth Continues

ICEMAGAZINE | JULY 2021

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IN FOCUS SPOTLIGHT

JORDAN ANAOKAR

BY JOHN WALLACE

n May of this year the Fox Chase Cancer Center announced the appointment of Jordan Anaokar, MD, as its new site director for radiology.

Jordan Anaokar is the site director for radiology at the Fox Cancer Center.

ICEMAGAZINE | JULY 2021

“In making this announcement, it is especially exciting for us to promote a rising star, who has earned the great respect of her peers, mentors, and trainees around Fox Chase, and whose talent and leadership will further advance radiologic services within Fox Chase and all of Temple University Health System,” said Richard I. Fisher, MD, president and CEO of Fox Chase. In her new role, Anaokar will coordinate with medical staff and the department of radiology in developing and implementing departmental programs in addition to her clinical care, research and teaching. She will serve as the department leader, working in consultation with the chair and chief of radiology for Temple University Health System (TUHS), acting as liaison with nursing services and other clinical areas throughout Fox Chase, as well as Fox Chase leadership and colleagues throughout TUHS. “I’m grateful for the opportunity to serve the Fox Chase community in this capacity as we continue to provide quality cancer imaging services to Fox Chase patients and the broader TUHS community,” said Anaokar.

Anaokar will also be responsible for implementing and assisting in the development of departmental programs, overseeing quality management and performance improvement in radiology care, overseeing medical records review, and engaging in physician recruitment and retention efforts, among other responsibilities. Anaokar has been an associate professor in the department of diagnostic imaging at Fox Chase since January 2016. She specializes in over a dozen different kinds of cancer with a treatment focus on gastrointestinal, genitourinary and thoracic imaging. She has been serving as the director of the Fox Chase Diagnostic Imaging Protocol Lab since 2020. Anaokar earned her undergraduate degree from Princeton University in 2001 and went on to receive her medical degree from Columbia University in 2008. She completed an internship in internal medicine at Beth Israel Medical Center in New York City and her residency in diagnostic radiology at the University of California, Los Angeles. During her time there she served as chief resident and completed fellowship training in abdominal imaging and cross-sectional interventional radiology. She is a member of several professional and scientific societies, including the Radiologic Society of North America, the Society of Abdominal Radiology, and the Society of

ADVANCING THE IMAGING PROFESSIONAL

JORDAN ANAOKAR, MD

Associate Professor of Diagnostic Imaging, Site Director of Radiology, Fox Chase Cancer Center (Temple Health System) What was the last book you read? Or, what book are you reading currently? I listen to audiobooks on my commute and recently finished “The Pull of the Stars” by Emma Donoghue. Favorite movie? “Good Will Hunting”. What is something most of your coworkers don’t know about you? I played rugby (briefly) in college.

Thoracic Radiology. She also serves on a number of committees at Fox Chase, including the Faculty Practice Plan Committee and the Research Review Committee. Anaokar’s decision to enter the radiology field was the result of some indecision regarding her future. “I was one of those students in medical school who was constantly changing my mind about which field I wanted to enter,” Anaokar explained. “Each new rotation brought new possibilities. I was originally drawn to radiology because it touches so many different aspects of medicine and I would still be able to interact with physicians from many different fields. Also, I knew that such a technology-dependent specialty was bound to evolve dramatically over the course of my career, and that was an exciting prospect for me.” In the end, it was the correct choice. “I love being an oncology imager because imaging is integral to cancer staging and surveillance, and radiologists are an important part of a patient’s interdisciplinary care team. But the people at FCCC really make my job special,” she said. “Our radiology staff and technologists see our patients regularly over the course of their cancer treatments. They realize that they are meeting patients at a WWW.THEICECOMMUNITY.COM

Who is your mentor? I’ve had multiple mentors at each stage of my career. Rob Suh and Steve Raman were my residency and fellowship directors at UCLA. More recently, Bart Milestone and Rosaleen Parsons at Fox Chase. What is one thing you do every morning to start your day? Coffee, always. Who has had the biggest influence on your life? My parents.

vulnerable and scary time in their lives. Because of this, the staff brings an exceptional degree of patience, kindness and attention to detail to their work. It makes me really proud to work at Fox Chase.” In fact, Anaokar’s work with others empowers and motivates her. “I’ve had multiple mentors up until this point, and I expect that I will have more. My residency director at UCLA, Dr. Rob Suh, helped me navigate the challenges of being a chief residency, which was probably my first adult leadership position. Dr. Steve Raman was my fellowship director at UCLA. He helped me push the boundaries of my comfort zone, encouraged me to

What would your superpower be? X-ray vision (of course!) What are your hobbies? Hiking, exercise and spending time with my kids. Travel and gardening are my aspirational hobbies, for when I have more time. What is your perfect meal? I try to eat plant-based, and I love breakfast. Oatmeal loaded with fresh berries and topped with granola is one of my favorites.

say yes to new ideas and projects to see where they would take me,” she said. As for her role as a leader at Fox Chase, Anaokar says her goal is to follow the golden rule and do unto others as you would have them do unto you. “I’ve always been drawn to people who lead by example, and I try to model that,” she said. A successful career is wonderful, but when asked about her greatest accomplishment she switched gears. “I’m mother to three amazing kids, ages 2, 7 and 10,” Anaokar said when asked about her greatest accomplishment. •

ICEMAGAZINE

SPOTLIGHT

RISING

STAR BRYAN BURNSIDE

BY ERIN REGISTER

ryan Burnside, 39, lives in Brandon, Mississippi, where he has been living the past 18 years. With an associate degree in applied science with a major in radiology, Burnside is the imaging director and patient experience champion at Merit Health Madison located in Canton, Mississippi. “I started my career as an X-ray tech at one of our sister hospitals, Merit Health Central,” said Burnside. “Within a year, I was working as a CT tech, and within five years, I was the CT supervisor. After 11 years total at that hospital, I was promoted to imaging director at my current location at Merit Health Madison.” ICE learned more about this Rising Star in a recent interview.

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: In late high school and early college, I really had my sights set on being a photographer. After working around town with a couple of local photographers, I decided that turning a then hobby into a career was not going to be all that I thought it was. My aunt was a nurse, and she introduced me to the idea of “taking pictures of bones.” After some research of the field, I decided to give it a shot, and here I am 18 years later.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: I like the reward that comes with helping others. We’ve had so many positive impacts on our community and have implemented programs that have had a direct 12

ICEMAGAZINE | JULY 2021

impact on saving lives. For example, we started a lung cancer screening program here. Of the first 100 patients screened, we found a dozen positive lung cancers. I also love being involved in developing ideas and projects to grow and improve our department, such as a complete renovation of our mammography suite. We went from a basic 2D mammo suite to the highest technology available in the nation. To be able to take something from that and see the fully realized project, along with seeing the response from our patients when they enter the room, is one the biggest highlights of getting to do a job like this.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: There really is an “art” to imaging patients. Every individual patient is unique. It’s fascinating the different ways we work to find that balance to create the best possible image. This is true across all modalities. Whether it’s simply manipulating technique in routine X-rays, table and tube speed in CT, phase and frequency in MR, or probe manipulation in ultrasound, they all have their own unique complexities when it comes to finding that balance to create the perfect image.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN THE FIELD THUS FAR? A: When talking about what it takes to be successful in the field, I actually came up with an acronym: P.R.O.M.I.S.E. It starts with being Passionate about helping others. Without that, it’s really nothing more than just a job. Respect is about putting yourself in another’s shoes and looking at various situations from their ADVANCING THE IMAGING PROFESSIONAL

Bryan Burnside enjoys playing fantasy football outside of work.

caption here

perspective. Being Open-minded is what opens doors to many different opportunities and allows you to be a sponge. Mistakes are part of anyone’s journey to success. Innovation is constant in imaging. If you’re not consistently evolving, you will get left behind quickly. Street-smart is honestly a phrase that conveys the message of good old-fashioned common sense. And lastly, Education. There are very few days in this field where I don’t learn something new. I’ve had wonderful success moving up in my career from a night shift X-ray tech to now a director of an amazing imaging department. I attribute it to a dedicated work ethic, a little luck and those seven ideas I just mentioned.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: Over the last six years, we’ve enhanced and improved both technology levels and patient comfort standards in every modality we offer. We’ve achieved ACR accreditation across the department and doubled the number of registries held by our staff. Over the next five years, we want to continue to build on that success. Personally, I’d like to grow my role in all our Merit market hospitals to try and spread this high standard of quality and comfort to all our imaging departments within the central Mississippi area •

FUN FACTS

Favorite Hobby: I love playing fantasy football and I’m a huge movie buff!! If I could do any other job, it would be a movie critic.

Favorite Show to Binge Watch: “Seinfeld” Favorite Food: Salted and buttered movie theater popcorn One Thing on Your Bucket List: I’d love to take a tour of Napa Valley via a Harley-Davidson

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ICEMAGAZINE

SPOTLIGHT

Rad idea NEW ORAL CONTRAST PRODUCT

We worked closely with our pharmacy and the Ohio board of pharmacy to introduce a new oral contrast product that patients can pick up and drink in their home. This was a Herculean effort because of all the regulations we had to live within. During the COVID-19 pandemic, the last thing you and your customers want is to come two hours early and sit in our waiting room drinking contrast (without a mask on). • JACQUI ROSE, PMBA, CRA, FAHRA, RT(R). Director of Medical Imaging, Telecommunications, IT and Lab UVMC. Medical Imaging - MVHN Share your RAD IDEA via an email to editor@mdpublishing.com.

ICEMAGAZINE | JULY 2021

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SPOTLIGHT

Off Clock THE

DAVE ANGEL

rom his earliest years, Dave Angel realized that he was a child of two worlds: music and medicine. His father was a dentist who attended college on a music scholarship before switching to pre-med and meeting his mother, a nurse. Their St. Charles, Illinois home was full of big band music and friends working in health care professions. As a youngster, Dave became fascinated with the sounds of the records his father spun in the house. He would lay on the living room floor, his head between the hi-fi speakers, straining his ears for the hidden details of the recordings. “I used to call it ‘listening into’ the music,” Angel said. “I could hear the rooms they were recorded in; whether someone was smiling when they were singing. I wanted to become a recording engineer because I never thought I would have the chops to be a musician.” Angel loved all the sounds of the studio, but few as much as the double bass. He wanted desperately to learn to play it, but everyone told him he was too little, so he started training on the tuba. By his early teenage years, Angel

ICEMAGAZINE | JULY 2021

was finally taking bass lessons and playing in the school jazz band. He realized he’d gotten good enough to replicate any piece of music he heard. At home, he was hearing quite a bit. Dad, who never lost interest in popular music, from Sinatra and Crosby to the Beatles and the Zombies, would come home from his dental practice, take his tie off, and play the clarinet. At one point, he brought home an electric guitar. As Angel remembered, “he was totally into helping us with rock and roll.” By high school, Angel had formed his own garage band, a group called Ultima Thule, which morphed into “a real crunchy, good-time band” that called themselves The Boyzz. By the time he was barely out of his teens, they’d signed a record deal with CBS Records subsidiary Cleveland International, where they were labelmates with Meat Loaf. Eventually, after the group lost its singer and its label deal, they changed tack, and shortened their name. The Boyzz became The B’ZZ. “The guys wanted to change the style we were writing in,” Angel said;

“we wanted to get into something more melodic, but evolve as musicians. Guys in the industry started calling us ‘The B’ZZ because we weren’t The Boyzz anymore.” Whatever they called themselves, the newly christened group showed they had the talent to back it up, becoming the first unsigned act to appear on Dick Clark’s “American Bandstand.” With a new singer in tow, the group headed to Los Angeles to perform in label showcases, searching for a new record deal. “By then, everybody knew us as The B’ZZ,” Angel said. “We hated the name, but we were stuck with it. We got signed again, around 1983, to Epic Records, for one record.” And then, he said, “things imploded.” In Los Angeles, The B’ZZ rubbed elbows with several popular acts of the time. Fresh off the High Infidelity tour, and dragging their feet on a follow-up album, REO Speedwagon offered to share their rehearsal space with The B’ZZ. The B’ZZ got the lion’s share of the time on a gigantic sound stage, and REO Speedwagon got an excuse to stave off their managers for a little

ADVANCING THE IMAGING PROFESSIONAL

Dave Angel has seen and done a lot in music through the years.

while longer. By this point, the California music scene had swung fully into hair metal. The two youngsters who used to watch their rehearsals at that sound stage? “Turned out they were Axl Rose and Slash from Guns n’ Roses,” Angel remembers. The house band at The Troubadour who slipped their demo to The B’ZZ producer, Tom Werman? Motley Crüe. “They take off, we break up,” Angel said. “In different forms, we’d been together 10 years.” “We had a management company and a bunch of dough, a lot of free booze, and all these guys were hanging out with us,” he said. “Maturity-wise, we were too young to handle the success. We self-destructed; lots of drugs and alcohol, fractions of the band with different interests.” “There were times when I would be with my group of friends, and I wouldn’t see anybody in the band until I was onstage with them,” Angel said. “We would arrive in different limos, go to different parties. The lead singer decided he wanted to play bass and sing, so the management company let me go.” Angel returned home to Chicago with his guitarist and keyboard player, preparing to reinvent himself in the music industry yet again. “My goal was to be a millionaire by the time I was 30, and then quit whatever band I was in to become a producer,” he said. “I wanted to get into the safe side of rock and roll: get married, have a family and record great artists. If you’re an engineer, it doesn’t matter what’s trendy, you just have to record them.” By the time his thirtieth birthday came, however, Angel wasn’t a millionaire, and he wasn’t married. The band was readying a new catalogue of songs for a return trip to Los Angeles, but Angel made other plans. “I had just met my future wife, and I knew she wouldn’t follow me to L.A.” he said. “I’d started seeing guys who’d WWW.THEICECOMMUNITY.COM

had big bands, playing local festivals, on their way back down. I saw my future. I was just ready to walk away. I sold some of my gear, and it became almost painful to listen to the radio or my favorite music.” Turning his thoughts to a more traditional version of responsibility, Angel became infatuated with X-ray school. He’d worked in a hospital as a teenager, and decided to go to college to become an X-ray technician. “I was in my mid-30s, again, just reinventing myself,” Angel said. “I thought, ‘I want to have a skill that nobody could take from me.’ By the time I went to X-ray school, I knew I wanted to be a department director.” One day, while having lunch with a friend who was an emergency-room doctor, Angel was advised to learn about a new technology called magnetic resonance imaging (MRI). “He goes, ‘it’s the future of imaging,’ ” Angel recalls. “ ‘You’re going to sit at a computer, look at screens, and navigate through the human body like Captain Kirk on the Enterprise,’ I went from being a studio rat to an MRI rat.” Angel applied to every MRI center within 50 miles of his home, nailed an interview, and was hired to perform mobile MRI. During the week, he was completing X-ray school, while working as an MRI technician on the weekends; Angel remembers having to ask for a day off to go to his own graduation. “At the hospital where I’m doing my clinicals, my colleagues are completely

ticked off at me because I have a job in MRI and they’ve been X-ray techs for 20 years,” he said. Once in the field, he was promoted to clinical coordinator, then operations management, and finally, a department director at Mercy Medical Center in Chicago. “It was what I’d always wanted,” Angel said. The professional success enabled Angel to continue doing the other thing he’d always wanted; namely, building up his own home studio, piece by piece. He started adding gear over the years, and what had started as a passion project became Rave Song Records, the home studio for Angel’s original act, The Willing, and his weekend cover band, The Raleigh Tuckers. “I just kept searching and moving and growing and learning and reading anything I could on engineering,” he said. “[The studio’s] really geared for my band, and I reinvest the money into it.” For the last 20 years, Angel continued to work in health care during the week and record or practice for four or five hours every Saturday. Two years ago, he was able to retire from the hospital and pay off his home. Now, in his sixties, Angel feels like he’s been given the opportunity to follow his bliss once more. “I’m back to being a full-time musician, but now I have an income,” he said. “I write, record, engineer, I play live, and it’s just a blast.” • ICEMAGAZINE

NEWS

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

RSNA ADDS TO RADIOLOGY HEALTH EQUITY COALITION The Radiological Society of North America (RSNA) has appointed Jinel Scott, M.D., as its representative to the recently established Radiology Health Equity Coalition. The coalition brings together the radiology community to address health disparities and measurably change outcomes. This network of patient-focused radiologists will collect and disseminate resources and best practices, advocate for and connect with patients and community members, and collaborate on programs and services to empower their colleagues to improve health care equity. “At the National Convention of the Medical Committee of Human Rights in 1966, Martin Luther King Jr. said,

‘Of all the forms of inequity, injustice in health care is the most shocking and inhumane,’ ” Scott said. “Radiology has a role in addressing inequities in health care and I am proud to represent the RSNA as a part of the Radiology Health Equity Coalition.” Scott is a clinical assistant professor in the department of radiology at SUNY Downstate Health Sciences University, and director of emergency imaging, quality and patient safety services at Kings County Hospital Center, both in New York City. In addition to being the RSNA representative to the Radiology Health Equity Coalition, Scott is a member of RSNA’s Committee on Diversity, Equity and Inclusion.•

NEW AWARD RECOGNIZED IMPROVEMENTS IN HEALTH CARE DISPARITIES The Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity is a new award program from The Joint Commission and Kaiser Permanente. The annual award in Tyson’s memory recognizes health care organizations and their partners that lead initiatives that achieved a measurable, sustained reduction in one or more health care disparities. All types of health care organizations that directly deliver health care and have addressed disparities for any vulnerable population, including but not limited to race/ethnicity, gender, sexual orientation,

ICEMAGAZINE | JULY 2021

or socioeconomic status, may apply. Bernard J. Tyson, the late chairman and chief executive officer of Kaiser Permanente, worked tirelessly to address the disparities that plague the U.S. health care system. The Joint Commission and Kaiser Permanente hope that the award will recognize achievement, inspire organizations to launch projects to address health care disparities, and provide concrete examples for others to emulate. • For more information, visit tinyurl.com/477t2mr6.

ADVANCING THE IMAGING PROFESSIONAL

CANON MEDICAL LAUNCHES E-COMMERCE PARTS PLATFORM When a medical imaging system needs a new part, getting a replacement quickly is an urgent matter for any health care organization. To support the needs of the customer, Canon Medical Systems USA Inc. has introduced Medical Marketplace, an online store for medical imaging parts. The platform enables customers to find OEM parts at reduced prices, maximizes efficiency through 24/7 access and supports a continuous workflow. Medical Marketplace streamlines the procurement process. The platform offers a wide range of inventory for all imaging modalities in one place, providing genuine OEM parts backed by Canon’s OEM parts warranty. And it’s easy to use: Instead of dependence on the availability of a parts specialist, customers can browse the parts inventory anytime, day or night. With 40 parts depots across the U.S., parts shipping is expeditious and includes same-day delivery options. In addition, the new platform offers a unique opportunity to reduce costs. Orders placed online are entitled

to 15% savings off the list price, which can make a big difference for organizations where replacement parts signify a big portion of their budget. Although anyone can buy through the portal, customers with existing MSA discounts will benefit from customized discounts established in the agreements. And for even more convenience, payment options include purchase order (PO) and credit card. “Medical Marketplace is yet another example of how Canon continues to evolve and innovate to better serve a range of customers,” says Dominic Smith, vice president, service field & sales. “With the launch of the platform, customers can tailor an approach that works best for them: They can choose the digital route and place their orders online, access Canon’s parts department for questions, or continue to order parts through telephone or email. Our service team is still readily available to assist customers with additional support if needed. So, give it a try and see how easy Medical Marketplace is to use.” •

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ICEMAGAZINE

NEWS

GE HEALTHCARE INTRODUCES NEW VIRTUAL SOLUTION To help provide nuclear medicine clinicians greater flexibility and more time with patients, GE Healthcare unveiled Xeleris V – a new virtual processing and review solution. Xeleris V eliminates the need for a standalone nuclear medicine workstation so that clinicians can have secure access to data from various locations. This increase in access – paired with new AI-enabled applications and GE Healthcare’s large install base of nuclear medicine cameras – can simplify and enhance workflows to help clinicians quickly discover, diagnose and treat patients with accuracy. “As we work to rebuild, recover and reimagine health care going forward, we believe AI will be critical in helping health care systems maximize resources to more quickly and easily deliver personalized care,” explains Jean-Luc Procaccini, president and CEO, molecular imaging and computed tomography, GE Healthcare. “Xeleris V helps do just that, offering clinicians a new way of working that enables more time with patients and helps them reach quick, confident diagnoses using the latest innovative technologies across all their devices.” There is a growing need for increased flexibility, access and efficiency in health care. “No one wants to spend their day clicking through windows at a workstation, but today’s manual workflows – such as organ segmentation – are time-consuming, te-

ICEMAGAZINE | JULY 2021

dious and highly operator-dependent processes,” explains Michael Soussan, MD, Ph.D., professor of medicine and chief of the nuclear medicine department at Avicenne Hospital. “Automating these workflows and gaining easy access to reproducible and precise results is essential to providing quality patient evaluation and treatment.” Removing the limitations of a traditional nuclear medicine workstation, Xeleris V offers clinicians a virtualized, flexible AI-powered solution that provides clinicians secure access to data from anywhere – helping them make personalized care decisions and treatment recommendations that are at the heart of precision health. “With AI-based technologies, we gain speed, confidence and reproducibility – it is transforming the radiology imaging process by delivering precise results that can help expand the utilization of nuclear medicine to personalize the patient treatment pathway,” adds Professor Soussan, whose nuclear medicine team at Avicenne Hospital evaluated GE Healthcare’s new Q.Lung AI solution. “Even in my own practice, I’ve observed that as we gain the surgical team’s confidence by providing precise results, we have the opportunity to be more involved in guiding the individualized care provided to each patient.” Xeleris V’s new AI-enabled clinical applications work to streamline workflows, provide accurate data, and help expedite diagnoses across care areas. •

ADVANCING THE IMAGING PROFESSIONAL

KA IMAGING SIGNS DISTRIBUTION AGREEMENT WITH ALPHA IMAGING KA Imaging has signed a distribution agreement in the USA with Alpha Imaging. Hospitals, medical facilities and practices from 14 states can now acquire Reveal 35C through Alpha Imaging, one of the largest distributors of medical imaging equipment in the country. Robert Moccia, vice president of sales for KA Imaging in the United States and Canada, is thrilled to have made this agreement. “Our partnership with Alpha is a big step towards KA Imaging’s vision to bring innovative X-ray everywhere. Alpha Imaging’s 30-plus year track record of providing imaging equipment to some of the most prestigious health care institutions in the U.S. gives KA Imaging the access and credibility to excite the market with our technology and ultimately improve patient care” said Moccia. Michael Perrico, CEO of Alpha Imaging, said, “The

addition of KA Imaging’s Reveal 35C adds yet another advanced imaging technology to our robust portfolio of medical imaging offerings. Single exposure subtracted chest imaging will provide clients with a low-dose and cost-effective alternative to traditional dual- energy systems. We are excited to partner with KA Imaging.” Reveal 35C is the world’s first and only portable dual-energy X-ray detector. The detector provides radiologists with three unobstructed images in a single shot that are free from motion artifacts. Reveal is currently being used in two clinical trials, for detecting both lung cancer and pneumonia (including COVID-19) with great initial success. • For more information, visit www.kaimaging.com.

MITA VOICES CONCERN REGARDING MCIT PATHWAY DELAYS The Medical Imaging & Technology Alliance (MITA) has expressed concern regarding the Centers for Medicare and Medicaid Services (CMS) decision to further delay the Medicare Coverage of Innovative Technology (MCIT) pathway as well as updates to the definition of “reasonable and necessary” for purposes of CMS coverage. In a final rule published in the U.S. Federal Register, CMS opted to delay implementation of the MCIT program and the updates to the coverage criteria until December 15, 2021. The decision was issued despite broad enthusiasm for the new coverage pathway from a wide array of concerned parties. “We are greatly disappointed by the CMS decision to postpone implementation of MCIT,” MITA Executive Director Patrick Hope said. “Once implemented, MCIT will modernize Medicare’s current reimbursement structure, ensuring broader beneficiary access to Food and Drug Administration (FDA)-authorized, breakthrough medical

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technologies that would otherwise be unavailable. Further delaying this coverage pathway effectively denies patient access to breakthrough technologies and ‘kicks the can down the road,’ leaving patients, health care providers and medical device innovators in limbo.” Initially finalized in January of this year, the MCIT pathway, as proposed, would have reduced the gap between FDA marketing authorization and subsequent Medicare coverage for innovative medical devices. However, on March 17, CMS published an interim final rule delaying the effective date of MCIT until May 15. The agency’s most recent decision is an even longer delay of the coverage pathway’s effective date, pending further review and input from interested entities. “Despite our concerns, we will continue our engagement with the agency to support the implementation of MCIT before the end of 2021,” Hope added. •

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NEWS

CARESTREAM ADVANCES X-RAY IMAGE QUALITY WITH SMART NOISE CANCELLATION Carestream Health has released Smart Noise Cancellation (SNC), an artificial intelligence (AI)-based technology that greatly improves image quality – producing images that are significantly clearer than with standard processing. SNC has received FDA 510(k) Clearance and is available as an optional feature with Carestream’s ImageView Software powered by Eclipse – the intelligent image-processing engine behind the company’s innovative imaging software – on DRX-Evolution and DRX-Evolution Plus systems. “Carestream is a leader in using AI for noise cancellation with X-ray images. Our team of imaging scientists has been able to separate image noise from sharpness and contrast using AI-based algorithms that result in remarkable image quality,” said Jill Hamman, worldwide marketing manager, global X-ray solutions at Carestream. “This technology provides improved anatomical clarity, preservation of fine detail and better contrast-to-noise ratio for images acquired at a broad range of exposures, which can help improve diagnostic confidence and alleviate physician fatigue. It also enables radiology professionals to better optimize radiation dose.” Optimizing radiation dose is especially important with neonatal and pediatric diagnostic imaging, where imaging at the lowest possible dose is crucial for young patients. Separating noise from an image has been a challenge for medical imaging scientists. Traditional noise reduction introduces blurring, which degrades image sharpness and might remove important anatomical information. Conversely, the more an image is sharpened, the more noise may be enhanced. Noise is often an undesirable byproduct of image capture and can obscure critical anatomical

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data. Carestream’s SNC is able to isolate noise to produce images that are significantly clearer than with standard processing. As the preferred level of noise on X-ray images is subjective – for example, some radiologists expect to see a certain degree of noise in images, which assures them that the patient was not overexposed – Carestream enables imaging professionals to adjust the amount of noise cancellation and exposure to meet their desired image quality. Objective testing demonstrated that SNC processing enables a 2x–4x noise reduction in flat image areas, preserves high frequency sharpness and improves contrast detail. Additionally, a blind clinical reader study using board-certified radiologists found that 89.5 percent of all study ratings showed a slight to strong preference for SNC-processed images. Sixty-four percent of the diagnostic quality ratings improved – based on the RadLex rating scale – and 56 percent of these ratings improved from “limited” or “diagnostic” to “exemplary.” When combined with SmartGrid software, Smart Noise Cancellation software promises benefits in gridless imaging where the removal of scatter typically leads to an increase in noise appearance. “At Carestream, improving image quality is a top priority for our R&D team,” Hamman said. “Smart Noise Cancellation provides the ability to consistently deliver high-quality diagnostic images for healthcare providers and their patients.”• For more information, visit www.carestream.com

ADVANCING THE IMAGING PROFESSIONAL

PHILIPS INTRODUCES NEW SPECTRAL CT 7500 SYSTEM Royal Philips has announced its newest solution for precision diagnosis with the global introduction of its spectral detector-based Spectral Computed Tomography (CT) 7500. This latest intelligent system delivers high quality spectral images for every patient on every scan 100% of the time to help improve disease characterization, and reduce rescans and follow-ups, all at the same dose levels as conventional scans. The time-saving spectral workflow is fully integrated, enabling the technologist to get the patient on and off the table quickly – spectral chest scans and head scans take less than one second, and a full upper body spectral scan can be completed in less than two seconds – while still delivering high quality imaging that

allows the physician to rapidly deliver a confident diagnosis and effective treatment plan for each patient. Spectral CT 7500 expands on Philips proven spectral-detector benefits to now include additional patient populations that were not previously served. The spectral insights are available for all patients, from pediatric to bariatric, and for any clinical indication, including challenging cardiac scans with high and irregular heart rates, without compromising image quality, dose or workflow. The spectral workflow enables radiologists to optimize reading with rich spectral results and AI-based smart tools available in any reading environment with Spectral Magic Glass on PACS. •

IMAGING SYSTEMS YOU AND YOUR PATIENTS DESERVE From adding another MRI unit to handle your patient backlog, to providing a short-term solution while upgrading your current unit, to adding a new service, KMG has the right imaging systems to keep you running efficiently and affordably.

612-757-6714 kingsmedical.com contact@kingsmedical.com

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OVER 20 YEARS OF EXPERIENCE IN TALENT ACQUISITION FOR THE MEDICAL EQUIPMENT SERVICE INDUSTRY. EMPLOYER SERVICES • Talent search and acquisition • Talent retention and training • Workforce planning

CANDIDATE SERVICES • Career placement • Career advising • Resume critiques • Interview training

JENIFER BROWN Jenifer@HealthTechTM.com Ph: 757.563.0448 | www.HealthTechTM.com

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ADVANCING THE IMAGING PROFESSIONAL

NEWS

ICE

A COOL SERIES FOR HOT TOPICS

IN-HOUSE STAFF AMONG MOST VALUABLE ASSETS STAFF REPORT

other industries, do you believe we will see an artificial intelligence solution for clinical engineerhe May 4 webinar “Your ing? Similar to what has happened in the medical Differentiating Asset, Your field?” In-House Staff” sponsored by Darweesh said this was another great question Technical Prospects was approved and something he has predicted previously. for 1 ARRT Category A CE credit by “I talked heavily about artificial intelligence,” he AHRA. said. “Yes, just like we learned now about something called telemedicine, over the last 50 years, In this 60-minute webinar, expert Sam Darit started in the UK and Rwanda. That in many, SAM DARWEESH weesh, chairman of engineering and vice presimany companies, that they have few doctors dent of operations of Technical Prospects provided attendees in the core, and a big artificial intelligence database and the with an opportunity to review how health care systems are patients can log into that database, and actually answer some capitalizing on their most loyal asset to change the imaging questions about their health, and then literally eliminate the industry. symptoms or up to 85% artificially intelligent diagnostic for Darweesh is an experienced CT and MRI senior engineer this.” who has been in the medical imaging industry for 20-plus “I believe if we can do this for the human illness, and for the years working with industry-leading CT and MRI manufacturhuman body, soon we should be able to do this for equipers, as well as major independent service organizations (ISOs) ment. I believe we are all going to see an artificial intelligence worldwide. He has provided expert recommendations to teams database in which you can eliminate reasons based on errors of engineers in North and South America; was responsible for or based on symptoms, eliminate reasons of malfunctions of major strategic projects on CT and MRI systems worldwide; systems and that database will serve as your tech support and is an adjunct professor of medical imaging. eventually or as your senior engineers and that will facilitate a After his presentation, attendees gained additional insights lot for frontline staff.” via a question-and-answer session. In a post-webinar survey, attendees provided feedback One question was, “After developing the in-house developregarding the webinar. One part of the survey stated, “Give us ment, how do you analyze your retention?” 3 words to describe today’s webinar.” • “That’s a great question,” Darweesh said. “So, the workshops, it would be really our checkpoints, our statistical -M. Pawelkowski, Radiology Supervisor approach to understand where the engineers are. Are they pressured through the learning? Do we need to expedite? Or do we need to slow down for each individual and their learning -C. Corciova, Associate Professor/Medical Bioengineer curve? Every sequence, we share insights with the administrators of the health care systems, and stakeholders who need -R. Lippincott, Director of Imaging Services to be involved, about where the engineers are, what’s their empowerment factor to date, how happy they are and how engaged they are. -E. Hammond, BMET2 Although statistically based on the interaction with the engineers and the overall evaluation, we will make the proper For more information, visit ICEwebinars.live adjustments if it’s in the engineering side or provide insights about engineering retention to the hospital administration staff Thank you sponsor! to take the required action, then we’ll measure again.” Another question was, “With everything going on in all

"Well-planned, methodical, informational" "Interesting, professional, new-notions"

"Program for thought"

"Interesting and eye-opening"

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PRODUCTS

Market Report Global X-ray Market Growth Continues STAFF REPORT

he medical X-ray equipment and imaging software market was valued at $17.17 billion in 2020, and is expected to reach a value of $21.68 billion by 2026, according to Mordor Intelligence report. The report indicates that the market will experience a compound annual growth rate (CAGR) of 3.92% from 2021 to 2026). “The growing aging population, coupled with rising investments in the health care ecosystem, is expected to have a positive impact on the overall market growth, over the forecast period. Developed nations have been facing this demographic challenge and have been investing to bring affordable health care systems to these people, thereby providing impetus to the market,” Mordor Intelligence states. The report also shared the following information: • According to the World Health Organization (WHO), approximately 70% of cancer deaths are recorded in the middle- and low-income countries. This is likely to create an opportunity and open new avenues for the companies to invest in research and development activities and offer equipment and imaging software at a competitive rather than standard market value. • Most of the countries spend highly on the health care industry and upgrade to the latest equipment and solutions with an aim to improve health. However, a few countries, such as the United States, relatively underperform in terms of health care. For instance, the United States spends approximately 7%-10% more than other similar countries; however, life expectancy is low. This creates a new avenue for the companies to invest in advanced equipment and imaging software, in order to improvise the health care ecosystem. • Notably, in Asia-Pacific, investment in health care is 26

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rigorously increasing, with an aim to provide adequate and quality health care services in the region. For instance, in November 2018, MGM Healthcare Pvt. Ltd announced its plan to launch a new chain of hospitals, establishing a 400bed state-of-the-art medical institution, in South India. As a result, it is expected to boost the need for X-ray equipment and imaging software in the country, thus having a positive impact on the market growth. Grand View Research also predicts continued growth. “The global medical imaging market size was valued at $15.9 billion in 2020 and is expected to expand at a compound annual growth rate (CAGR) of 5.2% from 2021 to 2028,” according to a Grand View Research report. “Major factors driving the industry are the increasing demand for early-stage diagnosis of chronic disease and rising aging demographics, which is expected to boost the demand for diagnostic imaging across the globe. Technological advancements, coupled with supportive investments and funds by the government, especially in developing countries, such as India and China, are also expected to contribute to market growth.” Global Market Insights (GMI) also predicts growth and sees the COVID-19 pandemic as one reason for continued expansion of the global X-ray market. GMI reported that the medical X-ray market size was valued at $13 billion in 2020 and is expected to witness 5.7% CAGR from 2021 to 2027. It says the surging burden of chronic diseases such as cancer, neurological diseases, dental problems, cardiac diseases and musculoskeletal disorders will spur market growth. “Moreover, due to the increasing incidence of COVID-19, the need for effective diagnosis and treatment has also surged globally. Several market participants in the medical device manufacturing industry are working continuously to escalate the production of medical X-ray devices to meet the growing needs of health care providers for imaging solutions,” GMI reported in January of this year. • ADVANCING THE IMAGING PROFESSIONAL

Product Focus CARESTREAM

X-Ray

DRX-Compass X-ray System Carestream’s DRX-Compass X-ray System, now with a new floor-mount option, delivers an innovative, scalable and efficient medical imaging solution that easily adapts to space requirements. Facilities can choose an overhead tube crane or the optional free-standing tube mount that eliminates the need for ceiling rails. The DRX-Compass – an upgrade-friendly unit with a broad array of advanced features and options to meet changing needs – helps keep customer budgets in line. It is ideal for community and private hospitals, as well as orthopedic and radiology practices; and offers smaller sites the ability to put Carestream’s exceptional image capture and processing to work.•

PHILIPS

DXR Portfolio

Philips’ X-ray and fluoroscopy equipment offers excellent workflow and quality images to drive throughput and confident diagnoses, while enabling high staff and patient satisfaction. Specifically, Philips’ DigitalDiagnost C90 allows the radiologist to comfortably see more patients per day and shorten patient wait times by decreasing the time to diagnosis with innovative tools. Features of the Philips DigitalDiagnost C90 include the Eleva Tube Head, which offers a live camera image for improved positioning support. In addition, versatile room configurations and exam automation technologies also help to assure outstanding patient throughput.

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FUJIFILLM

Persona RF PREMIUM Persona RF PREMIUM is Fujifilm’s next-generation, multi-purpose radiography fluoroscopy (RF) system engineered for versatility, ease of use and long-term reliability in interventional and routine radiographic examinations for patients of all sizes. The system accommodates a wide range of exams and patient sizes, with 94-inch patient coverage, +90° tilting and supporting patient weights up to 584 pounds without movement restrictions. For the latest in high sensitivity low dose image capture, Persona RF incorporates a 17x17-inch DR detector and for added versatility it can be configured with an optional overhead tube system and/or additional DR detector utilizing just one workstation and generator system.•

GE HEALTHCARE Critical Care Suite 2.0

Research shows that up to 25 percent1-5 of patients intubated outside of the operating room have misplaced endotracheal tubes (ETT) on chest X-rays, which can lead to severe complications for patients, including hyperinflation, pneumothorax, cardiac arrest and death. GE Healthcare’s Critical Care Suite 2.06 features a new AI algorithm to help clinicians assess ETT placements, a necessary and important step when ventilating critically ill patients. The AI solution is one of five included in GE Healthcare’s Critical Care Suite 2.0, an industry-first collection of AI algorithms embedded on a mobile X-ray device for automated measurements, case prioritization and quality control that can help improve efficiency on the front lines. 1. Jemmett ME, Kendal KM, Fourre MW, Burton JH. Unrecognized misplacement of endotracheal tubes in a mixed urban to rural emergency medical services setting. Acad Emerg Med 2003;10:961–5. 2. Katz SH, Falk JL. Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med 2001;37:32–7. 3. Lotano R, Gerber D, Aseron C, Santarelli R, Pratter M. Utility of postintubation chest radiographs in the intensive care unit. Crit Care 2000;4:50–3. 4 McGillicuddy DC, Babineau MR, Fisher J, Ban K, Sanchez LD. 5 Is a postintubation chest radiograph necessary in the emergency department? Int J Emerg Med 2009;2:247–9. 6 510k pending at the FDA. Distributed in accordance with FDA imaging guidance regarding COVID-19 public health emergency. •

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ADVANCING THE IMAGING PROFESSIONAL

KA IMAGING REVEAL 35C

Reveal 35C is a single exposure, portable, digital DES X-ray detector that overcomes previous DES technical limitations. This detector raised the possibility of a DES retrofit in existing digital X-ray rooms. The portability of a single exposure DES detector also allows for point-of-care high quality diagnostic imaging to increase access in underserved regions. With the same radiation dose as a chest X-ray, it is possible to create 3 different images without motion artifacts (your regular DR, soft tissue and bone) to give you the ability to see the lungs and soft tissue without having bones obstructing the view, as well as identify calcified tissue.•

SIEMENS HEALTHINEERS YSIO X.pree

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The YSIO X.pree ceilingmounted radiography system from Siemens Healthineers includes the MyExam Companion user interface, which provides proactive guidance to help radiologic technologists of any skill level navigate a radiography procedure and increase the efficiency of the imaging process. The new MyExam 3D camera helps speed up the clinical workflow. Its Virtual Collimation feature permits technologists to precise-

ly adjust the X-ray beam’s size and shape via the touchscreen monitor and reduce the volume of irradiated patient tissue. The camera-based Smart Virtual Ortho functionality enables shorter preparation times for orthopedic multi-image acquisitions. Finally, the system has an adjustable touch display and a tube touchscreen monitor that is positioned lower than monitors on previous ceiling-mounted units. •

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Pathways to

EDUCATION AND ADVANCEMENT in Medical Imaging BY MATT SKOUFALOS

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ADVANCING THE IMAGING PROFESSIONAL

n health care, just as in any industry, the skills that make a great clinical or technical professional aren’t always the ones that make a great leader. Despite the rigors of continuing education, and the breadth of opportunities that exist for advancement, determining a clear path forward to a management role isn’t always easy, particularly in the field of medical imaging. Nicole Dhanraj, Ph.D., SHRM-SCP, GPHR, PMP, programs exist outside of tackling a higher-edCPPS, CRA, R.T (R)(CT)(MR), radiology sysucation degree. tems director for Northern Arizona Healthcare The Medical Technology Management Instiof Flagstaff, Arizona, said that imaging leaders tute (MTMI) offers a spectrum of medical-imcan distinguish themselves from their peers by aging-modality-based certification programs seeking opportunities to build skills that sup— for radiography, mammography, computed plement, but are not necessarily established in, tomography (CT), magnetic resonance imaging the medical field. These supplemental skills are (MRI) ultrasound, radiation therapy, nuclear crucial because, despite coming into a work medicine, dosimetry, fluoroscopy, bone density, assignment with strong, job-related skills, the PACS, interventional radiology, and vascular modality-specific curricula imaging. that create a valuable cliniThese meet standards cian or technologist don’t established by professional always hone the expertise organizations such as the necessary for that same American Society of Radioemployee to thrive in a logic Technologists (ASRT), director-level position. the Society of MR Radiog“In that space, as a raphers and Technologists leader, how do you make (SMRT), the Commission yourself stand out to others on Accreditation of Medical around you?” Dhanraj said. Physics Education Pro“It’s important that we gain grams (CAMPEP), and the industry-specific credentials Accreditation Council for but even more important Continuing Medical Educathat we look outside of our tion (ACCME). – Nicole Dhanraj, Ph.D. industry for credentials The Certified Radiolothat help amplify our skills, gy Administrator (CRA) knowledge, and abilities, to support being an credential is the only one created specifically effective leader.” for radiology administrators; it highlights skills A variety of low- or no-cost options exist that span human resources, asset resources, for acquiring some of the fundamentals in finance, operations, and communication. It is these areas of specialization, from informal, managed by the self-governing Radiology AdYouTube-hosted how-to videos to credentialed ministration Certification Commission (RACC). services like Coursera and edX, which host The Institute for Healthcare Improvement web-based classes and certificate and degree (IHI) offers a Certified Professional in Patient programs from hundreds of universities and Safety (CPPS) credential, which educates private companies. health care professionals in patient safety “You can start out and just fill your bucket culture, leadership, risks and solutions, perof knowledge with things you don’t know, and formance measurement and improvement, then you can go to community colleges for and human factors. foundational classes in other core subjects such For those whose assignments will require as finance, or human resource management,” more specialization in areas of human reDhanraj said. “There’s a lot you can get from sources, The Society for Human Resource these organizations. These pathways offer mulManagement (SHRM) offers the SHRM-CP or tiple perspectives of the business operation.” SHRM-SCP certificates; the former is designed For those just starting out in the medical imfor those working in day-to-day HR functions, aging field, or seeking out continuing education whereas the SCP certification is meant for opportunities to satisfy their annual learning senior-level HR professionals who work more in requirements, a number of formalized training strategic roles.

“It’s important that we gain industryspecific credentials but even more important that we look outside of our industry for credentials that help amplify our skills.”

EDUCATION AND ADVANCEMENT The Human Resources Certification Institute (HRCI) also offers comparable certifications across eight other specific human resources assignments. Many radiology leaders are engaged in daily HR functions, and having this in-depth knowledge is beneficial to leading imaging teams. The Project Management Institute (PMI) Project Management Professional (PMP) certification can help an imaging leader learn various styles of leading task-oriented teams, reinforcing the technical standards of successful project management, and connecting those project goals to a larger, organizational strategy. “For a leader, there’s a lot of formalized training,” Dhanraj said. “You can go to school, you can get your degree, then you have all of these governing bodies that would support credentials for any leader. “But a lot of people are stagnated with their education and they think, ‘that’s all we can get,’” she said. “To really amplify our knowledge, skills, and abilities with these general leadership credentials, joining professional associations and finding a mentor is critical. This way you have support navigating your operation, especially when challenges arise” For those already in a leadership role, developing a fundamental understanding of skills more commonly taught in business school should be a priority, Dhanraj said. Disciplines including psychology, human resources, employment law, finance, and project management, are among them; more advanced skills including expertise in cultural intelligence, change management, and emotional intelligence, are especially valuable to any member of an organization tasked with a supervisory role, Dhanraj said. “Leading people who are motivated is easy,” she said, “but how do you lead those employees who can be challenging? Effective communication relies on things like body language, human behavior, understanding underlying motivations, and cultural competency. We have such a diverse staff that it comes 32

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down to knowing what people want, how are they motivated, what their values are, and how they want to be led.” For those whose medical careers began with military service, several free or low-cost resources exist to help them get started, including programs like Credentialing Opportunities On-Line (COOL) for each of the armed services divisions, and funding for four-year institutions provided through the GI Bill from the U.S. Department of Veterans Affairs. When selecting an institution from which to pursue a degree or certificate, Dhanraj urges students to consider the accreditation itself as well as the university from which it’s attained. “Employers do want the cream of the crop, but, to a great extent, aren’t necessarily expecting a person from Harvard or the like,” she said. “Employers want to ensure you have a terminal degree. Candidates should do their due diligence and ensure that their university is accredited, especially if they’re looking to transfer credits. “I’m of the belief that higher cost does not necessarily mean higher quality,” Dhanraj continued. “We should be asking ourselves, What is my return on investment? How am I going to leverage this degree? If I get five different certifications, and I spent $10,000, am I expecting to get this $10,000 back in salary? Am I getting monetary return, or making sure that I’m really stellar at my job, or that I have the competitive edge as compared to my peers? In some cases, there may be more intangible benefits from our educational investment.” Dhanraj also points out that completing a certificate program or even an advanced degree program isn’t necessarily a guarantee of higher earnings or an administrative title. Some believe they can earn a high-level position on the strength of their formal education alone, but they need to understand that’s not always the case, she said. “Employers want leaders to have some sort of experience in the job requirements,” Dhanraj said. “Employers want to see a balance of knowledge and experience in their leaders, and those with the scholastic knowledge

do not always have commensurate field experience to justify a directorship appointment.” Retired U.S. Army Radiologic Technologist John J. Beall, now a strategic planner with the Veterans Health Administration in Washington, D.C., said it’s also important for medical imaging leaders to identify soft skills — those rooted in communication, personality, mindset, character, and emotion — in professional development, and learn how to leverage those to advance their careers while uplifting the staff who work with them.

“A successful leader is one that is always learning, whether it is academically or in a self-help setting.” – John J. Beall

“Until a leader truly becomes selfaware, I think this is one of the hardest things for them to manage,” Beall said. “Ensuring that your soft skill toolbox includes learning how to read body language and how to truly listen is paramount to be a successful leader.” Like Dhanraj, Beall recommends that prospective leaders educate themselves on change management, a formalized approach to handling big changes in the workplace. Whether those changes are based in technological implementations, such as migrating from paper to digital health records, or portable imaging studies, for example, leaders “need to be the champions” of those changes, and demonstrate their engagement with the process, Beall said. “Otherwise, the buy-in and successful implementation will drag on, and kill the morale, which then lowers the level of service as well as engagement scores,” he said. Beall also notes that a commitment to continuing education is paramount to the longevity of any career, particularly one in health care. “A successful leader is one that is always learning, whether it is academiADVANCING THE IMAGING PROFESSIONAL

cally or in a self-help setting,” Beall said. “I feel that I have learned more in the latter part of my career than I did in the beginning. I attribute that to the fact that a lot of my early career learning came via the fire-hose methodology instead of an as-needed basis.” Beall believes that the ego he embodied and strong opinions he once held as a younger person “probably had a part to play” in those circumstances, as much as he is certain that strong, healthy relationships “helped me get through the tough spots.” Kimlyn N. Queen-Weis shares Beall’s perspective that health care leadership comprises “true believers in continuous learning.” Queen-Weis is the operations director of both patient logistics services and virtual health/telehealth services for OhioHealth in Ohio. She is also a board member of the Association for Medical Imaging Management (AHRA), as well as the current president-elect of the organization. “I believe that leaders are always learning, no matter what, whether it’s through informal channels or formal education,” she said. “The neat thing about imaging is that you get the opportunity to be exposed to multiple different modalities, which helps make you a well-rounded technologist.” “Along with learning about the technical aspects of imaging, the hands on patient care and customer experience aspect; you also get to develop some early leadership skills, working with new students, and precepting new technologists as you advance in your role as technologists,” Queen-Weis said. “For people coming up, that’s how you start to gain some informal leadership.” Those educational settings can appear quite informal, indeed: Queen-Weis said her own imaging career began just after high school, when she entered a two-year radiology program housed in the basement of the hospital in which she was working, back in 1990. When she wanted to advance from a certified technologist to an undergraduate degree, Queen-Weis opted for a business administration track, which helped her to prepare for a management role and, subsequently, the WWW.THEICECOMMUNITY.COM

CRA exam. That credential helped her continue moving forward as a director, a position from which she pursued (and earned) a master’s degree in finance, and a second master’s degree in business administration. “I’ve always paired my formal education with informal education outside of the classroom as well, searching for opportunities to attend seminars and conferences,” Queen-Weis said. “Whether it was a leadership conference, or some kind of training provided at work, my career continued to advance throughout the years to different roles in imaging and health care leadership.”

“I think mentorship and fellowship are great ways to bring up new leaders that have those soft skills.” – Kimlyn N. Queen-Weis Despite having attained an undergraduate degree and two graduate degrees, Queen-Weis must still pursue continuing education credits to maintain her certifications as a technologist. Including annual or local area AHRA meetings, or other, work-related conferences, there are various opportunities for medical imaging professionals to attain their technical and leadership specific continuing education credits on an annual basis. She urges those working in the field to keep an eye on the deadlines by which those credentials must be earned, and to adhere to them. “I think what happens a lot of times is everyone’s really busy, and it sneaks up on people, and then they find themselves having to hurry, or falling short of the requirements,” she said. “Knowing what you have to have every year, and knowing your deadlines and all the ways to obtain your continuing education units (CEUs) is important.” When selecting a CEU module, Queen-Weis urges professionals to try to match available offerings with

skills they might be personally seeking to enhance their individual leadership development goals. “What am I focused on right now as it relates to my team or something I may be working on as a special project?” she asked. “What’s going to help me, help my team, my organization, my personal growth and development; or, what do I need to know that might be going on in the industry? Those are the kinds of things that I look for when I consider a meeting, a program, an educational focus.” Just as important as attaining that coursework individually is creating a bridge connecting those with the ability to demonstrate the skills in question to those seeking their knowledge. In the workplace, Queen-Weis urges pairing new leaders with seasoned leaders in a variety of settings, especially when welcoming new graduates into the workforce. “You don’t just have all the skills when you walk out with your master’s degree,” she said. “We’ve all said the wrong thing because we weren’t prepared or no one showed us how. I think mentorship and fellowship, are great ways to bring up new leaders that have those soft skills.” “I’m also a firm believer in hands-on learning,” Queen-Weis said. “As someone who’s been in leadership for a long time, one of the things that’s been beneficial to me is to have a coach, and I am also an executive coach for our organization. I offer that to people who are looking to grow and develop.” “The world of Imaging is fastpaced and constantly changing, which I know a lot of leaders enjoy,” she said. “It has a lot of different paths that a person can go down, depending upon what type of leadership role they want or what career path they choose to follow. You can be a leader in a lot of different realms within imaging, whether you want to be in education, operations, on the vendor side, in sales or applications; there’s a lot of different opportunities to embrace.” •

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CT AND CTA INCREASES CONTINUE C CODING/BILLING

BY MELODY W. MULAIK

omputed tomography (CT) and computed tomographic angiography (CTA) are imaging studies that continue to see increases in volumes and are targeted by the payers for medical necessity and coverage. While it may seem that coding for these procedures is straightforward, there are some key considerations that should be acknowledged to ensure compliance billing practices. The first critical issue to be reviewed is the order for the service. If you are billing for a CTA study, then it would be expected you have an order for a CTA study for that patient. Remember most commercial (non-Medicare) payers will require pre-certification (aka pre-authorization) of CT and CTA procedures. If the facility, or physician, submits a procedure code other than the one preapproved by the payer, then typically no reimbursement will be provided since it does not match their pre-approved information. Now the trickier issue – should I code a CT or a CTA? The performed imaging study should match the ordered study and the radiologist’s dictation should clearly support what was performed. Challenges arise when the dictated report does not clearly include all of the required documentation to support the assignment of a CTA code. CTA requires and includes 3D angiograph-

ICEMAGAZINE | JULY 2021

ic rendering. Clinical Examples in Radiology (Fall 2011) states, “Only when 3D is documented should the coder assign a computed tomographic angiography (CTA) code, as CTA requires 3D postprocessing.” A study that includes only 2D postprocessing should be coded as a CT scan rather than a CTA. In addition to the term 3D, other terms such as maximum intensity projection (MIP), shaded surface rendering, and volume rendering may also be used to describe 3D postprocessing. However, multiplanar reconstruction (MPR) is a 2D postprocessing technique, according to (Clinical Examples in Radiology (Fall 2013)). Clinical Examples in Radiology (Spring 2017) provides the following example of proper CTA documentation: “CT angiography of the [body area] was performed without IV contrast followed by IV contrast, including 3D post processing CTA image reconstruction.” CTA is performed using intravenous contrast. The CTA codes are defined as “with contrast material(s), including noncontrast images, if performed.” This means if a noncontrast scan is performed prior to contrast administration, it is included in the CTA study and is not separately reportable. According to CP® Assistant (August 2011), “Although in many circumstances, noncontrast imaging is not required as a prelude to CT angiography, any noncontrast imaging performed during the same session – whether for localization or diagnostic purposes – should not be separately reported.” If intravenous contrast is not

ADVANCING THE IMAGING PROFESSIONAL

administered and 3D imaging is still performed, it is appropriate to report the non-contrast CT code specific to the anatomic site being studied, with either 76376 or 76377 for the 3D rendering, according to (Clinical Examples in Radiology (Spring 2020) In most cases it is not appropriate to report a CT code together with a CTA code for the same body area. As mentioned earlier, the CTA code includes noncontrast images if performed. Also, there is some degree of overlap between CT and CTA, because data acquired during a CTA exam includes images of non-vascular structures (bones, soft tissues, etc.). These non-vascular structures must be eliminated from the images during postprocessing to create the images of the vessels. According to Clinical Examples in Radiology (Summer 2008), performance of a CT and CTA on the same

body area on the same day would be infrequent. It might occur, for example, when a CT scan shows a tumor in the pancreas, following which a CTA is performed. In order for both exams to be billed, the CTA must involve a “new data acquisition.” In other words, the patient must be scanned a second time and a new data set acquired. In this situation, both exams may be charged. So, the bottom line is that in order to charge for both exams, there must be an order from the treating physician for both exams, both exams must be medically necessary, there must be two data sets acquired and both must be separately and completely documented. • 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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VISION BECOMES REALITY: BUILDING A CUSTOMER OBSESSED CULTURE WITH VOICE OF THE CUSTOMER Moving quickly and safely to achieve the core mission of health care BY BILL MAURO

anner Imaging will reach the one-year anniversary of its Voice of the Customer (VoC) program this month. The program collects customer feedback in real-time for leaders to make process and service improvements. Banner Imaging is a part of Banner Health, a nonprofit health care system based in Phoenix, Arizona, which has set its mission to make health care easier, so life can be better. In 2017, Banner Health started on its journey to improve customer care by transforming digital experiences to reduce the complexities for customers to manage their health care needs. The VoC implementation is one of several key digital initiatives Banner Health has embarked on to improve the care and experience customers receive. The VoC program has become a force multiplier for frontline leadership and continues to foster a service culture that influences customer perceptions across the 36

ICEMAGAZINE | JULY 2021

continuum of care while elevating Banner Imaging as a place where radiology professionals want to work, radiologists want to practice and customers choose for their medical imaging needs. Discovering what customers want is a cornerstone of Banner Imaging’s framework for success. As CEO Jason Theadore explains, “Customer service is part of our product. In health care, I think this often gets lost. We become so focused on our clinical delivery that we limit our focus.” To broaden their view of the customer, the Banner Imaging digital VoC program operates on a transactional basis to send email-toweb surveys 24 hours post-visit so results can be used as real-time feedback rather than lagging indicators. Net Promoter Score (NPS) is the key metric used. NPS is a relatively new take on measuring customer satisfaction in health care, but with the increased shoppable modalities and choice in the industry, understanding customer perceptions of care through brand loyalty gives Banner Imaging a leading edge on building better relationships

and improving care. Focusing on customer perceptions in this way also helps frontline leaders hold themselves accountable to consistency of service, which helps build credibility over time with their customers. Structurally, the VoC program consists of a fully automated, end-toend reporting platform that includes real-time performance tracking, commentary review and a service recovery management system. The survey itself is rather short; on average, it only takes two minutes to complete. To-date, the business has delivered over 90,000 survey invitations and received nearly 30,000 completed surveys – an impressive 33% response rate. Customer perceptions are extremely favorable as well. Overall NPS is 85.5 with four of their 30 imaging centers reporting an NPS of 90 or higher. A successful VoC program is more than metrics and Banner Imaging understands this well. In addition to performance tracking, they focus on celebrating their wins and recovering their losses. Their service recovery ADVANCING THE IMAGING PROFESSIONAL

A successful VoC program is more than metrics and Banner Imaging understands this well. In addition to performance tracking, they focus on celebrating their wins and recovering their losses. management system helps managers promptly follow-up on dissatisfied customer experiences after a service failure. The system automatically flags negative feedback and immediately notifies and directs managers to the customer’s details. Two percent of surveys are identified as service recovery opportunities and most are closed within 24 hours of notification. Frontline leaders use case forms to collect additional information at the time of recovery and are trackable for teams to prioritize pain points that

need attention. This makes action planning easier and more effective while also keeping teams focused on improvement and learning from past mistakes. The business also celebrates its wins with employee engagement efforts. A recognition system was established for employees who are called out for doing an outstanding job in customer commentary. Routinely, customer moments are shared in weekly updates, staff meetings, operations huddles and on enterprise social networking tools. All results are also accessible to frontline leaders to compare performance against one another. Naturally, a healthy rivalry between centers has spurred senior leadership to create a reward system that includes a traveling trophy to the imaging center with the highest NPS over the prior quarter. All these engagement efforts establish pride, morale and excitement that boosts overall performance. Banner Imaging’s VoC program aides the business in relentless improvement and helps build a customer obsessed culture. In turn, customers are front and center during the decision-making process.

Banner Imaging’s continued team member engagement and focus on perfecting the customer experience exemplifies Banner Health’s core mission to make health care easier, so life can be better. •

Banner Imaging operates 30 imaging centers primarily operating in the Phoenix, Arizona market and recently expanded operations in February 2021 with four new locations in Loveland and Greeley, Colorado.

The Banner Imaging Palm Valley center, located in Goodyear, Arizona is presented with the inaugural year-end performance trophy for having the highest NPS for 2020.

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ADVANCING THE IMAGING PROFESSIONAL

INSIGHTS

GENUINE COMMUNICATION

I DIRECTOR’S CUT

BY LYDIA KLEINSCHNITZ

think that it goes without saying for a year with a pandemic, my imaging department had to face many challenges. These challenges included a drop in outpatient volume and working with our health system to preserve our workforce. We also had to make sure we had enough personal protective equipment for the imaging teams along with correct cleaning products to keep our equipment safe for those patients that we provided service. We had to be flexible because in the early stages of COVID-19 we were getting updates from our infection prevention team daily, even several times a day. Our cleaning processes had to change as quickly as the cleaning recommendations were updated. As an imaging director, I had to make sure all this critically important information was communicated to my leadership team and to the front-line staff. This communication chain continues to be imperative as we navigate through 2021. The number of COVID-19 cases and deaths are declining within our community, but our outpatient volume is increasing – even faster than expected. Now, our challenges are maintaining patient care supplies along with keeping our imaging staff levels at a safe operational level. We have discovered at this time that many of our staff members are looking for other job opportunities. It seems the pandemic forced many techs and nurses to put a hold on any career moves or life events. Now, suddenly, I have staff moving to other states, getting married, and decreasing work hours or taking positions with travel services. Staffing has become even more of an issue as some local schools did not provide formal classes for higher imaging specialties such as CT or MRI. Not only must we focus great efforts on staff recruitment, but these circumstances have reinforced for me and the leadership

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team the need for genuine communication. This communication must include updates as to what we are doing as leaders to tackle the staffing challenges, reminding staff of support they have from leadership and addressing identified concerns or worries. We must ensure that we are communicating openly and timely with the staff that continue to work with us. I have found that this communication should consist of four essential factors. The first is to listen. Before any action, a leader must listen to staff to find out about the problem at hand and to discover how staff are feeling and thinking. It is important that one does not try to formulate an answer before the staff person has completed their thought. Only after one has a true understanding can an appropriate response be made. The second factor is honesty. An honest response helps to build trust in relationships and can go a long way to reinforcing the staff’s view of a leaders’ integrity. Being vague or giving answers that aren’t clear might contribute to a false narrative and only lead to the breaking down of work relationships. The third piece to genuine communication is dialogue and exchange of ideas. It is important, when possible, to work together with staff toward a solution. Working together will help promote buy-in and cooperation. The final factor is that sometimes the answer is no. If the answer to the question or problem is no, then say it. This will open the way for all parties to move forward and begin work on other possible solutions. Timely communication and dialogue must be the focus when tackling tough staffing situations. If there is any good that can come out of 2020 and the first few months of 2021 for me, it has strengthened the need for clear genuine communication with my team on a daily basis. • LYDIA KLEINSCHNITZ, MHA, BSN, RN, is the senior director of imaging services at UPMC Presbyterian Shadyside.

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DEATH IS NORMAL: SUPPORTING COLLEAGUES THROUGH LOSS

veryone who lives will die. Full stop.

RAD HR

BY KIAHNNA PATTON

ICEMAGAZINE | JULY 2021

Imagine a creepy-crawly you can’t see in the dark, the unknown of a seemingly bottomless ocean you can’t see the floor of, the anticipation of speaking in front of a crowd, or tapping the side of your head only to discover the sound and movement you felt in your inner ear was caused by a rogue spider! The hairs on your neck stand up! Death is Freddy Kruger, The Candyman, The Red Wedding, a knee on your neck. It’s unknown and the anticipation of it can be terrifying, just like the images conjured up in the previous sentences. Among the many things we’ve dealt with over the past year, death has been a major one. Countless colleagues and friends have lost loved ones this year to the pandemic and unrelated causes, and death remains a feared and taboo topic. Many of us are ill-prepared to deal with closing out the numerous personal affairs of the deceased as well as our own emotions. It can feel overwhelming and complicated. Some of us decide to tough it out and deal with it alone. Some deal with portions of what we’re feeling and ignore, or perhaps not recognize, the other emotions that negatively affect our mental and physical wellbeing. Others seek help

and heal in healthy ways. So, many scenarios are possible. Last year, in the early days of the pandemic, I unexpectedly lost my father to cancer. My job was to close out his affairs. While I was more than happy to do the work, little did I know how much was involved and the extent to which that work would distract from my grieving and the healing I so desperately needed. I sought solace from a fabulous psychologist who helped me work through the grief. Then, exactly one month later, we lost the love of my brother’s life and sister to us. I was on again, handling business. Some people love to keep busy and cope with death in that way, but we have to be careful that our coping mechanisms don’t turn into avoidance that makes for an even longer runway for healing. Death is not separate from life, meaning that we need not compartmentalize and avoid thoughts and feelings that pop up during work hours. After all, we bring our whole selves to work, not just a limb or organ. How then, can we support our colleagues through their healing? There are organizational resources and individual actions we can take to honor each other’s needs. They include: • Provide expansive and generous bereavement policies that allow for extended grieving ADVANCING THE IMAGING PROFESSIONAL

•

Recommend employee assistance programs to provide mental health benefits • Create a culture of psychological safety, which allows for individuals to be their whole selves without fear of negative consequences • Use an online service to send a meal to your colleague • Send a note to let your colleague know you are thinking of them • Give them space • Grant grace – emotions may be unpredictable, and regaining focus may be doubly hard I suggest that when you experience loss, as best you can, give people a little guidance around how to interact with you. Sometimes you may want to communicate but not be bothered at the same time. I remember sending a text to friends to inform them of my father’s death and in the same text to say that I was

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Kiahnna D. Patton and her father, Louis Patton Sr.

not ready to talk. At work, I left the following automatic email reply: “I’m grieving the loss of my first love and number one guy, my father Louis Patton, Sr. He was a magnetic personality, a great listener, a veteran, a singer and songwriter (google R&B group Side Effect), the most fantastic cook, my coolest dance partner, a political junkie, a friend to thousands, my inspiration to live my life on my own terms, my confidant, and my most enthusiastic cheerleader. I miss him dearly and have a bit of grieving to do. I will not respond to your emails in the immediate future, so please seek assistance from my wonderful teammates. In mourning, Kiahnna” I received a little more space to grieve and do a bit of work by giving people the opportunity to empathize while signaling that I was unavailable.

For those of you who have and will experience loss, I hope you will find your way to face it with courage and empathy for yourself and others. • KIAHNNA D. PATTON is senior human resources business partner at Children’s Hospital Los Angeles (CHLA) and a nonprofit founder.

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AI RESULTS DRIFT 10X10=105? I

f your calculator gave you a result of a calculation that 10x10=105, you would know that it was an error. We know that the output is not correct.

PACS/IT

BY MARK WATTS

ICEMAGAZINE | JULY 2021

In the world of artificial intelligence (AI) algorithms, the results of a calculation can “drift” over time. This means the true relation between inputs and outputs change over time. This is a serious consideration when treatment of patients can be influenced by the results. Today some AI are legally classified as software as a medical device (SaMD). The International Medical Device Regulators Forum, a voluntary group of medical regulators across the world whose aim is to assist in the standardization of medical devices, defines SaMD as “software intended to be used for one or more medical purposes that perform these purposes without being part of a hardware device.” The Food and Drug Administration (FDA) has embraced this term. The FDA defines “medical purposes” under the Federal Food, Drug, and Cosmetic Act, as “those purposes that are intended to treat, diagnose, cure, mitigate, or prevent disease or other conditions.” A system which looks for signs of diabetic retinopathy by autonomously analyzing images has received marketing authorization in the United States.

The FDA has cleared only “locked” AI-based SaMD algorithms. This is defined as an algorithm that provides the same results each time the same input is applied to it and does not change with use. AI systems can satisfy this definition if they are “fixed” in advance. However, this perspective has disadvantages. AI with machine learning can improve over time. It can become more accurate with more exposure to new datasets. An early diagnostic chest AI algorithm was trained on male chest X-rays. The algorithm was locked. When it was deployed for research purposes in a hospital the AI identified every female chest X-ray as having bilateral soft tissue masses. In my previous column “Seeing Color and Diversity with Imaging AI” I pointed out the need to include a more diverse training data set. If the FDA permits marketing of a locked AI algorithm that predicts breast cancer – but the AI was mainly trained using Caucasian women – the system will likely make false recommendations for African-American women who tend to have different breast densities than Caucasian women. However, if the algorithm learns continuously (is “adaptive”) and is used in clinics with more African-American women as patients, it will likely be able to make better recommendations in the future. Under current law, however, a change to the algorithm will likely require AI makADVANCING THE IMAGING PROFESSIONAL

ers to undergo a new FDA premarket review. The maker of the AI may want to avoid the cost of another review or may feel that this additional review may send the wrong message about the quality of the current product. The FDA has seen this problem and published a discussion paper on the modifications to AI-based SaMD. The paper suggests a “total product lifecycle regulatory approach” for adaptive AI-based SaMD that shall facilitate a fast cycle of product improvement by permitting such devices to learn continuously and shall ensure their safety and effectiveness. The maker will be given the option to update its SaMD to some extent after marketing authorization by submitting

a so-called “predetermined change control plan” during the initial premarket review. This plan would include a description of the types of expected changes and methodology used to implement such modifications. The FDA is ahead of other regulators in thinking about these issues. Its discussion paper, which will untimely lead into draft guidance, may likely shape the relevant regulatory architecture of other countries. This update problem could be improved by focusing on continuous monitoring and risk assessment rather than on predetermined change control plans. AI makers will often not know in advance the sorts of changes that might be needed. COVID-19 may in-

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crease the prevalence of pulmonary emboli or change the characteristic appearance so that the AI under or over diagnoses this life-threating condition. AI will be helpful to health care. How quickly and effectively the value can be delivered is limited by our collective understanding of its limits and opportunities. AI and machine learning algorithms will need to be monitored and the risk of “drift” must be acknowledged to promote trust and confidence that 10x10 will equal 100! • MARK A. WATTS is the director of informatics, technology and artificial intelligence and sales at Medical Technology Management Institute.

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TEAM BUILDING 101

T EMOTIONAL INTELLIGENCE

BY DANIEL BOBINSKI

o get things done in any organization, we need teams. Teamwork has been valued and recognized as necessary ever since Krog and Grog found it easier to hunt mammoth as a team instead of working solo. Still, teams can be effective or ineffective, depending on their makeup and their leadership, so let’s take a moment to explore six factors for building an effective team. First things first. I firmly believe a team is more productive and its members are more engaged when the team has a strong leader. That leader should be passionate about the vision and mission of the team, as well as the interests, attitudes and values held by each team member. The leader should also understand each team member’s capabilities as well as each person’s goals. And, since billions of dollars are wasted each year due to poor communication, team leaders should talk with each team member to learn his or her preferred communication methods. A clear understanding should exist between a team leader and team members on how frequently to stay in contact and what topics should be discussed. Also keep in mind that team leaders can be builders or climbers. Climbers are those who climb on the backs of others

ICEMAGAZINE | JULY 2021

to achieve promotions or status. Builders are those who invest in others, equipping them to be better. You can probably guess which style I recommend. Next, I think it’s important that every team understands its vision and mission. A vision is where the team sees itself going, and a mission is what the team will do to get there. Don’t buy into the idea that these statements must be wordy. If team members cannot remember their vision and mission statements, the statements are useless. At its founding, Microsoft’s vision statement was, “A computer on every desk and in every home.” I’m old enough to remember when that vision statement became public. People scoffed at it, saying, “That’ll never happen. People don’t need computers in their homes.” And yet, that simple vision became the goal that drove the employees of Microsoft, and today, pretty much everyone has a computer in their home. It was a short, clear, easy to remember vision statement, and because of that, it was powerful. Whereas a vision statement articulates where a team sees itself in the future (seeing=vision), a mission statement articulates what a team will do to achieve its vision. Personally, I think a statement with three to five points is best. Remember, it must be easy to remember to be useful. Nobody’s going to memorize a paragraph. I also think mission statements should ADVANCING THE IMAGING PROFESSIONAL

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correlate more to mission. My general recommendation for established teams is to have four or five tactical meetings for every strategic meeting held. Second, and this is vital, each meeting must have a purpose. I recommend a short agenda be created for every meeting. If no purpose can be articulated, then don’t have the meeting. Almost always, once a meeting starts, people bring up issues not on the agenda, and sometimes those issues can totally derail a meeting. Every situation is different, but I recommend putting those conversations on hold until after the agenda items have been addressed. This allows people to leave a meeting after all agenda items have been covered, and their time won’t be wasted if the new topic does not apply to them. Much more can be said about holding effective meetings, and multiple books exist on the subject, but I believe the above-mentioned fundamentals are important and should not be overlooked. Additionally, much more can be said or about creating effective teams, but be sure to include these fifth and sixth factors to create a winning formula. Fifth, be sure people are trained. Every team is unique, and so is every team member. Gaps can exist between expectations and capabilities, and learning does not occur by osmosis. It is the team leader’s responsibility to identify any gaps and ensure any needed training is provided. And sixth, celebrate achievement. People want to know they are contributing to something bigger than themselves. Recognize both individual and team accomplishments and celebrate as appropriate. • DANIEL BOBINSKI, M.Ed. is a bestselling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach Daniel on his office phone, 208-375-7606, or through his website, www.MyWorkplaceExcellence.com.

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be industry specific. Statements like, “we empower employees” and “we exceed expectations” are too generic. They could apply to a McDonald’s franchise as easily as the nuclear facility at Idaho National Laboratory. Think about the specific actions your team must accomplish to be productive and effective, then build a mission statement around those actions. Third, ensure everyone understands their roles and goals. I’m a huge fan of everyone having a well-defined job description that includes a duty and task list. Duties are general areas of responsibility, and tasks are those things that must be accomplished in order to fulfill a duty. It’s usually best if the team leader and each individual on the team agree on what those duties and tasks should be. And, for optimal productivity, it’s best if the team leader meets with his or her direct reports quarterly for a brief review of the assigned duties and tasks. Such one-on-one meetings need not take long. Thirty minutes should be sufficient. Neglecting this leads to blurred expectations and lower productivity. This leads me to my fourth point, which is maintaining a balanced diet of meetings. This is in addition to the one-on-one meetings a team leader has with his or her direct reports. I know meetings can be the bane of our existence, so allow me to offer a few suggestions. First, be clear about the type of meeting being scheduled. Is it a status update? Is it strategic? Is it a discussion of tactics? Status updates are best done via electronic means, but often those updates are not reviewed, thus making updates a necessary evil in face-to-face or group video meetings. Save time by hitting the highlights and referring people to the electronic communications. That leaves strategies and tactics. Think of strategies as big picture, direction-setting meetings that have to do with vision, and tactics as handson nuts and bolts discussions that

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FORGETFULNESS A

s I contemplated what topic to bore you with this month, I came across a ted.com talk about memory by Lisa Genova titled “How your memory works – and why forgetting is totally OK.” I watched, took some notes and resolved to write about it for this month. Then, I forgot about it. Apparently so did the editor of this fine publication. I received his email telling me that he realized that he did not have my column. This of course, reminded me that I had forgotten all about it myself. I thought that this was an interesting event: I forgot to write about forgetting. Genova presents a beautiful description of why we forget and that it is fine to do that. It seems that our brains are not designed to remember things like names and things to do later since it does not catalog everything we encounter. Our brains forget most of today’s experiences by tomorrow. We forget where we put keys, phone, glasses, car, etc. because we do not give these things attention to cause a memory. The brain cannot create a memory from all the competing sensory input without attention. We can only remember what we pay attention to long enough for the data to flow from short-term memory into long-term memory. It’s as if we need to provide a rehearsal buffer for the data so that it can be categorized, cataloged and stored with the proper tags. These memory tags make for easier retrieval. I personally have lost my car twice, once in one of two parking structures and once on a different level of the same parking structure. It took me over an hour to realize that I was in the wrong structure. For the different level, I had friends also lost with me. We had a great time using the key fob to blow the car’s horn and trying to decipher where it was coming from. I now take a picture of where I park. Who has not said, “The name is on the tip of my tongue but I can’t remember it.” We remember a loosely related word with a similar sound and it keeps popping up instead. Genova calls this word “the ugly sister of the target.” We become stuck in the wrong neural neighborhood and can’t get out. The process of trying to remember while we are in the incorrect location keeps us from accessing the information since it is stored elsewhere. We can provide the correct set of neurons a chance to activate by not continuing to WWW.THEICECOMMUNITY.COM

concentrate on the “ugly sister.” Then, we suddenly remember the correct name. Another memory loss issue is when we go into another room to get or do something and don’t know what THE ROMAN REVIEW that something is when BY MANNY ROMAN, CRES we get there. This is a very common forgetting event and the culprit is the change in venue. When we are in the first room all the cues are present for whatever we need to do. We need the cellphone in the bedroom so we could charge it. It is in the kitchen on the counter. As soon as we walk into the kitchen, the cues are gone and we forget what we wanted. “Why did I come into the kitchen? Am I hungry, thirsty or what?” The solution is to walk back where you came from. Your memory will come back when the cues used during its generation are again available. It may help to walk backward when returning to the original room. Genova makes it a point to reassure that the above type of forgetting is totally normal and we should not worry about it. She states that the use of a checklist is sound practice. Pilots follow a checklist even though they probably can remember to lower the wheels prior to landing. With today’s technology, we should not feel guilty that we use it as memory support. Go ahead and Google that name. Use your calendar app to keep track of tasks and timing. Set the reminders on your mobile phone. It is good practice to outsource the job of remembering these common things and let your brain relax. You can then eliminate the stress of having forgotten and use your brain for a higher purpose. I will use my calendar to remind me when the next column is due. Then, knowing that task is in good hands, I will use my brain for a higher purpose. Maybe I will spend some quality time with ted.com. Maybe I will gravitate to a poker game. Maybe I will practice Niksen, the Dutch concept of doing nothing, to be idle or doing something without any use. I am really good at Niksen. •

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