Tech nation dec 2015 by Md Abdul Haleem Bahadur

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vol 6

EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

DECEMBER 2015

HTM Trends and Issues in 2016

12 MD Expo Recap

VIEW

OUR NEW SERVICE INDEX ON PAGE 74!

Highlights from Vegas MD Expo

14 Professional of the Month

Ben Fletcher, BMET II

36 The Roundtable

Test Equipment

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HTM Trends and Issues in 2016

36 42

TECHNATION: EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

T HE ROUNDTABLE — Test Equipment Healthcare Technology Management professionals cannot do their job without test equipment. Of course, that means having the right testing equipment is just as important as having the right tools. We reached out to industry experts to find out the latest about test equipment.

LOOKING AHEAD: HTM TRENDS AND ISSUES IN 2016 These are interesting time for HTM professionals. This year has been hectic with many issues of concern, including clinical alarms, PM procedures, power strips, medical device integration, cybersecurity and an aging workforce. We take a look at the hot topics of 2015 and key on some topics to be wary of in 2016. Next month’s Feature article: HTM Professionals and Nurses: A Winning Team

Next month’s Roundtable article: Patient Monitors

TechNation (Vol. 6, Issue #12) December 2015 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to TechNation at 18 Eastbrook Bend, Peachtree City, GA 30269-1530. TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher.

DECEMBER 2015

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INSIDE

Departments PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Warren Kaufman Jayme McKelvey Andrew Parker

ART DEPARTMENT

Jonathan Riley Jessica Laurain

EDITOR

John Wallace

EDITORIAL CONTRIBUTORS

Roger Bowles K. Richard Douglas Patrick K. Lynch Todd Rogers Manny Roman Cindy Stephens Karen Waninger

p.24 p.26 p.29 p.30 p.32 p.34

WEB DEPARTMENT

Betsy Popinga Taylor Martin

P.50 EXPERT ADVICE

ACCOUNTING

Kim Callahan

CIRCULATION

Lisa Cover

P.12 SPOTLIGHT p.12 p.14 p.18 p. 20

MD Expo Recap Professional of the Month: Ben Fletcher Department of the Month: Banner Fort Collins Medical Center Clinical Engineering Department Biomed Adventures: Endurance Tested

P.24 THE BENCH

p.50 p.52 p.54 p.56 p.58 p.60 p.62

ECRI Institute Update AAMI Update Tools of the Trade Webinar Wednesday Biomed 101 Shop Talk Career Center Beyond Certification Ultrasound Tech Expert Sponsored by Conquest Imaging Karen Waninger The Future Patrick Lynch Roman Review

P.66 BREAKROOM

Karen Waninger: Director of Clinical Engineering at Community Health Network in Indianapolis KWaninger@ecommunity.com

p.66 Did You Know? p.68 The Vault p.70 MedWrench Bulletin Board p.72 Scrapbook p.78 Parting Shot

Eddie Acosta: A Clinical Systems Engineer at Kaiser Permanente, Northern California, Fastedy99@yahoo.com

p.74 Index

EDITORIAL BOARD

Manny Roman: manny.roman@me.com Patrick Lynch: CBET, CCE

John Noblitt: Program Director at Caldwell Community College & Technical Institute in North Carolina jnoblitt@cccti.edu

Like us on Facebook, www.facebook.com/TechNationMag

MD Publishing / TechNation Magazine 18 Eastbrook Bend, Peachtree City, GA 30269 800.906.3373 • Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

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HTM PROFESSIONALS WIN BIG IN VEGAS

Attendees and Exhibitors Praise MD Expo By John Wallace, Editor

TM professionals left Las Vegas big winners after attending the three-day MD Expo presented by MD Publishing. The fall conference attracted more than 600 industry leaders with a sold out exhibit hall, networking oppurtunities, continued education and more. Industry leaders teamed up on the links for the MD Expo Golf Tournament sponsored by DirectMed on the first day of the event. The MD Expo Welcome Reception, sponsored by Sodexo, had more than 250 people in attendance to officially kick off the conference. “First off, I think the opening reception was a great success. It gives us an opportunity to reconnect with existing business partners and explore new business partner opportunities,” Steve Cannon, Vice President of Sodexo CTM, said about sponsoring the Welcome Reception. “This is an opportunity for us also to support health care technology professionals where they can relax and learn more about different companies.” MD Expo continues to grow and offer new opportunities. MD Publishing President and Founder John Krieg said total attendance reached 649 with 100 booths in the exhibit hall. Krieg said the ability to give back to the HTM community continues to be a driving force behind MD Expo. He is excited to see new faces at every conference as MD Expo continues to attract every level of industry professionals from students to experienced veterans. 12

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The Welcome Reception, sponosred by Sodexo, was a great start to the MD Expo

“There were people from over 40 states in attendance,” Krieg said. “Our surveys show that they enjoyed the networking, education and The Joint Commission update. We make them feel appreciated with our warm hospitality which includes meals, food and beverage and the opportunity to network with HTM professionals from around the country. They share their knowledge and best practices.” Pacific Medical sponsored the Exhibit Hall Grand Opening where the latest high-tech products, world-class services and more were on display. Biomeds benefitted from more than 20 hours of educational seminars, product demos and a CBET review. The top-notch classes covered a wide range of topics from alarm fatigue to ultrasound. Some of the more popular classes included “Communicating with Confidence” by Abbe Meehan, “How to Assess and Centralize Clinical Engineering Operations” by Mike Busdicker, “Creative Problem Solving and Engineering Skills for the Biomedical Equipment Technician” by Dustin Telford and “An Efficient and Cost-effective Approach to Medical Equipment Assessments and Acquistions” by

DECEMBER 2015

Izabella Gieras. Rich Sable, a biomedical engineering supervisor at St. Francis Medical Center in New Jersey, said the quality of the educational seminars at MD Expo equals that of the classes offered at AAMI’s annual conference. “I like the smaller class size (at MD Expo),” Sable said. “It’s a little more intimate so it’s a lot easier to relate to the instructor and interact with other peers in the audience.” Exhibitors and attendees alike learned the latest from The Joint Commission at a keynote breakfast presentation by John Maurer. TechNation also presented its annual Department of the Year and Professional of the Year awards at the Friday morning event. The Banner Health Technology Management Department was presented with the Department of the Year award. The department maintains medical equipment and devices at 30 facilities spanning seven states with 6,200 licensed beds and 235 operating rooms. The department includes 250 personnel dedicated to a comprehensive medical equipment life cycle program that includes more than 300,000 pieces of medical equipment with a net asset

Mike Busdicker presents “How to Assess and Centralize Clinical Engineering Operations” at MD Expo on Thursday, October 22.

Purple Mic night, sponsored by Conquest Imaging, Kicked off at 6pm Friday night.

Attendees and exhibitors at the karaoke party in support of pancreatic cancer awareness.

Attendees and exhitiors networking in the exhibit hall.

“ It is definitely worth coming to. All the types of companies we are normally looking for are here. Coming here you get to meet all the vendors, talk to them in person and talk about what you are trying to do (at your facility). You talk to them face-to-face about how they can help you out.” - Randy Guess value in excess of $30 billion. Dustin Telford is the 2015 TechNation Professional of the Year. He is among the who’s who when it comes to the HTM community serving on committees in a variety of roles to promote, educate and motivate his peers. Telford is, or has been, a technician, a specialist, a field engineer, an educator, a clinical researcher, a clinical engineer, a manager, a soldier, a charitable service worker, a leader, and a member in children’s hospitals, professional associations, cancer hospitals, large hospital networks, trauma hospitals, universities, the military, the VA, with OEMs, and

with third-parties. At one time, he was even the lone biomed in Antarctica. Watch the award videos at www. mdexposhow.com/awards/. Randy Guess, biomedical equipment manager at Doylestown Hospital in Doylestown, Pennsylvania, said the exhibit hall combined with the networking events are a great benefit. “It is definitely worth coming to,” Guess said about MD Expo. “All the types of companies we are normally looking for are here. Coming here you get to meet all the vendors, talk to them in person and talk about what you are trying to do (at your facility). You talk to them face-to-face about

Elvis preforms a solo at the Fluke/RaySafe booth in the Exhibit Hall.

how they can help you out.” The MD Expo concluded with the Purple Mic Night sponsored by Conquest Imaging. The karaoke party raised awareness and funds for the fight against pancreatic cancer. Attendees and exhibitors teamed up to raise nearly $20,000 for the Pancreatic Cancer Action Network. MD Expo is headed to Dallas, Texas and will include a reverse expo attended by decision makers from some of the nation’s top health care systems. The 2016 spring conference will be at the Fairmont Hotel Dallas, April 21-23. For more information, visit www.MDExpoShow.com. TO VIEW MORE PHOTOS from MD Expo, visit www.mdexposhow. com/las-vegas-2015/photo-gallery/.

SPOTLIGHT

PROFESSIONAL OF THE MONTH Ben Fletcher, BMET II By K. Richard Douglas

ometimes, HTM professionals make it into the professional spotlight not only for what they do on the job, but based on a combination of things. There are many biomeds who volunteer their time away from work as well.

Ben Fletcher, BMET II, a biomedical engineer with Aramark Healthcare Technologies, who works at Phoebe Putney Memorial Hospital in Albany, Georgia, is a good example. Fletcher remembers that he was looking for something that would offer him a career and not just a job when he chose to become a biomed. “I wanted something that would challenge me and push me to think outside the box,” he says. “I was formally trained at Albany Technical College where I received certification in electronics fundamentals, computer electronics, industrial electronics, telecommunications, and biomedical engineering,” he adds. Working for Aramark since the start, he started his career nine years ago via an internship with Phoebe Putney. One of Fletcher’s instructors at Albany Technical College had worked in the biomed department at Phoebe Putney and Aramark was the contracted biomed provider there already. “Being that I had already completed several programs in the electronisc field, when I was presented with the

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opportunity to learn more about biomed, I gladly accepted the challenge,” Fletcher recalls. “My instructor introduced me to this field and also connected me with the internship where I was later hired as a full-time employee.” Fletcher never looked back as he built upon his knowledge and training at the facility.

FACING CHALLENGES These days, Fletcher is the biomed assigned to the OR at his hospital. “I am trained on the Aestiva 5 anesthesia machine; I have some on-the-job training on ventilators and I received my certificate of completion for the superDimension inReach system PM service training program in November of 2014,” he says. He has faced challenges on and off the job. Fletcher lost both parents to colon cancer; his dad in April of 2013 and his mom in May of this year. “It was a challenge to walk back into Phoebe Putney Memorial Hospital knowing that this is where they both took their last breath, but with the help of God, family and friends, I was able to keep pressing forward,” he says. After facing that kind of life-changing experience, the trials that face him as an HTM professional are far less daunting. “The (work) challenges I have faced have not been great in number, but each has taught me something new not only about the job but also about myself,” Fletcher says. “My initial challenge began [by] trying to learn more about the field and familiarize myself with the verbiage and language that this field entailed,”

DECEMBER 2015

he adds. “Also, when I began working full time in the OR as the main biomed, there were several pieces of equipment that I was not familiar with that I had to learn.” “One of the main pieces was autoclaves, as this is an essential piece in the OR. Another challenge I faced was learning the correct persons to communicate with regarding the status of equipment that was down for repair and learning to give status updates,” Fletcher adds.

AWAY FROM WORK A trip to Nigeria in 2006 still provides good memories for Fletcher. It was an eye-opening adventure that put life in the U.S. in a new perspective. Nigeria, which is Africa’s most populous country, sits on the continent’s west coast. It borders the Gulf of Guinea. The country’s population is 40 percent Christian. “My church traveled to Lagos, Nigeria in September 2006 for a mission trip there with a local pastor. The pastor became a part of our ministry fellowship, which is entitled International Covenant Fellowship (ICF),” Fletcher explains. “The church in Lagos is named Lion of Judah Lagos and my church traveled to be a part of their Crusaders Conference. While there, I was able to see how much I have taken something as simple as having clean drinking water, traffic lights, air conditioning and a stable electrical grid for granted,” Fletcher says. “Also, while there, we were able to fellowship with some of the local people, and also interact with some of the children that lived in the orphanage the pastor ran.”

“ Being that I had already completed several programs in the electronics field, when I was presented with the opportunity to learn more about biomed, I gladly accepted the challenge. My instructor introduced me to this field and also connected me with the internship where I was later hired as a full-time employee.” - Ben Fletcher

Fletcher recalls that it was amazing to see the smiles on the children’s faces even though they did not have a lavish lifestyle. “As far as the church services, the churches were not as nicely decorated as some are here in America. Though this is the case, the people still worshipped God and enjoyed themselves in the services,” Fletcher says. “Overall, the trip was a great experience that I have learned from and will remember for the rest of my life.” Back in the U.S., Fletcher enjoys spending time with his family. “I have been married to my beautiful wife, Stephanie, for nine years, currently we have no kids but one godchild,” he adds. “I have one sister Kerpasha Davis who is married and has three children.”

Ben Fletcher, BMET II, works on a piece of equipment.

Watching college and pro football is one of Fletcher’s favorite pastimes, along with playing video games. He says that the PlayStation consoles are the best. “I travel extensively with my church Lion of Judah International Ministries to help encourage people in our sister churches here in the U.S. and in Lagos Nigeria,” he adds. There is little doubt that Fletcher’s priorities in life have benefited him throughout his biomed career. “What I would like for TechNation readers to know about me is that I believe in faith, family, hard work, and teamwork. I would not be where I am without God and a great cast of family, friends and co-workers,” he says.

FAVORITE MOVIE: “300”

FAVORITE BOOK: The Bible

FAVORITE FOOD:

Just about anything barbecued

HIDDEN TALENT: I play the drums.

FAVORITE PART OF BEING A BIOMED: Never a dull moment

WHAT’S ON MY BENCH

“I have an ink pen, clipboard, breath mints, digital multi-meter, laptop and ESU analyzer.”

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DEPARTMENT PROFILE Banner Fort Collins Medical Center Clinical Engineering Department By K. Richard Douglas

n southeast Fort Collins, Colorado, sits one of Banner Health’s newest medical facilities in the state. A fullservice, acute-care hospital, Banner Fort Collins Medical Center offers emergency care, surgery, orthopedics, obstetrics, intensive care and many other services. The twostory facility includes 24 patient beds, two operating rooms and 17 pre-operative and post-anesthesia rooms.

The medical center opened in 2015 with 149 employees and 255 active staff physicians. Among the support staff at the facility is the regional clinical engineering team led by Area Services Director Tommy Lobato, CBET. “Banner Fort Collins Medical Center is part of the Banner Health Western Region Clinical Engineering team,” Lobato says. “Most equipment is supported through our in-house team. This includes anesthesia, ultrasound, ventilators, nurse-call, etcetera. With 23 technicians on our team, we are able to assist one another with the strengths of other individual team members.” “Tony Cody and Matthew Kolb are the Clinical Engineering Senior Managers of the North Colorado (NOCO) region which consists of Banner Fort Collins Medical Center, North Colorado Medical Center and McKee Medical Center,” Lobato adds. Kevin Harrell, CBET, CRES, is the stand alone biomed assigned to Banner Fort Collins Medical Center during normal working hours. After hours support is provided by four technicians who provide support to 11 facilities across five states. Fort Collins includes equipment assets with a value of nearly $14 million. The regional model that allows 23 HTM

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professionals to provide services to 11 hospitals requires support from all involved. Lobato likens it to having 23 technicians available to each hospital thought. At the same time, the biomeds housed in each facility are dedicated to that location. The previous stand alone biomed at Fort Collins was Jon Fernbach. Fernbach agrees that there was never a sense of really working alone. He has 22 colleagues in the region who can be called upon for support. “We also utilize a distributive model of service for high-end equipment: MRI, CT, imaging, anesthesia, ventilator, etcetera. This distributive service model is facilitated by internal Banner Technology Management resources,” Lobato adds. “The facility opened on April 6, 2015. Although Jon Fernbach was the primary technician assigned to the hospital, there were many other team members that were a part of the acquisition and installation of the equipment,” Lobato points out. “Scott Bauer was the Biomed Project Consultant who verified user needs, managed the equipment budget and oversaw the overall purchase. He was assisted by Fernbach (Biomed III), Peter Millington (Biomed II), Jeremy Whitt (Biomed II), Don Petering (Biomed II), and Bonnie Brown (Biomed II), who together made the opening possible.”

DECEMBER 2015

Scott Bauer and Bonnie Brown check out new monitoring equipment.

REGIONAL RESOURCES Because the facility is so new, service contracts are not yet an issue, with most equipment still covered under warranty. Like many Banner locations, there is ample in-house talent to tackle most types of equipment. “The goal of Banner Health Technology Management is to bring as much support in-house as possible through increasing the core competencies of the internal team; however there are some instances where this is not feasible,” Lobato says. “It is for this reason that all medical equipment service agreements are centrally managed through the Technology Management Department. This provides opportunities to leverage geography as well as economies of scale with respect to vendor relationships.” Clinical engineering manages data through the use of the Phoenix Data Systems AIMS Computerized Maintenance Management System. “Utilizing the Computerized Maintenance Management System, Banner Technology Management has set processes and protocols in place that allow for the

lead by [the] Technology Management department and engaging Information Technology resources as needed,” he says.

REGIONAL RESOURCES

The Banner Fort Collins project crew includes (from left to right) Peter Millington, Jon Fernbach, Bonnie Brown, Scott Bauer

Jon Fernbach shows Pete Millington some of the new equipment.

utilization of data collection to drive our overall business strategies,” Fernbach says. In the larger scheme of things, the Banner Health system includes the clinical engineering department and IT under the CIO. At the facility level, IT handles application issues, computer hardware, and networking, according to Fernbach. He says that clinical engineering has service responsibility for IT based systems such as: nurse call, patient monitoring, fetal monitoring, Natus and others. Lobato adds that Banner Health has achieved a progressive level of software integration with respect to medical

equipment transferring information in an electronic format to a clinical service line application housed in a Banner Health dedicated server farm. “Banner Health has over two dozen unique applications that encompass the following clinical departments: Anesthesia, Cardiology, EEG, Endoscopy, Labor and Delivery, Medical Imaging, Surgical Video Integration, Radiation Oncology, Alarm/alert secondary monitoring and RTLS,” Lobato says. “The service methodology to support the extensive list of software applications is a combination/collaboration of support

Anyone who has been a part of the launch of a new hospital knows that the considerations can be daunting. “When I joined the project in October 2014, our project manager, Scott Bauer, was just beginning to order the equipment,” Fernbach remembers. “By early December, we were beginning to take delivery of nearly 2,000 pieces of equipment. With support from our local team, Scott and I were able to get everything tagged, inspected, and placed into service to meet our April 6 opening. We received Colorado State Health Department certification, and a few weeks afterwards Banner Fort Collins Medical Center passed its initial Joint Commission survey.” Fernbach remembers that he arrived at the new hospital in December. He had been assisting with inventory since October. The area the biomeds were working in didn’t have any heat until the end of January or early February. They used Bair Huggers as personal heaters under their desks. Despite the inconvenience, Fernbach describes that time period as a “good time.” Fernbach was excited to volunteer for the Fort Collins project. He has been with Banner for three years. After getting the new hospital off the ground, he moved to Banner’s North Colorado Medical Center and also works at a facility in Brush, Colorado, one day a week. More recently, at the Fort Collins location, they have begun outfitting the last couple of rooms in the delivery area. This included about 20 pieces of equipment. A couple of clinics have also opened recently calling for the relocation of existing equipment as well as tagging and inventorying new equipment. The overall result of the diverse and talented regional workforce has produced a net affect that is very good for the bottom line; the current cost of service ratio is less than five percent. Fernbach reports that the Fort Collins facility is running smoothly. Under the Banner clinical engineering model, it’s no surprise.

SPOTLIGHT

BIOMED ADVENTURES Endurance Tested K. Richard Douglas

or some people, it’s not enough to run a 5K race. In a culture of couch potatoes, running a 5K should be an accomplishment, while getting a good dose of cardio exercise. But, the challenge may leave some wanting more. Like the participants in the popular TV show “American Ninja,” the challenge of testing one’s endurance and strength to the nth degree is more appealing.

Enter the age of extreme obstacle courses that would leave the average person lying on the ground during the first 50 yards. Events like the Tough Mudder Mud Run, the Superhero Scramble, the Warrior Dash and the Spartan Race leave some participants with bruised egos and a few scrapes to boot. Making it to the finish line, on the other hand, provides a real sense of accomplishment. If you are a devotee of these kinds of events, and you happen to own some land, the opportunity might present itself to build your own course. This takes the DIY concept to a whole new level. Meet Tim Bowers, a biomedical engineering manager for VCU Health Community Memorial Hospital in South Hill, Virginia, who is all in when it comes to obstacle courses and doing it yourself. Bowers has spent many a weekend involved in events like the Tough Mudder, the Rugged Maniac and the Battle Frog series. Alas, the family farm beckoned, and it wasn’t asking for more corn or cows. “When I’m not working, I’m building obstacles on the family farm to train on,” Bowers says. “I set up training runs with folks locally that are interested in OCR on the three-mile trail we have cut through the farm. Anyone who can complete the trail and all obstacles two times in a row earns a medal.” Bowers got involved in challenging

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himself through 5K and 10K races. He then began training for half marathons. “After awhile, the training runs became very monotonous and boring to me, so I started to look into alternative activities,” he says. “I kept seeing the advertisements for Tough Mudder on social media — 10 to 12 miles of possibly the toughest event on the planet — and it seemed to be something that not only looked tough but fun.” “What intrigued me most about the events is that, instead of being a solitary event where the goal is to get yourself across the finish line, it seemed the goal is to get everyone to the finish line regardless of your physical abilities and that appealed to me greatly,” he adds. The popularity of many obstacle course events can’t be understated. The Warrior Dash alone claims to have more than two million participants worldwide since 2009. With 12 obstacles included in the 5K event, with names like Goliath and Great Warrior Wall, the event offers a medal, T-shirt and Warrior helmet to those who complete the course. The Tough Mudder is a “teamoriented 10-12 mile obstacle course,” according to the organizer’s website. Tough Mudder events have attracted more than two million participants to more than 150 events since 2010. Likewise, the Rugged Maniac claims “25 epic obstacles” over a three-mile course. The Rugged Maniac doesn’t

DECEMBER 2015

Brandon Fleming (a local police officer) attempts to cross the “The Stairway to nothing.”

settle for an obstacle alone, but includes a daylong festival. A T-shirt, professional race photos and a medal are available to those who make it across the finish line. “I have done everything from 5K road races and mud runs up to a 26.2-mile trail marathon at Medoc Mountain State Park in North Carolina after a hurricane came through (lots of mud),” Bowers remembers. “The toughest race I have attempted by far was the Virginia Tough Mudder this past year. The course itself was considered a stadium style event which is relatively flat consisting of lots of weaving in and out of the state fairgrounds parking areas,” he says. “What made it tough was the heat. This event was in June and the temperatures

The “Bridge Rings” is one of the 18 obstacles on the The Blitzkrieg course.

“ What intrigued me most about the events is that, instead of being a solitary event where the goal is to get yourself across the finish line, it seemed the goal is to get everyone to the finish line regardless of your physical abilities and that appealed to me greatly.”

at the event neared the 100-degree mark the entire day. There were a lot of people who were not prepared for this and were unable to finish.”

BUILD YOUR OWN MOUSETRAP It’s a big jump from competing in these kinds of events and creating your own course. Bowers says that there were a few trails on the family farm that he would run when he first started training. “Since most of the events I trained for were team based, I started to invite people over that were interested in doing the runs with me,” he says. “I wanted to help them get used to running the varied terrain they would see at the event. I would throw in some push-ups and pull-ups throughout the run to help with the strength portion. During the runs, I noticed the obstacles that were giving my teammates and others the most trouble, so I decided to figure out a way to add some things to my course that would help,” he adds. Those things initially included a few old tires here and there. He then added an eight-foot wall, and the idea took off

from there. He now has the equivalent of a 5K, 18-obstacle course on the farm. “The biggest challenge by far is the upkeep of the trail and making sure the obstacles are safe to use,” Bowers adds. The course is called “The Blitzkrieg” and has 18 obstacles. Although there are no plans for officially sanctioned events, participants who finish the course successfully twice in the same day earn a medal. When not jumping walls, running trails or traversing hanging rings, Bowers can be found at VCU Health Community Memorial Hospital managing the two-man biomedical engineering department. The two biomeds handle all the medical equipment service for the 99-bed hospital, a long-term care facility and nine clinics. He was recently also involved in the equipment planning for a new hospital. Facing the challenge of equipping a new facility or jumping over fire, this is one biomed who takes on a challenge and then goes home to help others train for their own.

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Telehealth: Have We Passed the Tipping Point in Clinical Use?

s telehealth – or telemedicine – finally about to break free of the return-on-investment concerns that hobbled its use? After all, many hospitals have been participating in a telestroke program either as a hub or a spoke member of a network for some time. Grantfunded services to improve rural health care have been operating for years, and remote services provided to the incarcerated is another well-developed program. At the same time, information software and hardware developments have spawned remarkable advances in monitoring technologies. This includes the use of wearable sensors, which gives both the telehealth and wearable sensor markets the potential for huge growth. Most telehealth services, however, have been developed in isolation from each other, often at the request of an individual clinician and with little strategic analysis. Is telehealth now an imperative service rather than a niche application? WEARABLE SENSORS FUEL TELEHEALTH GROWTH “Wearable sensors” previously referred to large, bulky devices that recorded vital signs as a patient lay in a hospital bed. Now, wearable sensor technologies for health care use are significantly smaller and allow both healthy individuals and sick patients to monitor vital signs from home and other locations. These sensors come in different forms, from wristlet devices to skin patches to head domes designed to track vital signs from the head. The market for health care sensors is expected to grow tenfold, from $3 billion to at least $30 billion, in the next five years. This anticipated growth can be attributed to a focus by companies on remote monitoring of specific diseases (e.g., diabetes, heart failure) to enable just-in-time health care management – if the data are actively monitored clinically so that timely action can be taken.

GETTING A GRIP ON TELEHEALTH GUIDING PRINCIPLES While hardware, software, and individual niche uses are down in the weeds of

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telehealth, one question remains: Who is looking at the overall aims of telehealth in clinical care? With all the activities driving the explosive use of telemedicine, the American Medical Association (AMA) decided at its June 2014 annual meeting to approve a list of guiding principles. These principles are intended to help foster innovation in telemedicine use, protect the patient-physician relationship, and promote improved care coordination and communication with medical homes. The American Telemedicine Association, in partnership with another 12 organizations, is spearheading the development of telehealth coverage. It specifically calls for authorization of the following: • The use of telehealth for all Accountable Care Organizations (ACOs) and bundled payment programs • Telehealth payments for population health management to include all critical access hospitals and all federally qualified health centers (FQHCs) • Remote patient monitoring for chronic obstructive pulmonary disease and

DECEMBER 2015

congestive heart failure, and at FQHCs, remote monitoring for patients with diabetes • The facilitation of care by allowing video visits and remote monitoring for Medicare patients such as those undergoing home-based kidney dialysis Additionally, the Alliance for Connected Care is pushing lawmakers to allow telehealth services to be substituted for in-person care and that current Medicare restrictions on telehealth services be waived for ACOs. (The Alliance is composed of leading companies across the health care and technology spectrum, representing insurers, retail pharmacies, technology and telecommunications companies, and health care entrepreneurs.) The future of telehealth programs looks rosy and may mimic successfully operated telestroke programs that have been in use for some time. Telestroke is the delivery of neurologic care via remote video conferencing from a neurologist at the base – or hub – site to patients in outlying hospitals – the spokes – who

may be having a stroke. Telestroke is often viewed as the poster child for telehealth success by providers, payers and patients. Telestroke solved a particular need – coverage by an expert neurologist for hospitals that could not provide coverage 24/7. Regional programs using hospitals or a neurology physician group as the hubs have strived to improve stroke care. Now, in addition to calls for payment reform from industry groups, more momentum has been shown by the Veterans Administration Health System (VAHS). It reports that in fiscal year 2014, it delivered more than 2 million telehealth visits to more than 690,000 veterans. Also, the annual cost of treating veterans via telehealth fell 4 percent between 2009 and 2012. VAHS has achieved scalability, and it is looking for more use of telehealth as it expands from fixed-based telehealth access sites to mobile programs using cellphones. Google also announced it is conducting a trial of live-video medical advice. Google has partnered with several telehealth companies to provide the service to those online searching for medical information and to ensure that the participating clinicians are appropriately credentialed and licensed. While it does not offer live advice on every medical search, this basic telehealth application might break

down barriers even further among the patient population. So while telehealth barriers remain (e.g., reimbursement, licensure), the concept is beyond proof, even though hard evidence that it provides benefits for all clinical applications is not yet conclusive. Hospitals and clinicians are trying to figure out how best to proceed. In 2013, FDA and the Association for the Advancement of Medical Instrumentation held a joint Summit on Healthcare Technology in Nonclinical Settings. One of the summit’s chief messages was that new care locations enabled by advancing technologies like telehealth require new processes, practices, and products, not just those tweaked from traditional hospital care delivery processes. Any hospital with pilot telehealth programs has probably encountered this phenomenon – that modified traditional processes are not always the best solution. To develop best practices for telehealth services, processes need to be developed programmatically so that best practices can be easily shared. One of these best practices relates to the technical platform used for implementation. Health care systems are realizing that one of the criteria for success lies in the software that supports the clinical workflow. As hospital administrators know from experience,

one software platform will likely never be perfect for all clinical specialties and their appropriate workflows and documentation needs. Flexibility is needed and wanted. While the convenience of a single vendor/platform may look attractive from a telemedicine hub site’s perspective, it is not necessarily the best plan for telemedicine program development. Having a contractual agreement with just one telehealth platform supplier may not make sense to support all possible clinical applications of telemedicine. As health care changes to a patientcentered model, which in turn drives many program development questions, health care leaders need to be ready to implement telehealth to improve patient care, optimize staffing and maximize what reimbursements are available for care provision. THIS ARTICLE IS EXCERPTED FROM ECRI Institute’s 2015 Top 10 Hospital C-Suite Watch List. The full white paper contains more guidance on telehealth and other novel, new, or emerging technologies. To download the full C-Suite Watch List, visit www.ecri. org/2015watchlist. For more information on ECRI Institute’s evidence-based health technology assessment or consulting services, contact communications@ecri. org, or call 610-825-6000, ext. 5889.

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AAMI UPDATE

AAMI Publication Shines Spotlight on Infusion Systems

nfusion system safety, a subject of intense interest for medical device manufacturers, clinicians, regulators, healthcare technology experts, and patient safety advocates, is the focus of the newly released issue of AAMI’s award-winning Horizons magazine. The concepts and approaches of articles featured in the fall 2015 issue include the following:

• A roundtable discussion in which leading experts weigh in on questions such as: What recent advances have been made to improve infusion system safety? How can human factors engineering and user-centered design make infusion pumps easier to use? How effective is training on the use of infusion devices? For hospitals with smart pump technology, what is being done to ensure clinician compliance with the use of drug libraries for infusions? • Research on how a simplified user interface for intravenous smart pumps can improve programming times and reduce use errors. • Perspectives on how improved smart pump drug library use can help eliminate clinical workarounds. • Evidence of how syringe infusion pump programming errors can be decreased through the use of weight-based safety parameters for intermittent infusions. • The challenges and rewards of one group’s smart pump implementation efforts, including wireless issues, support-related challenges, and the leveraging of quality data to improve pump safety and usefulness. • A report on how human factors engineering and a simulated-use validation study was used to achieve improved ease of infusion pump programming, resulting in improved drug library compliance rates.

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Horizons is a peer-reviewed supplement to AAMI’s journal BI&T (Biomedical Instrumentation & Technology).

NEW GUIDANCE FOR ESTABLISHING AN HTM ASSOCIATION AAMI has published a new guide for establishing a local healthcare technology management (HTM) association. This guide, aptly called How to Establish and Formalize an HTM Association, aims to provide the most complete information about what a successful organization needs to do to develop, sustain, and promote itself. The process of establishing a local HTM association, whether it be city, state, or regional, can be a complicated and difficult task. This booklet outlines a suggested path for establishing a new association that ranges from determining interest level and raising operating funds to applying to become a federal taxexempt organization to creating a website and increasing membership. The new guide builds on a similar publication produced in 2004 by AAMI’s Technology Management Council. Over the last few months, a committee of dedicated AAMI members has restructured the content and updated guidance to reflect advances in technology. The full text of the guide is available at www.aami.org.

DECEMBER 2015

IUSS QUESTIONS ADDED TO BENCHMARKING TOOL Eleven new questions pertaining to immediate-use stem sterilization (IUSS) procedures were added to AAMI’s sterilization benchmarking tool. Benchmarking Solutions – Sterile Processing is a digital platform designed to help sterile processing departments measure their budgets, personnel, practices, and policies against similar departments at other facilities. “These questions were added to the platform as part of our continuous improvement and feedback loop from our subscribers and the joint AAMIIAHCSMM task force. We heard that this was a topic that the industry wanted to benchmark, and we listened,” said Damien Berg, manager of sterile processing at St. Vincent Hospital in Indianapolis, Indiana. Berg has played a key role in the development of the benchmarking tool. Many facilities have been working to reduce their use of IUSS to improve patient care and safety; however, reducing IUSS use usually involves purchasing more instrumentation. The sterile processing benchmarking tool can provide valuable information to support these purchasing requests. “Benchmarking of IUSS can help subscribers to justify the expenditures needed to minimize the use of IUSS,”

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DECEMBER 2015

TOOLS OF THE TRADE

Datrend’s vPad-ES Rugged Electrical Safety Analyzer with Phase 3 Defibrillator Tester

atrend Systems is a technological leader in the design and development of biomedical test instrumentation. Datrend’s philosophy is to design and develop products utilizing state of the art technology that will help biomeds and field service engineers increase throughput, improve traceability and improve documentation.

A prime example of this is the CMMS interface technology available on the vPad range of safety analyzers. Using the vPadCheck App and one of the several interfaces Datrend developed in conjunction with CMMS system suppliers, users have the ability to download work orders from their CMMS system directly onto the safety analyzer, carry out automated PMs by following step-by-step instructions (which can include images and videos), then upload the test records back into the CMMS System – all without the need of a laptop. Test records can be transferred locally using Bluetooth or a USB thumb drive, internally on a hospital’s wireless network, or externally using a VPN connection to a corporate CMMS or data collection system. Datrend also developed an interface that allows test records to be synchronized with Dropbox. If you are working remotely and don’t have access to the Internet, the safety analyzer can be paired with your cellphone and data can be transferred across a 3G/4G network. Knowing that biomed departments use a wide range of test equipment from different manufacturers, Datrend products have been designed to interface with many of these devices. Datrend’s range of electrical safety analyzers for example can control a defibrillator analyzer from another manufacturer, enabling closed loop automated testing. TO FIND OUT MORE, contact the Datrend sales team at customerservice@datrend.com or toll-free at 800-667-6557 ext. 228.

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DECEMBER 2015

1TECHNATION.COM

Webinar

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WEBINAR WEDNESDAY

Nuclear Medicine Expert Shares Insights By John Wallace, Editor

recent Webinar Wednesday session focused on the specialized area of nuclear medicine providing expert insights to help HTM professionals protect and maintain this valuable piece of medical equipment. Craig Diener’s presentation “Protecting Your Nuclear Medicine Imaging System Investment” sponsored by Universal Medical Resources Inc. drew 170 preregistered attendees. The webinar served as a reminder on how to maintain nuclear medicine equipment while providing a solid introduction for those not accustomed to servicing these advanced imaging systems. “Although I don’t work on nuclear medicine imaging systems, I thought that the general principles of maintenance for them are similar to other types of equipment that I do work on. It’s always good to review what kinds of things to look out for when maintaining equipment,” J. Wilkolak wrote in a webinar survey. Diener, a senior product manager at Universal Medical Resources Inc. (UMRi), has 22 years of

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experience in nuclear medicine, including 19 years with an original equipment manufacturer (OEM) in various capacities including product technician, production management, system procurement and asset management and product management. In his Webinar Wednesday presentation, Diener discussed ways to protect nuclear medicine imaging equipment by monitoring environmental conditions that could harm camera operation. He also discussed protection through maintaining the appropriate power quality. He reviewed preventive maintenance processes. He also discussed how to utilize critical product recovery (CPR) for backing up camera data. Environmental concerns are an important aspect of keeping devices performing. Diener discussed how temperature, humidity and weather fluctuations can impact nuclear medicine equipment. He stressed the importance of the fan as “the most important part” of a nuclear medicine device. He covered ways to maintain the fans to keep the device running in a efficient manner. Other areas addressed in the webinar included proper shielding, power quality, preventive maintenance and establishing a daily/weekly quality routine. He also touched on service contracts and end of service

DECEMBER 2015

“Although I don’t work on nuclear medicine imaging systems, I thought that the general principles of maintenance for them are similar to other types of equipment that I do work on. It’s always good to review what kinds of things to look out for when maintaining equipment.” - J. Wilkolak

notifications during the webinar. TechNation’s Webinar Wednesday continues to be a popular spot for free educational presentations with 6,038 registrations in 2015 with an average of 431 attendees per webinar. TO VIEW A RECORDING OF THE WEBINAR and for information about upcoming presentations, visit 1technation.com/webinars.

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BIOMED 101

A Guide to Root Cause Analysis By Dustin Telford

hatever flavor of technician or service engineer you are, knowing how to conduct a Root Cause Analysis can improve patient safety and build your reputation with key customers. Biomedical technicians, imaging service engineers, sterilizer technicians, and so on can use a simplified version of RCA (Root Cause Analysis) to reduce preventable damage caused by end-users repeating the same mistakes, evaluate safety risks with medical device systems after an incident or near miss, and even analyze risks before a problem occurs. RULES TO ROOT CAUSE ANALYSIS 1. Leave Bias at the Door When I speak to technicians and service engineers privately, most undoubtedly talk about those darn nurses. Clinical staff are often blamed for the repairs, the problems with the equipment that no one can duplicate, and even those events that harm or come close to harming a patient. The second most frequent bias that we lean on is that the equipment could never be the problem. Leave biases at the door. Root Cause Analyses need an almost scientific approach to ensure that patient safety comes first. 2. Collaborate with Stakeholders Whether the HTM department invites the team or some other hospital safety steward, biomed technicians may be the most qualified personnel in hospitals to recognize all the stakeholders. Technicians or service engineers travel amongst several key circles within health care including clinical and medical staff, health care information technology, facilities engineering, support services, purchasing, etcetera. Make sure the team to review near misses and incidents includes those who know the environment, the end-user and the equipment. Work with the team to leave bias at the door.

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DUSTIN TELFORD CBET, CRES, CLES, CHTM, Field Service Manager with HSS, Childrenâ&#x20AC;&#x2122;s Hospital Colorado

3. Investigate the Three Es The lead should ideally decide how questions will be developed and how information will be collected; however, the group should be asked what questions need to be asked. For instance, a nursing manager may suggest that the training records for the doctor should be reviewed while the biomedical technician may recommend an independent audit when reviewing an incident with an ophthalmology laser. Environment: Ask relevant questions about the conditions that existed during

DECEMBER 2015

the time the event took place. Is the environment designed for the services prescribed and provided? Is the environment free of distractions or interruptions? Were there conditions that do not normally exist in the same environment such as network outages, facilities maintenance, code blues down the hall? End-User: Examine the actions taken by the end-user during the event. Make sure the end-user is aware that a review is first and foremost an opportunity to ensure patient safety. Was training and education consistent and sufficient? When and was the end-user aware of the issue that affected patient safety? Were there physical limitations such as fatigue, stress, hearing, visual, and so on that contributed to the event? Equipment: Evaluate the full operation and effectiveness of the equipment and any integration points. Your first step should be to determine whether the FDA must be contacted under the Safe Medical Devices Act. As a second step, determine whether the equipment should be reviewed by a non-biased party (i.e. if the OEM performs the service, maybe you should use another provider to evaluate the event). The equipment in the room and in use should be considered in your investigation. Question whether the equipment has

been maintained according to your organization’s strategies. Question the qualifications of the service provider and the certificates of calibration of the test equipment used at the last routine service. Review the FDA and any other recall/hazard information sources that the organization has access to for problems which may have been previously identified. Review with the manufacturer whether the equipment operated as designed and approved in your country. 4. Review Findings and Add New Questions Root Cause Analysis is not a linear process in most cases. Investigators may find that other stakeholders or subject matter experts need to be included. Questions may arise that need to be answered or initial findings are too cursory to identify a root cause or causes.

5. Recommend Actions for Success Root Cause Analysis should result in documented recommendations which, in the case of health care, result in improved safety, more available equipment, better patient outcomes, or better business operations. Recommendations set a goal or goals to one or all of these ends. The goal should be SMART (Specific, Measurable, Achievable, Reasonable, and Timely). 6. Measure Your Organization’s Success There are two key reasons why you should review whether the Root Cause Analysis and pursuant recommendations were a success. If you set clear goals with measurable outcomes, this step may result in additional measures or professional satisfaction of a RCA done well. The first reason one should measure success is to improve health care outcomes and business.

The second reason that one would measure success is to identify areas where your next analysis may benefit. We can learn from our mistakes. In summary, a Root Cause Analysis is an approachable tool that all HTM professionals should use. An RCA may be used before an event or incident occurs to identify a potential issue before it happens. An RCA, of course, can be used whenever an event or a near miss occurs to identify the causes and take action to prevent a similar occurrence. DUSTIN TELFORD, CBET, CRES, CLES, CHTM, is a Field Service Manager with HSS assigned to Children’s Hospital Colorado and serves as the hospital’s Biomedical Equipment Manager. He is also Director of Clinical Engineering for earthMed.

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SHOP TALK

Conversations from the TechNation ListServ Q:

Is there a benefit to getting a flu shot? Does your hospital require Biomeds (HTM) professionals to get a flu shot? Do you get one voluntarily?

A: A:

Flu shots here are required, even for HTM.

Just think of the impact to your patients if you do not get the shot. It is not all about us, it is about the patients we serve.

Is there a benefit? Who knows, it is given to help prevent the flu, not necessarily to stop a person from getting the flu. Our hospital network makes it mandatory to get a flu shot unless you have a religious or health reason. I have never gotten one voluntarily, and I have only had the flu one time in my life (lucky me).

I did a year of graduate work in virology working with retroviruses after getting my undergraduate degree. In addition to HIV and FIV, I also did a great deal of study of the Orthomyxoviridae family of viruses which include influenza. Based on my knowledge and experience I feel that the vaccination for the flu is more than just beneficial, it is vital. Throughout history the flu has killed many millions of people. Due to its recombinant nature it is difficult to accurately tailor any vaccine to every possible variant of the flu, but it can greatly reduce the likelihood of catching the disease. Given our exposure to various strains in a hospital setting, this is vital to our own health. I also see this as a patient safety

1TECHNATION.COM

concern however, since by reducing our own vulnerability to influenza, we make ourselves less likely to be carriers of the disease. Since by nature of said hospital setting it also reduces the likelihood of our exposing patients, many of whom are immune compromised in one way or another to the flu. Our hospital requires all personnel who have direct patient contact to get vaccinated. Since by nature of our jobs we are often in patient rooms, this includes biomed. All staff are given the option to “opt out” of the vaccine, but this is discouraged. Going forward I believe it is the hospital’s intent to require staff who chose to opt out of vaccination to wear masks when in patient care areas. Based on my above statements, I doubt it will come as a surprise that I willingly get vaccinated every year.

Yes our hospital requires as a condition for employment. The debate is major; however I guess our greatest benefit is to remain gainfully employed. Whether it keeps me from getting the flu, I don’t know because I haven’t gotten it since I take the flu shot. Kind of like the “tree falling in the woods” debate. Would I continue if it was not a requirement for employment, I would have to say yes.

The answer to your first question (Is there a benefit to getting a flu shot?), is elusive. I did quite a bit of research on the subject, which lead me to my decision (below). Even the media recently admitted that last year’s flu shot was mostly ineffective. Our facility does require the flu shot for all employees

DECEMBER 2015

(including Biomed), but they also allow us to refuse. If we do refuse, we’re required to sign a declination form and wear a mask in patient care areas until flu season is officially over in our county. I’m really glad I get a choice. I choose to wear a mask, which protects me from more than just the particular flu strain “they” gambled on for this year. I’ve been wearing a mask every flu season for several years, and haven’t contracted the flu yet. When I sign my declination form, it asks why I’m refusing, and I always say “I’m allergic to neurotoxins.” What cracks me up is when other employees ask why I’m wearing a mask. I say, “I didn’t get the flu shot.” They start backing away, like I’m contagious, as if their flu shot offered them no protection at all. I absolutely support the theory of flu shots, but the science isn’t perfected yet, and in my opinion the benefits do not outweigh the risks. I can’t see any benefit from injecting neurotoxins directly into your bloodstream. But that’s my personal opinion, and I don’t judge or bash those who do get the flu shot. Just offering my opinion in response to your questions.

While I agree that we should think about the patients, I have a completely different experience that has caused apprehension towards the mandatory flu shot requirement at my hospital. My mother-in-law was diagnosed with Guillain-Barré syndrome as a result of receiving the flu vaccination. We ultimately lost her after an 18-month painful battle toward some form of recovery. She received flu shots in the past so there was no reason to

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It is now a requirement for employment here. Otherwise, I would not get it. You need to prove it works first.

I’m looking to see what the average on-call pay is among Biomeds. I feel the on-call pay I receive is not within the average for my area of the country and I was hoping other Biomeds could help me get a good estimate on what the average on-call pay is. At my shop we only receive $1.75 a hour and 2 hours minimum of OT when called in. I’m in the Midwest and I feel this is too low.

We receive $2 an hour and it isn’t worth it. Two hours for a call in. I’m in Ohio.

I no longer work there, but in Virginia we were getting minimum wage for on-call and a two-hour minimum to come in. We went salary and that went away and it turned into 50-60 hour workweeks plus rotating on-call, that’s why I left.

Here on an island we were getting the minimum wage and 40-45 minutes to come in. But all that stopped, now we are on recall which means we do not get paid on-call pay but if you get called in you get two hours minimum overtime pay after you complete a 40-hour workweek. I really think our management should pay us at least $2-$3 on call so the employees can be motivated.

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I don’t have on-call with my current employer, but at my previous position it ranged from $2.50-4 an hour. For some reason it started low and increased if you were on for more than 24 hours straight. They paid for 3 hours minimum of OT in lieu of paying for gas. I’m in the Pacific Northwest.

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THE BENCH

ROUNDTABLE Test Equipment

ealthcare Technology Management professionals cannot do their job without test equipment. Testing and maintaining medical devices is as much a part of the job as repairing life-saving devices. Of course, that means having the right testing equipment is just as important as having the right tools. We reached out to industry experts to find out the latest about test equipment and what features to search out when upgrading.

1TECHNATION.

NOVEMBER 2015 DECEMBER 2014

The roundtable panel of experts includes Greg Alkire from Pronk Technologies Inc.; Jack Barrett, National Business Development Manager, Rigel Medical; Mike Clotfelter, Vice President Business Development – BC Group International Inc.; Ron Evans, Vice President of Product Development, Datrend; Patrick Pyers, Vice President, Sales, Marketing & Business Development, Radcal Corp.; and Jerry Zion, Global Training Manager, Fluke Biomedical.

WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR WHEN PURCHASING TEST EQUIPMENT?

without additional training? Is it part of or comprise a complete portable solution? Does it provide the necessary accuracy? Will it deliver the test results in a format that makes documentation easy? Is the price supported by the value delivered?

Alkire: We believe, after assessing the test equipment has adequate features, the most important factors are portability, ease of use and reliability. Our experience in the medical device market has shown that having the flexibility to quickly grab your test equipment, go to where it’s needed, rapidly find the feature you need and having complete confidence the product will work every time, is of the upmost importance in the demanding hospital environment. Barrett: Durability, portability and data traceability. Durability in consideration of ever tightening budgets. What is purchased must last a long time. Portability to ease the burden of what the biomed needs to carry when visiting satellite locations or simply moving about in the hospital. And finally, data traceability. Looking forward, simple pass/fail is being replaced with what device functionality was tested and measured values. The requirement for data will continue to become increasingly important. Clotfelter: Value, but not necessarily the lowest price. Features and specifications are important, but often portability is also desirable. Instruments that measure multi-parameters are important because they can allow more work to be done with less equipment, which also saves on calibration costs since there’s less equipment to be calibrated. Evans: The use of technology integrated into the test equipment to enable the user to work more effectively, both today and in the future. A lot of test equipment is still

WHAT ARE SOME OF THE FUNDAMENTAL TEST EQUIPMENT CAPABILITIES BIOMEDS NEED TO BE ABLE TO DO THEIR JOB?

GREG ALKIRE

Pronk Technologies

based on the legacy model of “do a test, write down the results.” Today’s technology allows us to do a lot more, like automated tests and procedures, direct-to-file test reports, results evaluation, remote access and much more. Look for test equipment that has this type of technology integrated into its design. Pyers: The most important thing to look for is the quality of the product and the stability of the manufacturer. You are making an investment and you want to be sure that your investment will last and be supported for many years. The test equipment should possess the latest technology with provisions to upgrade as new functions are developed. Specifications should meet your testing requirements so the biomed is able to perform their job with ease and accuracy. Zion: Considerations include – Can the instrument be used out of the box

Alkire: Each biomedical engineer should carry their own complete set of tools which should include their own test equipment. With the demands and workload they have to manage, it is critical to have a complete set of test equipment required to service all the medical devices in the facility. This includes, and is not limited to, patient simulators, electrical safety analyzers, as well as, specialized test equipment for critical medical devices such as infusion devices, defibrillators and ventilators. Barrett: A manufacturer’s suggested preventive maintenance procedures pretty much spell out what capabilities are needed. Certainly electrical safety testing is core. From a different perspective, I would suggest test automation is an important capability as it positively impacts the biomed’s time and increases bandwidth. Clotfelter: electrical safety analyzers, multi-parameter patient simulators, ventilator analyzers, esu analyzers, as well as dmms cover many of the basic parameters required for biomed shops to maintain most medical equipment. Additional equipment, such as anesthetic agent analyzers and ambient nitrous oxide analyzers are needed in order to maintain and test specialty equipment,

THE ROUNDTABLE

such as anesthesia equipment. Evans: I would suggest test equipment with a high degree of automation will result in the biggest impact for a biomed. Facilities are looking for large savings in time, costs and manpower while at the same time fulfilling their accreditation needs. Automation helps achieve these goals. Pyers: Test equipment makes up a very broad arena of products used today by the biomed. It is comprised of many different testing instruments from electrical safety analyzers to sophisticated diagnostic X-ray test meters. Each instrument should have the latest capabilities for that modality to allow the biomed to perform all the required tests to diagnose a problem or verify the machines are working correctly. Each instrument has its own specific capabilities that makes it unique and the right tool for the job. Zion: The medical device categories present in inventory of a hospital or medical facility dictate the fundamental capabilities needed in test instruments used by the biomed. For example: Electrical safety (volts, ohms, micro-Amperes); liquid flow, volume, and pressure; gas flow, volume, and pressure; defibrillator: volts, amperes, power in joules; and gas concentration measurement

WHAT ARE SOME OF THE LATEST FEATURES OR CAPABILITIES THAT BIOMEDS SHOULD LOOK FOR WHEN PURCHASING TEST EQUIPMENT?

Alkire: Test equipment that has significant advancements in terms of accuracy and speed should always be a consideration during the purchasing process. An example of this are the infusion pump analyzers available five years ago could not meet adequate accuracy or speed requirements to both quickly assess an infusion pump and be

1TECHNATION.

accurate enough to be certain the pump was performing to the manufacturer’s specifications. This is no longer the case. Barrett: Test automation and ease of data capture on conducted tests. Self-contained analyzers for enhanced portability. Clotfelter: Test equipment that includes auto-sequence programs can provide PMs to be done in less time. Autosequence test results reports can be saved or printed. Other products offer pass/fail and numerical test results. Evans: Automation should be a big factor when looking at the features of new test equipment. But automation capabilities should be looked at closely as well, and consideration should be given to available forms of connectivity, integration with CMMS systems, integration with digital service manuals, remote service and training, and interfaces to other test devices, to name a few. Pyers: The use of new displays utilizing the latest in touch-screen technology is more prevalent today than in the past. With the emphasis on time savings, touch-screens speed up the testing setup procedures and analyzing the results obtained from the measurement. In addition, faster processors with better capabilities to store and analyze data provides more accurate information to the biomed. Zion: Evolving features include wireless capture of test results and on-board automation.

WHAT IS NIST TRACEABILITY AND WHY IS IT IMPORTANT?

Alkire: Traceability to NIST standards is all about an unbroken record of documentation that shows objective evidence proving the test instrument performance ties back to NIST standards and/or references. This provides critical information to the customer to

NOVEMBER 2015 DECEMBER 2014

MIKE CLOTFELTER

Vice President Business Development – BC Group International Inc.

determine whether the test equipment is adequate for testing a device based on its uncertainties (a.k.a. accuracy). This is extremely important because without it there would be no traceable method to have confidence that a medical device, for example, was ready to be returned to service for use on a patient. A general rule for adequate uncertainty of a test device is the 4:1 ratio – meaning the test instrument needs to be four times as accurate as the device under test (IV pump accuracy=5 percent, analyzer needs to have accuracy of 1.25 percent or better). Barrett: NIST traceability provides the path for the instruments used to calibrate the biomedical test equipment back to national standards. The accuracy of the tester or analyzer used for conducting PMs is critical. If the test equipment is not accurate, the end result could be that the medical device is calibrated incorrectly and theoretically adjusted outside the manufacturer’s specification. Clotfelter: National Institute of Standards and Technology. Calibration labs use calibrated standards to calibrate UUT

to “capture” into a test record within the CMMS software. On the other hand, if a hospital has determined they need to document results for the accuracy of infusion pumps, interfacing the IV pump analyzer to the CMMS can reduce errors and save time over an engineer writing down results or manually typing them in. The importance of that interface varies depending on a department’s policy on what has to be documented during testing, the benefit-cost analysis of capturing results over stating pass or fail of the device under test.

RON EVENS

Barrett: It eases the burden, and time required, for the biomed to close out their work orders. There are options ranging from a direct interface, purchasing another piece of software or simply attaching a data file. Some are easier, and less expensive, than others.

PAT PYERS

Vice President of Product Development, Datrend

Vice President, Sales, Marketing & Business Development, Radcal Corp.

(units under test). All calibration and reference standards used in the lab must have an unbroken chain of calibrations traceable to NIST. By using a calibration lab that uses standards traceable to NIST, you can have confidence in the accuracy of the measurements made by the calibration lab.

The importance is one of standardization to allow all users the same level of accuracy and like measurements within limits of uncertainties.

Evans: NIST traceability relates to the ability to trace the calibration of a test instrument back to an “official” reference standard (such as voltage, resistance, current, pressure, etc.), which is at or approved by NIST. It is important because it provides assurance that the test device is able to meet its specifications to perform the tests for which it is designed. Pyers: Traceability is defined as an unbroken record of documentation and/ or measurements with associated uncertainties. NIST, National Institute of Standards and Technology, maintains the standard that traceability is referenced to for accuracy. These standards are essentially the gold standard that all NIST traceable instruments are compared to.

Clotfelter: If you think about it, all test equipment is currently compatible with all CMMS systems. The real question is how does the data get into the system. If you use manual entry, everything is compatible. If all you need is a record that the test was performed, this is not too bad. If you need to keep all of the test data then an automated solution makes a lot of sense. The most important future proofing for test equipment is to be sure it has serial communication capabilities. Software will continue to evolve and if the test equipment can communicate, you will have options in the future even if you don’t need them now.

Alkire: Interfacing test equipment to CMMS software systems can be somewhat important depending on several factors. For example, if the test instrument doesn’t actually measure anything (i.e. an SpO2 simulator) the value of interfacing it directly to a CMMS system is virtually non-existent since there are no results from the tester

Evans: Maintenance of medical devices can be an onerous task in a health care facility, and CMMS software has a major role in managing this task. Anything that reduces the need for printing or data transcription is beneficial in this management role. Test equipment that interfaces to CMMS software (importing work orders/PM schedules, and exporting completed test reports) performs an important role in this process; reducing

Zion: It’s not just NIST traceability. Traceability can be through a national measurement institute (NMI) like NIST or directly to SI. The critical factors include unbroken chain of traceability to the primary standard of the test instruments used in the calibration of the medical device; the accuracy including uncertainties of all measured values.

HOW IMPORTANT IS IT TO HAVE TEST EQUIPMENT THAT INTERFACES WITH CMMS SOFTWARE?

THE ROUNDTABLE

allow analysis resulting in predictive maintenance, including greater cost savings, and less downtime during critical clinical-need seasonality. This functionality is typically missing from CMMS today.

WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT PURCHASING TEST EQUIPMENT?

JERRY ZION

Global Training Manager, Fluke Biomedical

time, enduring compliance, standardizing reports, reducing errors and enabling results evaluation. Pyers: For the biomed maintenance world, the CMMS can be an essential tool for recording, tracking and analyzing the recorded data to help manage the work with the ultimate goal of controlling costs. It allows the biomed the ability to keep detailed records of the test equipment, safety procedures, measurements, equipment downtime and historical data to be used in determining to repair or replace when the time comes. Zion: Having test equipment that interfaces with CMMS is critical to productivity and to be documentation compliant with regulation. Without this capability, a biomed would be less productive, because all of the documentations would be manual, and prone to error. Such an interface provides key measurement values that when properly populating a long-term trend functionality in the database can

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Alkire: We believe that all test equipment in the health care market should come with at least four years of warranty. Our customers should never have to run to a service call and find out their test equipment is malfunctioning. This is why, in part, all of our products are designed and tested to withstand being dropped 50 times at three feet. The four-year warranty is not only about the manufacturer standing behind the product, but also eliminates the possibility of expensive repair costs that can really impact the cost of ownership. Barrett: Define the must have and nice haves, with consideration to future need. Evaluate the options, do trial evaluations and select “best in class” for your price point. Clotfelter: When purchasing test equipment, all of the items listed above are important, but one thing I’ve seen customers do that’s a mistake is to only base their purchasing decision on the lowest price. In other words, to only look at the initial purchase price, rather than the long-term cost if they purchase something with minimal parameters or inadequate specifications. The best value is not always the lowest-cost instrument. Evans: It is important to remember that there are options out there. While it may seem safe to buy what you have always bought, you could be missing out on

NOVEMBER 2015 DECEMBER 2014

JACK BARRETT

National Business Development Manager, Rigel Medical

significant functionality by not considering other sources. Also, be careful not to lock yourself into a single vendor by selecting a system that can’t or won’t interface with other company’s products. Look for flexibility and scalability so you can choose what is best for you and expand your test suite accordingly. And be sure to check the warranty, service availability and service turn around time for the test equipment you are considering. Pyers: When purchasing new test equipment, consider the features of each system and compare them against your needs. Do not base your decision solely on price, but think how the new tool will benefit you the most. Consider all options for purchasing your new test equipment to meet your budget constraints. Purchasing equipment that is advanced today will allow for updating in the future to insure many more years of use and to be more cost-effective. Zion: An ongoing issue biomed

THE ROUNDTABLE

DECEMBER 2015

1TECHNATION.COM

HTM Trends and Issues in 2016 By K. Richard Douglas

1TECHNATION.COM

DECEMBER 2015

â&#x20AC;&#x153;

hen the winds of change W blow, some people build walls and others build windmills.â&#x20AC;?

- Chinese Proverb

n a field where a multi-meter, screwdriver or needle nose pliers may be common tools of the trade, the focus of issues and sweeping changes rarely have anything to do with tools or how they are used. The issues are rarely related to technology. The focus is often centered on soft skills or staffing, new regulations or budgetary concerns.

LOOKING AHEAD

IZABELLA GIERAS, MS, MBA, CCE

Director of Clinical Technology at Huntington Hospital, Pasadena California

“

his year has T certainly been a busy one for many clinical technology departments, between clinical alarms, PM procedures, power strips, medical device integration, cybersecurity, labor resources and more.” - Izabella Gieras

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The accumulation of knowledge and experience often dictate how things are done in HTM. As with evidence-based medicine, when certain procedures and diagnostic modalities work best for treating an illness, then you can be reasonably sure that this is an approach worth trusting. Within the HTM profession, this approach has proven true with best practices, supplemented training and education used as guiding lights and the impetus for changing or modifying the way things are done. More so than in the past, there is much more emphasis on sophisticated technologies. It’s HTM 2.0; the basis for nearly every change, every new class, every certification update and every workshop. It’s HIPAA requirements, interoperability, sterilization considerations, security of patient information and alarm fatigue. Innovation in thought processes and procedures, inventing a better mousetrap and adapting to new regulations and protocols all have a place in advanceing the profession. Keeping up with the education that is required in a high-tech field is part of the evolution that will be necessitated by change. New CMS rules have impacted hospital budgets and altered the HTM landscape. This, no doubt, affected many expenditures that were commonplace five years before. Belt-tightening has become a fact of life and HTM departments have found ways to contribute. “This year has certainly been a busy one for many clinical technology departments, between clinical alarms, PM procedures, power strips, medical device integration, cybersecurity, labor

DECEMBER 2015

resources and more,” says Izabella Gieras, MS, MBA, CCE, director of clinical technology at Huntington Hospital in Pasadena, California. Robert Preston, CBET, A+, director/account manager II of clinical engineering with Catholic Healthcare Initiatives in Lakewood, Colorado, agrees with Gieras about the focus on power strips during this year and adds alarm fatigue and Adjustable Equipment Maintenance (AEM) to the list of hot topics. Gieras says Clinical alarms and the TJC 2016 deliverables will continue “with [a] more significant focus,” she says. Health systems are more dedicated than ever on establishing and developing performance standards and The Joint Commission requirements are a great guide to establish a baseline. Continued medical device integration as hospitals expand their scopes and EMR deployments are on Gieras’ list as well. The issue of PM frequency, which CMS ignited in 2011 and then subsequently eased slightly a couple of years later, was addressed with a new publication in early 2015. “ANSI/AAMI EQ89:2015, Guidance for the Use of Medical Equipment Maintenance Strategies and Procedures” takes steps to help standardize many maintenance procedures. THE YEAR THAT WAS

This year saw some HTM issues that were holdovers from 2014 along with developments that provided new resources to the profession. AAMI made a substantial contribution to the usable knowledge of HTM professionals in 2015 according to Salim Kai,

“

s a working manager, and one A which has had to search for new and replacement employees, one of the top issues I find for 2016 is the shear lack of people getting into the HTM field.” - Patrick Frazier

MSPSL, CBET, clinical safety specialist in the Office of Clinical Safety at the University of Michigan Health System. “[For] risk management in health care, AAMI clearly took the initiative and built the business case for RM this year: FDA/AAMI joint summit on risk management and AAMI draft white paper, ‘Risk Principles and Medical Devices: A post-market perspective,’ on postmarket risk management of medical devices,” Kai points out. “Patient safety and cybersecurity were significantly highlighted this year by AAMI and will continue to be a hot topic during 2016. FDA safety guidance with infusion pumps is one example,” he adds. Also, Kai says that Matt Baretich’s electrical safety manual was a much awaited update, and is a good reference publication. The electric safety manual is the first update in six years and is an important resource for biomeds. Electrical safety also brought focus to an issue that spilled over from the previous year. In September of 2014, the Centers for Medicare and Medicaid Services (CMS) announced that they would allow power strips (RPTs) in patient care areas. Increased use of medical technology, and the accompanying need for a convenient power source, made earlier National Fire

Protection Association provisions counterproductive. The changes came with several requirements, including ampacity limits. The power strips must be used to power patient care devices – not personal electronics. Periodic assessments of the assemblies should be made and the strips should not be used outside of patient care areas. The memorandum from CMS had contradicted some earlier information. ASHE has since issued resources that address this issue. For additional details, visit http:// www.ashe.org/resources/tools/ powerstrips.html. SEEKING QUALIFIED CANDIDATES

Interestingly enough, one of the most important issues of the past year, and certainly one that will haunt managers during 2016, is not related to interoperability or electrical specs. It is associated more with HR than a particular technology. The issue is one of staffing. Despite Time magazine’s conclusion that the HTM profession is one of the best jobs you have never heard of, the ability to fill vacated positions or expanding departments is a challenge. “As a working manager, and one which has had to search for new and replacement employees, one of the top issues I find for 2016 is the shear

PATRICK FRAZIER, CRES

Imaging specialist and biomedical engineering senior technician, East Cooper Medical Center

lack of people getting into the HTM field,” says Patrick Frazier, CRES, imaging specialist and biomedical engineering senior technician at East Cooper Medical Center in Mount Pleasant, South Carolina. “As several national magazines have reported in the last year, HTM a.k.a. Biomedical Equipment Repair Technician, is one of the top 10 jobs you didn’t know about. Another magazine quoted that by the year 2020, there will be a 30 percent shortage of qualified technicians,” Frazier says. “This problem has many ramifications; one being the cost of vendor and third-party service. In the last couple of years, we have seen vendor costs skyrocket,” Frazier adds. “Imaging hourly rates are right at $600/hour, anesthesia and monitoring are approaching $400/ hour and even local third-party biomed guys (are) getting $200/ hour for general biomed service

LOOKING AHEAD

“

Biomed departments have to become true partners of health care systems and instead of being an expenditure to the systems. A culture where they are seen as an equal partner with cost-saving initiatives to provide opportunities for success.” - Eddie Acosta

EDDIE ACOSTA, CBET

clinical systems engineer with Kaiser Permanente.

such as PMs and minor repairs.” Frazier says that these costs create a desire for many hospitals to achieve a full staffing of their biomed departments, which in many areas, he says, just isn’t happening. “The hardest position to fill in my opinion, as well as some of my local colleagues, is a Biomed II position. Someone with the experience to get the job done without constant supervision but who doesn’t cost the facility a arm and leg to hire. In some hospitals I know of, they have had open Biomed II positions for more than a year,” Frazier says. “Demand sets the salary higher for the new folks getting in the field while the pressures of vendor service costs keep the salaries in check if not flattened for the experienced folks. In short, the pay scale between just starting and highly qualified is shrinking. Not always a good thing,” he says. “Got to agree that staffing is

1TECHNATION.COM

the top issue for this year and the foreseeable future,” says John Pollard, Northern California regional manager of clinical engineering for St. Joseph Health/ Tech Knowledge Associates. “Recruiting and hiring has always been a stressful time, but in today’s environment, it is complicated by lack of qualified or interested candidates, lifestyle along with quality of life issues and budgetary restraints,” Pollard says. “Faced with a small talent pool here in Northern California, we’ve created our own apprentice programs where we hire folks that have a mechanical curiosity and fit in with the crew, and train them into biomeds. Takes a couple years, along with training expense, but it has been successful for us,” Pollard adds. Frazier also says that training costs have joined repair costs in a trend that has been escalating over this past year. “Training classes that average $3,000-$6,000 a week for tuition are getting harder and harder to justify,” he says. “A lot of hospitals have lumped their training dollars into a single fund which means for us, we have to compete with nursing staff and educators for training dollars,” he

DECEMBER 2015

adds. “Used to be easy to justify a school. Take the cost of proposed contract over a three-year period, subtract the cost of training and add a percentage of what parts would cost, somewhere between 10-30 percent of the contract proposal and bam, the return on investment was obvious to the A Team. But, with tuition cost climbing, the ROI is shrinking and we are finding that the nursing staff gets most of the training funds.” Clinical engineering departments again found themselves facing a quandary in 2015; shrinking hospital budgets and these ever escalating costs of training, repair costs and well-trained employee acquisition expenses. “One of the ongoing top issues in the biomed community is reducing medical equipment costs. Biomed departments are being stressed to provide advanced technology systems and also provide reduced cost medical equipment maintenance,” says Eddie Acosta, CBET, clinical systems engineer with Kaiser Permanente. “This is practically an oxymoron, advance technology has a higher cost of support, and older equipment doesn’t get cheaper to maintain.” “Biomed departments have to become true partners of health

care systems and instead of being an expenditure to the systems. A culture where they are seen as an equal partner with cost-saving initiatives to provide opportunities for success,” Acosta adds. Twenty-sixteen could be a year when many biomeds take a pass on obtaining a professional credential, according to Frazier. He points out that there are reasons they might want to reconsider. “Another issue I see for 2016 and beyond is the amount of folks that are not getting AAMI certified. I don’t have the numbers to back it up, but it seems to me that many entry- and mid-level folks just don’t find AAMI certification important; I find this unfortunate,” Frazier says. “I don’t know many professions that have the responsibility of patient care we have and do not have to have some kind of certification,” he explains. “I know this conversation ruffles some feathers, but it’s a conversation that needs to progress as we merge with IT departments.” Frazier points to the IT world as an example of a profession where certifications are important to career growth. He believes that it instills a higher level of professionalism when biomeds are confronted by people who “don’t know of us, our work habits and our achievements.” “By no means am I saying that you have to be certified to be professional or have high work standards,” he says. “I know of many wonderful technicians out there who are not certified. What I’m saying is if three technicians were looking for a job and one was certified, I’m going to be inclined to take a little closer look at that individual simply because I think he/

SALIM KAI, MSPSL, CBET

Clinical safety specialist in the Office of Clinical Safety at the University of Michigan Health System.

“

atient safety P and cybersecurity were significantly highlighted this year by AAMI and will continue to be a hot topic during 2016. FDA safety guidance with infusion pumps is one example.”

she took a little more time to study, take a test and put some letters behind his name,” Frazier says. “Would I hire him specifically based on his certifications? No,” he adds. Kai says that 2016 will also be a year where we see “more IT and biomed convergence and partnerships” occurring. And related to this, he also expects “IEC800001 application of risk management for IT networks to become a more referenced standard.” Patient deaths will stop an industry focused on patient safety in its tracks. That began the summit convened to assess the problem presented by clinical alarms in 2011. Since then, the HTM industry along with health care systems and hospitals across the country have assessed and addressed The Joint Commission patient safety goal regarding clinical alarms that plagues nurses and endangers patients. “The deadline is summer 2016 for the second phase of the goal and hospitals should expect Joint Commission inspectors to ask questions about what important alarms were identified, about policy and plan of action, staff education on alarms management, etcetera,” Kai says. As an old Chinese proverb says; “When the winds of change blow, some people build walls and others build windmills.” HTM will no doubt find a way to once again harness the wind in 2016.

- Salim Kai

LOOKING AHEAD

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How to Ace the Interview By Cindy Stephens

he résumé may get you the interview, but it is the interview that gets you the job. Once you have made it past the résumé stage, there is still work to be done. For many, the interview is the single most stressful part of the job search process. Any number of things can go wrong, and you don’t want to short-change your efforts in preparing for a successful interview.

CINDY STEPHENS Stephens International Recruiting, Inc.

1TECHNATION.COM

During our education years, we are taught to “study” for tests and prepare for classes ahead of time. Once we are working we are held to our job performance with performance reviews and I am sure everyone prepares ahead for those. However, when it comes to the job search process, most people find interviews intimidating and are not really prepared for their interviews. So, more often than not, they “wing it” and hope for the best. When speaking with clients, one of the main reasons they do not consider an applicant after an interview is because the candidate was unable to “sell” their skills and qualifications to the hiring authority. You want to stand out from the competition. The candidates who ace the interview show they are capable of doing the job, are willing and eager to do the job, and need little supervision or motivation. They also demonstrate that they have a good personality and work well with others. You should spend more time getting ready for the interview than the interview itself. Go above and beyond to research the company, reading the company’s website and social media

DECEMBER 2015

sites so you understand what they do and what products and services they offer. Read news articles about the company and the industry so you appear to be informed and up-to-date. Be familiar with the job description and the qualification requirements to help you connect your experiences and skills with the company’s needs. Be prepared to highlight how you are suited for that particular job based on your experiences, talents, strengths and abilities. If it is a telephone interview, it is very important to find a quiet room and do not allow interruptions. Remain 100 percent focused on the caller and interview. If you are asked to do a Skype interview, be sure to practice the setup and the call with a family member or friend ahead of time. In addition to meeting the qualifications for the position you are interested in, there are some very basic fundamentals to keep in mind for a successful face-to-face interview. Be sure you are well rested and your appearance is clean and neat. Be sure to arrive at least 10 minutes early. Prepare a list of references and specific contact information and bring additional copies

of your résumé with you. Neatly and completely fill out any application forms and do not write, “see résumé.” Professional attire and attention to detail still count. Remember your appearance, your tone of voice, and personal conduct all contribute to the impression that you make, whether positive or negative. If you’re uncertain about what to wear for the interview, dress more formally rather than too casually. Be clean and well groomed. Greet the interviewer with a smile and a firm handshake. Maintain eye contact, be a good listener and smile! Be honest in your answers, and never be negative about any person or company! Be confident, show enthusiasm and energy during the interview, and participate in the conversation. Use good communication skills detailing your experiences and accomplishments. Focus on the discussion and the question that is being asked. Expand on your answers, using this time as an opportunity to tell the interviewer more about you and to demonstrate some of the qualities they are looking for (such as team player, leadership). Clarifying the question exhibits good listening and communication skills. Demonstrate your attitude with your smile and by remaining positive. Be sincere and passionate about your interests and experiences. Exhibit excitement about the position you are interviewing for. If you really want the job you are interviewing for, say so. If the company is your top choice, make it known. Potential employers are impressed by candidates who seem sincerely interested in them. The key here is sincerity – they will know if you are putting on an act. Know your strengths and major accomplishments as they relate to the job you are applying for and the company. Show what you can offer the company and explain how your skills can help get the job done. Demonstrate you are a team player with leadership skills by using “we” instead of “I” when speaking about group achievements. Use this opportunity to turn your weaknesses into positives, such as: “I am a workaholic – I like to get things completed before I go home.”

Discuss some details of your experiences and accomplishments working with people, projects, as well as relating your technical and professional skills. Interviewers are looking for qualities such as initiative, attention to detail and reliability. For technical questions, be direct and to the point. Show confidence in your abilities and if you are unable to answer a question, be honest and explain how you would approach a problem situation. When asked, “tell me a little about yourself,” managers are looking for serious answers. Talk about your accomplishments and abilities, NOT about your childhood, family or hobbies (unless specifically asked). Your goal is to be clear and concise, but descriptive enough to sell your skills and experiences. However, don’t talk yourself out of a job by going into too much detail.

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EXPERT ADVICE

BEYOND CERTIFICATION

AAMI Alters Certification Process By David Scott

here are always small changes to certification. The test obviously changes constantly. The newest changes are from the AAMI side. AAMI has a new website and a new way of doing things. They also have a new director of its certification programs in Sherrie Schlte. The following is taken from an email I received from AAMI. Many of you might have received the same email.

DAVID SCOTT CABMET, CBET Review Study Group

1TECHNATION.COM

“One way that you can help us is by making sure AAMI has your most updated information, especially your address and email address, in our database. We recently mailed certification renewals for those of you in a certification cycle ending in 2015, so you should be seeing them in the mail now. If you do not receive one and you believe you should have, most likely this is due to a wrong address. You can email us with an address change or change it yourself by logging on to your AAMI account. You can also update your address on the renewal if you would like to and we will make any edits to the database that we need,” the email reads. “One question that we have been getting a lot is, ‘What is going on with the online journal? Is it coming back?’ The old online journal will not return in its previous format. If you have information in the old journal and would like us to retrieve it and send you a PDF version please email aci@aami.org and we will get that out to you as soon as possible. Staff is working on developing a new system that will allow certified professionals to electronically submit their continuing education. The system will communicate directly with our database and should be

DECEMBER 2015

available for your use in 2016,” the email continues. “While things have not always run as smoothly as we would have liked over the past several months, I can assure you that we are striving to make things right by putting procedures in place that will streamline certification activities. My goal is to communicate with you several times a year to ensure all certified professionals are up to date with program updates, changes and policies. If you ever have any comments or concerns, please feel free to contact me directly at sschulte@aami.org or call 703-647-2776. I will be more than happy to discuss them with you.” From reading this email you will know that the online journal is no longer available. For now the journal is a paper that you print and fill in. It requires your supervisor’s signature and yours at the bottom of the form. It is available on the AAMI site. I recommend you go to the site and check to see when your renewal is due if you don’t already know. The renewal fees have also gone up. Fees for AAMI members: Primary Certification: CQSM, CHTM, CCE, CBET, CRES, CLES: $100. Additional Certifications: $50 – each. Recertification fees for non-members: Primary

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Certification: CQSM, CHTM, CCE, CBET, CRES, CLES: $150. Additional Certifications: $75 each. This brings me to my next point. AAMI has an associate membership. This membership is $85. So you can see the advantage of getting this membership with the cost of certification renewal. If you have one certification it will save you $50. If you have more than one certification then the associate membership almost pays for itself. The other advantage of being an AAMI associate member is a discount on their products and access to online information, including publications. The other part is you can claim 0.5 points a year toward renewal points (1.5 points over three-year period) for being a member of a professional society. One part that didn’t change is that you still need 15 points for the three-year period. My last word of advice is if your certification renewal is due this year then you need to start working on it ASAP because it is going to take a little more time and effort to complete the form and mail it. You may also need to get information that used to be in your journal by contacting AAMI. The best way is just to keep up to date and do it early.

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