RSTI FocalSpot > Summer 2014

SUMMER 2014 rsti-training.com News from the Leader in Radiological Service Training > RADIOLOGICAL service TRAINING INSTITUTE > ISSUE 2014.3

29 YEARS OF Maximum Value for Your Educational Growth and Development

SCORE! 2014 COURSE INSERT INSIDE! President’s Letter..............2-3 New! Nuclear Medicine....4-5 Coach’s Corner....................6-7 Get in the Game.....................8 Getting Rookies Ready........9 Course Schedule........... 10-11 The Up-and-Comer............. 12 Opponent Outlook.............. 14 Warehouse Roster.............. 16 C-Arm Service...................... 18 Score Big in Digital.............. 19 Course Index........................ 21

Dale Cover’s “Winning With the Affordable Care Act” // PAGE 2-3 //

SPECIAL ISSUE

IMAGING

GRAND SLAM! KEYS TO A WINNING GAMEPLAN

FOR EQUIPMENT SERVICE

A Heartfelt Farewell from Chairman “Coach” Jim Monro // PAGE 6-7 //

State of OH Reg. No. 93-09-1377T ©2014 RSTI | Design by MossMedia

Winning With the Affordable Care Act Setting Goals to Excel with Imaging Equipment INSIGHTS from RSTI PRESIDENT, DALE COVER

TAKE A LOOK at THE IMPACT ON YOUR GAMEPLAN: 1 > Clearly if hospitals are holding equipment longer

than planned, the purchasing cycle will be delayed.

It is no secret that manufacturers are experiencing slow sales. I personally know several people in sales that have fallen victim to this.

2 > With sales down, service is pressed to increase their revenue stream to support the company.

Increasing billable hours and selling additional service contracts is one way for service to improve their numbers.

3 > Manufacturers at this point almost need to keep

W

ith baseball season in full swing, boats in the water and beautiful weather I couldn’t be happier, but those are all leisure time issues.

From a business perspective, in the medical industry, things are a bit more challenging. Budgets, cost cutting, belt tightening and expense reductions are common buzz words in today’s healthcare technology maintenance lexicon.

Without debating the merits or pitfalls of the Affordable Care Act, one thing is certain. There is and will continue to be less revenue in the system for medical procedures and hospital operations. These budget restrictions are having substantial effects in the entire hospital enterprise and specifically, for this discussion, in the imaging departments.

One of the outcomes of tighter budgets is the retention of systems beyond their initially planned replacement date. This simple change now has and will in the future have far reaching effects.

2 | focalspot.SUMMER.2014

others off their playing field. The pattern of restricting access to service information is already an established practice; however, recently these policies have had a fair amount of press as well as pressure applied against them. Still, improvements in access for independent servicing of equipment move at a glacial pace.

4 > Older equipment requires more maintenance,

which should go without saying. This is a double edged sword though. No money is actually saved by not buying new equipment; the expense is simply avoided for a period of time. At the same time, maintenance costs go up because the systems are older. When I first started in imaging it would have been no big deal, but the equipment exceeding its planned replacement date now may have digital detectors that can average around $100K and other hardware that is very expensive, may have been superseded by newer revisions or may simply not be manufactured anymore.

5 > The shocking potential costs of repairing the older systems push facilities to maintain the highest price lowest risk contracts.

Another result of the Affordable Care Act is that hospitals and clinics are consolidating and reorganizing operations.

These now larger organizations are stronger and can distribute the effects of ACA across the organization while reducing redundant operations.

Varying equipment preferences from facility to facility will bring together a wider array of technologies and manufacturers. An in-house group may find themselves overwhelmed in the beginning by the new technology they must manage.

Hospital groups are maintaining a central location where the ‘best of the best’ equipment or the most advanced procedures are done. At the same time they are building new facilities in the bedroom communities with general medical capabilities.

When the patient’s needs exceed the capabilities of the local facility, referrals are generated for the main campus. Service can also be centralized to the main campus and the rural medical facilities can be treated as if they are customers of the main campus service group.

systems that are not in your current inventory. You never know what systems you will get in the next consolidation or merger. Diagnostic Imaging has great potential to save budgets and holds less risk than most people think it has. Done correctly and incrementally, the chance for success is very high.

Since our beginning, RSTI has been helping hospitals and independent service organizations adapt to the changes in the imaging marketplace. Now, more than ever, our ability to help your organization reduce the lifetime expenses of operating your imaging equipment is essential. Our reasonably priced training courses are only the beginning of the real dollars that can be saved through the reduced reliance on expensive OEM service contracts and second sourcing aftermarket replacement parts.

Dale Cover

Dale Cover, President

There are things that can be done to EXCEL in this COMPETITIVE environment: Keep pressuring OEMs to provide not only documentation but access to the service software.

The two most cited codes to justify your request for information and access are 21CFR and NFPA99.

If your HTM group is not already maintaining the imaging equipment, look for ways to get involved.

Introductory classes, like our X-Ray Certificate series, can get you in the ballgame quickly.

Remember though, don’t just dump all of your contracts at once, work your way into it. Small contracts on general radiographic, mobile C-Arms and portables are a great way to get started. It may seem like playing small ball, but I remember sitting at a game where the Indians hit a couple home runs but the Yankees took us apart with single and doubles.

If you’re already in the service game, always, always take advantage of training opportunities.

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Warmups: A Primer to Nuclear Medicine New Course: Principles of Servicing Nuclear Medicine Systems

By Todd Boyland RSTI Director of Training RSTI is proud to announce the return of our Nuclear Medicine training course in September. “Principles of Servicing Nuclear Medicine Systems” is a one week course designed to teach service engineers (with little or no nuclear experience) the basics of NM, including NM principles, operation, troubleshooting, and preventive maintenance.

When it comes to medical imaging modalities, computed tomography (CT), radiology, magnetic resonance imaging (MRI), and ultrasound spring most readily to mind. Often overlooked is nuclear medicine.

Nuclear medicine involves the use of radioactive isotopes and was actually in existence as an imaging modality prior to the arrival of ultrasound or CT. Nuclear medicine differs from other imaging modalities in a number of ways. Unique in its ability to diagnose bodily function at the molecular level, nuclear medicine looks at the function of body parts while most other modalities look at the anatomical position of those parts. For example, a CT procedure might show the existence of brain tissue (dead or alive), while a nuclear medicine procedure would show only the brain tissue that is alive and active.

Another major difference between nuclear medicine and other imaging modalities is its source of radiation. All imaging modalities that rely on radiation for imaging generate their own radiation, except for nuclear medicine. In nuclear medicine, the patient gives off the radiation by way of injected or ingested radioactive isotopes. Different isotope solutions tend to concentrate in particular organs.

The basic nuclear medicine systems include a singleor dual-camera head, a gantry, a patient table, lead 4 | focalspot.SUMMER.2014

collimators, monitors, and a processing console. These systems perform different types of nuclear medicine studies or procedures. During preventive maintenance (PM), the detectors must be checked for proper calibration. Calibrating a detector array can be very time consuming as there are four different calibrations (PMT peaking, linearity, energy, and uniformity) that must be performed to tune a detector.

Also, during a PM, all the mechanical devices such as latches, motors, gantries, tables, and brakes all need to be adjusted, cleaned, or lubricated. Checking all the mechanical devices and performing electrical checks during a PM can take the better part of a day.

Nuclear medicine is a unique medical imaging modality. If this short introduction sparks an interest in Nuclear Medicine service, please contact Anna to register for our “Principles of Servicing Nuclear Medicine Systems” course scheduled September 2226 and February 23-27.

COURSE INTRODUCTION The Principles of Servicing Nuclear Medicine Systems course is a hands-on course for service professionals new to the Nuclear Medicine modality. It is designed to teach all of the skills necessary to service to the subsystem level.

Heavy emphasis is placed on basic Nuclear Medicine principles, image analysis, operation, safe laboratory practices, system troubleshooting, and preventive maintenance. The lectures, hands-on lab procedures, and documentation are designed to provide the student with all of the knowledge needed to service Nuclear Medicine system.

COURSE OBJECTIVES At the conclusion of this course, participants will be able to: Demonstrate an understanding of Nuclear Medicine Verify system operation Verify system specifications Troubleshoot system problems Perform preventive maintenance

Tech Tips Siemens LX/SX Series By joe Geary RSTI Instructor When performing preventive maintenance, most service professionals do a tube calibration as part of the procedure. This can lead to having to replace the tube prematurely due to an older tube failing the filament calibration.

Starting with the LX/SX series of x-ray controls, the calibrations became automated. Many service professionals stopped paying attention to the calibration data, which can be a valuable service tool as this information is an indication of the condition of the filaments.

TIP 1: Always do a data backup before you start a tube calibration. This will ensure you have a good set of calibration data in case the tube fails the calibration. This is required since the software dumps the old calibration data and performs the calibration the tube’s emission tables. Without a known good backup, you are out and now your only option is to replace the tube.

TIP 2: Pay attention to the calibration data during the calibration. During the “Learn Filament Correction” part of the calibration procedure, the software has you release two exposures on each filament. The first one is done at 10% of the maximum tube current for this focal spot. You can think of this exposure as a test shot.

If the actual mA for this exposure is close to what the software was looking for, the tube has good filaments with lots of life left. The next exposure will be done at 80% of the maximum mA for this focal spot. However, if the first exposure’s actual ma was much higher (20%) than the 10% of maximum mA the software was requesting, then the second exposure will be done at the reduced level of 60% to prevent the possibility of damaging the tube with excessive tube current. The fact that the second exposure was done at 60% lets you know that you’d better start budgeting for a new tube.

Also make sure you do a data backup before doing the next tube calibration. Hope this keeps you from striking out on you next Siemens PM.

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COACH’S CORNER THE HIGHLIGHT REEL

for us to put the companies back together once again. My only regret is that Terry, Sr. wasn’t able to sign the deal.

Despite having no official role at RSTI, I have an agreement to function as a consultant as needed. Through this transition I will be involved in smoothing out the new responsibilities of the new owners. If you know me at all, you know that bashful is not in my vocabulary, so they will get my opinions for as long as they can stand having me around.

As most of you know my health has not been good, so while not being here all day, every day, I will budget my time to assist whenever needed and maybe sell some equipment along the way. Over 14 years you get attached to the employees, the industry and the challenge of being a pertinent educator over time for the diagnostic imaging field of medicine.

RSTI has helped thousands of young men and women grow in a field of extreme importance. They actually manage and maintain all of the imaging equipment, that most every doctor today cannot practice without.

O

n March 31st of this year, my stock in RSTI was purchased by three inside executives. Dale Cover, Todd Boyland and Terry Speth, Jr. now own my shares, as the final piece of an ongoing plan to put in place the next complete management team.

There is only good news here for me and for RSTI, because we have now insured that Radiological Service Training Institute has a top notch, hand-picked group of professionals, capable of moving RSTI forward on all fronts. Fresh blood and new ideas have the hallmark of making our 29 year old company successful through all of the changes in technology, curriculum, instructors and modalities taught.

One of the highlights of my 14 years is and remains the purchase of DITEC last October. In 1992 this group left RSTI to form a viable competitor. Even though they initially devastated RSTI, time and new thinking proved we were able to win them back. RSTI now owns DITEC, even though there is no plan to use the name going forward. It should be said that the DITEC group at that time raised the bar on the education of service engineers around the country.

Their inability to invest in technological change, and the loss of several key instructors last year made it possible 6 | focalspot.SUMMER.2014 focalspot.summer.2014

Not only have we taught them x-ray basics, but we have added multiple advanced courses on the newest equipment available. It gives me great pride when I have to personally visit the radiology departments in Cleveland for my own health, because 90% of the time RSTI has trained the individual responsible for maintaining the high level of diagnostic accuracy on each piece of equipment.

When you add to that primary objective, the fact that we save hospitals hundreds of thousands dollars, you know you made a difference. It has been an honor to help our vocational school strive to improve every year. This change in management will only take these objectives to a new level of importance.

My new role will be to coach the new team. As they hit singles, doubles and home runs, I will be flagging them around third base to score again. If they strike out, ground out or fly out, I will be there to cheer them to success!.

Jim Monro Jim Monro, Chairman

WIN BIGGER.

RUN FASTER. REACH HIGHER.

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Get in the Game Service Engineers Can Help Save Hospitals Millions

By Mike Petelin RSTI Instructor

M

any of us seeing the impact of the Affordable Care Act on biomedical services and imaging departments, and to a larger extent medical care facilities. Many changes in our health care facilities are due to the reduction in reimbursement rates and additional costs added to the vast majority of medical devices.

This got me thinking; what else can we, as Service Professionals do to help mitigate the costs of supplying healthcare services? With this information the discussion touched on the need to have the equipment function over a longer time frame, as well as having third parties and in-house Service Professionals take over OEM service contracts earlier than in the past.

Much of the Service Engineer’s job is reactionary. We get a call that a system is “down” and we rush into action. We need a different outlook, and that is Proactive Service. Proactive Service has to encompass everyone in the imaging department: the Service Professional, Technologist, and anyone else using the equipment.

If something happens with the equipment, whether it be an “intermittent” error or an unusual sound, we need to be aware of the problem before it becomes a larger issue. If your air conditioner starts to make a loud grinding noise you do not say it is fine because it is still cooling the room, you address the issue before it becomes a much larger problem

8 | focalspot.SUMMER.2014

We also need to trend our systems during PMs. Many of the tests we complete and just mark pass or fail can tell us a great deal about the current and future status of the systems. For example, trending the HVL of a radiographic system can tell us we may have to budget for a new tube, rather than having to find the money when a failure occurs.

As Service Engineers we need to be more aware of what may happen and take steps to minimize these occurrences. Let’s look into the future and prevent future system failures.

Getting Rookies Ready for the Major Leagues

By ANNA MORRISON RSTI Registrar RSTI recently had the pleasure of hosting two classes held specifically for Associates Degree candidates from various biomed programs throughout the country. The class was a condensed, accelerated version of Phase I “Principles of Servicing Diagnostic X-Ray Systems” taught in one week to accommodate the students’ busy academic schedules. The majority of the participants were attending the biomed school right out of high school, but some were more seasoned professionals, looking for a career change.

The first class, held in April, consisted of soon-tobe BMET graduates from Milwaukee Area Technical College (MATC in Milwaukee, WI), Western Technical College (WTC in LaCrosse, WI) and Stanly Community College (Albemarle, NC). While it was not easy to absorb all the information that was presented in such a short period of time (one week vs. two), everyone rose to the challenge and passed the class.

The second class was held in May exclusively for students in the Penn State Biomedical Engineering Technology Program.

Comment s about the class ranged from “Great” to “Loved the exposure” to “Can’t wait to come back again.”

Thanks to RSTI instructors Dave Domanski and Joe Geary, and the support of Department Heads Lilly Kosir (WTC), Ed Stanclik (MATC), Sonny Richards (Stanly Community College) and Myron Hartman (Penn State), and the dedication of the students themselves, the diagnostic imaging service profession has 26 potential candidates for entry-level employment.

We hope that our partnership with these schools continues, and welcome other colleges to contact us for similar programming. We believe that giving these future biomedical engineers a jump start in learning about radiology service will promote their personal and career growth and give them the edge when moving from biomed into radiology service.

Don’t forget to explore our new 2014 Course Schedule Insert, conveniently redesigned and reformatted as a pullout insert in this newsletter!

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RSTI 2014 SUMMER Course Schedule May 30, 2014

Principles of Servicing Diagnostic X-Ray Systems (Phase I) Advanced Radiographic System Maintenance (Phase II) Advanced Fluoroscopic System Maintenance (Phase III) Advanced Diagnostic Imaging System Analysis (Phase IV) PACS Engineer/Administrator Certification (Phase I) PACS Engineer/Administrator Certification (Phase II)

9

16

JULY 23

June 16 - 27

June 2 - 13

Introduction to Networking & DICOM PACS Troubleshooting Techniques

MANAGEMENT

PRODUCT SPECIFIC

C.A.M. (Capital Asset Management) 2.5 Day: Intro to Diagnostic Imaging & PACS - For Managers & Sales Professionals GE Advantx 1, Advantx E, Legacy, Compax 40 GE Definium Family: Definium 6000/8000, Discovery XR650/XR656, Optima XR640

June 9-11

30

7

14

28

4

11

18

SEPTEMBER 25

Aug 4 - 15 July 7 - 18

Aug 18 - 29 July 21 Aug 1 Aug 4 - 15

1

8

15

22

OCTOBER 29

6

13

Sept 8 - 19

20

NOV 27

3

10

Oct 20 - 31 Sept 22 Oct 3

Nov 3 - 14

Sept 8 - 19

Oct 20 - 31

Nov 3 - 14 July28Aug1

June 16-20

Aug 4-8

Sep29 Oct3

Oct 6-8

Aug 18 - 29 Sept 8 - 12 Oct 20-24

GE Precision 500D R/F GE Revolution Family (XR/d 1X & 2X)

Oct 20 - 31

GE Proteus (JEDI Generator) Philips Bucky Diagnost June 23-27

Private Practice X-Ray Systems

July 7 - 11 July 7 - 11

Sept 22-26

July 21-25

GE AMX Portable (IV, IV+)

PORTABLES

AUGUST

21

LABOR DAY

NETWORKING & DIGITAL INFORMATION

2

INDEPENDENCE DAY

X-RAY CERTIFICATE SERIES

JUNE

TRAINING COURSE TITLE

Nov 10-1

Sep2 Oct 3

GE AMX 700 Portable June 9-13

Shimadzu MobileArt Portable

Oct 13-17

Siemens Mobilett Portable

Nov 3-7

C-Arm OEC 9600 Multi-Product C-Arm OEC 9800/9900

C-ARM

C-Arm OEC 9900

Aug 18 - 29 June 2-6

July 14-18

Siemens Siremobile C-Arm Philips BV Pulsera C-Arm

CARDIAC

WOMEN'S HEALTH

Siemens AXIOM Artis Family (FP)

June 2-13

GE Innova Family (2100/3100/4100)

June 2-13

Analog Multi-Vendor Mammography (GE, Lorad, Siemens) Lorad Multicare Platinum Breast Biopsy System GE Digital Mammography Family (2000D/ DS/ ESSENTIAL) Digital Mammography (Hologic Selenia)

Nov

July 21-25

Oct 6 - 10

July 21-25

Sep29 Oct3

Oct 27 Nov 7 Oct 6 - 17

Aug 4 - 15 July28 Aug 1 Aug 18 - 29 June 16 - 27

Oct 6 - 17

Lorad MIV Platinum and ACR Multi-Vendor Bone Densitometry

ULTRASOUND

CT

June 2-6

Multi-Vendor Ultrasound Principles of Servicing Computed Tomography Systems (Phase I) Advanced Computed Tomography System Maintenance (Phase II)

Sept 15-19

June 16 - 27

Oct 13 - 24 Oct 27 Nov 7

GE Brightspeed & LightSpeed CT

Nov

GE VCT Philips Brilliance Family

NUCLEAR MEDICINE

July 28 -Aug 8 Sep 22 -26

Principles of Servicing Nuclear Medicine Systems Notes

EXHIBITS & PRESENTATIONS

AAMI 5/316/2

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MD Imaging 7/16 - 7/17

FIME 8/6 - 8/8

Register Online or Call 1.800.229.7784

VEMBER

0

17

DECEMBER 24

Dec 1 - 12 Dec 8 - 19

JANUARY 29

5

12

19

FEBRUARY 26

2

9

Jan 5 - 16

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MARCH 23

2

9

16

APRIL 23

30

Feb 16 - 27 Jan 19 - 30

6

13

MAY

20

27

4

11

18

Apr 6 - 17 Apr 20 May 1

Mar 2 - 13 Feb 2 - 13

May 4 - 15 Mar 16 - 27 Apr 27 May 8 May 11 - 22

Dec 1-5

JUNE 25

1

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15

22

Jun 1 - 12 Jun 15 - 26

Jan 26-30

Jun 22-26

Dec 15-19

Mar 16-20

29

INDEPENDENCE DAY

Dec 1 - 12

22

MEMORIAL DAY

Nov 17-21

15

NEW YEARS

4

8

CHRISTMAS

THANKSGIVING

4

1

Jun 8 - 12 Apr27 May 1 Jun 8 - 19

v 14

Dec 1-5

Feb 23-27

Feb 2-6

Dec 8 - 12

Jan 26-30

Mar 23-27

Feb 2-6 Feb 9 - 13

v 10 - 21

Mar30 Apr3

Jun 1-5

Feb 16-20

May 11-15

Jan 19 - 30 Dec 15-19 Dec 15-19

Jun 8 - 12

Feb 2-6

Mar 16-20

Mar 23 Apr 3

May 18-22

Jun 15 - 26 Apr27 May 1

Jan 19-23

Apr 20-24

Mar 9 - 20

Jan 12-16 Dec 1 - 12

Jun 22-26 Feb 16 - 27

May 11 - 22

Jan 5 - 16

Apr 6 - 17

Nov 17-21

Mar 9 - 13

Feb 16 - 27 Mar 2 - 13 Mar 30 Apr 10

v 10 - 21 Dec 8 - 12

Mar 23 Apr 3

Dec 1 - 12

Apr 13-17 Jun 15 - 26

Feb 23-27

RSNA 11/30-12/5

State of OH Reg. No. 93-09-1377T

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The Up-and-Comer RSTI Talent Report WRITTEN BY Josh Mericle RSTI Service Engineer

In the time since my last article I have successfully completed Phase 1. Although I’m still a rookie, taking this class has made a big impact how I perform for RSTI. Understanding the fundamentals of servicing x-ray systems has allowed me to get much deeper into the installation, testing, and repair of diagnostic systems.

Many parts and systems come through RSTI. Having multiple people with the ability to test and repair units helps keep parts available and units ready for classes.

I have officially tested and certified my first unit, a Lorad M-IV. I was nervous going in to it, but some of the more experienced guys here helped me through it.

I have deinstalled a few of these units so I was familiar with it, but installing and testing it is a whole different ballpark. It feels good to be able to install and test a unit, put my name on it, and say with confidence that it works. This is a pretty simple unit compared to some, but it’s a good start to grow my knowledge in the field.

I am excited to receive more chances to work on units and become more of an asset to the company.

Recently I got to experience my first install in a real medical facility. Another coworker and I delivered a GE Definium 5000 to a clinic in Texas near Houston. It took almost two full days to drive the 1300 miles to our destination. After a good night of sleep, we met with RSTI’s Director of Training, Todd Boyland, who was there to test and help install the unit. The gantry on this unit was extremely heavy, and I knew we had our work cut out for us getting it to the second floor of an unfinished building. We all muscled through it, got it in place, and bolted it down. The rest of the day consisted of difficult rewiring of the machine, and

12 | focalspot.Summer.2014

properly routing cable into the wall so the unit had a clean professional look once we were done. The next morning we went back, ran some tests, and it worked!

The install was a success, and the customer was happy with our work. Todd stayed at the site to calibrate the machine as we headed for Tennessee. On our way back we stopped near Nashville to deinstall a Lorad Selenia.

It was a long trip. After 5 days, two units, 2600 miles, and 50 dead armadillos on the side of the road we were finally home! The trip was tough, but I learned how far I could push myself to get the job done.

Working at RSTI presents so many opportunities, and is never boring. I have visited more states in the last few months than I had in my previous ten years. A lot of the trips I go on are local and can be done within one day. Whether traveling the state, or traveling the country, I always bring my “A” game.

The job doesn’t stop when the units reach RSTI. We part out and recycle some of the units to help the environment, and make repairs to units still in service. So remember if you have anything at your facility that you no longer need, give Terry Speth or Darrel Kile a call, and maybe your unit can be my next homerun!

Do you have the most efficient

X-ray QA solution?

Piranha. The Complete X-ray QA Solution kV, time, dose, dose rate, HVL, TF, mA, mAs for R/F, Dent, Mam, and CT.

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From Radiation to Information RTI US Office

33 Jacksonville Road, Bldg. 1 info@rtielectronics.com

Phone: + 1-800-222-7537

RTI Inc

Towaco, NJ 07082, USA

www.rtielectronics.com

Phone: +1-973-439-0242

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Opponent Outlook Bringing the Mobile Home Part II WRITTEN BY MATT MONDELLO RSTI Instructor

I

n my previous article, I talked about some of the obstacles that try to stand in the way of bringing the maintenance of your portable in-house.

Congratulations on taking the first steps in managing your own equipment by taking on the portable maintenance responsibility. To add further incentive to the liberation from the binding contract monopoly, watch the dollar signs in the following scenario and don’t let the OEMs steal any extra bases.

“The night time technician leaves a message for the day shift that the portable system is inoperative. The service ticket gets initiated with said OEM and the field service engineer gets notified and dispatched. I know it never happens that fast, another reason to have the maintainers in house! Back to the story. From the time of dispatch, the clock starts ticking and the dollar signs start adding up. Anywhere from $250 - $300 dollars for travel time, on the low end, just to get the FSE on site.

No travel expense required if the FSE is a site employee.

Unfortunately, it took the FSE 2 hours to get to the site and he only had an hour to work on the portable unit. At $400 an hour the total is now up to roughly $1000 and the unit is still not working. With the overtime rate of time and a half, the next two hours of maintenance cost $1200 bringing your bill up to $2200. The good news, the FSE was able to isolate the problem to a faulty power supply board. The bad news, the radiology department head needs the system up yesterday because it is the one that everyone uses so he instructs the FSE to have the replacement part sent overnight. The board itself wasn’t too expensive because it is a popular portable system. It’s only around $600 not including the shipping. Otherwise, it would have been upwards of $2,000 to $3,000. So at a running total of ~ $2800 the replacement part is on its way and everything will be up and running… on Saturday morning.

I forgot to mention that the system broke down on a Thursday night so the FSE didn’t get to it until Friday afternoon. This might seem like a minor detail if it

14 | focalspot.Summer.2014 focalspot.SUMMER.2014

weren’t for the double time pay, $800/hour, which the FSE gets for his two hours of work on the weekend, plus another two hours to get back to the site. With our total now pushing over $5,000 the system should be good to go.

While this may seem like a far-fetched dramatization of how the system works, it is actually not far off.

Whether the values are low, most likely, or high, probably not, the point is, that if you take this or any other example and multiply it by the hundreds of maintenance calls each year, the cost will still come in well under the cost of any maintenance contract. A maintenance contract will not be sold that would cause the contracted company to lose money. Case in point, digital detectors… digital detectors are no longer being covered by contracts because the companies that used to provide servicing on the detectors were starting to take a loss after having to replace them time and time again due to misuse/abuse. The bottom line is, do the maintenance in-house and save a truck load of money.

What better way is there to start your summer than by sweeping out the big companies with their outrageous maintenance contracts and saving money in the process?!? It is time to play hard ball and come out swinging. Don’t be intimidated by the opponent.

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Warehouse Roster WRITTEN BY DALE JARZEMBAK RSTI Warehouse Manager

Many great improvements have come to RSTI over the last several years.

New test bays have been installed to accommodate more training and testing of used equipment.

The RSTI Exchange for used equipment was introduced.

Our used equipment staff has grown.

More space has been allocated to our parts inventory.

Just last week we received in 2 GE Revolution XR-d detectors to test and place into our growing inventory along with 2 GE Definium 8000 detectors.

The warehouse personnel wear many hats, not only shipping and receiving of equipment and parts, but also installing and testing. When equipment needs to be removed or added to the training labs, or when used equipment needs to be tested for inventory, our trained technicians do it right. The next time you are at our facility, check out our warehouse and say Hi to our boys in the back.

Dale Jarzembak Warehouse Manager

TECHNOLOGYLIFE

TM

It’s something you’ll only find here at Aramark. The opportunity to work side-by-side with a team of outstanding biomedical technicians, imaging service engineers and professionals—fixing, not just clinical equipment, but the workflow challenges our customers face every day. So they can better care for patients, and healthcare can work better for everyone.

We’re seeking talented, experienced professionals: • Biomedical Technicians (all levels) • Imaging Service Engineers (all levels) • Senior Technology Managers • Technology Managers

Visit aramarkhealthcaretechnologies.com/join-us to apply online. (EOE)

16 | focalspot.SUMMER.2014

Test and record effortlessly

Measure ionizing radiation quickly and accurately in three simple steps with the 451 Ion Chamber Survey Meter.

• Displays values accurately using dependable ion chamber technology –Not energy dependent –No correction factors necessary • Fast measurements of dose rate and dose simultaneously • Simple one-handed operation makes it easy-to-use • Light-weight to reduce hand fatigue (only 1.07 kg) • Log data quickly using Excel® Toolkit

Three steps. Only two buttons.

For more information visit:

www.flukebiomedical.com/effortless

Fluke Biomedical.

Proven Victoreen reliability. ©2013 Fluke Biomedical. 2/2014 6001528A_EN

WWW.RSTI-TRAINING.COM | CALL 440.349.4700 | 17

C-Arm Service Dominating on Defense

By Dave Domanski RSTI Instructor In my last article, we talked about saving big money by taking your C-arms off of their expensive service contracts. Let’s say that you have. What now? You are on base, sure, but you really want to hit the ball out of the park, right?

Now you have to decide HOW you want to service these systems. Sure, you could play it fast and loose, do your yearly PM and otherwise sit back and wait for things to break just like many manufacturers do (what I like to call “reactive service”). Or you can choose to be better than that! You can be proactive and bring the heat!

Keep in mind that your portable C-arms tend to see a lot of heavy use, equipment that comes up to bat that often could benefit from a bit of extra attention. I’m not talking about tripling the PM schedule or anything that extreme. I’m suggesting that you periodically touch base with your systems and give them a quick performance evaluation.

Image quality typically doesn’t deteriorate overnight.

It is a long, slow slide from fantastic to unacceptable.

If you periodically stop by and check a few simple things like resolution, focus, camera/ co lli mato r a lig n m ent s a n d mechanical movements you can catch a lot of things and correct them BEFORE you find yourself caught in a rundown.

18 | focalspot.SUMMER.2014

Touch base with the users as well and see if they have any concerns. Talking to your techs and doctors actually serves a dual purpose. It helps them see you as an active member of the team that is making sure that they have optimal image quality and you will have an opportunity to hear about and fix the little things that have been bothering them but may not have warranted a service call.

Think about it, when a system is down completely they want it fixed as fast as possible and they want us to get out of the way.

They don’t have the time to mention a loose handle or a sticky brake. If, however, you can chat with them for a minute or two after a case or at the end of their day you can often nail down those minor annoyances, greatly improve the customer experience and score the winning goal for your service department.

Score Big in Digital With Digital X-ray Equipment By ken Brady RSTI Service Engineer

H

ave you ever walked down the hallway of your clinic and gotten queasy at the smell of your darkroom? Have patients ever been delayed or cancelled due to the need for films to be retaken?

Do you have to schedule months in advance because you’re only able to scan a few patients a day? Well, it may be time to upgrade your old clunky analog system with a newer and more advanced digital system.

Upgrading to a fully digital clinic has many benefits, the most noticeable of which is the lack of film.

No longer would you need to store cassettes in the exam room, walk them to the dark room, or wait for them to process to make sure they are viable. This allows you to increase your patient throughput by eliminating many of the tasks that eat up time between exams. The darkroom, processor, smelly chemicals, film, and view boxes are all eliminated in a digital set up. All of the tasks done by the previous equipment are now done digitally and automatically. The elimination of the above also saves your clinic the costs associated with keeping up your processor, and the continual purchasing of chemicals and film.

the image during viewing, so adjustments do not have to be made to take another exposure.

Are your films being sent off site for review? Well, with a digital system that is still possible. Your digital exam can be sent over the Internet to your remote viewing location. Again because it is digital, this is near instantaneous. The x-rays can be reviewed, diagnosed, and results sent back to you in a matter of hours. This is simply not possible when it comes to sending x-ray films through the mail.

Another advantage to upgrading is the ability to instantly review the x-ray. In an emergency situation, the ability to obtain a quick diagnosis is crucial. Using an analog system, you must wait for the films to develop.

But with a digital system, you can go to a review station and instantly examine the image.

An often overlooked factor when considering upgrading to a digital system is the appearance of your x-ray room. Often times, a patient will select a clinic based on the appearance of the equipment, even if the level of service is comparable. Replacing your old, worn-out, metal monsters in favor of smaller, sleeker, and more attractive digital models may be all it takes to get patients to return to you for annual screenings.

This may mean the difference between life and death. In addition to the ability for the image to be instantly read, using a digital system helps keep patient dose down. The need for images to be retaken is virtually eliminated using a digital system. The software on the review station is used to make adjustments to

If your clinic was on the fence about upgrading into the digital age, don’t balk, the pros outweigh the cons. Streamlining operations, speeding up diagnosis, and lowering patient dose, all amount to a clinic that a patient will want to return to, and tell their friends about.

WWW.RSTI-TRAINING.COM | CALL 440.349.4700 | 19

vc_RSTI_ClrAd_8x5_14Jun8.pdf

1

6/5/14

11:08 AM

Finally, Smaller is Better!

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Smallest sensor available today with improved stacked sensor technology.

Now, one sensor for radiography, fluoroscopy and mammography diagnostic measurements!

Designed for biomed and service professionals.

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Visit us at MD Imaging Expo Booth #1 426 West Duarte Road Monrovia, CA 91016, U.S.A T: 1 (626) 357-7921 F: 1 (626) 357-8863

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For over 65 years, Dunlee has built its business around being more than just a CT tube manufacturer. We provide the highest quality products and a wide range of services to help our customers take more control over their service - like industry exclusive replacement tube programs, unmatched customer support, and extensive educational resources.

Contact Dunlee for information about how our programs and services can benefit your organization.

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20 | focalspot.SUMMER.2014

sales@radcal.com www.radcal.com

2014 Index & Registration 2014Course Course Index & Registration X-RAY CERTIFICATE SERIES

Mobile C-Arms

Phase I…………….……………………………………………...............….….$4695 (for 2 weeks) Phase II…………………………........……………….……………………….….$4795 (for 2 weeks) Phase III…………..……………………………….…………….……..………….$4895 (for 2 weeks) Phase IV…………..……………………………………………….….……….….$4995 (for 2 weeks)

PACS Administrator/Engineer Certification Phase I…………….…………………………………...........................….….$2995 (for 2 weeks) Phase II……………………………………….………………….……………..….$3995 (for 2 weeks)

RAD & R/F PRODUCT SPECIFIC

OEC 9600/9800..........................................................................$6995 (for 2 weeks) OEC 9800/9900..........................................................................$7995 (for 2 weeks) OEC 9900.......................................................................................$4995 (for 1 week) Siemens Siremobile C-Arm ........................................................$3995 (for 1 week) Philips BV Pulsera C-Arm ............................................................$3995 (for 1 week)

Ultrasound Multi-Vendor Ultrasound Systems...........................................$5995 (for 2 weeks)

Management

GE Precision 500D………….……………………………………...……..….$7995 (for 1 weeks) GE Revolution Family: XR/d 1X & 2X (DR) …………….….…..….$7995 (for 2 weeks) GE Proteus XR/a .………………………….……………………..………...….$3995 (for 1 week) GE Definium Family (DR).............................................................$9995 (for 1 week) (Definium 6000/8000, Discovery XR650/656, Optima XR640) Philips Bucky Diagnost….……………….……………………..………...….$2995 (for 1 week) Private Practice X-Ray Systems….….……..……………..………...….$2995 (for 1 week)

Capital Asset Management.........................................................$1995 (for 1 week) Introduction to Networking & DICOM.........................................$1995 (for 3 days) Intro to Diagnostic Imaging for Managers & Sales Staff…….$1250 (for 2.5 days)

CT (Computed Tomography) Phase I..........................................................................................$4995 (for 2 weeks) Phase II.........................................................................................$5995 (for 2 weeks) GE LightSpeed/BrightSpeed......................................................$7995 (for 2 weeks) GE VCT............................................................................................$5295 (for 1 week) Philips Brilliance Family.............................................................$7995 (for 2 weeks)

Cardiac CATH LABS Siemens Axiom Artis (DR) ......................................................$14995 (for 2 weeks) GE Innova 2100/3100/4100 (DR) ........................................$14995 (for 2 weeks)

CRES (Certified Radiology Equipment Specialist )

Portable X-RAY GE AMX Portables: IV and IV Plus...............................................$2995 (for 1 week) GE AMX 700 Portables: ……………...............................................$4495 (for 1 week) Shimadzu MobileArt Portables…….............................................$2995 (for 1 week) Siemens Mobilett Portables........................................................$2995 (for 1 week)

CRES Exam Prep (includes CRES Package)................................$1795 (for 1 week) CRES Exam Prep (without CRES Package).................................$1495 (for 1 week)

NM (Nuclear Medicine) Principles of Servicing Nuclear Medicine Systems..................$4495 (for 1 week) Effective 07/01/2014

WOMEN’S HEALTH Multi-Vendor Mammography Systems (Analog)...................$2995 (for 2 weeks) Multicare Platinum.......................................................................$2995 (for 1 week) Hologic Selenia (DR) ...............................................................$12995 (for 2 weeks) GE Digital Mammography Family (DR) .................................$12995 (for 2 weeks) (2000D, DS, Essential) Multi-Vendor Bone Densitometry..............................................$3995 (for 1 week)

Cancellation Policy - Tuition is only refundable if cancellation is received in writing by RSTI at least 14 calendar days prior to the course or seminar date. Allow 30 days for receipt of the refund. Registrants who cancel within 14 days of the course or seminar date will have the tuition transferred to another course or seminar on a space available basis. In the event that a course does not attain our minimum enrollment, RSTI may postpone it. Paid tuition will remain on account to be applied to the rescheduled class.

Payment Due Policy - Payment for all courses and/or seminars is due three full weeks in advance of the course start date. Purchase orders are accepted, but also must be paid one week prior to the course start date. We also accept VISA, MasterCard, American Express, and Discover as a method of payment. All past due invoices will be assessed a late fee of 1.5% per month on any unpaid balances.

Schedule - Typically, courses run from 8:30 am-4:30 pm Monday through Friday. You will receive a detailed schedule when we confirm your registration. You should schedule your incoming flight to arrive Sunday afternoon or evening. On the last Friday, class ends at 12:00 noon. You may schedule your return flight any time in the mid- to late-afternoon.

Full Coverage Package - You are responsible for expenses you incur while attending courses. However, RSTI has negotiated a reduced package rate that includes 12 nights hotel accommodations, transportation between the hotel and training center, breakfast, and lunch. We will notify you of this rate when you enroll; if you wish, we can add the full coverage package cost to your tuition.

Course Materials - In addition to specially designed manuals and daily course handouts, you will also receive where appropriate:

• •

Document package of the lecture

• •

• •

Troubleshooting charts

Class Photograph

Flow diagrams Performance evaluation forms Certificate of Completion Due to copyright issues, some courses require that students bring their own manuals. These may include, but are not limited to, Operators Manual, Service Manual and Schematics. We will advise you of this when you enroll.

Make checks payable to: Radiological Service Training Institute (RSTI)

• •

Tuition and Full Coverage Package rates are subject to change.

Please confirm rates with our Registrar when you enroll.

HOW TO REGISTER: Phone 440.349.4700 • Fax 440.349.2053 • www.rsti-training.com/register

How to register: 440.349.4700 FORM • Fax 440.349.2053 • www.rsti-training.com/register.htm MAILPhone COMPLETED TO: RSTI 30745 Solon Rd. Solon, Ohio. 44139 Mail completed form to: RSTI 30745 Solon Rd. Solon, Ohio. 44139 Course Name

Dates

1._________________________________________________________________

_______________________________

Course Name 2._________________________________________________________________

_______________________________

1. ____________________________________________________________________________________________

Dates

__________________________

________ Full Coverage Package (Yes or No)

___________________________________________________________________ Name of class attendee Title 2. ____________________________________________________________________________________________

__________________________ ________ Bill my organization P.O. ________ ___________________________________________________________________ Company/Organization Phone ____ Full ________ Coverage Package (Yes or Registration feeNo) enclosed: $________ ___________________________________________________________________ Address Fax ____ Bill my organization. P.O. No. _________________________ Name of class attendee Title ________ Bill my credit card: _____MasterCard _____Visa ___________________________________________________________________ City State Zip ____ Registration fee enclosed: $ __________________________ _____AMEX _____Discover ___________________________________________________________________ Company/Organization Phone Email ____ Bill my credit card: ___ MasterCard ___ VISA Number: __________________________ Exp Date __________ Address FAX

___ AMEX ___ Discover Signature (required): ___________________________________ Number: _________________________ Exp. Date: __________ City State Zip

Signature (required):___________________________________________ State of Ohio Reg. No. 93-09-1377T

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| 21

CRES Certification RSTI has made it easy for you to become CRES certified.

Our CRES self-study package is a powerful tool to help you focus on specific certification objectives. There are nine different criterion-referenced modules that give a comprehensive review of subjects covered on the exam.

The nine modules are entitled:

• Anatomy and Physiology • Radiographic Physics • Electricity and Electronics • Radiographic Equipment Applications • Fluoroscopic Imaging • Radiographic Circuit Operation • Regulations and Laws • Technical Problem Solving • CRES Exam Review

Mastering these topics will enable you to succeed on the final CRES Certification Exam. With RSTI’s self-study CRES package you can learn anytime, anywhere, at your convenience and on your schedule.

Visit http://www.aami.org/certification/ journal.html for Certificate Renewal details.

The modules contain both practice exams with answers and exams which can be returned to RSTI for grading. We are offering a 20% discount off of the list price of $398. The sale price is $318.40.

Call (800) 229-7784 for info or visit www.aami.org/certification/exam.html for detailed exam info.

Presorted Standard Mail U.S. Postage Paid AKRON, OH Permit #286

30745 Solon Road Solon, Ohio 44139

www.rsti-training.com Address Service Requested

22 | focalspot.SUMMER.2014