TechNation - November 2015

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VOL 6

EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

NOVEMBER 2015

TOOLS FOR CAREER ADVANCEMENT Updates on AAMI’s Career Planning Handbook

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Biomed Adventures Helping Hand

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The Roundtable Anesthesia

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TECHNATION: EMPOWERING THE BIOMEDICAL / CE PROFESSIONAL

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THE ROUNDTABLE — ANESTHESIA MACHINES Our expert panel discusses how to extend the life of anesthesia devices and the most important features to look for when purchasing these important medical devices. We also look at the latest advances and what the panel members think TechNation readers should know about anesthesia devices.

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AMMI CAREER LADDER UPDATE Career advancement is a great goal for HTM professionals.

AAMI’s Technology Management Council has developed a career planning handbook to assist biomeds. This concise handbook is designed to help HTM professionals identify various career opportunities; describe what skills are needed to move up, and what career paths are available.

Next month’s Feature article: Best of the Best: Year in Review

Next month’s Roundtable article: Test Equipment TechNation (Vol. 6, Issue #11) November 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.

NOVEMBER 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.20 p.22 p.25 p.26 p.29 p.31

WEB DEPARTMENT

Betsy Popinga Taylor Martin

P.48 EXPERT ADVICE

ACCOUNTING

Kim Callahan

P.12 SPOTLIGHT p.12

p.14 p.16

Department Profile: NewYork-Presbyterian Hospital and Health System Biomedical Engineering Department Professional of the Month: Staff Sergeant Michael J. Muschong, U.S. Air Force Biomed Adventures: Helping Hand

P.20 THE BENCH

ECRI Institute Update AAMI Update Tools of the Trade Webinar Wednesday Biomed 101 Shop Talk

p.48 Roman Review p.50 Ultrasound Tech Expert Sponsored by Conquest Imaging p.52 The Future p.54 Patrick Lynch

P.68 BREAKROOM

EDITORIAL BOARD

Manny Roman: manny.roman@me.com Patrick Lynch: Biomed Support Specialist at Global Medical Imaging, patrick@plynch.us Karen Waninger: Director of Clinical Engineering at Community Health Network in Indianapolis KWaninger@ecommunity.com Eddie Acosta: A Clinical Systems Engineer at Kaiser Permanente, Northern California, Fastedy99@yahoo.com John Noblitt: Program Director at Caldwell Community College & Technical Institute in North Carolina jnoblitt@cccti.edu

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DEPARTMENT PROFILE NewYork-Presbyterian Hospital and Health System Biomedical Engineering Department

By K. Richard Douglas

N

ew York, New Jersey and Connecticut are served by the NewYork-Presbyterian Hospital and Health System, comprised of six major campuses, specialty institutes and continuing care centers. The health care system is affiliated with major academic institutions. Those medical schools include Columbia University College of Physicians and Surgeons and Weill Cornell Medical College. The system is listed on the U.S. News and World Report Best Hospitals honor roll for this year and includes 6,000 affiliated physicians, 2,508 certified beds and 135 bassinets. With 70,000 assets to look after; it is a big project for any HTM department.

To manage so much equipment, the NewYork-Presbyterian Hospital and Health System Biomedical Engineering Department is comprised of 120 full-time employees.

Heading the department is Director Chif Umejei, BBA, MS, PMP, PRINCE2, CSM. He is assisted by six division heads to run the large department. They include General Manager of Biomedical Engineering Operations Genevieve Redman, BSEE/ BME, MSOL; Manager of Diagnostic Imaging Christopher Schaefer; Manager of Technology Integration and Planning Bokang Rapoo-Motlotle, MS, CCE, PMP, PRINCE2; Manager of Performance Excellence and Regulatory Compliance Carlos Chung, MSEE; Manager of Technology Systems Roman Szewczyk, BS, ITIL; and Manager of Finance Victoria Kutepova, BS. The team has a wide range of expertise that allows for working on everything from anesthesia to Zeegos, with particular expertise in imaging. They also cover respiratory, dialysis, laboratory, physiological monitoring, medical device interoperability, project management and technology integration.

The department is split between two functions; Operations, which includes General Biomed, Diagnostic Imaging,

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Performance Excellence (Regulatory) and Finance and the Value function, which includes Technology Integration and Technology Systems.

BIG DEPARTMENT/BIG PROJECTS Integration with the Information Systems department is reflective of modern-day realities at NewYork-Presbyterian for the biomedical department.

“The Biomedical Engineering team reports into the Converged Technologies Division of Information Systems,” Redman says. “We are embedded in the IT infrastructure team. Within the Biomed Department we have an internal team focused on technology integrations, medical device interoperability and standards.”

Recent special projects and areas of concentration include the latest technology and cost savings.

Redman says that the department has worked extensively on reigning in vendor contract spend. She says that the department sold and successfully implemented the insourcing of several maintenance functions. This had a significant impact on hospital finances.

“We reviewed our database spend and we centralized the procurement of assets working very closely with our procurement

NOVEMBER 2015

Front row (left to right), Genevieve Redman, Bokang Rapoo; Back row (left to right), Christopher Schaefer, Chif Umejei, and Roman Szewczyk. Not pictured are Carlos Chung and Victoria Kutepova.

department,” Umejei says. “We then put in controls, not only for the procurement of assets, but the service contracts get negotiated ahead of time. Once we were able to centralize that, it created a bottleneck for us to look at the contracts individually as they came due. What we determined was that a significant number of those contracts, if we compared the history of the spend to what we are paying in contracts, we were literally just giving money away.”

Columbia University College of Physicians and Surgeons team

Weill Cornell Medical College team

Umejei says that they then revisited their vendor relationships; which included about 400 contracts.

“Where it made sense, (we) switched from full-service contracts to time and materials; and we did this over the last four years,” he adds. “What we have been looking at is improving our technician talent to be as capable as the vendor talent would be and then pulling them to T&M and that saw significant reduction in our cost per device.”

The department was also able to bridge the physiological monitoring data from their proprietary vendor-managed network to a hospital-managed infrastructure.

“We actually looked at this more from a security and ease of use perspective.

What we’ve done, with some investment, is build a secure mechanism whereby all

the OR data is stored centrally,” Umejei says. “Clinicians can access them using the right hospital access controls, so therefore we’re protecting things from a HIPAA perspective.”

“We are also beginning to make people figure out what they really need,” he adds.

“Before, people just stored everything.

There were four hours of video, but at the end of the day, there were only 10 minutes of it that were worth anything. Because of the constraints on storage, the clinicians are only keeping clinically relevant information.”

Umejei says that clinicians can then edit video and store it.

“It’s been great and we’ve integrated with our AV teams to be able to do live broadcasts, which is something that our clinicians wanted, since we are an academic

medical center; so it’s been really, really good,” he says.

They have recently rolled out a mechanism that matches patient to waveform and they are able to post in the right space in the EHR. The waveforms are available in EHR in real time and they were able to coordinate the installation of a state-of-the-art automated laboratory.

“The clinical team needed to come up with a way to ensure that clinicians documented clinically relevant waveforms in the EHR. Our department led the initiative to automate the process. This led to compliance with the initial goals as well as cost savings as it pertained to scanning and reprinting waveforms,” Redman says.

Biomedical engineering also led the creation of a clinical video infrastructure to enable the OR to utilize existing AV capabilities to broadcast clinical procedures.

The department has also deployed and managed the RTLS infrastructure for the hospital. They are expanding services beyond medical equipment.

“The biomed team is directly impacting patient care by leading automation efforts to ensure that the right equipment is available at the right time for the right patient,” Redman says. “We have aggressively educated the hospital on the capability of automated workflows using RTLS (RFID, BEACONS, etcetera.)”

The department’s clinical colleagues don’t have to wonder where an asset is or speculate that it might be sitting in the biomed shop.

“We are seeing a more transparent view of where pumps are, where the assets are.

We are beginning to work with them (clinicians) to help them see where things are and how it can improve their flow,” Umejei says.

The department, and its managers, stay involved in the HTM community outside their facilities as well.

“We are actively involved in the New York Metropolitan Clinical Engineering Directors Meeting, AAMI, RSNA and ECRI,” Redman says. “We have representation on the examining board for the ACCE.” When it comes to managing 70,000 assets, it takes a special team to do it while saving money and satisfying the clinical staff. NewYork-Presbyterian’s biomedical engineering department gets the job done.

SPOTLIGHT

PROFESSIONAL OF THE MONTH

Staff Sergeant Michael J. Muschong, U.S. Air Force

By K. Richard Douglas

D

iving into the biomed profession headfirst was Staff Sergeant Michael Muschong’s indication that he trusted the word of his Air Force recruiter; it was just that simple.

Muschong is the Medical Maintenance Non-Commissioned Officer in Charge at the 366th Medical Group, Mountain Home Air Force Base, Idaho. He oversees Medical Maintenance operations and the Medical Equipment Management Office, supporting a 10-bed hospital, serving a 24,000-eligible beneficiary population, which provides 60,000 annual medical appointments.

Muschong leads three personnel responsible for maintenance support and life cycle management for 2,000 pieces of medical equipment valued at $12 million.

He is a hands-on biomed in addition to his management duties.

“My first interest in the biomed profession was completely unexpected. I was in the delayed enlistment program, waiting for my enlistment into the United States Air Force, when my recruiter called me up and told me that there was an opening in the biomed career field,” he remembers.

“I had no idea what it was, but I trusted him when he told me it is one of the greatest jobs to have. With that I

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didn’t hesitate, I said ‘sign me up.’ After I got off the phone with him, I hit the Internet and researched what I had just got myself into. I instantly was filled with excitement as what I read seemed to be right up my alley. After all, who doesn’t like to take things apart and forget how they go back together,” Muschong jokes.

After committing to become a biomed, the next step was 10 and a half months of technical training school provided by the Department of Defense. He took his training at Sheppard Air Force Base in Wichita Falls, Texas.

“The training consisted of 12 courses beginning with two courses of electronic principles and then going through an extensive line of medical equipment ranging from blood fluid warmers and infusion pumps all the way to sterilizers and radiology equipment. When I went through the radiology portion, they had the Continental X-ray unit and that is where I learned what 220V feels like,” Muschong says.

ACHIEVING THE MISSION Starting out as a Biomedical Equipment Apprentice and performing on-the-job training requirements for one year, Muschong then achieved his Biomedical Equipment Journeyman statu.

“As a Biomedical Equipment Journeyman or 5-level, I spent most of my time as a worker bee at Mike O’Callaghan Federal Medical Center at Nellis Air Force Base in Nevada,” Muschong says. “I didn’t have a specific job title at this time, but I performed various tasks like preventive

NOVEMBER 2015

maintenance, calibrations and learned the ins and outs of most of the equipment the Medical Center had to offer.”

Once he mastered PMs and calibrations, he moved to the unscheduled team or repairs team.

There, he was able to concentrate on fixing stuff.

“I worked on the team for about a year and then was promoted to Unscheduled

“ The biggest challenge I have encountered is the leadership aspect of managing a shop. Trying to make changes to an organization is the hardest thing a leader has to do.”

Team Chief; finally received my first duty title,” he says.

“I ran the unscheduled team managing roughly 150 work orders per month with three technicians including myself,” Muschong recalls. “After doing that for about a year, I was moved over to Scheduled Team Chief to broaden my horizons. There, I managed 11

MICHAEL J. MUSCHONG is the Medical Maintenance Non-Commissioned Officer in Charge at the 366th Medical Group, Mountain Home Air Force Base, Idaho.

FAVORITE MOVIE

Anything with Jason Statham in it and “Boondock Saints.”

technicians with an average of 550 work orders per month.”

After a few months, he received notice that he would be moving to Mountain Home Air Force Base.

“Once I arrived on station, I was told I would be the Non Commissioned Officer In Charge of the BMET shop. I have been in this position since October of 2014 and recently took over another department in Medical Logistics, the Medical Equipment Management Office,” Muschong adds.

Muschong says that the primary challenge he encounters in his work is related to his management duties.

“The biggest challenge I have encountered is the leadership aspect of managing a shop,” he says. “Trying to make changes to an organization is the hardest thing a leader has to do, and if you don’t do it the right way, then you will fail; but failure is just the first step in learning. Trust me, I learned the hard way. My most recent project that I would like to mention was, and still is, the procurement and installation of a stand-alone steam generator for our large

pass through steam sterilizer. I have received a couple awards throughout my career but so far the best one has been 99 Medical Support Squadron’s Airman of the Year for 2012.”

AWAY FROM BASE At 26, Muschong has already been in the Air Force for more than seven years. He loves to fish and build things in his garage. A recent project was an inflatable raft that he modified to be a worthy fishing vessel. He is also a family man.

“I have a beautiful wife named Casandra and two wonderful kids. My daughter Mikayla age five and son Zayden; age four months,” he says.

The future includes the HTM profession, even after his Air Force years.

“I hope to one day retire from the Air Force, and at some point along the way, acquire skills to specialize in radiology and apply those skills in the civilian sector,” he says.

If the first part of his career is any indication, it’s very likely that there will be a very competent imaging engineer added to the HTM community some day.

FAVORITE BOOK

Alex Cross series by James Patterson

FAVORITE FOOD

Chicago-style anything because it reminds me of home and of course Sushi.

HIDDEN TALENT

I can ride a unicycle and juggle, but not at the same time.

FAVORITE PART OF BEING A BIOMED

My favorite part of being a biomed is that every day is something different; I constantly get to learn something new.

WHAT’S ON MY BENCH 1. Monster Energy Drink (The red one)

2. My Leatherman multi-tool 3. Pictures of my family 4. Various quotes I look up on a weekly basis. “Don’t limit your challenges; Challenge your limits.”

- Jerry Dunn 5. My project board to keep me and my shop on task

SPOTLIGHT

BIOMED ADVENTURES Helping Hand K. Richard Douglas

I

n January of 2012, TechNation ran a cover story titled “Biomeds Give Back – Surprising ways to use your skills for the greater good,” that looked at ways that HTM professionals could volunteer their time with worthy organizations. Many of these organizations provide medical care or reconditioned medical equipment to hospitals in developing countries. The need for working medical equipment in many poor areas of the world is great.

Places like Haiti, many African nations, eastern Europe and Southeast Asia, have a need for modern medical equipment, medical supplies and medical training for their clinicians. Through the resources of several charitable organizations in the U.S., many of these needs are met.

In the central valley of California, Medical Ministries International (MMI) has been on a mission to recycle new and used medical equipment and supplies and provide them to clinics and hospitals in underserved areas around the world. The Christian-based nonprofit organization was incorporated on October 30, 1998.

The organization has warehouses in Clovis and Fowler, California.

The used medical equipment that the organization collects through donations needs to be serviced, inspected, calibrated and packaged for shipment. While there is a need for HTM volunteers, there is also a need to have an HTM professional as part of the staff to manage the maintenance, repairs and modifications that are in constant demand. Those shoes are filled

by Tod Harris, MMI director of Bio-Med Equipment Technology.

IT TAKES A BIOMED “When finishing college and volunteering at one of the local hospitals, I was invited to a local California Medical

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Instrumentation Association (CMIA) meeting,” Harris says. “MMI was looking for a biomed technician to set up a biomed department at their local organization here in Fresno, California.

The director of the hospital and the chairperson of our local CMIA spoke about the fact that I was looking for a job.

The next thing I knew, I was contacted by MMI and asked to come in for an interview.”

Harris’s bachelor’s degree in electronics engineering technology and his associate degree of applied science in electronics and computer technology have proven instrumental in preparing him for a biomed career. He works part-time for MMI and volunteers with a local hospital’s biomed department. The volunteer work pays real-world dividends.

“This is a great resource to ask for ideas and help with equipment,” he says. “At times, other biomeds stop by the MMI warehouse to give their time, which is greatly appreciated. This helps out with the need for continuing my education.

Due to constantly updated and changing medical equipment, and as technology continues to evolve, education is needed.”

He belongs to the San Joaquin Valley Chapter (SJVC) of CMIA. Harris says that CMIA holds meetings every other month and they are another great resource.

NOVEMBER 2015

“In our SJVC chapter, it includes networking with other hospitals, vendors and a presentation on topics in the latest BMET field,” he says.

“Just knowing about the basics of how to repair some medical equipment, having worked for corporations in management and having my own business at one time is all I had to offer.

MMI had medical supplies and all I could see was the medical equipment going to the dump. They needed a biomed to help out in this area. Now I’m working for MMI as their biomed tech and starting a department. This has been a real blessing to me and my entire family,” Harris says.

The work is not without some challenges. It’s one thing to provide functioning equipment, it’s another to send it with documentation.

“There can be some challenges on older medical equipment as to searching for manuals. All equipment that MMI sends out has manuals that we provide. This helps doctors [and] nurses, and if they have a technician, they can figure it out if a problem arises,” he says.

“Troubleshooting, analyzing and quickly assessing the problem can be challenging also. There are only so many hours in a day, with more and more equipment coming in.”

Harris says that since medical equipment is changing at a faster pace, it means biomeds must keep up with the technology, while the older equipment seems new to individuals in some countries.

GETTING THE WORD OUT How have the staff at MMI been able to get the word out about the need for medical equipment?

“The best way that I have found to get the word out about donations is by networking. Everywhere I go, I meet new

“ This is the first time that I’ve worked for charitable organizations. As time goes on, I feel better as a person. Knowing what I accomplish at MMI, helps others that I do not know in other countries.”

Tod Harris plyas a vital role in Medical Ministries International’s goal to provide new and used medical equipment to developing countries.

people or old friends,” Harris says.

“During our conversations, the topic always turns to business. This is the perfect opportunity to bring up MMI, explain what they do and how I fit in. I let them know that we accept donations of all types,” he explains. “I hand them a couple of my business cards and encourage them to call if there is anything they can help us out with and also to please pass out my card.”

Harris says that equipment is one of the most needed and requested items from Medical Ministries International recipients.

“MMI receiving hospitals in thirdworld countries have a great need for ultrasounds, centrifuges, anesthesia machines, defibrillators, EKG recorders, exam lights and there is a lot more. [The] most important part of the equipment are accessories that attach to the equipment.

This is not an easy task as we receive older equipment that the manufactures don’t support any more,” Harris explains.

He says that ISOs have proven to be a great place to look for the accessories.

“This is one of the areas that MMI was lacking in when receiving the equipment donation. As the new BioMed

Director, I implemented a list of questions to ask before we receive donated equipment,” he says.

Harris points out that MMI recovery efforts save thousands of pounds of surplus medical supplies and equipment from landfills and incinerators that, for various regulatory reasons, hospitals and medical companies must discard.

“We accept donations of supplies and used biomedical equipment through our hospital recovery program, doctors and the community,” he says. “I am also going to implement a plan for donation from medical manufacturers and distributors.”

The good news is that Harris reports that the response is getting better every month with a new director, warehouse manager, and now a biomed tech.

“MMI is in the middle of the San Joaquin Valley. We have cities and small towns north and south that are miles apart from each other for receiving donations,” he says.

“This is the first time that I’ve worked for charitable organizations. As time goes on, I feel better as a person. Knowing what I accomplish at MMI, helps others that I do not know in other countries,” Harris says.

“I also see a need in other countries; they need help with repairs and making sure that all medical equipment is working efficiently. At some point MMI would like to send a team of biomeds to help out in this area,” he adds. “It’s all about helping those in need and giving back to the people of the world. Working with MMI is a wonderful way of putting that into practice.”

Harris has proven that there are many ways that biomeds can be a blessing to patients everywhere. They don’t have to be close by.

FOR INFORMATION about donating to MMI, visit www.medministries.org/donate/

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ECRI UPDATE

Future Proofing your Hospital

T

echnologies in health care are rapidly changing and hospitals need to have great foresight in order to plan appropriately for them. One of the areas where ECRI Institute sees movement towards technology-rich environments are the critical care units. What do future critical care areas look like? What technologies will be in use? How are hospitals going to be able to take advantage of these technologies, while at the same time keep patients safer and be more cost effective? These are challenging questions and this is why “future proofing” your current hospital design is more necessary than ever before.

What are critical care units? The sickest patients are cared for in these units. While each type of unit cares for different patients of different demographics and ages, they all have a high acuity level and longer-thanaverage lengths of stay. Because of this, critical care units are revenue generators and facilities must keep up with the associated rapid advances in critical care technology.

Some of those rapid advances are in the areas of medical device integration, infrastructure, medical equipment, and communication technologies. Even beds, mattresses, and patient lifts are among the ever-evolving pieces of the patient care puzzle. Particularly up and coming are the “smart room” technologies, which include medical device integration solutions, alarm integration systems and real-time location systems.

MEDICAL DEVICE INTEGRATION Medical device integration is, essentially, the process of transferring information gathered by medical devices to a facility’s electronic medical records (EMR) system. Without this interconnectivity, the federally mandated process of EMR adoption will be greatly hindered. Medical device

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integration bypasses the manual data transcription process and thereby decreases workflow inefficiencies.

Research has shown that medical device integration increases patient safety and the automated/increased data collection reduces nursing documentation time.

Additionally, the Health Information Technology for Economic and Clinical Health (HITECH) Act is driving the need for more comprehensive and up-to-date documentation in EMRs and other clinical information systems.

Developing the interface for this complex technology is challenging. It’s complicated to connect legacy devices, especially if the devices don’t have the ability to export data. Other capabilities, such as pushing clinical waveforms automatically into an EMR for documentation, are still not possible.

It’s always wise to plan in advance what medical devices are critical priorities for integration and which ones are not.

ECRI recommends that facilities start with continuous monitoring devices (like physiologic monitors) that do not require third-party integrators or point-of-care (POC) devices in order to capture vitals into the EMR. As these devices are already networked, the vendor gateway can capture and transmit all data to the EMR.

NOVEMBER 2015

Medical device integration and big data analytics in the critical care unit of the future have the potential to provide health systems with various patient profiles and alerts. Middleware can sync a facility’s medical device integration and real-time intelligent monitoring process to automatically identify those patients at risk for deterioration. These types of middleware can offer information regarding sedation, infections, antibiotic controls and can be used for research.

REAL-TIME LOCATION SYSTEMS Real-time location systems (RTLS) are a method of automatic identification and data capture which are used to identify and track objects or people. Typically, small tags are placed on the objects to be identified and are read by a scanning device. Different communication technologies can be used to exchange information between the tag and the reader. Used with patients, this technology can help control wandering and elopement and track patients waiting to receive tests or other services.

Patients can also be tracked during transport or when on telemetry. This tracking of telemetry patients is beneficial in the event of an emergency and a code team can be dispatched to

the correct location. Real-time location systems assist in the identification and association of patients with their personal admission or transfer records.

Some systems even permit the storing of medical records.

RTLS technology can track equipment and inventory, as well, and to verify that equipment and medical instruments were cleaned between uses.

RTLS benefits the biomedical engineering department as it can help manage inventory and supplies and alert when equipment requires planned maintenance.

beds, facilities should look for: 1) Radiolucent window for radiographic purposes 2) In-bed scale to minimize the need to transfer patients for weight reading 3) Pressure-reducing mattress 4) Bed-exit alarms 5) Continuous lateral rotation therapy to prevent pneumonia 6) Quick-release control to adjust the bed to a flat and stable position for CPR administration

OTHER TECHNOLOGIES TO NOTE The disinfection technology marketplace tackles a huge problem in health care today. An estimated two million patients are affected with hospital-acquired infections (HAI) each year, resulting in nearly 100,000 deaths per annum. The U.S. Centers for Disease Control and Prevention (CDC) estimates that HAIs add anywhere from $28 billion to $45 billion to U.S. health care costs per year. Technologies utilizing copper surfaces are “surfacing” in the marketplace, and antimicrobial copper is the only hospital touch surface with a U.S. Environmental Protection Agency (EPA) public health registration which allows manufacturers to claim that copper surfaces can kill specific bacteria. These surfaces are being incorporated into a variety of components such as bedrails, handrails, door handles, IV poles, sinks, faucets, etc. The added cost for this technology is about 10 to 30 percent more than a typical hospital room. A clinical study of ICUs in two leading institutes showed that rooms with copper alloyed surfaces had lower instances of HAI than in standard ICU rooms.

Disinfection by robot is another technology that is being utilized to combat HAIs. Ultraviolet (UV) light robots are designed to kill microorganisms by deactivating their DNA or RNA, while another type of disinfection robot uses hydrogen peroxide vapor to kill harmful microorganisms. The cost of the UV

robots is around $100,000, while hydrogen peroxide vapor robots range from $45,000 to $65,000.

“Alarm integration” is a popular buzz phrase in the health care industry today, especially with The Joint Commission’s National Patient Safety Goal on alarm management (effective January 1, 2016).

Alarm integration systems are complex – especially in critical care settings. They require a multidisciplinary approach and are unique to each organization. They are being implemented rapidly and require careful consideration regarding key functionalities. ECRI Institute recommends that facilities should utilize a middleware system that can collect alarm and alert information from the primary alarming devices and then prioritize those incoming alarms and alerts. Alarm integration should provide reporting abilities, be able to indicate nursing assignments, and easily accommodate advance escalation schemes.

Getting critical care bed technology right is extremely important since patients in these units typically stay longer and are not ambulatory. These beds differ from typical hospital beds as they are models with the most technical functionality, are designed specifically for the critical care environment, and offer features such as X-ray access, chair positions, and other therapeutic features. The mattresses are designed to reduce the risk of decubitus ulcers and relieve pressure points during extended hospital stays. When choosing these

Design is evolving to focus on the concepts of both patient safety and a pleasant healing environment. Over the past three years, every CCU that we have planned has had both ceilingmounted patient lifts and equipment booms mounted on either side of the patient bed. Previously, hospitals preferred traditional headwalls to supply data, power, and medical gases rather than using ceiling-mounted booms. The latest thinking is that ceiling-mounted booms can be used to deliver gas, power, and data to the various medical devices which are mounted on the booms. This configuration frees up floor space and eliminates clutter and the issue of wires and cables laying on the floor as tripping hazards. While there is no definitive clinical evidence that suggests one option is better than another, there has been literature published which indicates that ceiling-mounted booms offer greater flexibility and better access to patient and bed positions.

While high-tech devices have radically changed the way critical care units work and look, one thing remains the same – the personal care remains the most important factor in a patient’s successful outcome.

CONTRIBUTORS TO THIS ARTICLE INCLUDE ECRI Institute’s Michael Linehan, director, Medical Equipment Planning, and Rikin Shah, senior associate, Applied Solution Group. To learn more about ECRI Institute’s medical equipment planning services, visit www. ecri.org/MEP; call 610-825-6000, ext.

5655; or email consultants@ecri.org.

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AAMI UPDATE

New Certification Lets Healthcare Technology Managers Shine

M

ark Woods, a healthcare technology management professional for more than three decades, is feeling especially proud about his work these days, and it’s all because of a test.

This past June, Woods took and passed the new certification exam for healthcare technology managers (CHTM).

“It is my 35th year in this field, and it just felt great,” said Woods, who started his career in the U.S. Navy as a biomedical equipment technician and now works as director of clinical engineering at Cheshire Medical Center in Keene, New Hampshire. He already had several certifications under his belt, including the one for biomedical equipment technicians (CBET), but he felt this new certification reflected his career and strengths today.

“This certification provides the opportunity to demonstrate your operational and management skills, and it does measure a significantly different skillset than CBET,” Woods said.

Elizabeth Smith, another proud recipient of the CHTM designation, agreed.

“Certification was a personal goal for me,” said Smith, the capital asset manager for the University of North Carolina Hospitals in Chapel Hill, North Carolina. “I have been in healthcare technology management for more than 20 years.”

The certification focuses on two major areas: the management of healthcare technology operations and the management of personnel.

Jennifer DeFrancesco, a lead

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“ This certification provides the opportunity to demonstrate your operational and management skills, and it does measure a significantly different skillset than CBET.” biomedical engineer with the Department of Veterans Affairs, is also newly certified. She urged more colleagues to consider taking the exam.

“I think anybody who is looking to continue in this field for the long run should be looking into certification,” she said.

The CHTM exam is a closed-book two-hour exam which consists of 100 multiple-choice questions. The exam is offered four times a year during a testing window. If you have questions about the exam, please visit www.aami.org/

NOVEMBER 2015

certification or write Director of Certification Programs Sherrie Schulte at sschulte@aami.org.

THE BENEFITS OF A MENTOR RELATIONSHIP For most of his professional life, John Weimert has enjoyed the guidance of mentors.

He had one as a teenager in Houston, Texas, while working for a newspaper company. He also had a mentor in the U.S. Navy and later had mentors when he moved into the private sector, working as a biomedical engineer.

So, with a sense of gratitude and a desire to give back, Weimert, the assistant director of biomedical engineering at Texas Children’s Hospital in Houston, signed up for AAMI’s Mentorship Program, wanting to guide younger professionals with the same dedication he experienced.

“These mentors taught me how to act responsibly, how to speak in a professional manner, how to respond in a critical situation, how to carry myself professionally,” Weimert recalled. “In short, I would not be who I am today without having learned from strong mentors.”

Launched at the start of this year, AAMI’s Mentorship Program is a match-making exercise of sorts: pairing AAMI members new to their respective fields – whether healthcare technology management, sterilization, or another discipline – with veterans who have learned the ropes and want to help those who are just starting in their careers.

“Clearly, there are mistakes to be made, and I would like to help guide a younger biomedical engineer through the

mine field,” said Weimert, who is working with one such younger professional, Priyanka Upendra, a clinical technology analyst with Stanford Health Care in Palo Alto, California.

The two have bimonthly phone meetings, each set for about one hour. In between those meetings the two correspond via email. The two have discussed The Joint Commission survey processes, clinical alarm management, budget forecasting, staff development, crucial conversations, capital equipment acquisition and equipment planning.

“Throughout the program, not only have I gained a deeper understanding of how to run HTM operations, I have also learned how to understand and motivate my team to perform better, respond to conflicts, hold crucial conversations as a manager, and lead a team toward effective delivery of program and project goals,” Upendra said.

For more information about AAMI’s Mentorship Program, visit www.aami. org/mentorship.

AN ESSAY CONTEST FOR HIGH SCHOOL STUDENTS Do you know a high school student who is interested in healthcare technology? If so, encourage that student to participate in AAMI’s essay contest about the future of healthcare technology. AAMI wants students to describe their ideas for a new medical device or systems, explaining how they would function and how they would improve patient care.

The deadline is Dec. 1, 2015, and essays should be sent to Patrick Bernat at pbernat@aami.org.

Applicants are asked to use the following format for file names and

email subject line: ESSAY-MMDDYYLASTNAME. For example, a submission from Bill Smith on Nov. 22, 2015, should have “ESSAY-112215-SMITH” in the email subject line and “ESSAY112215-SMITH.doc” as the file name.

Members of AAMI will vote on the submissions. Winners will be announced the second week of January 2016. Prizes will be awarded as follows: first place: $500 gift card; second place: $300 gift card; and third place: $200 gift card.

Additionally, the top three authors will receive a complimentary one-year AAMI student membership. Also, the top submission, along with an article about the author, will be published by AAMI.

PITCH A PRODUCT IDEA TO AAMI Are there resources for healthcare technology management or medical device industry professionals that you would like to see developed? Let AAMI know.

While AAMI already has an impressive array of books, manuals and videos available for sale, the association wants to develop additional resources to meet the needs of the healthcare technology community.

If you have an idea for a new product, please send it to Special Projects Editor Melissa Coates at mcoates@aami.org In your email, please describe the idea, both the proposed content and format, and indicate whether you’d be interested in leading development of the product.

“We want to develop products that are both relevant and timely, and those who are on the frontlines of healthcare technology are in the best position to say what those resources might be,” Coates said. “What resource or guide would you like to have?”

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Webinar

Wednesday

WEBINAR WEDNESDAY Series Provides Expert Knowledge

By John Wallace, Editor

T

he latest Webinar Wednesday presentations “Why Metrology Matters in Medical Device Quality Assurance Testing” and “Principles of Medical Equipment Maintenance Automation” drew more than 400 health care professionals.

“Why Metrology Matters in Medical Device Quality Assurance Testing” presented by Jerry Zion from webinar sponsor Fluke Biomedical began with the basics of metrology.

Zion covered the concept of uncertainties and how they affect calibration adjustments.

He examined how metrology and traceability apply to the test instruments used by HTM professionals and the medical devices upon which they make calibration adjustments.

He pointed out the importance of measurements and why they matter. Among the examples he used to illustrate their importance are fair trade, safety and legal requirements, interoperability, traceability and consistency.

Zion also pointed out the importance of standards when it comes to measurements.

“You are really doing science when you are doing measurements in quality assurance testing, in periodic inspections. Anytime you are making a measurement on a medical device that measurement

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1TECHNATION.COM 1TECHNATION COM

needs to be reliable in terms of what you measure and for what somebody else measures for the same parameter,” Zion said.

Zion’s presentation received great reviews in the post-webinar survey.

“Having been a metrologist for the USAF for over 20 years I greatly appreciate the connection between biomedical engineering and metrology. Every parameter we measure is one that should be verified to ensure the patient is safe and treated as well as possible,” webinar attendee James H. wrote.

Mark Miller’s webinar “Principles of Medical Equipment Maintenance Automation” was sponsored by Datrend Systems Inc. Miller discussed regulation requirements including inventory creation, test performance, safety, compliance with manufacturer maintenance procedures and frequency. He also addressed alternative equipment maintenance schedules and procedures. The Joint Commission’s regulations governing maintenance was another topic examined in the webinar.

NOVEMBER 2015

Miller gave an in-depth overview and drilled down on important topics including preventative maintenance (PM), corrective maintenance (CM) and incoming inspection (IIN). He also touched on biomed workload and compensation, CMMS, computerized automation of preventative maintenance, mobile computing technologies and security issues.

Attendees paid close attention throughout the webinar and provided outstanding questions for Miller during a Q&A session.

Miller took time to answer questions providing additional insights on medical equipment maintenance automation. He also answered questions about Datrend’s leadingedge biomedical testing equipment for hospitals, clinics and medical equipment manufacturers. Miller said Datrend will unveil a new product at the MD Expo in Las Vegas, October 21-23.

The webinar received great reviews via a post-webinar survey emailed to attendees earning a 4.3 rating on a 5-point scale with 5 being the best possible score.

TO REGISTER for the next free Webinar Wednesday session, visit 1TechNation.com. Recordings of previous webinars are available on www.1TechNation.com.

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BIOMED 101

5 Cost-Effective Strategies for Improving Your Regulatory Compliance Practices

By Deb LeMay, MPH, R.T. (R)(N)

K

eeping up with the most recent regulatory accreditation and compliance requirements for medical equipment can be a full-time job. In an effort to save on costs, many hospitals assign this area to the already-taxed clinical engineering staff, which is problematic because it can feel outside their scope of expertise. Risk mitigation includes more than just preventative maintenance – it’s processes and strategies that ensure equipment is appropriate for intended use, proper staff training, current accreditation adherence and patient safety. of patient safety related to potential device malfunctions and lowest level of risk related to lack of compliance.

Being found in violation of a regulatory requirement is costly – incurring fines, loss of Medicare/ Medicaid monies and reputation in the community. So it pays to be prepared.

Here are five cost-effective ways your health care organization can achieve excellence in regulatory compliance.

4) EXECUTE A MOCK AUDIT.

1) ASSESS YOUR RISK. Using various risk criteria, such as incident and alert monitoring, repair trend analysis, EOC/safety meeting discussions, you can use error monitoring and safety huddle discussions to assess your organization’s risk.

Include review of outside sources such as The Joint Commission Sentinel Reports, state regulatory governing bodies, CMS and other accreditation agencies. An assessment will help you identify areas needing attention so you can achieve the lowest potential for adverse impact on the safety and health of patients, staff and others in your facility.

2) DEVELOP A PLAN. After you uncover the risks associated with your medical equipment, you can then manage them through a variety of processes and strategies that ensure the equipment is appropriate for intended use, schedules are set to ensure proper

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DEB LEMAY, MPH, R.T. (R)(N) Manager of Regulatory Compliance, TriMedx

operation and patient safety, staff members are properly trained, and the equipment is correctly maintained by qualified individuals.

3) UTILIZE TECHNOLOGY. Your clinical engineering department may use a computerized maintenance management system (CMMS) to track medical device performance indicators, preventative maintenance schedules, safety issues, equipment recalls and manufacturer recommendations. Tracking this information ensures the highest level

You never want to be caught off guard when a regulatory agency comes knocking, and there’s a good chance they will. Failing an audit is first and foremost a threat to patient safety, but can also come with hefty financial penalties. Start now – know what each regulatory agency requires for an audit and gather the necessary materials, create a checklist and perform a mock audit. If you identify gaps, create a plan to mitigate the risk prior to being inspected, so you’re not left scrambling.

5) FIND A PARTNER. Your organization may not be able to devote a full-time employee to regulatory compliance due to budget strain. You also may not have the latest technology in place. In this case, partner with an independent third-party provider that can assist with the staffing and technology you need to avoid large fines and achieve best-in-class regulatory compliance.

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SHOP TALK

Conversations from the TechNation ListServ Q:

What are the test equipment devices every Biomed should have to be able to perform his/her duties? What are your suggestions?

A: A: A:

I would start with electrical safety, defib, esu, and nibp testers.

Also include a patient simulator.

Our basic test kit includes: Pronk kit with NIBP, Slimsim and Spo2 simulator. This allows testing of most monitoring equipment and the NIBP also has a manometer mode for pressure testing of BP accuracy. A defib analyzer.

A safety analyzer. An ESU analyzer – be sure that the loads available match up to the equipment you are testing. A pressure meter, scale and stopwatch. We use these for IV pump testing as the most cost-effective way to equip multiple techs. If in a single facility some of the new IV analyzers have acceptable accuracy. A digital scale for some PT equipment (traction units), also use stopwatch. A tachometer for centrifuges, treadmills, etc. We are an ISO servicing multiple accounts so most of our techs carry these items.

A:

I particularly like the multi function test equipment such as “The Cube” which is a small multifunction unit with NIBP, IVB, ECG. It’s battery operated, easy to use and portable. I also like the Fluke 175 Safety Analyzer. It is very compact and easy to use. Let’s face it, most shops have a PM cart that has large test equipment hanging all over the cart and we look like mad scientist plugging and unplugging equipment and test equipment when doing PMs. White lab

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coat, thick glasses, frizzy hair, you get the picture! A lot of times we just need to check something in before a case or run to an off-site location. Portable test equipment sure fits the bill in these situations while still being able to handle the heavy PM days. Some basic test equipment we use here are: ECG, NIBP, IBP, electrical safety analyzer, defibb analyzer, multi-meter, flow analyzer for vents, fetal simulators, dedicated pressure gauges for IV pumps, temperature meters for infant warmers and fluid warmers, water flow meters for fluid warmers, temperature air meters for Bear Huggers, light meters for light sources and billi meters. ESU analyzers, photo tachometer for centrifuges, test weights for infant scales, oscilloscope, graduated cylinders for fluid output and of course the best test equipment of all … Biomeds.

Q:

How important are certifications (CBET, CRES, etc) when it comes to career advancement? Is it worth the time to get the certification?

A:

When an individual becomes certified it shows that the individual is determined to be the best they can be in that field by taking the effort to go beyond the normal knowledge level. Certification is important for advancement in any career.

It demonstrates your willingness to go the extra mile in your position. Managers will look at individuals with certification as a better candidate because the certification demonstrates a thorough understanding of the field. The certification will make an individual more likely to be able to mentor another tech in the field. In my opinion, the certification is well worth the time and expense.

A:

It depends on the hospital (or group of hospitals). Some place a lot of weight on being certified, others not so much, some not at all.

I’m glad I became certified, although keeping up with it is a PITA and if you don’t earn enough points to get recertified, you might not get it. But that is another subject.

A:

None of the places I have worked has paid any extra for certification. Two of my technicians here have earned their CBET, but it was for their own satisfaction.

A:

To tell you the truth, I believe that personally it is important.

But, that being said, I don’t think that means that companies care. Everyone still thinks that we are just maintenance people.

A:

When I’m looking to hire, I always look for someone who is either certified or in the process of certification.

The reason; I want someone who is dedicated to their trade and willing to go the extra mile to get certified, this speaks about their character and work ethic, just my opinion. I see several states contemplating making it mandatory to be able to work on medical devices.

California, North Carolina, Florida and South Carolina are considering such.

A:

We value certification for our staff. Over 10 years ago we updated our job description for all Senior BMETs to be certified. We also pay for the certification test and the recertification costs.

A:

Certification matters. As our industry continues to change, we

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Conversations from the TechNation ListServ (Cont.) must examine our place and the perception of those with whom we interact. All too often I hear the age-old argument that a corresponding increase in salary did not come with certification.

Many of the same people who make that statement also make the statement that we aren’t treated as professionals. We as an industry do not require a four-year or, in many cases, even a two-year degree.

We do not require certification. We cannot, it seems, agree on something as simple as a name for the position at the technician level. Through the efforts of AAMI we have agreed upon a name for the department though there is resistance to even that change. The only thing that we all agree upon is that there is a certification that we all recognize. If we wish to be perceived as professionals we need some method of proving that we have earned that perception. We are one of the few career fields in health care that does not require formalized training and certification or licensure. When hiring, I will always seek out the certified BMET. That shows a minimal knowledge base and a commitment to ones self and profession. Certification does not mean a given individual will be a good BMET but it does draw a baseline of knowledge. With the continued integration of HTM and IT this is the time that we as industry professionals can make a lasting and important change for our industry. If we can use this time to show our value, to put ourselves on equal or higher footing as our degreed and certified IT counterparts, then we can be seen as the highly skilled professionals we are and earn the respect and the pay that all agree we deserve.

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A:

Where I work you get a pay raise and I think the test cost paid if you pass.

A:

When I talk to friends in IT they say that their certifications do not make them better at what they do, but good luck getting a job or promotion without them. You may say the certifications weed out some and gives their “profession” a more professional appearance. It seems to impress the C-suite.

A:

Where I work you have to have 8 years in the company to even be considered to be a Tech III. If you are certified it is only 5 years and a difference of $4 and hour in your base pay from Tech II to Tech III. We will only be valued as we value ourselves.

professional such as a doctor, lawyer or contractor or co-worker. I agree with what Dan said in such as how do we as professionals want to be perceived by the general industry. Certification aids in perception but as you say, does not always define a technician. But I will say this, if my loved one needed a balloon pump and knowing what I know today, I would have a better feeling knowing a certified tech did the last PM. As you say, it does not make one tech better than another but it is an industry benchmark.

A:

Where I work, certification is a personal choice. Personally, I am working towards it, but by no means does it make someone a better technician than another. There are way too many tangibles that must be considered. A multiple guess test is not a reliable indicator of problem-solving capabilities, accountability or soft skills. Most of those who are truly great and successful are not compelled by paper certificates, but by the desire and enthusiasm to fail and learn from it.

I have been in this field since 1977 – one of the old school techs – and I have considered taking the CBET and CRES – currently studying for the latter, because I want to. I have been selected over CBETs because of my experience and time in the field. Will certification make me a better Biomed? I do not think so, but if the C-suite sees that you are certified there is some knowledge for them to know that you are an expert – although I am an expert, it just seems that the C-suite sees it differently. I personally will be taking the CRES test next year for my own benefit and not the benefit of others. My choice no one else’s. As a choice for hiring – I feel the best qualified person and team orientation is a better fit than someone who is not team oriented but certified.

A:

A:

A:

I think there is a misconception about the actual test. Though it has been a while for me, my recollection was there were parts of the test which specifically involved problem solving as well as safety, physiology and practical applications. I also believe that paper certificates mean a lot when choosing a

NOVEMBER 2015

I just believe real-world situations make or break a person. Then add in political correctness and office politics; no paper test can prepare you for these. But I do strongly believe in aptitude/competency tests, whether they be internal or from an outside organization and documented.

TRIM 2.25”

Agreed, there are many variables when considering someone to hire and certainly and importantly one is being a team player. I think the gentlemen that started the thread was kinda fishing if being certified was a product that would help him stick out from the crowd and I say yes. I think he was a young person looking for experienced advice from folks who have been in the field a while.

Aramark, Sodexo, my organization, Tenet Health Systems (which is an awesome place to work), all look for someone other than ordinary. They don’t really know Pat, Dan, Chris or John but as a Biomed Manager since 1984, 9 years military prior to that, I can say with a good degree of confidence that the ones that are certified will likely be the ones that will get a more in-depth look if you will, considering equal years of work and experience among the candidates. Just a moment ago, I was looking at the Social Security retirement calculator, no joke, and I look at publications and how this field is merging with IT and the strong desire to change our name to Healthcare Technology Management. I oppose the name change. The field is under staffed with an estimated 30 percent shortage by 2020. Newsweek magazine calls it one of the top 5 jobs in the U.S. you don’t know about. My point is, I think all of us should be certified and set the example for those getting in the field.

As others mentioned, it’s one of the only professions in the clinical environment that does not require some type of certification. Being in an IT position with no certifications is not likely to happen.

TRIM 4.5”

A:

A:

The University of Maryland Medical Center and Johns Hopkins requires it for higher level jobs.

A:

I too am an old school tech (1977). I worked for a couple of companies (shared service companies) until 1987 and they encouraged you to become certified. They did not offer any pay increases or assistance if you passed the test, but they did love to promote that they had certified techs doing the work. I was offered a $2,000 pay raise and all expenses covered if I passed the test in 1991. I took the test and passed. Does being certified make a better technician? I don’t believe it does. Some people are great at taking tests but cannot get it from their head PUBLICATION to their hands. I have seen this a lot in MEDICAL TECHNATION my career.

There DEALER are a lot of things that youBUYERS need toGUIDE know that OTHER are not covered in any test. Only experience MONTHwith issues that arise make and dealing you a better technician. I do believe that ifJ youF want M toA move M upJ in this J A S O field you do need to become certified.

JL look at what’s after A lotDESIGNER: of the C-suite the name in the medical field. We do need to promote that we are professionals in our field.

AD SIZE 1/4 Page Vertical

STOP

A:

If a member of the C-suite sets two people down and they both explain to him technical operations in words he doesn’t understand he will use certifications as a measurement of competence. That is just their world.

THESE POSTS are from TechNation’s ListServ. Go to www.1technation.com/ listserv to find out how you can join and be part of the discussion.

ORTODAY

NOTES

N

D

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THE BENCH

ROUNDTABLE Anesthesia Equipment

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1TECHNATION.COM 1TECHNATION.COM

NOVEMBER 2015

E

xtending the life of anesthesia devices and the most important features to look for when purchasing these important medical devices are among the topics addressed by TechNation’s panel in this month’s roundtable article. Industry experts on the panel are Julie Anderson, General Manager, Sharn Anesthesia; Joe Bowen, Senior Technician, Anesthesia Department Lead, USOC Medical; Scott Garrett, BMET III, Piedmont Atlanta Hospital; Thomas G. Green, President, Paragon Service; Garth O. Meikle, CBET, Supervisor, Clinical Engineering Technology, CE-Tech; Thomas G. Green, President, Paragon Service; and Nancy Werfel, Perioperative Marketing Manager, Mindray North America.

Q:

HOW CAN A BIOMED EXTEND THE LIFE OF ANESTHESIA DEVICES?

Anderson: Preventative maintenance is the key.

Bowen: The best way to extend the life of your anesthesia equipment is to do regular PMs. PMs on anesthesia equipment typically entail changing out filters and hoses. The reason these get changed out is that these filters and hoses will get clogged up over time and if not taken care of that material will eventually work its way into other more sensitive pieces of hardware inside your anesthesia equipment.

Then, instead of spending $600 on a PM kit, you’ll be spending several times that on a repair.

Garrett: I’d say by getting the proper training and doing the required PM. Replacing parts when required and sometimes when it is not indicated by the manufacturer. For example, I replaced all the rubber seals, bellows, etc. even though the manufacturer has no recommendation for this.

Green: The life of an anesthesia machine is limited to either the desired new features of newer equipment or the availability of parts and service. If an anesthesia machine is no longer supported by the manufacturer, then the service provider must have all of the parts available to immediately return the life support device back into use by the anesthesia provider. If the service technician cannot do so, then I would say that the device has reached the end of its life.

Meikle: First and foremost, the biomed can ensure that they have an excellent working relationship with their anesthesia (tech) staff; a relationship that fosters care and pride for the devices that impact their ability to provide patient care. This type of relationship has many ancillary benefits including device up-time and service life.

Werfel: Perform the preventive maintenance per the schedule in the service manual. Be vigilant in monitoring moisture produced by the breathing system. Some combinations of machines, CO2 absorbers, and HME filters create more moisture than others. A heated breathing system reduces moisture which can have a corrosive effect on the internal components of the machine over time. It is also beneficial to use bacterial filters on the inspiratory and expiratory ports.

Q:

WHAT ARE THE MOST IMPORTANT FEATURES TO LOOK FOR WHEN PURCHASING ANESTHESIA DEVICES?

Anderson: Post-purchase costs are a key feature that is often overlooked. In the heat of pursuit of new technologies, the cost of related consumables and associated maintenance costs are often overlooked. They can be budgetbusters. All too often the incremental improvements provided by newer technologies do not justify added expense. For example, a rural eye surgery center may not need as robust of an anesthesia machine as a busy hospital with a transplant program, two robots and a trauma program.

Bowen: Most anesthesia equipment I have worked on use the same types of hardware inside, so there really isn’t much difference between one brand and another. This is especially true of newer equipment, as most companies, nowadays, are using Draeger parts internally. I would recommend that whatever equipment you’re purchasing, you make sure it meets all your needs today and any needs you might anticipate for the future.

Garrett: Ease of use for the anesthesia staff.

Does the unit have the ventilation modes you need to handle all your different types of cases?

Repair history of the machine. Did another

THE ROUNDTABLE

JOE BOWEN

JULIE ANDERSON

hospital have any issues keeping these units performing?

Green: Service support. The hospital or surgery center must have dependable and responsive service.

Meikle: Considerations would depend on the answers to questions such as: What are the clinical needs of my patients and the capabilities of my facility (medical center, teaching hospital, surgery center, etc.), service (heart, general, orthopedics, etc.) or staff? What ventilation modes do my patients need (VCV, SIMV, PCV, PCV-VG, …)? Is my patient information currently shared electronically? Does the device allow for future upgrades (electronic health records, vent modes, etc.)?

Werfel: Safety is paramount. The machine should be able to ventilate and deliver agent in case of complete power failure, have an extended battery life, and the ability to protect against surgical fires with the advantage of blending O2 and air to reduce the combustible percentage of oxygen. Device Connectivity – as hospitals become more connected and work toward interoperability objectives, interfacing with devices of various suppliers can be challenging and expensive. Utilizing Open Standards like HL7 can simplify implementation and reduce costs. Reliable and easy to service

36

1TECHNATION.COM

SCOTT GARRET

Senior Technician, Anesthesia Department Lead, USOC Medical

BMET III, Piedmont Atlanta Hospital

– key components for diagnosis, repair or exchange should be easily accessed. The anesthesia system design should be sturdy and compact, preventing accidental damage under normal handling and transport conditions.

to adapt, to include anesthesia. The need to have anesthesia systems interfaced with EHR is becoming more widespread, all while controlling cost/improving patient outcomes.

General Manager, Sharn Anesthesia

Q:

WHAT ARE THE LATEST ADVANCES OR SIGNIFICANT CHANGES IN ANESTHESIA EQUIPMENT? WHAT TECHNOLOGIES ARE WORTHY OF THE INITIAL INVESTMENT? Anderson: We see a lot of innovative airway devices. All seem to help, but none is perfect for every patient in every scenario. A wise department would have many options available at all times.

When a rescue device is needed, it is needed. Budgets should not be the concern at that moment.

Green: Older anesthesia systems had only volume or pressure control ventilators.

Modern anesthesia systems incorporate ICU ventilator technology such as pressure support, SIMV, SMMV, etc. Another new technology is the incorporation of a semiautomatic self-test of the anesthesia machine before use on a patient.

Meikle: A more stringent CMS (Center for Medicaid and Medicare) reimbursement criterion and increased access to health care is driving industries

NOVEMBER 2015

Werfel: Electronic fresh gas flow improves accuracy and supports low flow anesthesia which reduces cost to the facility and pollution to the environment.

It is important to note that too much reliance on electronics and technology is a departure from the traditional anesthesia delivery many anesthesiologists are experienced with. For example, electronic vaporizers may be more precise, however they require power and cannot be used in the case of total power failure. That is also true of alternative re-breathing systems, which may be beneficial for use with certain patient acuities, but do not provide a visual indication of potential system leaks as do traditional bellows.

Q:

HOW WILL NEW TECHNOLOGY AND OTHER ADVANCES IMPACT THE ANESTHESIA DEVICES MARKET? Anderson: In the long-term, new technologies will improve patient safety.

That has been the goal, it remains the goal and there has been significant, measurable success.

Meikle: Real-time data (patient and

TOM GREEN

President, Paragon Service

systems) acquisition is a much sought after feature that promises to increasingly improve patient safety outcomes, as well as the bottom line in an ever competitive and changing health care environment.

Werfel: New technologies will continue to advance anesthesia practices. This will happen by: • Offering new ventilation modes to the clinician that specifically target varying patient population requirements.

• Next generation devices will begin to offer decision support tools. (Some of these options are already available in Europe.)

• Simplifying the user experience with user interface and setting customization.

• Taking advantage of other technologies already available in the general consumer market (IT, hardware and consumer user interface advances).

Q:

WHAT TYPE OF CREDENTIALS SHOULD THIRD-PARTY ORGANIZATIONS POSSES OR MAINTAIN? WHAT SHOULD BE CONSIDERED WHEN EVALUATING THIRD-PARTY ORGANIZATIONS? Garrett: I think third-party techs should definitely be factory trained. I’m not comfortable at all letting someone work on a life support piece of equipment that

GARTH MEIKLE

NANCY WERFEL

CBET, Supervisor, Clinical Engineering Technology, CE-Tech

Perioperative Marketing Manager, Mindray North America

was shown by someone who was shown by someone else how to repair/PM my anesthesia machines.

Green: Are the technicians factory trained? What is the response time?

Experience of the service technicians?

How long has the company existed? What is the amount of liability insurance? Parts inventory? References?

Meikle: Any organization (in-house, third-party, or OEM) must have leadership in place which values continued personal and professional development.

This can be exemplified by among other things – certified manufacturer/vendor training, CBET/CLES/CRES, and formal schooling. Cost of service, verifiable references and proven organization standing in the industry cannot be overlooked.

Werfel: Third-party service providers can be effective as long as they remain current with OEM training requirements. Biomed technical courses are offered by manufacturers and participants should receive a certificate with an expiration date, requiring periodic re-certification.

Q:

Anderson: They are not all created equal.

Garrett: Anesthesia machines have some of the same features as respiratory ventilators. They also have some software driven calibrations that make it a little less intimidating to work on.

Meikle: An anesthesia machine is a collection of systems that work together and understanding the various systems (i.e. ventilator, high/low pressure circuits, gas delivery, scavenging, electronic vaporizer, etc.) will make servicing easier, taking away much of the intimidation factor that occasionally comes from working on such high-profile life-support devices, particularly in a high-paced/high-stress environment like the operating room.

Werfel: Increasingly important, in addition to the cost of acquisition, is the cost of ownership. This includes cost for maintenance, consumable accessories, and realization of drug costs savings through utilization of low-flow anesthesia and agent usage calculations. The platform should be upgradeable as new features, both software and hardware, become available so your fleet will not obsolete prematurely.

WHAT ELSE DO YOU THINK IS IMPORTANT FOR TECHNATION READERS TO KNOW ABOUT ANESTHESIA DEVICES?

THE ROUNDTABLE

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1TECHNATION.COM

39

AAM Plan I’s Ca ning reer Han A Re sour db M ce anag

f eme or Heal thca nt P r r

ook

TOOLS FOR CAREER ADVANCEMENT Updates on AAMI’s Career Planning Handbook

By K. Richard Douglas

I

t’s a fact that structure in our lives can reduce stress and keep us on track. Better yet, a structured approach to a goal can get us there with a higher probability of success. It is with these facts in mind that AAMI developed a guide to career advancement. Career advancement can mean many things, but the goal is to do something that is fulfilling and meaningful.

New York Yankees great, Yogi Berra once said; “If you don’t know where you are going, you might wind up someplace else.” AAMI’s goal with the Career Ladder is to make sure HTM professionals end up where they want to be and where they need to be.

As part of AAMI’s Technology Management Council (TMC), the Job Descriptions Task Force developed the AAMI Career Planning Handbook, which debuted in June of last year. It was designed with the goal of bringing clarification and standardization to the required skill set of HTM professionals who often have disparate roles and titles across the spectrum of health care settings. The handbook outlines the education and experience that is required to climb the career ladder in any chosen HTM career path.

“AAMI’s Technology Management Council developed this career planning handbook to fill a major void in the HTM field,” said AAMI Chief Operating Officer Steve Campbell. “This concise handbook is designed to help HTM professionals identify various career opportunities,

42

1TECHNATION.COM

STEVE CAMPBELL

AAMI Chief Operating Officer

“

We owe a great debt of gratitude to the HTM leaders who worked on this AAMI project ... They went above the call of duty to develop this handbook which will help so many professionals in the HTM field.”

- Steve Campbell

describe what skills are needed to move up, and what career paths are available. And that’s what I love most about it – it’s practical and easy to use.

The handbook includes everything from interviewing tips to guidance on meeting with supervisors and human resources.”

NOVEMBER 2015

“We owe a great debt of gratitude to the HTM leaders who worked on this AAMI project – Barb Christe, Mary Coker, Barrett Franklin, Jack McNerny, Pat Lynch, Dave Scott, Dustin Telford, Karen Waninger, and Steve Yelton. They went above the call of duty to develop this handbook which will help so many professionals in the HTM field,” Campbell added.

The HTM professionals Campbell mentions come from a diverse cross-section of leaders in the field. Barbara Christe, Ph.D, is program director of Healthcare Engineering Technology Management and associate professor of the Engineering Technology Department at Indiana UniversityPurdue University. Mary Coker, CBET, CCE, is director of Clinical Engineering at Providence Hospitals.

Barrett Franklin, MS, CCE, is chief clinical engineer at the VA New England Hospital. Jack E. McNerny Jr., CBET, works for Johnson & Johnson Healthcare. Patrick Lynch, CBET, CCE, is chief do-gooder for Global Medical Imaging. David Scott, CBET, is a biomedical technician at Children’s Hospital Colorado. Dustin Telford, CBET, CRES, CLES, is with earthMed and Children’s Hospital Colorado.

Karen Waninger is the clinical engineering director at Community Health Network. Steven Yelton is a professor at Cincinnati State Technical and Community College.

This group brought a wide range of experiences, perspectives and professionalism to the task of developing a sequential, logical and methodical set of steps to lead HTM professionals through their career.

“The development of the handbook was both challenging and rewarding,” says Franklin. “In all, the team was very dedicated, meeting consistently, over several months, and taking on considerable ‘homework’ between each meeting.”

“We recognized early on, that the tool we sought to create had a significant potential value, not only to new and veteran members of the HTM field, but also for HTM leaders and human resources alike. As such, we worked diligently to consider the details and the inter-relationships that we sought to more clearly define,” he adds. “Ultimately, for a tool to have the backing of a nationally recognized organization such as AAMI brings significant validation, and as such, we want to make sure we got it right.”

“We worked diligently to create the basis for a career roadmap of sorts – one that would support a new technician or engineer as well as an HR department working to design career progression within their organization,” Franklin says.

“The journey to AAMI’s Career Ladder and Career Planning Handbook grew out of a recognition that the Biomedical/Clinical/Medical – Engineering (now Healthcare Technology Management) community, when compared to physicians, nurses, or hospital administrators, was a numerically small group without clearly defined career pathway(s) or opportunity,” McNerny says. “HTM is not a licensed practice in the U.S. as it is in some other countries.”

“The group then ideated on those career options and step-by-step detail on how individuals could or would reach each of those end goals, ultimately giving our HTM audience clear and defined steps to reach their individual career goals,” McNerny adds.

McNerny reflects that the process was long and detailed, including investigating, reviewing, refining, and validating endless details, with the goal of delivering a comprehensive guide in the end.

“The team set many self-imposed goals for our group, that we were all determined to fulfill. The group partnered with Alice Waagen,

BARRETT FRANKLIN

MS, CCE, Chief Clinical Engineer at VA New England Hospital

“

We recognized early on, that the tool we sought to create had a significant potential value, not only to new and veteran members of the HTM field, but also for HTM leaders and human resources alike.”

- Barrett Franklin

Ph.D. of ‘Workforce Learning’ to help ‘monitor’ the team’s focus, direction, and productivity (if you will). Alice did just that and helped keep us focused, kept us on task, and summarized our progress each step of the way. By the fall of 2014 AAMI’s Career Planning Handbook and AAMI’s Leadership Development

Guide was published.”

With accreditation from The Accreditation Board for Engineering and Technology (ABET), AAMI is the lead society in the HTM profession for setting guidelines and assisting in accreditation of college degree programs for biomedical engineering programs.

What all this means is that there can be more standardization, development of best practices and materials disseminated that provide guidelines for programs and career paths. And, career growth doesn’t necessarily mean moving up the proverbial corporate ladder. Many HTM professionals are very happy in their current position. So, it can mean growth within that position as well.

Conversely, career growth can mean moving into the next higher level of responsibility and skill set. It can mean aiming for a position in department management and beyond. In any case, having a blueprint to achieve that career path, can make it happen. The guide is also a tool that management can use to develop well-defined career paths within an HTM department.

DEVELOPMENT To put the whole effort into perspective, it is necessary to go back to 2011 and revisit the aspirations of AAMI’s “Future Forum I,” which was a foreshadowing of what became the HTM profession. If the field was beginning to feel like Rodney Dangerfield, it was about to experience some brainstorming to change that feeling. For starters, the name “healthcare technology management” was chosen as a single unifying moniker for the field.

The following year, “Future Forum II” was convened and the field advanced some more through recognition of newer risk management requirements and creating more standardization. This included job titles and descriptions and a need to define career paths more succinctly.

AAMI CAREER HANDBOOK

“

The first steps for the team included a great deal of dialog on requirements.

Specifically identifying what the employment and career development requirements — and preferences — are in the 21st century.”

- Mary Coker

AAMI’s “Future Forums” encouraged HTM leaders to deliberate, discuss and debate the future of the field. The forums in turn helped set the stage for the career handbook. It was understood that health care was changing and advancing technologically and the newly named HTM profession had to be cutting edge, as well as provide thought leaders, to stay relevant.

Several participants from Future Forum II agreed to work together to establish a definition and outline for job titles and to describe the daily activities for those roles. They considered much of the current debate within the field as well as guidelines for management and HR. The result of all the work by the Career Planning Handbook participants was presented by Scott and Waninger at the AAMI Annual Conference in June of last year. The presentation gave an early review of

44

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what the career ladder concept was all about.

“It’s also worth noting that there’s a companion publication, called ‘AAMI’s Leadership Development Guide,’ which provides practical guidance to managers and those who aspire to be managers,” Campbell says. “Think of it as a 32-page toolkit – filled with helpful tips and guidance. A special thanks goes out to AAMI’s Healthcare Technology Leadership Committee, who worked on the guide too.”

“These two handbooks are important elements of AAMI’s work to support the great work of HTM professionals and to strengthen the HTM field,” Campbell adds.

“The handbook is a foundation tool to verify and standardize the profession. Each step of the way, content was discussed in detail by a team of HTM professionals from many aspects of the industry as well as input at large from the HTM community,” says Coker.

McNerny says that the discussion drilled down to identify requirements and skills.

“The first steps for the team included a great deal of dialog on requirements. Specifically identifying what the employment and career development requirements — and preferences — are in the 21st century. Meaning, a) What are current expectations or desires when employing individuals this day and age? b) What are the specific skills needed for HTM in practice? c) How are those skills acquired? d) We identified several sub-specialties or career tracks that any HTM could use as a guide. e) What are specific requirements for individual career development for any of the subspecialties or career paths?”

POINTING THE WAY The guide starts out with something so obvious that many may overlook

NOVEMBER 2015

it; setting career goals. A ship without a rudder will drift wherever the tide takes it. Nobody can afford to let their career mimic a rudderless ship.

With several suggested steps, the first step in the career guide spells out what questions to ask yourself when setting some medium-term goals.

Once these questions are answered, a clear statement of that goal can be formulated and written out.

“The structure of the guide was aimed at being accessible. We recognized from our own experiences that defining a roadmap no matter where in your career path you are can be daunting and as such we wanted the tool to be approachable, clear, and provide insight on the steps to get from A to B,” Franklin says.

Do your homework. This is the gist of the second step in the guide.

It suggests that if you want to move into a new position, find out all of the minutiae that is not listed in a job description. You may understand the technical requirements of the position, but you may not know the real-world experience of a person working at that job. The guide offers many suggestions about how to learn all that you should really know before setting your sights on that position.

Taking an inventory and selfassessment of your skills, strengths and weaknesses. This is the direction that the guide suggests in the third step. It presents a list of resources that will allow you to evaluate your work habits, interpersonal skills and time management skills. You can then have a baseline based on your studied evaluation.

Knowing your strengths is just one side of the coin. The guide then suggests that you determine your deficits and deal with them. The guide instructs that you take your future needs from the second step and the results of your current assets from the third step and determine what’s lacking after comparing both.

By the guide’s fifth step, you are ready to create your plan. Your plan contains clearly defined goals and steps to achieve each. This is where the Career Planning Handbook shifts into overdrive. The guide goes into detail about creating a personal development plan and prioritizing activities to achieve results.

No amount of planning matters until it is put into action. The guide outlines how to take this important step in step six. All of this preparation preempts the next section which is labeled the toolkit. It includes a “Technician Career Progression Grid,” and a graphic depicting three potential career progressions for an HTM career; technician, clinical engineer and leadership.

A skills inventory worksheet, gap analysis and personal development plan are included along with planning worksheets within the toolkit section.

A section titled “Career Planning Opportunities” follows with a list of formal education programs available to HTM professionals.

Some suggested developmental activities are included and suggest ways to implement the education information. There is also a page devoted to those targeting leadership opportunities followed by a definition of general skills and experience along with related developmental activities. More specific experience and associated developmental activities round out the section.

The handbook offers a section on public safety and regulatory requirements followed by customer service. Both areas of development are part and parcel of an HTM career regardless of the path you choose.

And, for those who want to develop special equipment expertise, there are development activities that will get you there.

Communicating your plan gets it all from paper to reality. The career

JACK MCNEARY, CBET

Johnson & Johnson Healthcare

“

Now, and in the future, U.S. HTMs may be recognized and valued for their contributions as their licensed counterparts are in other parts of the world.”

- Jack McNeary

handbook outlines everything you should do to meet with your boss and HR to set your goals into a real career path. An informative FAQ section rounds out the guide.

ENTERING HTM AND FEEDBACK “The career ladder helps my students who are certain they want only one track: imaging field service (“radiology specialist” in the guide), because it earns the highest

paychecks,” says Christe.

“The material in the guide outlines the steps to move into this field and shows that it is not a quick or simple process,” she adds.

“In addition, I strongly endorse the education stipulation of an associate degree for a level one technician,” Christe says. “For many years, I have been vocal that a college degree should be an entry-level credential. In a world where everyone in the clinical setting has some kind of academic credential, it seemed that our profession was not doing ourselves justice by implying/stating/advocating no degree requirement.”

“I am certain many long-time HTM professionals disagree, but recommending this background now offers hope that it will be implemented in the future,” Christe adds.

The response from educators has been positive.

“Thus far the feedback I have received has been very positive. I have talked with several educational institutions that have shared the document with their students,” Franklin says.

“HTM practitioners now have some clear guidance to accomplishing their personal career goals that was not cohesively here-to-fore available to these individuals. In the past, we could only hope that opportunity would shine on HTMs. Now, and in the future, U.S. HTMs may be recognized and valued for their contributions as their licensed counterparts are in other parts of the world,” McNerny says.

Through this guide, we were able to produce clear career opportunity and development direction, from entry-level technician or staff engineer, through the C-suite.

Steer your HTM career in the right direction with the AAMI Career Planning Handbook. Take advantage of all the thought, debate and discussion that went into its creation.

Find it online at http://goo.gl/EY9aab

AAMI CAREER HANDBOOK

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THE ROMAN REVIEW

Presentation is Everything

By Manny Roman

I

will be conducting presentations at upcoming conferences and am preparing myself by reviewing the presentations. As I review, I remind myself about what makes good presentation skills. These are skills that cause the audience to actively listen and possibly act as a result of the presentation.

MANNY ROMAN CRES, Founding Member of I.C.E. imagingigloo.com

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Among the many skills that service and management professionals must have are effective presentation skills. I’m not talking just about how to use PowerPoint. I’m talking about the ability to effectively transfer information to another individual or a group of individuals so that understanding is assured. Without this effective communication, a misunderstanding will be the certain outcome.

The first thing to realize is that perception is reality. I’m sure you have heard this many times. It means that our reality is based on our perception not on actual reality. Now, as I always do, I am going to change that.

Since what you see depends on where you choose to sit, then if I can provide the chair that I want you to sit in, I can change your perception and, thus, your reality.

This of course requires that I do more than make the chair available. I must also guide you to sit in it. How do I do that? Glad you asked. You do that by providing an effective presentation. So it follows that presentation determines reality, therefore presentation is everything.

To begin the presentation, you must be confident that you understand what you want to communicate. You must also prepare mentally and physically for the particular encounter. This means you must know your audience. You must know the vocabulary to use, the motivation needed by the audience, what expectations they will bring and anything else you can find out about them.

NOVEMBER 2015

Set the environment. You must minimize external and internal noise. External noise comprises things like the room temperature, the comfort of the seating arrangements, the lighting and, of course, actual noise. Internal noise refers to the fact that people can think much faster than you can speak. So at any time during your presentation, you can lose people to their own thoughts. You must remain observant of their body language to ensure to bring them back on point.

Part of the introduction should outline who you are and why you are the right individual to be making this particular presentation. If it is a formal presentation then you will need contact information and anything else that will make it easy for them to follow up.

The presentation itself should begin, if at all possible, with a tie in to some previous event or knowledge so that there is a smooth flow to the start. You want to take them from the known to the unknown. The reason for the presentation should be made obvious so there is no misunderstanding as to why you are there.

Whether you call them objectives or not, there should be measurable reasons for the presentation. You should also provide a motivational statement so people know for sure why they should listen.

Then you start the presentation. First, tell them what you are going to tell them.

This is an overview of the topics of discussion. This lets people know what to look for during the presentation. Then, you tell them. This is the body and meat of

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the presentation. Then, you tell them what you told them. This is a short, well-designed review. So tell them what you are going to tell them, tell them and then tell them what you told them.

The number one rule for effective presentations is: Do Not Make the Audience Work Hard.

Keep any slides to one point per slide. Keep slides simple. Do not read to the audience. Do not use whole sentences on slides.

Slides serve as a cue to you as the presenter to ensure you cover the topic. They also serve to cue to the audience regarding the slide topic. Complex slides break Rule # 1.

Engage the audience with your statements. Speak with the audience not at them. Restate questions so all hear them. Thank the audience for questions and comments. I suggest that you try to incorporate some of these points into your presentations and see how they work for you. You might find that your presentations go a little more smoothly and effectively.

So in closing, please make believe that I told you what I was going to tell you, that I told you and that I told you what I told you. Remember rule number one.

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Troubleshooting Power on the Philips Epiq 5 /7

By Matt Tomory

P

hilips Medical recently released the successors to the extremely popular iU22 and iE33 ultrasound/ echocardiography systems. The new flagships are the Epiq 5 and Epiq 7 premium ultrasound and echocardiography systems.

MATT TOMORY Executive VP of Sales & Marketing at Conquest Imaging

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As with any new product release from any manufacturer, there are service challenges which may include software and hardware design issues as well as malfunctions. The design issues are why we always recommend customers ensure their systems are at the latest hardware and software revisions prior to expiring warranties and if problems continue, to remain with the OEM until the product stabilizes. If products are unstable, it may be difficult to determine whether a service event is a malfunction or related to design problems.

Let’s take a brief look at troubleshooting common power problems on the Epiq. Starting with the main power button, there are four states: 1. Off – no power applied to the system 2. White steady – system is in standby/5V DC standby present 3. Green steady – system on 4. Green blinking – system is in standby If the system does not power on using the main console switch, there may be a problem with the user interface. You can bypass this by pressing the momentary switch on the backplane located just below and left of the board barcode. If the system fires, you likely have a bad control panel, audio input output (AIO) or cables. There is a USB cable from the

NOVEMBER 2015

AIO to the control panel you can disconnect for troubleshooting purposes.

Troubleshooting the ATX power supply module is simplified by LED indicators for the 12V, 5V, 3.3V, -12V and 5V standby. Note: The -12V is not generated by the main power supply.

There are also LEDs on the main power supply which provide status of: 1. LED 1 above main AC input – On is AC present The following LEDs are from right to left beside the power supply ground lug starting with number 2 2. Battery status a. Off – AC absent, battery not enabled b. Yellow/green blinking – battery calibration ongoing c. Steady yellow — battery charge low d. Yellow blinking – battery fault e. Green blinking – battery partially charged and available f. Green steady – battery fully charged and available These are just a few basic troubleshooting tips for these new systems. For greater detail, please register for our Epiq Troubleshooting Session on TechNation’s Webinar Wednesdays. The session is on November 18 at 2 p.m. EST and registration is available at: www.1TechNation.com/webinars

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51

THE FUTURE Changing Times

By Roger A. Bowles

A

s I write this, we are almost a month into the fall 2015 semester with an encouraging number of new students eager to begin their careers as BMETs. We average around 46 new students in the fall and this year we have 57. The larger than average number of new students is an excellent sign.

Roger A. Bowles MS, EdD, CBET, Texas State Techinical College

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As the department chair, I teach the introductory course because I want to get to know the students at the beginning of the program. One of the first assignments I give them is to write down goals for themselves for the next 2 to 5 years. Most of the responses are what you would expect. Many of them already have ideas of what type of employer they want to work for and where. Some have no clue and really aren’t even sure why they picked the program. I’ll be honest, when I started in the program as a student in 1989, I really didn’t know why I picked it either. The description in the catalog sounded good and mixing health care and electronics sounded like a good career path to me at the time. I’ve never regretted my decision.

Of course some of the responses I get are a little off the beaten path. I have one student whose goal in 5 years is to open a salon in Bulgaria. Another one wants to be a welder. And another sees himself living in a two-story house in Japan.

Maybe they are just messing with me.

Things have certainly changed since I first became a student here over 25 years ago, mostly for the better. The department certainly has more and better equipment. Students have many

NOVEMBER 2015

more choices for internships and employment. And the curriculum has changed with more emphasis on computer skills. One course that has drastically changed is our shop skills course. In the past, it focused mainly on soldering skills. These days, basic tools and measurements are covered more extensively. We have found that many of the younger students have had no exposure to basic hand tools growing up and have no idea how they are used.

Some cannot read a tape measure.

Nothing against their upbringing … just different priorities I guess. They certainly know how to use smartphones and other gadgets that I am still getting used to. In fact, I wonder if they focus on them too much.

I might have mentioned in a previous article that over the last year or so I have been doing a lot more walking (thanks to my Garmin Vivofit 2) during the day.

Typically, I’ll take a 10-minute walk every hour somewhere on campus. This has afforded me the opportunity to make some interesting observations of students walking around campus. One of the strangest things I’ve noticed is how a lot of people walk around staring at their phones, drive around staring at their

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phones or just stand around staring at their phones. Perhaps it is my age, or the fact that I can’t see my phone without the help of reading glasses, but I just can’t understand the fascination (some say addiction) with such a device. I have to watch where I step so I don’t get run over while walking. We even had a student file a complaint against one of our instructors because the instructor left the classroom door open in the hallway and the student ran into the door while walking because he was staring at his phone. You can’t make this stuff up!

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going through the intersection BUYERSeither GUIDE OTHER NOTES talking or texting on their phones.

MONTHhere and I Technology is our livelihood from KEI inventory direct to your site have nothing against it, but I’m beginning Resize document to fit ou to think it has consumed some people to J F M A M J J A S O N D the point where they pay attention to it DESIGNER: and nothing else around them. At JL my age, I think of the smartphone as a sometimes useful tool but most often a leash. On one hand, students have access to the world at their fingertips and the library is fast becoming a relic of a building where older students gather to marvel at historical documents called books. On the other, the basic arts of conversation, Need Tech Support and Part Installation, too? writing and simply looking where you are going seem to be suffering.

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And it makes me wonder what my grandparents thought about the changing times as they observed them years ago. One thing is for certain, it will only get more interesting.

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A Checklist to set up a new HTM (Biomed) Shop

By Patrick Lynch

H

ere is a list of things to be included, as a minimum, for a small biomed shop. This is to serve as a list of things to consider when planning a new shop. Obviously, if you can exceed the items listed, you will be much better off.

But I consider the items listed to be the absolute least required for a functional HTM shop operation.

LOCATION • Inside hospital — cannot take patient care equipment outdoors in inclimate weather.

• Must not require ramps or steps to move from hospital to shop.

• Near maintenance and receiving, but with easy access to major clinical departments (surgery, central supply, critical care, nursery, neonatal) SPACE • Technician work bench space, usually 150 sq ft per tech

• File cabinets for small manuals and reference documents.

• Padded stools and chairs, appropriate height for benches and desks.

OFFICE TECHNOLOGY • Computer, 1 or 2

• Technical library, for manuals, catalogs, reference material

• Printer, laser, color, two-sided if possible.

• Storage area • Parts, equipment storage, receiving, supplies, old equipment for cannibalization.

• Photocopier • Should have ability to scan documents, as well as send and receive faxes.

• May be combined with printer for a single device to meet all needs.

• Work benches along outside walls.

SOFTWARE • Microsoft office or a free alternative (for .doc. .xls, .ppt files)

• 1 Office for manager

• Adobe reader (for pdf files)

• Secure - must be securely locked when no one is in shop.

• Cmms - basic functions of inventory, pm scheduling, equipment history, personnel activity and cost reports.

UTILITIES • Water, with large utility sink

• Virus protection, very important!

• Many electrical outlets.

BASIC TOOLS • Complete set of electronic hand tools

• 1 If dual electrical voltages, must have all present in shop • Medical oxygen

• Complete set of mechanical hand tools • Wrenches, hammers, voltmeters, files

• Medical compressed air • Computer network plus robust WiFi

POWER TOOLS • Drill and bits, solder gun, cordless drill

• Internet access, fast!

SUPPLIES • Glues, Tapes, fasteners, screws, sandpaper, plugs, wire, cables, tie wraps, gloves, glasses, lubricants, lamps, fuses, labels, tags

• Cellular telephone coverage.

FURNITURE • Electronics workbenches, 1 per 1TECHNATION.COM

• Bookshelves for manuals and catalogs

• Office/supervisor/computer area

• Open, few, if any, walls.

54

• Desk for office

• Laptop, may be needed for equipment calibration or to view service literature outside of the biomed shop.

LAYOUT • Wide doors leading into main, open area.

PATRICK K. LYNCH, CBET, CCE Biomedical Support Specialist for GMI

technician, plus 1 or 2 for outside service personnel to use.

NOVEMBER 2015

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THE VAULT

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o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo.

Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-november-2015. Good luck!

LAST MONTH’S PHOTO A D1 Radiographic X-ray System The photo was taken at the RSNA 100th Scientific Assembly and Annual Meeting 2014.

To find out who won a $25 gift card for correctly identifying the medical device visit 1TechNation.com.

SUBMIT A PHOTO Send a photo of an old medical device to editor@mdpublishing.com and you could win lunch for your department courtesy of TechNation!

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NOVEMBER 2015

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FBS SPOTLIGHT

Testimonials from the 2015 Symposium “Thank you to all the attendees of our 2015 FBS Symposium held at Disney’s Coronado Springs Resort. I hope that the training that was offered has helped you to add to your abilities to be the best at your job and profession. I also hope it gave you the opportunity to do some networking and make valuable contacts and new friends. Thanks also to the exhibitors who helped to make the Symposium a success. Your continued support of the Biomedical profession is of an intangible value and I look forward to working with you at the 2016 symposium which will be held at Disney’s Yacht Club Resort, December 8 through 10. Finally, I want to thank my fellow Board members for all of their support. Our symposiums could not be as successful as they are without your commitment to our profession.”

– FBS President-Elect Richard L. Morris

Richard L. Morris President-Elect

Ashley Miceli

Bill Hascup

Carlos R. Villafañe

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“The 2015 symposium attracted an excellent showing of exhibitors, technicians and students from the biomedical industry. It was great to see the educational classes filled and the rooms were buzzing with excellent feedback from the attendees. The exhibitors were very pleased with the quality time they spent with decision makers from the field.”

“As Symposium Director for FBS, it’s hard for me to pinpoint one highlight from this year’s Symposium, but if had to, I would say it was the educational tracks that were offered. From OEM-offered ESU training to ventilator service, this year had to be the most beneficial offerings I’ve ever seen or attended.”

“The Symposium was very special to all of the FBS Board members, as we were celebrating FBS 30th Anniversary. We had a great time!”

“Training at the 2015 FBS Symposium was a huge success! Two days, 54 hours, 18 different classes, 16 instructors providing over 400 FBS Members and Non Members FREE education, training and instruction within all three of the biomedical modalities – radiology, laboratory and biomedical.”

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1TECHNATION.COM

NOVEMBER 2015

SCRAPBOOK Florida Biomedical Society (FBS)

1.

3.

2.

4.

5.

The Florida Biomedical Society’s annual Symposium is one of the more popular state association events each year and this year was extra special as the organization celebrating its 30th anniversary.

“Apart to the normal expo hall and training classes, we had some activities to raise funds for Tyler’s Hope,” FBS President Carlos R. Villafañe said. “On Friday night, we had the Beach Bash, where all attendees and vendors had time to relax and share experiences in a beach-themed party. We presented the FBS President’s Award to USOC Biomedical Services that night. On Saturday, we had two activities at Disney’s EPCOT Center: A dinner in the Living Seas restaurant, where we presented the FBS Biomed of the Year award, and a cocktail party in the Canada Pavillion, where everybody had a blast while watching the fireworks.” For information about FBS, visit www.fbsonline.net.

1.

Injector Support and Service staff celebrating at the FBS Epcot reception.

2.

Jayme McKelvey & Kaylee McKaffery ready to greet attendees during the happy hour sponsored by TechNation and MedWrench.

3.

Iris Orihuela, 2015 Biomedical Technician of the Year for BAAMI; Joel Camargo, 2015 BMET of the Year for FBS; Carlos Vilafane FBS Board member.

4.

From left to right: Seth Valliere, Brandon Karas, Ben Pridgeon, Ken Staab, & Shawn Koehn at Intermed.

5.

USOC was the 2015 President’s Award, (FBS Vendor of the Year).

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North Carolina Biomedical Association (NCBA)

1.

2.

4.

3.

5.

The 37th annual Symposium of the North Carolina Biomedical Association was held September 8-11 at the Embassy Suites Hotel in Concord, North Carolina. The Symposium included a variety of top-notch educational opportunities, a busy exhibit hall, networking opportunities and a keynote address by Marilyn Neder Flack, senior vice president of patient safety initiatives at AAMI and executive director of the AAMI Foundation. One of the more popular state association conferences, the NCBA Symposium had over 70 exhibitors, and 200 attendees.

Educational opportunities included manufacturer certifications on the Covidien Force FX and the Covidien Force Triad. GE training was also offered. There was an all-day class on alarm management by Jim Welch. John Maurer from The Joint Comission taught class on the environment of care and compliance. McCoy said NCBA is excited about a return to Pinehurst for the 38th annual NCBA Symposium. It will be held Aug. 23-26, 2016. For more information about NCBA, visit www.ncbiomedassoc.com.

1. Presenter Manny Roman of ICE (center) with NCBA President Clint McCoy (right) and past President Greg Johnson (left).

2. Marilyn Neder Flack addressing the NCBA membership.

3. The NCBA Board of Directors 4. Bill Franklin with MindSet LLC, presenting “Working With Difficult People� at the NCBA Symposium.

5.

64

John Noblitt has a full room for his class on the new AAMI Certified Healthcare Technology Management program.

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BULLETIN BOARD

A

new resource where medical equipment professionals can find all the information needed to help them be more successful! The easy to navigate Bulletin Board gives you access to informative blogs, expos and events, continuing education opportunities, and a job board. Visit www.MedWrench.com/BulletinBoard to find out more about this resource.

Career Opportunities

Job Description: View a full description at www.medwrench.com/BulletinBoard under the careers tab.

WRITER ASSEMBLY TIPS

Having issues with the writer assembly Greg Smith of Southeastern on your GE case Biomedical Associates stress system? One tech support call we get routinely is regarding paper not tracking correctly. View the rest of the blog post at www.MedWrench.com/BulletinBoard

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TO JOIN ICE SIMPLY VISIT WWW.IMAGINGIGLOO.COM/JOIN-ICE

INDEX

CONNECT & LEARN WITH

4med ………………………………………… 24 Ph: 888.763.4229 • www.4med.com

ReNew Biomedical ………………………… 24 Ph: 844.425.0987 • www.RenewBiomedical.com

AllParts Medical ……………………………… 8 Ph: 866.507.4973 • www.allpartsmedical.com

Maull Biomedical Training LLC …………… 18 Ph: 440.724.7511 • www.maullbiomedical.com

Ampronix ……………………………………… 4 Ph: 800.400.7972 • www.ampronix.com

MedWrench ………………………………… 56 Ph: 866.989.7057 •www.medwrench.com

Bayer Healthcare - MVS …………………… 38 Ph: 1.844.MVS.5100 • www.mvs.bayer.com

Pacific Medical LLC …………………………… 7 Ph: 800.449.5328 www.pacificmedicalsupply. com

BC Group International, Inc. …………… BC Ph: 888.223.6763 • www.bcgroupintl.com BETA Biomedical …………………………… 53 Ph: 800.315.7551 • www.betabiomed.com BMES/Bio-Medical Equipment Service Co. Ph: 888.828.2637 • www.bmesco.com

28

BioMedical Equipment Service Co. LLC…… 55 Ph: 208.888.6322 Conquest Imaging …………………………… 11 Ph: 866.900.9404 • www.conquestimaging.com Dunlee ………………………………………… 3 Ph: 800.238.3780 • www.dunlee.com ECRI Institute ……………………………… 59 Ph: 610.825.6000 • www.ecri.org/TruVu Ed Sloan & Associates ……………………… 18 Ph: 888.652.5974 • www.edsloanassociates.com Engineering Services ………………………… 6 Ph: 330.425.2979 • www.eng-services.com Fluke Biomedical ………………………………51 Ph: 1.508.435.5600 • www.raysafe.com Global Medical Imaging ……………………… 2 Ph: 800.958.9986 • www.gmi3.com ICE/Imaging Community Exchange ……… 68 www.imagingigloo.com InterMed Biomedical …………………………27 Ph: 800.768.8622 • www.intermed1.com International Medical Equipment & Service 23 Ph: 704.739.3597 • www.IMESimaging.com JD Imaging Corp. ………………………………33 www.RadiologyAuction.com KEI Med Parts ……………………………… 53 Ph: 512.477.1500 • www.KEIMedPARTS.com KMA Remarketing Corp. …………………… 24 Ph: 800.411.4101 • www.kmabiomedical.com

INDEX

Philips Healthcare ………………………… 49 Ph: 800.229.64173 • www.philips.com/mvs Pronk Technologies …………………………… 5 Ph: 800.609.9802 • www.pronktech.com Rieter Medical Services …………………… 46 Ph: 800.800.5402 • www.rietermedical.com RSTI/Radiology Service Training Institute 39 Ph: 800.229.7784 • www.RSTI-Training.com RTI Electronics, Inc. …………………………51 Ph: 1.800.222.7537 • www.rtigroup.com Sage Services Group ……………………… 55 Ph: 877.281.7243 • www.SageServicesGroup.com Soaring Hearts Inc ……………………………27 Ph: 855.438.7744 • www.soaringheartsinc.com

Earn valuable CE Credits for the ICC Recorded webinar and companion workbook available on demand Learn from industry leading professionals Keep up with the industry’s latest technology All for FREE!

Soma Technology, Inc. …………………… 65 Ph: 1.800.GET.SOMA • www.somatechnolgy.com Southeast Nuclear Electronics …………… 49 PH: 678.762.0192 • www.southeastnuclear.com Southeastern Biomedical ………………… 28 Ph: 888.310.7322 • www.sebiomedical.com Stephens International Recruiting Inc. … 46 Ph: 888.785.2638 • www.BMETS-USA.com Tenacore Holdings, Inc. ………………………61 Ph: 800.297.2241 • www.tenacore.com

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Tri-Imaging Solutions …………………………19 Ph: 855.401.4888 • www.triimaging.com

OR

USOC Medical ………………………………… IBC Ph: 855.888.8762 • www.usocmedical.com Valcon Partners …………………………… 46 Ph: 815.477.1000 • www.valconpartners.com Zetta Medical ……………………… 30, 47, 57 Ph: 800.991.1021 • www.zettamed.com

Visit www.1TechNation. com/webinar-calendar to view upcoming webinars.

NOVEMBER 2015

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“WE CAN’T SOLVE OUR PROBLEMS WITH THE SAME THINKING USED WHEN WE CREATED THEM.” – ALBERT EINSTEIN 70

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