Medical Dealer - April 2016

MEDICAL EQUIPMENT, PARTS & SERVICE

APRIL 2016 | WWW.MEDICALDEALER.COM

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52

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CONTENTS_Features 52 FDA EXAMINES THE MEDICAL DEVICE INDUSTRY

Stakeholders in the medical device industry weigh in on the Food and Drug Administration’s recent announcement of the a docket for public comment titled “Refurbishing, Reconditioning, Rebuilding, Remarketing, Remanufacturing, and Servicing of Medical Devices Performed by Third-Party Entities and Original Equipment Manufacturers; Request for Comments.”

60 ED SLOAN & ASSOCIATES

Ed Sloan & Associates’ mission continues to focus on delivering for its customers and that goal is even more important as the company experiences significant growth. In the end, it all goes back to a love for the work and a desire to provide excellent customer service along with quality parts.

Medical Dealer (Vol. 20, Issue #4 April 2016 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

POSTMASTER: Send address changes to Medical Dealer at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

For subscription information visit www.medicaldealer.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2016

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MEDICALDEALER 11

INDUSTRY UPDATE 14 News & Notes 22 Block Imaging 25 OEM Updates MD Publishing 18 Eastbrook Bend Peachtree City, GA 30269 (800) 906-3373 Fax: (770) 632-9090 Publisher

John M. Krieg john@mdpublishing.com

MARKET ANALYSIS Radiology: MRI 33 Market Analysis 34 Product Showroom 38 Preferred Vendors

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editor

John Wallace jwallace@mdpublishing.com

Med/Surg: Anesthesia 45 Market Analysis 46 Product Showroom 49 Preferred Vendors

Art Department Jonathan Riley Jessica Laurain Kara Kronen

Account Executives Jayme McKelvey Andrew Parker Warren Kaufman

SLICE OF LIFE 72 The Other Side 74 Dan Bobinski 78 Pay It Forward

Contributors

Jim Fedele Matthew N. Skoufalos Dan Bobinski

Accounting

Kim Callahan

Circulation

80 Success Story 91 Marketplace 92 Categorical Index 94 Alphabetical Index

Lisa Cover

Web Department Betsy Popinga Taylor Martin Adam Pickney

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MEDICAL EQUIPMENT, PARTS & SERVICE

Please Probe Around, Take Our Pulse, and Scan our Parts

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INDUSTRY UPDATE_News and Notes

Staff Reports

FORMER GE HEALTHCARE OFFICER JOINS CONTROLRAD SYSTEMS ControlRad Systems has announced that Paul J. Mirabella has joined the company’s board of directors. Mirabella has more than 40 years of experience in the health care industry most notably as president and CEO of GE Healthcare’s Global Diagnostic Imaging business.

“We are thrilled that Paul has joined our board,” said Guillaume Bailliard, President and CEO, ControlRad Systems. “His experience in leading product development, service, marketing, sales and global business teams, along with his relevant industry relationships, will bring tremendous value to the company.” •

ANALYST: SUSPENSION OF TAX WILL REJUVENATE U.S. MARKET Stryker Corp. has reached a definitive look forward to welcoming the Physagreement to acquire 100 percent of io-Control team to Stryker.” the stock of Physio-Control Interna“Joining Stryker is an exciting tional Inc. in an all cash transaction next step in the evolution of Physfor $1.28 billion. Physio-Control man- io-Control for both our team and our ufactures monitors/defibrillators, customers,” said Brian Webster, Presautomated external defibrillators ident and Chief Executive Officer of (AEDs) and CPR-assist devices along Physio-Control. “Stryker has a deep with data management and support understanding of capital equipment services. and of our core market segments. We The company’s portfolio is highly will build on the success our team has complementary to Stryker Medical’s achieved in partnership with Bain EMS (Emergency Medical Services) offering and will drive a greater balance between capital and disposables. Physio-Control also brings an enhanced presence and infrastructure that will expand Stryker’s global footprint. Physio-Control sales for fiscal 2015 totaled $503 million, up 6 percent in constant currency over the prior year.

“Physio-Control has achieved global leadership positions with a strong brand and customer-centered solutions that can predict or intervene in life-threatening emergencies,” stated Stryker’s Kevin A. Lobo, Chairman and Chief Executive Officer. “Physio-Control’s focused strategy and their culture will fit well within the EMS business of our Medical division, further leveraging our existing call pattern. We 14 MEDICALDEALER | APRIL 2016

Capital, and further accelerate the execution of our strategy, including continued investment in great product solutions for our customers.”

The closing of the transaction is subject to expiration or termination of the applicable waiting period under the Hart-Scott-Rodino Antitrust Improvements Act and other customary closing conditions. The acquisition of Physio-Control is expected to close at the beginning of the second quarter. •

MEDICAL EQUIPMENT, PARTS & SERVICE

_News and Notes

RICHARDSON HEALTHCARE OPENS EUROPEAN HEADQUARTERS Richardson Healthcare, a division of Richardson Electronics Ltd., has announced the opening of its diagnostic imaging replacement parts and training center in Amsterdam, Netherlands. Adding a center in Europe is a direct response to Europe’s growing demand for high-quality, cost-effective parts to help lower the cost of health care.

The Amsterdam facility will include quality assurance testing bays, classrooms, and replacement parts inventory, representing an extension of the offerings and expertise of International Medical Equipment and Service (IMES) located in Fort Mill, South Carolina.

Richardson Electronics acquired IMES in June 2015. The new facility is co-located with the Richardson Electronics European distribution hub making it ideal for shipping replacement parts quickly and cost effectively throughout Europe, the Middle East and Africa.

Because of the increasing cost pressures of health care delivery, Pat Fitzgerald, executive vice president and general manager of Richardson Healthcare, says, “Our presence in Europe is directly in line with our goal of helping hospitals and third-party service organizations around the world lower costs. This is an important time for imaging service providers, and we are excited to bring a local parts and training solution to this market. Capitalizing on Richardson Electronics global presence and infrastructure enables us to act quickly to opportunities in the health care market.” • For more information, visit www.rellhealthcare.com WWW.MEDICALDEALER.COM

THE INTERMED GROUP ADDS CFO The InterMed Group has announced the hiring of Cris Baldwin as chief financial officer (CFO). Baldwin comes to InterMed with over 15 years experience in financial systems, organization/planning, and business management.

Baldwin is a twotime graduate of St. Leo University in Gainesville with a BA and MBA (concentration in accounting).

Baldwin will report directly to CEO Rick Staab and will have responsibility for all key financial management functions of the newly consolidated company.

“I am honored to be a part of this amazing team.

InterMed is an incredible success story, and I am excited to be joining the team as we rollout enhancements and significantly expand our presence in each of our focus areas,” Baldwin said. “This is a powerful management team, and I look forward to contributing to their momentum.”

Rick Staab, InterMed’s CEO, said “Cris has already had a measurable impact on our team, and has brought new ideas and fresh thinking to several areas of our operations. He is a natural fit with InterMed and we are extremely pleased to welcome Cris to our team.” • MEDICALDEALER 15

INDUSTRY UPDATE_News and Notes

VARIAN MEDICAL SYSTEMS BEST IN KLAS Varian Medical Systems has announced its ARIA oncology information system and Eclipse treatment planning software have been named “2015/2016 Category Leader” in the “Best in KLAS: Software and Services Report” by KLAS, an independent research firm specializing in monitoring and reporting on the performance of health care vendors.

In use in some 3,200 cancer treatment centers around the world, ARIA was named the “2015/2016 Category Leader” for oncology software. ARIA is a comprehensive electronic medical record and image management system that aggregates patient data into an organized, oncology-specific medical chart with functional components for managing clinical, administrative and financial operations for medical, radiation and surgical oncology. The ARIA system provides a seamless flow of information for managing the patient’s entire journey – from diagnosis through follow-up.

Named a “2015/2016 Category Leader” for treatment planning software for the third year in a row, Eclipse software is in use at about 3,400 cancer treatment centers around the world. The software creates an optimized radiotherapy treatment plan based on a physician’s dose instructions, and information about the size, shape and location of the tumor to be treated with radiation. The Eclipse software incorporates unique features such as RapidPlan knowledge-based planning, which makes it easier and faster to plan sophisticated cancer treatments like intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), and RapidArc radiotherapy. • For a list of Best in KLAS winners, visit http:// klasresearch.com/best-in-klas-2016 16 MEDICALDEALER | APRIL 2016

Staff Reports

GMI SIGNS AGREEMENT WITH SIEMENS HEALTHCARE GMI has announced a new strategic relationship with Siemens Healthcare to distribute its ultrasound systems and related services to hospitals within defined geographies across the United States.

Siemens offers ultrasound technologies that will broaden and enhance GMI’s ultrasound portfolio.

The agreement, which began February 1, gives GMI distribution rights to Siemens’ line of diagnostic ultrasound equipment in hospitals’ “point-of-care” environments. Siemens ultrasound systems will help providers address clinical and business needs in specialty areas such as pain, anesthesia, E-MED and MSK. The Siemens portfolio is designed to meet a broad set of imaging needs, ranging from compact, portable systems such as the innovative and wireless ACUSON Freestyle ultrasound system to fully featured, multi-disciplinary systems.

Tom Siffringer, POC Sales Manager at GMI, is excited about the new strategic agreement with Siemens and what it will mean for the companies and their customers.

“Since our founding, GMI has been an advocate for facilities purchasing ultrasound equipment.

Our agreement with Siemens Healthcare allows us to expand that advocacy to the fastest growing segment of the ultrasound market, point-of-care imaging,” Siffringer said. • For detailes visit www.GMI3.com.

MEDICAL EQUIPMENT, PARTS & SERVICE

_News and Notes

JEFF DALTON JOINS RELINK MEDICAL reLink Medical has announced Jeff Dalton as president and chief operating officer. reLink Medical founder A. Ray Dalton, who also started PartsSource, is excited to reconnect with Jeff Dalton.

“As we saw the negative impact of the ACA on the hospitals’ ability to repurpose excess and overstock medical devices and inventory, it became apparent that PartsSource and the ISO marketplace needed an organization to bring a repeatable and HIPAAcompliant process to our health care partner,” A. Ray Dalton said.

The response to this approach has been exciting and it seemed a natural fit to ask Jeff Dalton to join in expanding reLink Medical globally, according to a press release from the company.

“Jeff and I have worked together for 15 years building PartsSource and I am confident we will build another great company together,” A. Ray Dalton said. • For details, visit relinkmedical.com.

BC GROUP WINS SALES AWARD BC Group is proud to announce that it has received Rice Lake Weighing Systems’ Award for Outstanding Sales Performance in 2015. BC Group and Rice Lake Weighing Systems have been partners for years, with BC Group as a distributor of Rice Lake’s weights and weight sets.

Rice Lake Weighing Systems is a manufacturer of multiple products including grip handle and weight sets. Cast iron griphandle weights are primarily used to test patient scales by service technicians. They come in Class F, 7 and M1 weights.

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EXCEL MEDICAL APPOINTS NEW VICE PRESIDENT Excel Medical recently announced the appointment of Kelly Arnold to the new position of Vice President, Interoperability Solutions. Arnold brings more than 20 years of hands-on sales and management experience to the position, including 14 years at GE Healthcare and a clinical enterprise focus on cardiology, monitors and ventilators.

He will be responsible for the strategic direction, business development and adoption of Excel’s medical device integration (MDI) platform by health care systems nationwide. He will partner with Excel’s commercial team, industry organizations and corporate partners.

“Kelly has a tremendous track record working with innovative health care companies and technologies. He is passionate about helping hospitals achieve their internal goals while improving patient care,” said Lance Burton, general manager of Excel Medical. “As our company continues to re-define the boundaries of the medical device integration and interoperability category, Kelly has one of the most informed, astute perspectives on the challenges and opportunities ahead.” •

BC Group offers 26 different weights and weight sets from Rice Lake.

It also has access to the entire Rice Lake line. Each of these have an optional NIST Traceable Calibration and etched serial number. • For more information about Rice Lake weights, call 800242-8428 or email sales@ bcgroupintl.com.

For information about BC Biomedical products, visit www.BCGroupStore.com.

MEDICALDEALER 17

INDUSTRY UPDATE_News and Notes

Staff Reports

FRESENIUS KABI USA ANNOUNCES NEW MEDICAL DIRECTOR Fresenius Kabi USA has announced and scientific exchange with stakeholdthat Seema Kumbhat, M.D., has ers in the medical community. joined the company as senior vice “Seema is a highly regarded president and medical director. physician executive and we are Kumbhat reports to John Ducker, extremely pleased to have her join president and CEO of Fresenius Kabi our leadership team,” Ducker said.

USA, and is a new member of the “This is an important new role for company’s executive committee.

Fresenius Kabi in the U.S. as we Kumbhat and her team will be expand our business with more clinresponsible for pre- and post-launch ically differentiated products and clinical and medical strategies; cliniservices in both our pharmaceutical cally focused training and education and medical devices businesses.”

MEDTRONIC AMONG WORLD’S MOST ADMIRED COMPANIES Medtronic plc has been designated as one of the World’s Most Admired Companies by Fortune Magazine. Within the Medical Products and Equipment industry category, Medtronic ranked second globally. This 2016 listing was released in February, and is considered one of the leading measures of corporate reputation among the world’s largest companies.

Fortune magazine develops the Most Admired list by surveying top executives and board members from major corporations around the world, along with leading financial analysts. Companies are scored in nine key areas of financial performance and business management.

This ranking is the latest by a third-party organization to recognize Medtronic for excellence. The company ranked fourth on Business Insider’s list of Most Meaningful Companies to Work for in 2015, No. 31 on Business Insider’s list of Best Companies to Work for in America and No. 14 on ComputerWorld’s Best Places to Work in IT. In 2016 the Human Rights Campaign Foundation named Medtronic a Best Place to Work for LGBT Equality for the seventh consecutive year with a 100 percent Corporate Equality Index score. • 18 MEDICALDEALER | APRIL 2016

Kumbhat has more than 20 years of experience in health care. Before joining Fresenius Kabi, she held similar roles of increasing responsibility at Hospira, where she was global medical director, biosimilars, in clinical development and medical affairs and medical director, device development. She has also held medical affairs roles at McKesson Provider Technologies, GE Healthcare and Epic Systems Corp. •

HOYA GROUP APPOINTS GLOBAL PRESIDENT OF PENTAX MEDICAL PENTAX Medical, a division of HOYA Group, has announced the appointment of Gerald W. Bottero to the position of Global President of PENTAX Medical as of February 1, 2016.

“HOYA Group is pleased to have Gerald W. Bottero lead the global division of PENTAX Medical,” said Hiroshi Suzuki, President and CEO of HOYA Group. “Mr. Bottero brings a wealth of knowledge, insight and experience from his various global executive roles within HOYA, especially from our Life Care divisions. He has a proven track record of delivering results through developing and implementing strategic and operational changes in a global multicultural environment. We expect his leadership to further advance the PENTAX Medical growth strategy.”

Bottero joined HOYA Corp. in 1988 and has served HOYA in a number of Information Technology and Life Care segments.

Most recently, he was the president of HOYA Vision Care from April 2005 through September 2014. Before that he served as president of HOYA Conbio, a medical laser firm focused on dermatology and hard tissue dentistry, and has also served as HOYA’s representative on the Boards of Directors of Decibel Instruments (intra-canal hearing aids) and Lifespex Inc. (early detection of cervical cancer). • MEDICAL EQUIPMENT, PARTS & SERVICE

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MEDICALDEALER 19

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A SYMBOL OF ADVOCACY, ETHICS, & NETWORKING Become an IAMERS member and ensure your customers feel confident doing business with you. IAMERS’ members each have made a commitment to provide a quality product to their customers while pledging to conduct business in an honorable and ethical manner. Today IAMERS is comprised of more than 130 organizations worldwide conducting business.

TO BECOME AN IAMERS MEMBER, APPLY AT WWW.IAMERS.ORG 20 MEDICALDEALER | APRIL 2016

MEDICAL EQUIPMENT, PARTS & SERVICE

INDUSTRY UPDATE_IAMERS

Staff Report

IAMERS 23 ANNUAL MEETING SET FOR MAY RD

I

AMERS invites industry leaders to network and learn in Charleston, South Carolina this May at the 23rd annual IAMERS meeting being held May 4-6 at the Charleston Place Hotel.

The reason for the first annual meeting in 1993 was to discuss the potential expansion of regulations by government agencies that could limit the availability of quality pre-owned equipment. Quickly the participants recognized that a trade association was required to address regulatory and other industry issues that these highly specialized companies frequently faced.

David Band was the catalyst for the meeting and became the first president of the organization that 23 years later is referred to as IAMERS. Through the efforts of IAMERS many agencies and institutions have a better understanding of the importance of pre-owned medical imaging equipment in the clinical marketplace.

IAMERS members recognized early on that to be a respected trade assoWWW.MEDICALDEALER.COM

ciation they needed to self-police members. A code of ethics was created and every member must agree to comply with it to remain in the association.

Today, the IAMERS logo is recognized worldwide and is an assurance that the buyer is purchasing equipment or services from a competent and trustworthy seller.

IAMERS continues its efforts to reach out to regulatory agencies around the world to educate and inform about the association and the importance of pre-owned medical imaging equipment.

The organization’s global membership represents the best companies ranging from the largest OEMs to smaller highly specialized ones that sell, service and finance pre-owned medical imaging devices.

The 2016 annual meeting, like previous IAMERS annual meet-

ings, features casual networking opportunities and enhanced educational opportunities focused on meeting the needs of IAMERS members.

The event kicks off with a welcome reception dinner at the host hotel at 6:30 p.m. on Wednesday, May 4. On Thursday, breakfast will be served at 8 a.m. to fuel attendees for a day of educational business sessions on a wide range of pertinent topics including networking, unique device identification, FDA updates, marketing solutions, ISO certification, and the top issues of 2016.

The annual meeting continues on Friday with

another hearty breakfast followed by business sessions on advanced medical logistics, best practices for service and practical solutions for financing equipment.

Lunch follows the morning sessions.

FOR DETAILED INFORMATIONÂ and a registration packet for the 2016 meeting visit http://www. iamers.org/iamers-23rd-annualmeeting-charleston-sc-2/.

FOR ADDITIONAL INFORMATION about IAMERS and the annual meeting contact Diana Upton via email at Diana@ iamers.org, by phone at +1-201357-5400 or fax +1-201-833-2021.

MEDICALDEALER 21

INDUSTRY UPDATE_Block Imaging

By Steve Rentz

LOW-FIELD OPEN MRI VS. CLOSED MRI SOLUTION

U

nderpowered, underutilized, but frequently misunderstood, open MRI systems are under-appreciated here in the USA and virtually ignored in other “developed” countries. Many radiologists don’t want to read from open MRIs, governments and insurers don’t want to pay for them, and the appetite for higher and higher magnet power has, in many cases, relegated the open MRI to a “back-up” role in larger imaging facilities. Whether or not that relegation is deserved, it’s a fact that the demand for low-field open MRI (.2T - .35T) has never been greater in developing countries. So what exactly is the market for open MRI vs closed MRI? No Power? No Helium? No Problem!

Though there are exceptions, most low-field opens (LFOs) use permanent magnets, which means that they are always “at field.” While this might necessitate a few more transportation precautions (make sure you work with a shipping company 22 MEDICALDEALER | APRIL 2016

that has some experience), it’s a major selling point for countries where power isn’t so clean and the liquid helium used in higher-field closed MRIs isn’t readily available or is extremely expensive. Once installed, these systems tend to have very low maintenance costs relative to closed MRI and, if properly cared for, can run for years.

If You’re Not in Deep Tissue, it May Not Be an Issue Don’t forget that, in many instances (even in the U.S.), open MRI is more than adequate for imaging needs. In addition to being invaluable as a solution for larger or claustrophobic patients, many orthopedic studies in particular can be adequately performed with an open MRI. In addition, newer versions from Hitachi like the Airis Elite and Aperto have fat saturation capabilities. Still, it is outside the USA that most of the current demand for low-field open MRIs exists.

Care and Handling of a Permanent Magnet In this age of wider bores and higher Tesla strengths, low-field open MRIs are

Steve Rentz

almost solely a product dealt in the secondary market. If you have one to sell, or if you’re in the market to buy, make sure you’re dealing with a company that is used to working with these units. Even though you’re not dealing with cryogens and potential quenching, exit pathways, containers, crating, and craning can ALL be expensive and complicated. “Always at field” means just that – and it also means they are typically very heavy. If you are outsourcing, be sure to share any issues that might arise with the exit pathway.

This is always an issue with MRI systems, but it is especially an issue with open MRIs due to the weight involved.

HighTube MHU Capacity Creating an accurate treatment plan requires a lot of images, which produces a lot of heat in a scanner’s X-ray tube over a short amount of time. A system with a high tube heat capacity (expressed in millions of heat units or MHU) is needed to accommodate this. CT scanners designed for simulation use generally have tubes rated at 5 MHU or above.

Buying and Selling an Open MRI Just because these systems are older and often being replaced in favor of newer short/wide bore MRIs doesn’t mean that, with proper placement, they can’t be valuable assets. It also doesn’t mean they aren’t the right option if you’re buying and want to keep your equipment, maintenance and energy costs low. Is open MRI “niche equipment”?

Perhaps, but in the right niche, it may be the right equipment.

STEVE RENTZ is the Product Manager-MRI for Block Imaging International. He has been managing the MRI business at

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MEDICAL EQUIPMENT, PARTS & SERVICE

INDUSTRY UPDATE_OEM Updates

FUJIFILM ANNOUNCES FDA 510(K) CLEARANCE FOR SYNAPSE 5 Fujifilm Medical Systems U.S.A. Inc. customers keep up with the changes that have already taken place and, has received FDA 510 (k) clearance for the sale and distribution of its more importantly, to help them stay most recent innovation in PACS out ahead of what comes next.” technology, Synapse 5. The latest Fujifilm’s current PACS offering of Fujifilm’s Synapse line customers will be able to take of solutions includes VNA, 3D, RIS, advantage of the speed of Synapse cardiovascular and mobile offerings. 5 through an upgrade to their current system. It will deliver a “As reimbursement continues server-side, zero-download viewer to move from volume-driven to utilizing a browser-independent value-based, radiologists need desktop experience. Synapse to boost their efficiency, their 5 stands to save organizations productivity and their accuracy. significant resources due to less The challenge is to be a speed desktop management, and a reader who, despite the high dramatic reduction in bandwidth velocity, doesn’t miss a single requirements which many are abnormality on a single study,” currently consuming today with said Johann Fernando, Ph.D., last generation PACS technology. chief operating officer at Fujifilm “Synapse 5 has the potential to Medical Systems U.S.A. Inc. “Synapse 5 is designed to help our be a disruptive technology in the WWW.MEDICALDEALER.COM

Staff Reports

PACS market. It truly addresses all of the challenges customers face today from the management of desktop clients to reading large data sets,” said Bill Lacy, division vice president of Informatics Marketing and Enterprise Sales at FUJIFILM Medical Systems U.S.A. Inc. “Synapse 5 will provide our customers with solutions to work remotely and across multiple locations and will satisfy the performance demands.”

For more information, visit http://www.fujifilmusa.com/products/medical/medical-informatics/

MEDICALDEALER 25

INDUSTRY UPDATE_OEM Updates

Staff Reports

FOX VALLEY HEMATOLOGY & ONCOLOGY ADDS TOSHIBA PET/CT SYSTEM and patients,” said Sheri Krueger, needs, including tumor detection, Patients at Fox Valley Hematology diagnostic center coordinator, treatment evaluation and CT sim& Oncology’s new cancer care cenFVHO Health & Wellness Center. ulation. Helping to ensure patient ter are receiving a better imaging “In our experience, the system prosafety is not a choice, Celesteion experience and more accurate PET/ duces phenomenal and clear images comes standard with Toshiba’s CT scans with Toshiba America with little to no artifacts, especially advanced CT dose reduction techMedical Systems Inc.’s Celesteion with larger patients.

Additionally, nology, AIDR 3D. PET/CT system. The new FVHO claustrophobic patients regularly “With health care providers putHealth & Wellness Center, which comment on the system’s large bore, ting greater emphasis on patient opened in September 2015, will use satisfaction, the Celesteion’s numerwhich gives them a feeling of openthe Celesteion PET/CT system to ous patient-friendly features are ness and more room.” image and plan treatment for cancer designed to meet our customers’ Toshiba’s Celesteion PET/CT patients, as well as open up a new goals in this new landscape,” said system delivers a more comfortable service line in the future for orthoDominic Smith, senior director, CT, patient experience with the induspedic imaging.

PET/CT, and MR Business Units. try’s largest bore (90 cm CT and “The Celesteion is a ‘one-stop“The Celesteion allows providers like 88 cm PET), an expansive field-ofshop’ system that can perform PET Fox Valley Hematology & Oncology view and time-of-flight imaging. and CT imaging all at once, which to provide the highest quality images The versatile system combines eliminates the need to schedule and faster exams without sacrificing high-performance PET and CT for multiple appointments, making patient comfort and safety.” • all radiation and oncology imaging imaging easier and faster for staff

26 MEDICALDEALER | APRIL 2016

MEDICAL EQUIPMENT, PARTS & SERVICE

_OEM Updates

HUS UNDERTAKES CLINICAL STUDY OF CARESTREAM CONE BEAM CT SYSTEM HUS Medical Imaging Center, based in Helsinki, Finland, is undertaking the first European clinical test study of the new Carestream OnSight 3D Extremity System in preand post-operative cases. The study of the new cone beam CT (CBCT) scanner and image reconstruction technology, applied within orthopedic imaging, will last six months and will yield valuable data for HUS and Carestream regarding pre- and post-trauma studies involving new algorithms and advanced technology.

“HUS is always keen to test new technology and the impact on patient care that new technologies can have,” said David Chan, Carestream’s Global Product Line Manager, DMS. “When this Carestream test trial was available, it was clear that HUS would be able to offer the large number of preand post-trauma studies required for a meaningful trial.”

The Carestream extremity CBCT system (Investigational: Not available for commercial sale) captures low-dose, high-quality CT images for orthopedic med-

icine, delivering pristine, 3D weight-bearing images at the pointof-care, not otherwise possible with traditional CT. During the research work, experienced radiologists at HUS will

RADIOLOGY PROTOCOLS PLATFORM COMING TO THE GE HEALTHCLOUD Radiology Protocols has announced care enterprise including large, that its platform will be added to the complex IDNs. GE HealthCloud suite of applications Radiology Protocols provides a when the Cloud goes live later this customizable, scalable, HIPAAyear. GE HealthCloud radiology secure hosted solution to department customers will be able to document, organize, and tailor access and use Radiology Protocols’ imaging protocols. Its platform protocol management platform, also allows providers to share best providing increased productivity and practices across their systems, improving quality of exams. instantaneously and seamlessly, The GE HealthCloud includes eliminating paper-based files for this a suite of enterprise imaging critical information. applications and provides a platform “Radiology Protocols is pleased for software vendors to deliver health to take its place as one of the GE care applications across the health HealthCloud’s early and core

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evaluate the image quality in bone structure, fractures and the level of metal artifacts. In addition, a medical physicist will contribute to the physical image and radiation exposure assessment.•

applications which will enable exceptional connectivity and scalability for customers,” said Stephen Baker, founder and president of Radiology Protocols.

“This will allow for standardization of imaging protocols across IDNs resulting in better utilization, sharing of best practices and improved patient care.”

Radiology Protocols’ platform is vendor agnostic allowing customers to utilize the system across different equipment modalities and vendor platforms.•

MEDICALDEALER 27

INDUSTRY UPDATE_OEM Updates

Staff Reports

ANALYST: MULTITOM RAX HERALDS NEW ERA IN DIAGNOSTIC IMAGING A new robotic advanced X-ray device, the Multitom Rax, precision of medical robotics,” Janer explains. “The device could allow X-ray devices to compete with more advanced offers a high level of precision and flexibility, and could be imaging modalities, such as ultrasound and computed used as a partial substitute for CT scanners. Furthermore, it tomography scanners, says an analyst with research and has a long lifespan, and Siemens has engineered the device to consulting firm GlobalData. be adaptable to future technological trends.”

Developed by Siemens Healthcare, the device demonstrates GlobalData forecasts that the U.S. market for digital the company’s innovation within the diagnostic imaging space. radiography X-ray devices will expand from $644 million The Multitom Rax was cleared by the FDA in November 2015 in 2015 to reach $942 million by 2020, expanding at a and is expected to launch in the U.S. this April.

Compound Annual Growth Rate (CAGR) of 7.9 percent.

According to Sarah Janer, GlobalData’s analyst covering However, the introduction of robotic advanced X-ray technology could significantly boost future growth. medical devices, the Multitom Rax can perform a wide “Once Siemens receives clearance for the Rax’s 3D range of diagnostic examinations including fluoroscopy, applications, GlobalData expects that robotic advanced radiography, angiography, and orthopedic scans, giving it an X-ray instruments will become a hospital standard, and edge over the current generation of devices. competition in the field will increase as hospitals look to “As digital radiography has traditionally been limited replace their outdated digital radiography models with by 2D imaging and a lack of flexibility, the Multitom Rax is designed to overcome those barriers and offers the distinctive superior, more universal devices,” Janer concludes. •

OLYMPUS CORP. TO PAY $646M FOR KICKBACK SCHEME care programs. OCA has entered into The United States’ largest distributor a three-year deferred prosecution of endoscopes and related equipment agreement (DPA) that will allow it to will pay $623.2 million to resolve crimavoid conviction if it complies with the inal charges and civil claims relating reform and compliance requirements to a scheme to pay kickbacks to docoutlined in the agreement. tors and hospitals, U.S. Attorney Paul “For years, Olympus Corporation of J. Fishman of the District of New Jerthe Americas and Olympus Latin Amersey and Principal Deputy Assistant ica dropped the compliance ball and Attorney General Benjamin C. Mizer failed to have in place policies and pracof the Justice Department’s Civil tices that would have prevented the Division announced. Fishman and substantial kickbacks and bribes they Principal Deputy Assistant Attorney paid,” said U.S. Fishman.

“It is approGeneral David Bitkower of the Justice priate that they be punished for that. At Department’s Criminal Division also the same time, the deferred prosecution announced that a subsidiary of the distributor will pay $22.8 million to resolve agreement takes into account the comcriminal charges relating to the Foreign panies’ cooperation and commitment to fully functional corporate compliance.”

Corrupt Practices Act (FCPA) in Latin As a result of the conduct outlined America. in the government’s criminal comOlympus Corp. of the Americas plaint and DPA, OCA has agreed to pay (OCA) was charged in a criminal coma $312.4 million criminal penalty and plaint filed in Newark, New Jersey, an additional $310.8 million to settle federal court with conspiracy to viocivil claims under the federal and varilate the Anti-Kickback Statute (AKS), ous state False Claims Acts, the largest which prohibits payments to induce total amount paid in U.S. history for viopurchases paid for by federal health 28 MEDICALDEALER | APRIL 2016

lations involving the AKS by a medical device company.

“The Department of Justice has longstanding concerns about improper financial relationships between medical device manufacturers and the health care providers who prescribe or use their products,” said Mizer. “Such relationships can improperly influence a provider’s judgment about a patient’s health care needs, result in the use of inferior or overpriced equipment, and drive up health care costs for everybody. In addition to yielding a substantial recovery for taxpayers, this settlement should send a clear message that we will not tolerate these types of abusive arrangements, and the pernicious effects they can have on our health care system.”

In a separate DPA, Olympus Latin America Inc. (OLA), a subsidiary of OCA, will pay a $22.8 million criminal penalty for violations of the FCPA.• MEDICAL EQUIPMENT, PARTS & SERVICE

_OEM Updates

PHILIPS SECURES 510(K) CLEARANCE FOR PATIENT MONITORING SOLUTION Royal Philips has announced that the Expression MR400, a new technology that monitors patients undergoing magnetic resonance imaging, has received 510(k) clearance from the U.S. Food and Drug Administration. The MR400 provides ICU-comparable, bedside quality monitoring in the MR suite for all patients, including those with serious medical conditions or who require anesthesia.

In the MR suite, strong electromagnetic fields make it impossible for clinicians to use traditional patient monitors without causing complications with the monitor or degradation of the images. The lack of adequate monitoring is particularly problematic for patients, including children, who require anesthesia when getting an MRI. Without the ability to reliably track key vital signs, clinicians may not know a patient is in distress until it is too late.

The MR400 is designed not to create image artifacts or other interference from the electromagnetic fields when used according to the labeling, ensuring that patients receive the level of clinical care and monitoring they need.

The MR400 monitors the same vital signs that are tracked in the operating room and in the intensive care unit, including heart rate, oxygen and carbon dioxide levels, body and surface temperatures, and blood pressure, and also includes advanced ECG monitoring. Patients with serious medical conditions, including critical care patients or patients undergoing cardiac procedures, can also be monitored with the MR400, regardless of whether they are under anesthesia.

Similar to traditional patient monitors, the MR400 uses intelligent alarms to warn clinicians of severe patient changes, including desaturation, apnea and extreme bradycardia/tachycardia. Clinicians and staff are able to customize the monitor settings for each patient to prioritize warning signals to reduce alarm fatigue.

The new monitoring system uses a touchscreen with the same interface as other Philips’ monitors, making it easier for clinicians to view and respond to patient data.

The MR400 uses wireless technology, connects with the Electronic Healthcare Record, and shares information with IntelliBridge Enterprise to seamlessly send and receive patient information. • For information, visit www.philips.com/monitoring.

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MEDICALDEALER 29

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MEDICAL EQUIPMENT, PARTS & SERVICE

PRODUCT SHOWROOM_MRI_Market Analysis

Staff Reports

MRI MARKET CLIMBS HIGHER

M

agnetic resonance imaging (MRI) is a useful tool in health care. MRI uses a magnetic field and radio waves to make pictures of organs and structures inside a human body. In many cases, MRI gives different information about internal structures than can be acquired with other diagnostic imaging modalities including X-ray, ultrasound and computed tomography. MRI can be used to generate images that cannot be created using other imaging methods.

MRI is done for many reasons and is used for the treatment of a variety of injuries and illnesses including studies of the head, heart, blood vessels, abdomen, bones and joints as well as the spine.

The MRI market is experiencing continued growth and researchers agree that the future is bright.

“MRI systems market is estimated to grow at a CAGR (compound annual growth rate) of 5.0 percent to reach $6,802.7 million by 2020,” according to MarketsandMarkets.

MarketsandMarkets, the second-largest market research firm worldwide in terms of premium market research reports published annually, reports that the growth of the market is being propelled by a increase in the world’s aging population and technological advancements such as superconducting magnets, open architecture, high-field MRI and software applications.

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“The global MRI systems market is estimated to reach $7 billion by 2020.

The market is expected to register a CAGR of 6 percent between 2014 and 2020.”

“The global MRI systems market is estimated to reach $7 billion by 2020. The market is expected to register a CAGR of 6 percent between 2014 and 2020,” according to Report Buyer.

“There are two systems of screening available, the open and the closed type. The open MRI system has a faster growing market as it is preferred over the closed system alleviating claustrophobia in the patients. MRI is the tool of choice for medical investigations as it is more sensitive than CT and does not use ionizing radiations. MRI is widely used in the diagnosis of cancers, neurological and cardiac disorders. The increasing incidences of these diseases favor the fast growing MRI market.

The United States, Europe and Southeast Asia hold about 80 percent of the market share but Asian countries like India and China have the fastest growing market as the large investments made in medical research and health care have resulted in advanced technologies. The affordability and awareness of medical health facilities have also increased in these countries.”

Grand View Research also predicts continued growth for the MRI market.

“Growing geriatric population, rising awareness about early diagnosis, technological advancements such as the introduction of software application in the system that in turn increases the accuracy are amongst key factors attributing for the growth of magnetic resonance imaging market over the forecast period (2015-2022). Introduction of technologically advanced products such as Espree MRI systems and the way the entire RF subsystems has been operated in MRI are the major drivers of this market,” according to Grand View Research. “Moreover, increase in incidences of road accidents caused by rash driving or driving after being intoxicated and increasing prevalence of cardiovascular diseases, tumors and other neurological disorders are also few factors propelling market growth.”

“Emerging markets (China, India, Brazil, and Middle East), novel application areas such as multiple sclerosis and breast cancer, and advent of hybrid magnetic resonance imaging systems provide new growth opportunities to players in the market,” according to MarketsandMarkets. “However, high costs of magnetic resonance imaging system, declining reimbursement rates for MRI procedures, shortage of helium gas deposits, dearth of trained personnel, and uncertain outcomes of changing health care reforms are hindering the growth of this market.”

MarketsandMarkets considers GE Healthcare, Hitachi Medical Corp., Philips Healthcare, Siemens Healthcare and Toshiba Medical Systems to be key players in the MRI market.

MEDICALDEALER 33

PRODUCT FOCUS_MRI_Product Showroom

Staff Reports

APRIL PRODUCTS: This month, Medical Dealer explores MRI

GE HEALTHCARE SIGNA Pioneer

T

he SIGNA Pioneer is a 3T MRI system that embodies the exploration and expansion of modern medical imaging. This system features an enhanced SilentScan package enabling SilentScan for musculoskeletal (MSK) imaging and spine imaging, in addition to a complete neuro exam that also includes Diffusion Weighted Imaging (DWI). The SIGNA Pioneer also features technology called Total Digital Imaging (TDI) enabling improved image quality and increasing signal to noise ratio (SNR) by up to 25 percent. TDI is composed of Direct Digital Interface (DDI), Digital Surround Technology (DST) and Digital Micro Switching (DMS). •

34 MEDICALDEALER | APRIL 2016

MEDICAL EQUIPMENT, PARTS & SERVICE

MRI_Product Showroom

TOSHIBA Vantage Titan 3T

T

o give customers the best possible experience for their patients while being mindful of their business needs, Toshiba America Medical Systems Inc. is introducing the Vantage Titan 3T/intelligent Solution (iS) Edition MR system. The new system includes patient-friendly upgrades that improve image quality and throughput while providing more coverage and a better exam experience. These new technologies give providers increased efficiency and productivity and add to the Vantage Titan 3T’s comprehensive suite of applications.

The enhancements include: Saturn Gradient, Dedicated 16-Channel Tx/Rx Knee SPEEDER Coil, Atlas SPEEDER Head/Neck Coil, and Automatic Alignment Tools in EasyTech. •

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MEDICALDEALER 35

PRODUCT FOCUS_MRI_Product Showroom

Staff Reports

SIEMENS HEALTHCARE MAGNETOM Amira

T

he MAGNETOM Amira 1.5 Tesla magnetic resonance imaging (MRI) system features technologies found on Siemens’ flagship MRI systems and is distinguished by its low operating costs. Boasting new “Eco-Power” technology that enables significant power savings in standby mode, MAGNETOM Amira is designed to meet the requirements of radiology practices, small- and medium-sized hospitals, and larger facilities that are interested in an MRI scanner to complement their existing systems. MAGNETOM Amira is designed to enable customers to operate their MRI systems efficiently, with the potential to shorten many exams and enable many patients to undergo scans in routine applications. Siemens offers a comprehensive package of protocols for MAGNETOM Amira that is optimized for rapid examinations while maintaining high image quality. •

36 MEDICALDEALER | APRIL 2016 2016

MEDICAL EQUIPMENT, PARTS & SERVICE

MRI_Product Showroom

PHILIPS Ingenia 1.5T S

D

esigned for first-time right imaging and increased patient comfort for a faster workflow, Ingenia 1.5T S, a new addition to the Ingenia and dStream family, is specifically designed for medium- to large-scale hospitals that serve large patient volumes with high-performance MR imaging and a superb patient experience. •

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MEDICALDEALER 37

PRODUCT FOCUS_Radiology_Preferred Vendors

Staff Reports

PREFERRED VENDORS

MRI

Bayer HealthCare Multi SEE OUR AD ON Vendor Service PAGE 77 625 Alpha Drive Pittsburgh, PA 15238 Toll-Free: 1-844-MVS-5100 Email: mvscustomercare@bayer.com Website: www.mvs.bayer.com

Carolina Medical Parts 985 Pinebrook Knolls Dr. SEE OUR Winston Salem, NC 27105 AD ON PAGE 51 Phone: 877-267-2784 Fax: 336-661-6207 Email: sales@cmparts.com Website: www.carolinamedicalparts.com

SEE OUR Diagnostic Solutions AD ON PAGE 94 4935 S Prospect St, Ste D Ravenna, OH 44266 Phone: 330-296-XRAY (9729) Fax: 330-296-2555 Email: sales@diagnostic-solutions.com Website: www.diagnostic-solutions.com

Bayer HealthCare Multi Vendor Service is your trusted provider for MRI coil, ultrasound transducer, CR reader and dry film printer repair. With exceptional repair capabilities, quality solutions and dedicated customer care, we provide excellent value in third-party service.

As the largest independent depot level MRI coil and component repair company in the industry, CMP has the experience to handle your entire MRI coil and component repair needs for GE, Siemens and Philips models. We are a team of dedicated professionals, with over 35 combined years’ experience, ready to handle your entire MRI coil and component repair needs.

Diagnostic Solutions is a customer service based parts provider that specializes in all imaging Modalities and Manufacturers. Created to offer hospitals and ISOs a cost effective and time saving solution for ordering imaging replacement parts.

We are confident you will see Diagnostic Solutions as THE Parts Solution.

BC Technical, Inc. 7172 South Airport Rd. SEE OUR AD ON West Jordan, UT 84084 PAGE 10 Phone: 801-280-2900 Fax: 801-280-3900 Email: Rachel.masey@bctechnical.com Website: www.bctechnical.com BC Technical is the largest non-OEM provider of medical imaging solutions.

Our customers trust us to provide the best refurbished NM, SPECT/CT, PET, PET/CT, MRI and CT systems from all major OEMs.

38 MEDICALDEALER | APRIL 2016

SEE OUR AD ON PAGE 90

Cool Pair Plus Dave Baldwin 2812 Corporate Parkway Algonquin, IL 60102 Toll-Free: 800-861-5956 Fax: 724-446-1182 Email: sales@coolpair.com Website: www.coolpair.com

SEE OUR AD ON PAGE 82

Since 1996, Cool Pair Plus has been proving the cryogenic industry with Coldheads, Compressors and Cryocoolers.

We have made significant investments in both management and infrastructure in 2010 to better support our growing demand and to provide first class parts, technical support and complete MRI Magnet Service for Sumitomo, Balzers, Leybold and APD systems.

DirectMed Parts, LLC 9401 Waples St., Ste. 125 San Diego, CA 92121 Phone: 855-463-3727 Fax: 855-463-3727 Email: sales@directmedparts.com Website: www.directmedparts.com DirectMed Parts is an ISO 9001:2008 certified company and brings over 20 years of experience servicing the medical imaging equipment, parts and service market. We specialize in MRI & CT parts for GE, Siemens and Philips.

MEDICAL EQUIPMENT, PARTS & SERVICE

Anesthesia_Preferred Vendors

SEE OUR AD ON PAGE 63

Ed Sloan & Associates 508 Kasper Way Goodlettsville, TN 37072 Toll-free: 888-652-5974 Phone: 615-448-6095 Fax: 615-448-6099 Email: sales@ed-sloanassociates.com Website: www.edsloanassociates.com Over 25 years of experience and a staff of industry professionals allows Ed Sloan & Associates to offer unparalleled service in the area of GE CT and MRI systems, parts and service.

• Quality tested parts • 48,000 square foot facility • MRI and CT QA Bays • CT and MRI Systems • Service on and T&M or Contract Basis

THE INTERMED GROUP

13351 Progress Blvd.

Alachua, FL 32615 Phone: 800-768-8622 Fax: 386-462-5330 Email: sales@intermed1.com Website: www.intermed1.com

SEE OUR AD ON PAGE 58

Your Medical Equipment Sales and Service Experts: • Multi-Vendor Repair Services, All Levels of Coverage • 24/7 availability • National Ultrasound: Service, Sales & Training • East Coast Nuclear Medicine: Sales, Service & Training • Southeast Biomedical Services: Comprehensive Programs & Equipment Repairs • Jump teams available

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SEE OUR AD ON PAGE 40

Kopp Development Inc. 785 NE Dixie Hwy Jensen Beach, FL 34957 Toll-Free: 888-838-KOPP (5677) Phone: 772-225-6932 Fax: 772-225-6291 Website: www.koppdevelopment.com Kopp Development Inc., the leading manufacturer of ferromagnetic detectors for MRI Safety, is introducing two new products; the entryway detection system, FerrAlert™ HALO II Plus and the ferromagnetic incident log manager, FerrAlert™ F.I.L.M., which in combina-tion reduces alarm fatigue, facilitates The Joint Commission compliance and assists with Root Cause Analyses.

Metropolis International LLC Leon Gugel 21-11 44th Avenue, 3rd Floor Long Island City, NY 11101 Phone: 718-371-6026 Fax: 718-371-6032 Email: info@metropolismedical.com Website: www.metropolismedical.com

SEE OUR AD ON PAGE 86

Metropolis is one of the largest stocking dealers in the world with a large warehouse and office in the heart of New York City. Metropolis provides all imaging systems; C-arms, DEXA, Ultrasounds, Mammography, portables, CTs, MRI and Cath/ Angio. Metropolis has it all, that is the reason customers are 110% satisfied with the Metropolis team.

MEDICALDEALER 39

PRODUCT FOCUS_Radiology_Preferred Vendors

Staff Reports

SOLUTIONS

Tri-Imaging Solutions 10 Fant Industrial Dr. Madison, TN 37115 Toll-free: 855-401-4888 Email: sales@triimaging.com Website: www.triimaging.com

SEE OUR AD ON PAGE 41

Tri-Imaging Solutions is a replacement parts, equipment, service support, and technical training company. We provide quality tested imaging parts – and can even help to install, we buy-sell-move equipment, and provide technical support.

All replacement parts come with a 90-day warranty. Available 24/7/365.

Zetta Medical Technologies 1313 Ensell Road Lake Zurich, IL 60047 Phone: 847-550-9990 Toll-Free: 800-991-1021 Fax: 847-550-9994 Email: Salesteam@zettamed.com Website: www.zettamed.com

SEE OUR AD ON PAGE 57

Zetta is a high performance independent service organization offering preowned/used medical equipment, dedicated CT, MRI & PET/CT service and quality replacement parts to the medical imaging industry. The name Zetta is a mathematical term meaning 1021 and it simply reflects our dedication to achieve the PROOF APPROVEDhighest CHANGES levels of NEEDED customer satisfaction.

PROOF

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40 MEDICALDEALER | APRIL 2016

800-521-2978 FAX: 734-761-3220 www.enmet.com info@enmet.com

MEDICAL EQUIPMENT, PARTS & SERVICE

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PRODUCT SHOWROOM_Anesthesia_Market Analysis

Staff Reports

ANESTHESIA DEVICES MARKET ON THE RISE

A

nesthesia machines are used by anesthesiologists to support the administration of anesthetic and other medical gases such as nitrous oxide. The most commonly used device is the continuous-flow anesthetic machine, which provides a continuous flow of air, containing a regulated supply of gas. Modern anesthesia devices include a monitor and a touch screen display that helps in monitoring a patient’s heartbeat.

The evolution of anesthesia machines has advanced from standalone systems to networked anesthesia workstations that include monitors and information systems. Also, in the past 10 years, manufacturers have started introducing anesthesia machines with features, such as advanced ventilators, new modes of ventilation, graphical screens, and loops that offer a clearer picture of the patient, with a major proportion of the ventilators being electronic and driven by software.

TechNavio’s analysts forecast that the global anesthesia devices market will grow at a compound annual growth rate (CAGR) of 7.47 percent from 2013 to 2018.

TechNavio’s is not alone and researchers indicate that the refurbished devices market will also experience healthy growth.

“Procuring refurbished anesthesia equipment has been a significantly noticeable trend among a number of health care organizations, clinics and outpatient surgery centers. The familiarity of anesthetists with a WWW.MEDICALDEALER.COM

specific machine due to years of proficiency in using it and longer waiting periods for new equipment to be delivered are factors that have opened the gates for refurbishers to enter the anesthesia equipment marketplace,” according to the research firm Industry Experts. “Other reasons for investing in comparatively cheaper refurbished equipment include easy availability of spare parts that can help in keeping the machines in proper working order, which can also be used in cases of maintaining back-ups. Readily available parts help in decreasing downtime, and facilities with extensive research departments opt for refurbished equipment for extending their purchasing power within limited budgets, thereby ensuring that resources are either stretched to the maximum or employed for other gainful and unavoidable requirements.”

Industry Experts expects the global market for anesthesia to maintain a CAGR of about 7.5 percent between 2010 and 2020. The Industry Experts report also forecasts that

“The global respiratory and anesthesia devices market [...] was valued at $12.2 billion in 2013 and is expected to reach $19.5 billion by 2018, at a CAGR of 9.8 percent, for the given period.”

the global anesthesia devices will reach $11.8 billion by 2020.

MicroMarket Monitor agrees with the forecasted growth.

“The global respiratory and anesthesia devices market, mainly driven by geriatric population and increasing prevalence of Chronic Obstructive Pulmonary Diseases and Obstructive Sleep Apnea accompanied by rapid rise in the number of surgical procedures worldwide, was valued at $12.2 billion in 2013 and is expected to reach $19.5 billion by 2018, at a CAGR of 9.8 percent, for the given period,” according to MicroMarket Monitor.

Key players in this market include Draeger, GE Healthcare, Phillips Healthcare and Covidien.

MEDICALDEALER 45

PRODUCT FOCUS_Anesthesia_Product Showroom

Staff Reports

APRIL PRODUCTS: This month, Medical Dealer explores Anesthesia

DRÄGER Perseus A500 Anesthesia Workstation

T

he Dräger Perseus A500 anesthesia workstation is one of the largest development projects ever from Dräger. This innovative device offers unprecedented configurability, high-performance ventilation, enhanced ergonomics, and automation to support the workflow of the operating room. More than 100 different versions of the anesthesia workstation can be created to match the needs of hospitals by combining various hardware options, shelf arrangements, and storage areas. In addition, various software options – such as ventilation and monitoring modes – increase the number of possible configurations. To learn more about the Perseus A500 or interactively configure an anesthesia workstation, visit www.draeger.com/perseusA500.•

46 MEDICALDEALER | APRIL 2016

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odular and upgradeable, with Aisys CS² you’re planning for the future while protecting your investment. Electronic agent control allows you to capture set agent concentrations and precisely measures agent usage. The 15” touchscreen ventilator display and ecoFLOW option displays oxygen flow alongside pre-set targets while calculating anesthetic agent cost and usage in real-time.

Clinicians can use this to adjust oxygen flow to help avoid unnecessarily high fresh gas flow rates.•

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MEDICALDEALER 47

PRODUCT FOCUS_Anethesia_Product Showroom

Staff Reports

MINDRAY A7 Anesthesia Workstation

T

he new A7 Anesthesia Workstation takes the popular A-Series to a higher level. The feature-rich A7 combines traditional bellows driven ventilation with electronic fresh gas technology, to provide effective care across a wide range of patients. Electronic gas control ensures precise gas flow dynamics with accurate and responsive support for both clinical and cost-saving requirements, including low-flow anesthesia delivery.

Gas analysis with agent usage calculation, advanced ventilation modes, integrated suction, auxiliary common gas outlet, and a convenient pull out table, provide the necessary tools for today’s clinical and cost-saving requirements.

With HL7 connectivity to AIMS and EMR systems, the A7 functions as a truly comprehensive workstation that saves time, space and cost.•

48 MEDICALDEALER | APRIL 2016

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PRODUCT FOCUS_Med/Surg_Preferred Vendors

Staff Reports

PREFERRED VENDORS

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CIM med® Euro-Industriepark Margot-Kalinke-Str. 9 80939 Munich, Germany Phone(US): 404-382-0025 Phone: +49 89. 978 94 08-00 Fax: +49 89. 978 94 08-29 Email: info@cim-med.com Website: www.cim-med.com

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Paragon Service is the premier refurbisher of anesthesia systems in the United States for over 25 years. Paragon Service is an anesthesia specialist which sells new and refurbished anesthesia systems, new and refurbished patient monitors, defibrillators and anesthesia accessories.

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Doctors Depot 638 North US Hwy One, Ste 171 Jupiter, FL 33469 Toll-Free: 800-979-4993 Phone: 561-427-6770 Fax: 561-427-6771 Email: aaron@doctorsdepot.com Website: www.doctorsdepot.com Doctors Depot provides the highest quality remanufactured anesthesia equipment in the industry. We focus primarily on Anesthesia Machines and Patient Monitors. All of our equipment comes with 1-2 year warranties and includes a money back satisfaction guarantee. Doctors Depot stands by you every step of the way.

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AD ON Pacific Medical PAGE 5 Repairs & Equipment 32981 Calle Perfecto San Juan Capistrano, CA 92675 Phone: 800-449-5328 Fax: 800-369-9804 Email: info@pacificmedicalsupply.com Website: www.pacificmedicalsupply.com

Experience our quality on all purchase and repairs: • Infusion Pumps • Monitors • Modules • Endoscopes • O2 Blenders • Telemetry • Patient Cables • Gas Analyzers • Fetal Transducers • Suction Regulators From a wide variety of OEMs: Philips, GE, Datex Ohmeda, Datascope and more.

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By John Wallace

T

he Food and Drug Administration surprised the medical device community on March 4, 2016, with the announcement of a docket for public comment titled “Refurbishing, Reconditioning, Rebuilding, Remarketing, Remanufacturing, and Servicing of Medical Devices Performed by Third-Party Entities and Original Equipment Manufacturers; Request for Comments.”

“This docket is open for comments concerning the service, maintenance, refurbishment, and alteration of medical devices, by third-party entities, as well as challenges third-party entities face in maintaining or restoring devices to their original or current specifications,” according to the FDA. “These devices include endoscopes, and radiation-emitting devices subject to the electronic product radiation control (EPRC) provisions of the FD&C Act. We seek comments from the medical device industry and the health care community, and from other interested persons, including those that use these types of devices. This docket is not intended to address the reprocessing of single-use or reusable medical devices. The comment period will be open for 60 days.”

According to an email from the FDA, this docket is designed to address concerns voiced by members of the

52 MEDICALDEALER | APRIL 2016

medical device industry. The deadline to submit comments is May 3.

“The FDA is taking this action, in part, because various stakeholders have expressed concerns about the quality, safety, and continued effectiveness of medical devices that have been subject to one or more of these activities when performed by both original equipment manufacturers and third parties, including health care establishments,” according to the FDA. The request for comments is just the beginning.

“The FDA also intends to hold a public meeting later in 2016 to further engage this segment of the device industry and health care community. Your comments to this public docket will help inform the content of the public meeting,” according to the FDA email announcing this docket.

Valerie Flournoy with the FDA’s Center for Devices and Radiological Health elaborated on the creation of the docket and the FDA’s goal in a telephone interview.

“We had received some information from concerned members of the industry. We decided to get input,” Flournoy said regarding the decision to open the comment period.

She said communications prompting the issuance of the docket mentioned concerns regarding “quality, safety and the continued effectiveness of used medical devices.”

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Flournoy said those voicing concern included OEMs and third-party companies in the medical device industry.

International companies and other interested parties are invited to share their insights during the comment period.

The goal is to get everybody “on the same page” regarding terms used in the medical device industry, Flournoy said. Other terms listed in the docket are recondition, service, repair, remanufacture and remarket. She said it is important for everybody to be in agreement and have the same definitions for these terms.

The FDA’s 60-day comment period is designed to provide a foundation for future discussions. She explained that the FDA wants to author a one-page white paper ahead of a workshop this fall. The FDA is seeking individuals to speak at the workshop. Flournoy said individuals interested in speaking may contact her at 301-796-5495.

“After the workshop, we would decide if we need to regulate them,” Flournoy said. “We would determine if we need to regulate them or have a guidance document.”

However, Flournoy said that the fall workshop could result in another meeting before a determination is reached to issue a guidance document or regulations.

In summary, the FDA will have a 60-day comment period followed by a one-page white paper and public meeting in the fall of 2016.

“Then, we go back and determine if we need to do another public meeting or where we need to go from there,” Flournoy said.

She said the FDA had a similar docket in the 1990s and “nothing really came of that.” Flournoy said advances in technology and the rapid changes brought about by today’s technology is a reason the FDA is revisiting this issue.

WWW.MEDICALDEALER.COM

“The major thing for the FDA is to protect the public health,” Flournoy said. “It is all about patient safety.”

ISO CHALLENGE There is not a consensus about the goal of the FDA and some members of the medical device industry voiced concern for independent service organizations.

Medical Resources Alliance President Tom Quinn sees the opening of the docket as a means to revisit the FDA’s attempt to regulate the industry that was blocked in 2015.

Supplementary information provided in the FDA literature states: “Stakeholders have expressed concerns that some third-party entities who refur-

“Our industry, third-party ISOs and HTM professionals, should see this as an opportunity to be heard by the FDA.” – Jason Crawford bish, recondition, rebuild, remarket, remanufacture, service, and repair medical devices may use unqualified personnel to perform service, maintenance, refurbishment, and device alterations on their equipment and that the work performed may not be adequately documented. Possible public health issues arising from these activities include ineffective recalls, disabled device safety features, and improper or unexpected device operation. OEMs have also requested clarification of their responsibilities when their devices have

been altered by a third-party entity.

Federal Agencies other than FDA address service and maintenance activities as well.”

Quinn wants to know who these stakeholders are, especially if patient safety is the reason for the docket. He asks, “Where are all of these complaints from the last 20 years?”

“I think the goal is not patient safety.

That’s a bunch of hooky,” Quinn said.

“The goal is to put ISOs out of business. If this was about patient safety they would have fixed it 20 years ago. If everything had been working the way it should be working the last 20 years, this docket wouldn’t be necessary.”

He said the best defense for ISOs and hospital biomedical departments is “a good compliance plan.” Yet, he said that he believes this is going to be “devastating for hospitals.”

However, many believe ISOs play an important role in health care by providing less expensive options for medical equipment service and maintenance and therefore help to lower health care costs for consumers.

ISOs provide quality service on medical equipment that is typically about 50 percent the cost charged by manufacturers. Also, ISOs often are able to respond faster to a service call than a large manufacturer.

The same argument can be made regarding refurbishers. Capital costs can be 50 percent less when hospitals buy refurbished equipment as compared to brand new equipment from the manufacturer.

A CHANCE TO BE HEARD The opening of the docket and the call for comments has garnered a mixed reaction from the medical device and HTM community. Many see this action as an opportunity.

“Our industry, third-party ISOs and HTM professionals, should see this as

MEDICALDEALER 53

an opportunity to be heard by the FDA,” Block Imaging Parts and Service President Jason Crawford said. “The FDA is doing this for one reason only: To increase the safety of medical devices.

We need to honestly ask ourselves what the most practical ways are to increase medical device safety.”

Wanda Legate, vice president of sales and marketing at Tri-Imaging Solutions, welcomes the opportunity to assist the FDA. Quality, Legate pointed out, has long been an important aspect of the “aftermarket.”

“For several years now there have been rumblings of the FDA being involved in the medical devices aftermarket,” Legate said. “I am very confident they will find the aftermarket is a lot more advanced than they realize. Quality standards are not new to the aftermarket. Companies have been pursing ISO certifications and implementing QMS procedures to insure quality for some time. I think I speak for all of us when I say we are very proactive in providing quality equipment, service and parts to this industry.”

AAMI President and CEO Mary Logan said this as an opportunity to be proactive.

“It’s great to see this docket garner so much attention, especially as it follows shortly on the heels of AAMI’s November 2015 event on the supportability of medical devices. This is a very important conversation that the FDA is starting, and we applaud the agency’s interest,” Logan said in a prepared statement. “There are many opinions about service and repair, and what we hope the conversation will bring out is data that will support a strong analysis of the issues. I would encourage companies and health care organizations to submit comments that not only offer their perspectives but also evidence to support those perspectives.”

GE Healthcare also commented on the FDA’s decision.

54 MEDICALDEALER | APRIL 2016

“I am very confident they will find the aftermarket is a lot more advanced than they realize. Quality standards are not new to the aftermarket.

Companies have been pursing ISO certifications and implementing QMS procedures to insure quality for some time.

I think I speak for all of us when I say we are very proactive in providing quality equipment, service and parts to this industry.”

– Wanda Legate “GE Healthcare is pleased that the FDA has opened the docket for comments regarding the servicing, maintenance, refurbishment, remanufacturing and alteration of medical devices. We believe the implementation of appropriate minimum standards for these activities supports the quality and effective performance of medical devices as well as patient safety,”

according to an email sent to Medical Dealer magazine. “GE Healthcare is working alongside its partners to prepare comments accordingly.”

Toshiba America Medical Systems Inc. also released a statement concerning FDA’s call for comments.

“At this time, Toshiba is not actively involved with the FDA’s recent docket, however we will review and comment if necessary. Toshiba prioritizes safety in regards to our customers and their patients. Toshiba invests in its customers and employees through extensive research and training on each product that it markets. Toshiba applauds the FDA taking action that will provide a standard of safety for all patients,” said Paul Biggins, director, regulatory affairs, Toshiba America Medical Systems Inc. Legate added that it is imperative that the FDA listen and give equal weight to the concerns of everyone within the medical device industry.

“I am for defining standard terms or definitions for our industry. However, I think the industry as a whole should have a voice in defining the terms or definitions not just the OEMs,” Legate added.

Crawford added that this is also an opportunity to express concerns and seek solutions that benefit everyone involved.

“The greatest opportunity to increase the safety and effectiveness of our industry is by increasing the accountability on the manufacturers to provide the technical documentation and access to maintain equipment,” Crawford said. “The FDA already requires OEMs to provide the information necessary to Assemble, Install, Adjust, and Test (AIAT) radiographic equipment. Broadening the scope of AIAT and increasing the accountability on the manufacturers for the accuracy of this information would benefit HTM professionals, ISOs and, most importantly, patient safety.”

MEDICAL EQUIPMENT, PARTS & SERVICE

FDA EXAMINES THE MEDICAL DEVICE INDUSTRY

When asked what the opening of the docket means for third-party organizations Technical Prospects Chief Operating Officer Jeremy R. Probst said it will lead to the “standardization of processes, terminology, quality, training, compliance and documentation.”

Probst also said this measure could result in better access to service manuals and other documents which in turn would empower ISOs to provide even better service on medical devices.

“It may also become the beginning of government intervention in our

private entities. There is the potential for the OEMs to be required to share service documentation at a higher level to allow third parties the ability to confidently service the device per OEM documentation,” Probst said.

IAMERS RESPONDS TO FDA DOCKET

BY DIANA UPTON, PRESIDENT OF IAMERS

The Food and Drug Administration (FDA) has called for comments regarding: Refurbishing, Reconditioning, Rebuilding, Remarketing, Remanufacturing, and Servicing of Medical Devices Performed by Third-Party Entities and Original Equipment Manufacturers.

What Does This Mean for Health Care Providers and ThirdParty Service Providers?

While understanding that the ultimate goal is patient safety, IAMERS is concerned that future regulations could limit the options of health care providers, while having minimal, if any, impact on safety.

Current FDA regulations require OEMs to provide the information necessary to Assemble, Install, Adjust, and Test (AIAT) radiographic equipment. As we all know, OEMs are not always forthcoming with needed service/installation information. This requirement is often completely disregarded by the OEMs. Surely this could have an effect on patient safety.

Additional regulations could also put an unfair burden on third-party providers which, in turn, limits the choices for health care providers.

If regulation is approaching our industry, then it should be done in consideration of the following: • Are there more complaints against third-party service than OEM service?

• How can third-party service providers be regulated, yet OEMs are not complying with existing regulations?

• OEMs are frequently unwilling to train third-party entities.

• Who is to formulate regulations? All parties, not just the OEMs, should have a say in the outcome.

IAMERS Encourages Members to Formulate Standards IAMERS has long encouraged its membership to become ISO certified. We agree that the ultimate goal is patient WWW.MEDICALDEALER.COM

safety. As the only trade association representing preowned imaging equipment (members comprised of companies that service and/or sell diagnostic imaging equipment), we see the need for standards. The reputation of our members is of the utmost concern to IAMERS. All should strive to improve customer/clinician satisfaction – to provide the best possible service on medical equipment. Many IAMERS members are ISO certified. We will continue to help and encourage our members to take this important step.

IAMERS will continue to focus on patient safety. Earlier in the year IAMERS formed a committee to study and recommend best practices. If you have suggestions as to best practices, please contact me so that I may pass along your recommendations to the committee and, as appropriate, to the FDA. You can contact me at diana@iamers.org or 201-357-5400.

IAMERS believes the industry can and should adopt best practices without the necessity of further regulation.

Nonetheless, IAMERS will continue to encourage methods to improve patient safety. These methods must include greater access to assembly information as mandated by existing FDA regulations. For stakeholders, such as some OEMs, to suggest uneven levels of quality and to concurrently withhold AIAT information is disconcerting. We hope this practice will not be pursued. We look forward to offering further comment to the FDA. IAMERS Will Submit a Formal Response to the FDA IAMERS encourages members and other industry stakeholders to submit comments to the FDA. The deadline for submission is May 3, 2016. Instructions on how to submit comments can be found online at https://www. federalregister.gov/articles/2016/03/04/2016-04700/ refurbishing-reconditioning-rebuilding-remarketing-remanufacturing-and-servicing-of-medical-devices. • MEDICALDEALER 55

FDA EXAMINES THE MEDICAL DEVICE INDUSTRY

Crawford said he does not believe the goal is to eliminate competition in the marketplace. He also expressed the opportunity to acquire a powerful ally.

“The idea of regulation is often scary, but the FDA does not have a motivation to shut down third-party service or stop competition,” he said. “If our industry comes to the table with practical solutions to make medical devices easier to service, the FDA is in a powerful position to help make those solutions a reality.”

“Let's look at a practical worst-case scenario. It's not a complete shut down of service providers; it's not a forced OEM-only service solution. The FDA could choose to regulate the third-party ISOs and HTM professionals in hospitals. That will mean audits of assemblers and potentially tracking of adverse events by service provider in addition to system information,” Crawford said.

Depending on the outcome of the open comment period and workshop, the FDA could find itself policing who can and cannot work on medical devices.

“If the FDA requires third parties to be in compliance with standard and regulated practices, the end user should receive a higher quality product as a result of using documented processes and quality replacement parts to refurbish, recondition, rebuild or remanufacture spare parts or equipment,” Probst said. “The FDA is also reviewing the fact that medical devices may be ‘repaired/serviced by’ unqualified personnel without adequate documentation which may or may not result in a device functioning to OEM specifications.

The outcome may result in a requirement for documented training certificates from an OEM or third-party training company in order to service/repair the device.”

“Regulation as a whole is not always good if regulation gets in the way of free enterprise. However, if handled correctly, companies with Quality Management Systems (QMS) will already have a foot in the door. Thus, providing continuous improvement in products and services that is an overall win for health care,” Probst added.

One thing everybody agrees on is the need to submit comments and make the FDA aware of issues as well as possible solutions. Comments may be submitted electronically or in written format. For details, visit https://www. federalregister.gov/articles/2016/03/04/2016-04700/ refurbishing-reconditioning-rebuilding-remarketing-remanufacturing-and-servicing-of-medical-devices.

MD Expo will feature a special meeting hosted by expert panelists at 9 a.m. on Friday, April 22 to discuss the FDA docket.

For details, visit MDExpoShow.com/FDA. 56 MEDICALDEALER | APRIL 2016

You may submit comments as follows: Submit electronic comments in the following way: Federal eRulemaking Portal: http://www. regulations.gov. Follow the instructions for submitting comments. Comments submitted electronically, including attachments, to http://www.regulations.gov will be posted to the docket unchanged.

Submit written/paper submissions as follows: Mail/Hand delivery/Courier (for written/ paper submissions): Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.

For written/paper comments submitted to the Division of Dockets Management, FDA will post your comment, as well as any attachments, except for information submitted, marked and identified, as confidential, if submitted as detailed in “Instructions.”

Instructions: All submissions received must include the Docket No. FDA-2016-N-0436 for “Refurbishing, Reconditioning, Rebuilding, Remarketing, Remanufacturing, and Servicing of Medical Devices Performed by Third-Party Entities and Original Equipment Manufacturers; Request for Comments.” Received comments will be placed in the docket and, except for those submitted as “Confidential Submissions,” publicly viewable at http://www. regulations.gov or at the Division of Dockets Management between 9 a.m. and 4 p.m., Monday through Friday.

For detailed information about FDA's posting of comments to public dockets, see 80 FR 56469, September 18, 2015, or access the information at: https://www.federalregister.gov/articles/2016/03/04/2016-04700/ refurbishing-reconditioning-rebuilding-remarketing-remanufacturing-and-servicing-of-medical-devices. •

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57

䔀砀瀀攀爀椀攀渀挀攀 匀椀攀洀攀渀猀 洀攀搀椀挀愀氀 椀洀愀最椀渀最 攀焀甀椀瀀洀攀渀琀 琀爀愀椀渀椀渀最 椀渀 漀甀爀 猀琀愀琀攀ⴀ漀昀ⴀ琀栀攀ⴀ愀爀琀 昀愀挀椀氀椀琀礀⸀ 圀攀 栀愀瘀攀 ㄀㘀 栀愀渀搀猀ⴀ漀渀 儀䄀 戀愀礀猀 椀渀 愀 挀氀椀渀椀挀愀氀 攀渀瘀椀爀漀渀洀攀渀琀Ⰰ 琀眀漀 挀氀愀猀猀爀漀漀洀猀Ⰰ 愀渀搀 攀砀瀀攀爀椀攀渀挀攀搀 攀渀最椀渀攀攀爀 椀渀猀琀爀甀挀琀漀爀猀⸀ 䐀漀渀ᤠ琀 樀甀猀琀 挀漀洀攀 昀漀爀 琀爀愀椀渀椀渀最⸀ 䌀漀洀攀 昀漀爀 琀栀攀 攀砀瀀攀爀椀攀渀挀攀⸀

圀攀 栀愀瘀攀 琀栀攀 洀椀猀猀椀渀最 瀀椀攀挀攀⸀ 䌀漀洀攀 椀渀 甀渀搀攀爀 戀甀搀最攀琀Ⰰ 愀栀攀愀搀 漀昀 猀挀栀攀搀甀氀攀Ⰰ 愀渀搀 挀甀琀 漀甀琀 琀栀攀 伀䔀䴀⸀ 䔀渀最椀渀攀攀爀 琀爀愀椀渀椀渀最 挀漀甀爀猀攀猀 昀爀漀洀 吀攀挀栀渀椀挀愀氀 倀爀漀猀瀀攀挀琀猀⸀

58 MEDICALDEALER | APRIL 2016

琀攀挀栀渀椀挀愀氀瀀爀漀猀瀀攀挀琀猀⸀挀漀洀⼀琀爀愀椀渀椀渀最 㠀㜀㜀⸀㘀 㐀⸀㘀㔀㠀㌀ 琀爀愀椀渀椀渀最䀀琀攀挀栀渀椀挀愀氀瀀爀漀猀瀀攀挀琀猀⸀挀漀洀

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MEDICALDEALER 59

CORPORATE PROFILE

ED SLOAN & ASSOCIATES A

popular quote says, “If you love your job, you never have to work a day in your life.” Everybody at Ed Sloan

& Associates, a provider of diagnostic imaging products and services, personifies those words on a daily basis from President and Founder Ed Sloan to the most recent hire.

One recent experience Ed Sloan recounted illustrates just how much he and the rest of the expert workforce love the work they do at Ed Sloan & Associates.

“I was at the facility recently around one o’clock one morning helping unload a MRI. While I was working, Scott walked in,” Ed Sloan says. “He had been helping a local customer who was having problems getting their system up and running.

A short time later, another employee came in to get a part ready to be driven to a customer via courier.”

“In total there were 7 people working in the middle of the night,” Ed Sloan continues. “I realized, again, how fortunate I am to surround myself with others who are dedicated to their work and our customers.”

As an industry veteran, Ed Sloan knows the importance of quality customer service and quality products when it comes to diagnostic imaging.

60 MEDICALDEALER | APRIL 2016

Ed Sloan President and Founder of Ed Sloan & Associates “Our strength at Ed Sloan & Associates centers around our technical expertise and personal attention to every aspect of product delivery. We take the responsibility of fulfilling the customers’ needs with the ‘One Stop Service’ approach,” Ed Sloan says.

Ed Sloan & Associates is his second successful entry into the diagnostic imaging market. It is a calling that came unexpectedly, but one that has been more rewarding than he could have ever imagined.

ED SLOAN & ASSOCIATES “Having a career in the medical imaging industry is not something that was planned, but I have thoroughly enjoyed every minute of it,” Ed Sloan says. “In 1986, I was buying and selling excess electronic components and equipment when I sold my first piece of medical equipment and realized there was a market for refurbished medical imaging equipment and parts. Soon after, ReMedPar was formed. The company was built on the principles of growing one customer at a time and providing legendary customer service. At the time of my retirement, in 2008, the company had grown to a $40 million business.”

Retirement came too soon for Ed Sloan. He missed helping customers and ached for an opportunity to once again deliver quality equipment and outstanding service.

“After a very short stint at retirement, I realized how much I enjoyed this industry and missed working.

I missed the people and the daily activity,” he shares. “Just a few brief months after retirement, Ed Sloan & Associates was formed. It was started with myself and Kelley Nelson selling complete systems, each of us working out of our homes.”

The company grew and evolved as required by its focus on meeting customers’ needs.

“We eventually leased a warehouse, hired a few employees and spent the first couple of years selling complete systems. We had some systems that were not abundant in the used market and we started receiving calls from customers who MEDICAL EQUIPMENT, PARTS & SERVICE

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A LOOK AT SHIPPING/RECEIVING and the stocked inventory of quality tested parts and equipment.

“As you might expect, there were significant logistical challenges with the move, however, making sure that we never failed to pick up the phone when a customer called, and never compromising the quality of our product demanded everything that the Ed Sloan & Associates team had to give physically and mentally.” – Ed Sloan would ask us to pull parts from systems we had in inventory,” Ed Sloan explains. “Pulling the occasional part for a customer who was in a bind and couldn’t find it anywhere else was the first step that led us back into the parts market.”

As it would turn out, the growth of the company also presented challenges and provided a homecoming of sorts for Ed Sloan.

WWW.MEDICALDEALER.COM

“The biggest challenge we have faced was moving into our facility in July 2015. We were in a 48,750-square-foot building in Goodlettsville, Tennessee. Around the time we started to realize we were running out of space, the building located at 101 Old Stone Bridge, the former ReMedPar building, became available,” Ed Sloan says. “I could not pass up the

A couple of our engineers testing parts in one of our 8 CT QA bays.

opportunity to move back to the building where it all started, where my career in this industry began.”

“As you might expect, there were significant logistical challenges with the move,” he added.

“However, making sure that we never failed to pick up the phone when a customer called, and never compromising the quality of our product demanded everything that the Ed Sloan & Associates team had to give physically and mentally. Long hours, dedication to the mutual success of our customers and the successful execution of the move by every member of the team has gotten us through.”

“Based on the history that I, along with quite a

few Ed Sloan & Associates team members, have had at this facility, it has taken a while to feel like ‘home.’

But I feel that I can speak for all of us when I say I believe this is where we are meant to be,” Ed Sloan says.

The company’s new home includes dedicated areas for 12 CT bays, 4 MRI bays and 4 X-ray bays with room for expansion. It also has test and repair areas for mammography, portable X-ray and C-arms. The facility’s training classroom is designed for training classes that can be customized to fit each customer’s needs.

The company’s growth brought about the need for its new home and other adjustments.

MEDICALDEALER 61

CORPORATE PROFILE SPECIAL ADVERTISING SECTION

“While we are currently experiencing a lot of changes and growth, I am most excited about our expanded parts offerings. Ed Sloan & Associates entered the parts market specializing in GE CT and GE MRI and we are transforming into a complete Tier 1 parts and support facility supporting Siemens, GE, Philips and Toshiba,” Ed Sloan explains.

“We will continue, over the next few years, to expand our parts and equipment offerings,” he adds. “This includes a tube repair facility in Northern California. I also see Ed Sloan & Associates becoming more involved in the international market.”

Some of the company’s growth includes areas that might not be noticed by the casual observer.

“This past year has been an exciting time for Ed Sloan & Associates as we have been presented with many opportunities and changes. While the move into the new facility and expanded product offerings have been the most visible changes, we have also experienced a lot of internal changes,” Ed Sloan explains.

“Our expansion into the product lines of the other major OEMs has contributed to an increase in our staff by over 85 percent. An influx of the best and the brightest the industry has to offer who are totally committed to delivering the Ed Sloan standard of quality.”

“We are also in the process of integrating a new, custom inventory and sales software package which will allow us to better serve our customers,” he adds.

Ed Sloan & Associates’ mission continues to focus on delivering for its customers and is even more important as the company continues to grow.

“We focus on the Reliability of the products we provide, the Availability of our services and the Capability of our team to sup62 MEDICALDEALER | APRIL 2016

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“Our team of employees, and the unique skill sets and backgrounds brought by each, definitely provides us an advantage in this market. By far the most important advantage is having employees who enjoy their work.” – Ed Sloan port our customers. Our goal is to provide this while meeting the Affordability demands of the Healthcare Market today,” Ed Sloan says when asked about his company’s mission statement.

“We are proud of our history, proud of our product, and proud of the relationships we have developed over the years,” he adds. “We look forward to continuing to build on those relationships while forging new ones as we build the company to meet our customers’ needs.”

In the end, it all goes back to a love for the work and a desire to

provide excellent customer service along with quality parts.

“Our team of employees, and the unique skill sets and backgrounds brought by each, definitely provides us an advantage in this market. By far the most important advantage is having employees who enjoy their work,” Ed Sloan says. “I have been fortunate to surround myself with people who, like me, enjoy what they do.”

FIND ADDITIONAL INFORMATION about Ed Sloan & Associates online at www.edsloanassociates.com.

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PUTTING OUT THE CALL FOR TELEMEDICINE

By Matt Skoufalos

T

he ability to participate in work via a real-time, virtual presence has transformed communication in professions as diverse as business, the arts, education, and now medicine. By the end of the decade, the market for global telemedicine is projected to hit $6.5 billion, according to various industry estimates that foresee its compound annual growth rate approaching 25 percent.

The largest share of that market will be in North America, and its fastest-growing segment is projected to be “real-time interactions,” with provider experiences dominating both the size and growth categories for telehealth end-users,” according to industry research aggregator Market Reports Hub. The firm also noted that mobile health businesses are poised for the fastest growth, “leveraging 9.5 billion smartphones and 5 billion connected tablet devices installed all over the world by 2021.”

That squares with the understanding of Dr. Judd Hollander, Associate Dean of Strategic Health Initiatives for Thomas Jefferson University in Philadelphia, Pennsylvania. To date, the market for telemedicine has largely been driven WWW.MEDICALDEALER.COM

by technology manufacturers and not by researchers, Hollander said. As the tech sector continues to push, the regulatory and clinical aspects of the industry must sort themselves out as well; to do that will require greater proofs of the value of the technology..

“The companies have made devices or toys which do various things, some of which work well, and some of which don’t work quite so well,” Hollander said.

“What we’re missing is an evidence base on where these things work best: where and when telemedicine should be used, and how to use it.”

At its simplest, telemedicine can be defined as a long-distance patient-doctor communication; usually, a video chat, Hollander said. The process is fairly conventionally recognized as appropriate for “minor, urgent-care complaints,” but he believes that telemedicine can also be used to care for patients who have more complicated concerns.

“Telemedicine is not for everything and it’s not for everybody,” Hollander said. “Of course I can’t take care of a heart attack on telemedicine, but if you’re having chest pain, and you’re not sure what it is, and you’re planning on waiting it out for the next few hours at home, I hope you call

someone via telemedicine. I might just get [the patient] to the ER sooner. Ironically, I might save a life more often when I cannot treat the condition, than when I can.”

Hollander believes that many patients with chronic conditions are in touch with their symptoms and the mechanisms they use to manage them. With the information available from medical devices — an asthmatic taking peak air-flow measurements, for example — and patient self-reporting, a physician consulting via telemedicine can help determine appropriate interventions, whether sending the patient to the emergency room or supporting their recovery at home.

“We tend to think of chronic and acute things as different,” Hollander said. “People with chronic diseases get sick, usually with an acute exacerbation of their chronic disease. People don’t die ever of their chronic diseases. They die of an acute worsening of their chronic disease, which previously was stable.”

“If you’re a diabetic and your blood sugar is controlled, you may not need to be seen in the office,” he said. “It’s really a visit to make sure you stay stable. If you’re a diabetic whose blood baseline tripled, we really need to see you. I think telemedicine needs to be able to deal with both patients.”

MEDICALDEALER 67

Putting Out the Call for Telemedicine

“Right now, patients who seek after-hours care often go to the ER,... let’s reproduce that model in a way that patients don’t have to go to the ER.” -JUDD HOLLANDER

JUDD HOLLANDER From a process standpoint, telemedicine expands office hours for physicians to speak with patients who might otherwise only connect with their doctors in a limited window of time. That improved access is a knife that cuts both ways. On the one hand, it expands the opportunity for physicians to have increased engagement with the people who need medical attention; on the other, “at some point doctors need to go home and be with their family and do other things, or else they’re not going to be effective physicians,” Hollander said. Ideally, what patients should receive from a telemedicine relationship is to have a doctor who is connected with their personal medical history.

“The ballgame is about coordinating care,” Hollander said. “The problem is we have a lot of this field being driven by technology. People using the technology right is the optimal solution.”

Hollander oversees the Jeff Connect telemedicine service at Thomas Jefferson University in Philadelphia, where more than 400 doctors perform scheduled video visits and also coordinate after-hours, acute, unscheduled care for patients through an on-demand app.

When patients seek on-demand care, they understand that they aren’t always calling their primary care physicians; 68 MEDICALDEALER | APRIL 2016

they’re effectively contacting an on-call emergency room doctor. The difference for Jefferson’s patients, he said, is that they are connecting with a physician who has access to their entire patient history.

That’s an advantage that even the on-call coverage at a patient’s primary care office may not have.

“How are ER docs doing telehealth?

Sitting at a computer with the records,” Hollander said. “We know your past history, your meds, and we can close the loop with a summary of the visit as well as discharge papers. In the end, what everybody is trying to do is coordinate care. If you’re just talking to some random person who doesn’t know you, whether they’re affiliated with your primary care group or an online group from one of the national telehealth vendors, it doesn’t close the loop.”

“Right now, patients who seek afterhours care often go to the ER,” he said.

“Let’s reproduce that model in a way that patients don’t have to go to the ER.” Jeff Connect is managed in part with a mobile application that allows patients to input their information and immediately speak with a doctor at any hour of the day as well as to schedule appointments with their primary care physicians and specialists. Its pros, in Hollander’s view, include an ability to observe patients in their home environment, which allows him to take context clues from the interaction.

“When people get readmitted, it’s often not for medical reasons, it’s social issues,” Hollander said. “Let’s say you

send home somebody with hip surgery and they have to go up three flights of stairs to their bedroom. Are they going to come down to the kitchen to eat, or are they going to their bedroom? Are there rugs? Could they fall?

“We’ve had patients who don’t want to do telemedicine visits because they don’t look well,” he said. “[On a tele-visit], I can see how old their medicine is for, what the date of the script is, and whether they could have mathematically explain the number of pills left over, or whether they have taken all the pills they should have in that time period.”

For as much as telemedicine allows doctors to communicate with their patients more often or more conveniently, Hollander says it functions best as an option and not “the overall solution for everybody.”

“People who are driving this are people who make the devices,” he said. “It’s not the people who create and analyze the evidence. Remote patient monitoring might be really useful, but it might not be. Public housing in Philadelphia doesn’t have Wi-Fi. How are they going to transmit that information? If you’re smart enough to connect a scale to Wi-Fi, can’t you just tell me what you weigh every day? We need to figure out which strategy works best and for whom. It is unlikely to be a one size fits all approach” Another hurdle for telehealth to overcome is a regulatory one. The current focus of Centers for Medicare & Medicaid Services (CMS) telemedicine rules involves MEDICAL EQUIPMENT, PARTS & SERVICE

“However you describe it, telemedicine will increase exponentially going forward.” -KAREN THOMAS getting care for patients in rural environments who don’t have access to care. The limitation of this approach — favoring geographic need over questions of access — keeps some patients in more densely populated areas from benefiting from telemedicine. Even though New York City is home to a significant population of need, it’s by definition not a rural area, and therefore CMS won’t reimburse practitioners for telemedicine there, Hollander said.

“If you can’t get to a primary care physician, that’s access. If you don’t drive a vehicle. If you don’t have a driver license.

If you don’t have legs. There are a whole host of things that are more complicated than zip code but are better reflections to figure that out,” Hollander said. “Do you have a primary care provider? If you don’t have insurance, do you want to spend $1,200 in the ER or $49 on telehealth?”

Another stumbling block for telemedicine is the idea that patient access to providers should be conditional upon a prior, established relationship; the American College of Physicians recommended as much in a September 2015 position paper. Hollander points out that ER physicians, many of whom staff telehealth desks, do not have any such prior relationship with their patients. Neither do physician partners who share a practice necessarily have any such shared access among their patient pools that would provide a greater depth of service based on familiarity.

“My whole life as an ER physician is working with patients with whom I don’t WWW.MEDICALDEALER.COM

have an established relationship,” he said.

“You’re going to tell a patient they can’t call me on the phone or do a video visit but they have to come see me in the ER, and it’s the same doctor? A lot of times the doctors who do telehealth are in the ER. This is an illogical way to limit who does telemedicine.”

Those hang-ups aren’t necessarily permanent obstacles, however, said Karen Thomas, President of Advanced Telehealth Solutions of Springfield, Missouri.

As the executive of a telehealth call center, Thomas foresees significant growth opportunities in remote patient monitoring services like hers, which she said mixes equipment needs among patient populations “to get the best clinical outcomes at the best price point.”

“However you describe it, telemedicine will increase exponentially going forward,” Thomas said. “Reimbursement is changing, and I learned a long time ago that things change when the financial flow is in the favor of the new technology or the new service.”

The conferencing technology around which telemedicine is principally based and is becoming more affordable, as is the access to it via a supporting network, and the stability of the underlying infrastructure. Improvements to the video feed can improve clinical outcomes as physicians can see more with a better-quality signal. Combined with the strictures of an outcomes-driven business model that includes value-based purchasing for hospitals, physicians and

KAREN THOMAS home health care, incentives are also evolving with care methodologies — which in turn drives the next iteration of telemedical technologies, Thomas said.

“You’re beginning to see that the technology has enabled us to be more efficient with it,” she said. “If you think about remote patient monitoring, we’re now able to touch these people in the home and only deal with the situation when it’s warranted. What we have is the ability now to reach even further.

We have done depression counseling for an isolated population, speech therapy; all the technology is inexpensive enough where it can go into the actual home.”

As the applications for telemedicine diversify and multiply, Thomas anticipates that the number of startups in the sector will likewise increase rapidly. As the field becomes crowded with competitors, companies will come to distinguish their products by security and interoperability as well as by superiority of function.

“The real skill is knowing what to look for in a market with a lot of new players; how long they’ve been in business and how progressive they are,” Thomas said.

“You’re asking people to change, and the more efficient it is, the more apt you will be to get buy-in from people who are using it, whether it’s people on the road or physicians consulting with a specialist.”

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71

SLICE OF LIFE_The Other Side

By Jim Fedele

TECHNOLOGY CAN SOLVE ALL OUR PROBLEMS?

T

he past few months I have spent a lot of time attending committee meetings and participating in work groups. One of the great things about the hospital environment is that there is always a problem that needs to be solved and we love to get together and talk about them. Some days it drives me crazy because I feel like it takes too long to get anything solved. Lately a common theme is developing and that is to throw technology, (software/integration products) at the problem to solve it. On the surface this sounds great and if you listen to the salespeople, there really is not a better way to solve a problem. However, my experiences tell a different story.

The business of providing care for patients is complex; there are many moving parts to ensuring successful outcomes and efficiency. A single departmental decision can unintentionally disrupt work flows for many other departments. This is why we form committees to work through problems.

We try to identify and mitigate unintended consequences of a decision made to solve problems. However, the more people that are on the committee, the longer it takes to get something done. We are trying to do a better job of limiting participants by bringing in subject matter experts on an ad hoc basis.

This has helped to keep us on track and 72 MEDICALDEALER | APRIL 2016

move a little faster.

I have noticed that the problems we are trying to solve are not unique to us. Most facilities appear to be trying to improve patient throughput, increase efficiency, manage alarms, and etcetera. With this demand comes products to solve these common problems. Highly inventive and smart entrepreneurs have developed solutions to solve hospitals’ most common

ments contributing to the problem, from social services, to the nurse and even the patients themselves. My favorite reason is that older patients who live alone do not want to go home before lunch because they really like our food. Also, they won’t need to eat when they get home. It has been a great learning experience for me. The committee has been doing site visits looking at a vendor that claims to have

Too many times, I see technology implemented that does nothing more than shift labor from one area to another. and daunting problems. In fact, on many of the committees I participate on, people are visiting other hospitals to look at the products they are using to solve problems. However, care must be exercised during these visits because committee members can be romanced by a product’s bells and whistles without considering implementation.

For instance, I am part of a throughput committee. We are analyzing all the reasons patients are not getting out of the hospital on time.

There are many parts and depart-

the solution to all our problems. When I hear the reports from the site visits it is clear the team is being allured by the features and has not asked about implementation. I would estimate that if we tried to implement this system it would take at least a year before we would be operational and frankly we do not have that much time. From my perspective, the issue is simply poor processes and poorly executed processes.

I have been a part of purchasing technology to solve a process problem MEDICAL EQUIPMENT, PARTS & SERVICE

_The Other Side

and it has never gone smoothly. I feel like it is a common pitfall. When there is a problem that is not easily identified or there are too many stakeholders to change processes we think technology is the answer. I am not saying technology is not the answer, but it can’t be the only answer. If the processes are bad and nobody owns them or is responsible, technology can’t solve that problem. Using technology won’t solve the problem and can even make it worse.

I have seen the addition of technology be successful when it augments existing sound processes that are already in place. When applied correctly, the use of technology can eliminate a manual process and/or automate decision making. When the process is sound and you are able to reduce work loads without shifting it to someone else then you have won with technology. Too many times, I

see technology implemented that does nothing more than shift labor from one area to another.

In closing, hopefully you are invited to bring your talent and expertise to bear on problems in your facilities. When technology becomes the “be all end all” solution, stand up and ask questions. How long will it take to implement? What processes will improve today? Who will be in charge of it? Be the voice of reason. Be the one who says (because you have lived it) that salespeople do not always deliver what they promise and products do not always do what they are supposed to do.

JIM FEDELE, CBET, has been with Medical Dealer magazine for more than 12 years. He is currently the director of clinical engineering for Susquehanna Health Systems in Williamsport, Pa. He can be reached for questions and/or comments

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SLICE OF LIFE_Bobinski

By Dan Bobinski

THE HIDDEN COSTS OF CONFLICT

I

ndira Gandhi made a great point when she said, “You can't shake hands with a clenched fist.” Disagreements occur in even the best working relationships, and whenever people work closely together, conflict is inevitable. Experts say that conflict can be healthy or unhealthy. In other words, handle conflict well and you’re likely to reap rewards.

Handle it poorly and you’ll suffer negative consequences.

Before I get into the hidden costs of unhealthy conflict, let’s consider what healthy conflict should look like.

In healthy conflict the issues in question are put on the table and discussed with objective language. Each party is empowered to state his or her position with confidence that the other party is genuinely listening, wanting to understand. Possible solutions are explored with open minds, and ripple effects are considered and weighed for each solution offered.

It’s an easy process to understand, but as most of us know, it can be incredibly difficult to do. After all, people want what they want, value what they value and believe what they believe. Each person has a picture or framework in their heads of how things ought to be. To consider the notion that their interests, attitudes and values can be fulfilled differently than how they perceive it to be can be a long stretch.

For many, that stretch is too long and too uncomfortable. Others may not even know how to go about resolving conflict in healthy ways, so they remain (or become) aggressive, or passive, or even worse, passive-aggressive.

As a result, unhealthy conflict is 74 MEDICALDEALER | APRIL 2016

Dan Bobinski Workplace Consultant

common. When two parties remain aggressive they can become stubborn and forward progress becomes deadlocked. Conversely, if one party is or becomes passive, they’re giving in and giving up, not getting their needs met. This can lead to hidden resentment and even internal health problems. A passive-aggressive approach is when one or both parties become manipulative and begin sabotaging the opposition from behind the scenes.

In many forms of unhealthy conflict, personal attacks are common, be they open or veiled.

People can get angry, feelings can get hurt, and words can become weapons that leave long-lasting scars.

By the way, when conflict is avoided altogether, a common result is tension. As Patrick Lencioni says in his book, “The Five Dysfunctions of a Team,” tension is another term for unspoken conflict. Lencioni

explains how healthy conflict (open dialog on differences) is good, but tension is almost always bad. Unspoken conflict results in chronically unresolved problems.

Another huge impact due to unhealthy conflict is reduced levels of trust. Remove trust and you remove synergy, often a necessary component for innovative problem-solving.

During informal conversations with business leaders, I often hear stories about conflicts that erupted into turf wars, ego battles and even resignations. Interestingly, many of these leaders brush off such incidents as “the cost of doing business.” What I don’t think these people realize is that the cost of unhealthy conflict is much higher than they may think.

Daniel Dana, the founding president of Mediation Training Institute International, identifies eight “hidden” costs of conflict that many employers overlook.

Dana says, “Not all cost factors are relevant to every conflict, but every conflict incurs cost by several of these means.”

Following are the eight cost factors Dana identifies, along with my comments on each: 1. Wasted time Productivity goes by the wayside when unhealthy conflict persists. Not only does it affect employees’ work, managers have to stop what they’re doing to act as negotiator. Studies vary, but the findings show that between 30 percent and 42 percent of a manager’s time is spent simply dealing with squabbling co-workers.

2. Reduced quality of decisions As I stated earlier, in healthy MEDICAL EQUIPMENT, PARTS & SERVICE

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Give people training on emotional intelligence and how to resolve conflict in a healthy manner.

Although the costs of conflict are hidden, they’re much higher than most of us realize.

WWW.MEDICALDEALER.COM

levels of conflict eat energy that could be applied to incomeproducing activities.

7. Absenteeism The proverbial “mental health” day has become a staple in many companies. Sure, deadline pressures can be a source of stress, but a higher correlation exists between absenteeism and needing a break from fighting with co-workers.

8. Health costs Insurance premiums rise when employees make more claims, and employees working with high levels of interpersonal conflict are more likely to have injuries. The consequences all have an impact on a company’s bottom line.

What’s my recommendation in all of this? Give people training on emotional intelligence and how to resolve conflict in a healthy manner.

The cost of training for how to resolve conflict in a healthy way is far, far less than the cost of chronically unresolved conflict. In fact, such training brings a very high return on investment, because although the costs of conflict are hidden, they’re much higher than most of us realize.

TRAINING

DAN BOBINSKI holds a Master’s Degree in Training and Development, and is president of Workplace-Excellence.com and Everything-Training.com As a consultant, speaker, and trainer, he helps organizations of all shapes and sizes. He is also the author of several books, including the best-selling “Creating Passion-Driven Teams.” Reach him at dan@workplace-excellence.com or 208-375-7606.

MEDICALDEALER 75

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conflict, options are explored and ripple effects are considered and weighed. This rarely happens in unhealthy conflict. Backbiting and sabotage, deadlocked debates, or simply “giving in” either destroy or greatly damage the chances for arriving at the best decisions.

3. Loss of skilled employees Researchers studying exit interview data on volunteer departures (i.e., people who leave a company on their own accord) state that “chronic unresolved conflict is a decisive factor in at least 50 percent of all such departures.” I bounced that figure off of a few HR managers I know, and they agreed.

One manager’s numbers were even higher. He told me, “At least 60 percent of our departures are due to interpersonal conflict.”

4. Restructuring inefficiencies Productivity often suffers when a company redesigns workflow simply so two or more people don’t have to interact with each other.

The original system was designed for a reason. Changed procedures are rarely more efficient.

5. Sabotage/theft/damage If two opposing parties are willing to manipulate and backstab each other to get their way, it’s only a short step to passive-aggressive behavior.

Interestingly, the amount of theft and damage in a company has a direct correlation to the level of employee conflict.

6. Lower levels of motivation Working with conflict is stressful, and stress eats energy. Therefore, it’s only simple logic that higher

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MEDICALDEALER 77

SLICE OF LIFE_Pay It Forward

Staff Report

CAMBODIA REVISITED P

hilip Camillocci is a graduate of the U.S. Army Medical Equipment and Optical School who has been in the biomedical field for 30 years and is an Instructional Developer for GE Healthcare.

In December 2014, Camillocci used three weeks of his vacation time to go to Phnom Penh, Cambodia, to teach biomedical electronics to students from hospitals throughout the country.

The program was created and started by Engineering World Health (EWH) and they partnered with University of Puthisastra-Faculty of Health Science.

Sine the trip in 2014, Camillocci remained in contact with the EWH team and provided what support he could from the U.S. In October 2015, Program Director Steve Goeby reached out to Camillocci and invited him to return to Cambodia and teach again.

“We exchanged a few emails on the timing and 78 MEDICALDEALER | APRIL 2016

Philip Camillocci is seen with a group of students he taught in Cambodia over the holidays.

subject lessons they would like taught. I accepted the invite and started working on the material,” Camillocci says.

The EWG program has expanded to four groups of students and they wanted me to teach the new students.

“I was able to schedule three weeks of vacation time with my manager, who supported me in this project,” Camillocci says. “After reviewing the requirements with

the local EWH staff for the new students it was decided that I would review infant incubators, radiant warmers and touch on resuscitation systems, infant photo therapy equipment and uninterruptible power supplies.”

“I researched and put together the course material in a PowerPoint format,” he explains.

“Once I was satisfied that I had everything together and spell checked, I uploaded copies to Drop-

box so that the local EWH staff could have the material translated into Khmer and printed up into study guides for the students by the time I arrived.”

Camillocci scheduled his trip for December 5-28.

He flew out of West Palm Beach to Atlanta and then took a connecting 15-hour nonstop flight to Seoul, Korea where he made a connecting five-hour flight to Phnom Penh, Cambodia.

“The local EWH staff let me sleep in on Monday,” Camillocci recalls. “So, I used that time to get sleep and get settled into the hotel. Tuesday, we started the students with infant incubators-radiant warmers. When I created the material I combined the two into one presentation as they are both closely related with infant care.

I presented the lecture material with the help of a translator over the next two days. We had available three older infant incubators and two overhead radiant warmers for the students to work with.”

After allowing them to

MEDICAL EQUIPMENT, PARTS & SERVICE

_Pay It Forward

“Supporting a very worthwhile project... is very satisfying and worth the effort to help improve patient

outcomes.”

Philip Camillocci demonstrates the proper use of a donated c-arm to a class at a hospital in Cambodia.

operate and check out the equipment, I set up a lab exercise to test the students.

The second week started with a review on phototherapy equipment. There we two overhead bili lights and fiber optic units available for the students to work with. Then, the class moved on to uninterruptible power supplies.

“The students found this course helpful as the electrical grid in the rural areas of the country, where most of them worked, is very unreliable and subject to brownouts and blackouts during the hot season,” Camillocci says.

“The Cambodian government is working to improve the electrical system in the country and just opened a new hydroelectric dam, one of many projects the country is investing in.”

“Week three, I assisted WWW.MEDICALDEALER.COM

the EWG trainers in a review of infusion pumps and syringe pumps,” he adds. “After the material review, the students got to work with a couple of different types of syringe and infusion pumps. For the lab exercise I created faults with the pumps and had the students rotate through stations writing up the system’s, troublingshooting steps and the fault.”

Another course centered on electrosurgical units.

Two units were available for the class along with a lab exercise.

During this week, one of the students had a service request from his hospital.

They received a donated mobile C-arm unit from Australia. The unit needed new batteries when it arrived and it took the hospital months to locate and get batteries for the unit. The batteries were

installed, but no one knew how to check the unit out.

The C-arm was declared to be end of life by the OEM in December of 2007 and there is no biomedical or service support structure in Cambodia yet.

“The hospital asked me to check the C-arm out and then give them a class on its use. I went out to the hospital with two members of the EWH staff and the student,” Camillocci says. “We checked out the C-arm and tested its operation and found everything working correctly. We scheduled a day to return and train the hospital staff.

We took the class over to the hospital as an opportunity to do training. The training went great and now the hospital staff has a new tool to help improve patient care that they were not able to use before.”

“That is the main focus of the EWH project,” he adds. “To train biomed technicians from the ground up, to be able to return to their hospital, keep the equipment serviced and running to improve patient care in a developing country. On average 70 percent of the equipment is out of service and gathering dust because no one is trained to service it or show the hospital staff how to use it.”

The trip was a success and rewarding for Camillocci as well as the health care system in Cambodia.

“Supporting a very worthwhile project such as Engineering World Health’s Biomedical program is very satisfying and worth the effort to help improve patient outcomes,” Camillocci says.

MEDICALDEALER 79

SLICE OF LIFE_Success Story

By Matt Skoufalos

RTLS HELPS SURGERY CENTER ‘WORK SMARTER’

A

At best, a surgery center can be described as “controlled chaos,” said Brett McGreaham.

“There’s so much going on, so many people moving through at such a high pace, that bringing any type of stability or automation into that process is going to help save time,” McGreaham said.

As Senior Product Manager of Healthcare Innovations for Versus Technology of Traverse City, Michigan, McGreaham is in the business of trying to do just that.

Versus Advantages OR is a combination hardware-software solution that enables surgery centers to shave valuable minutes off their days by more closely managing staff resources.

Effectively, every member of the team who interacts with a patient, from nursing staff to surgeons to assistants, carries an RFID badge that tracks his or her movements within the facility. It helps the surgery center keep tabs on what staff needs to be where, when and for how long. The system keeps supervisors apprised of milestones in the transition from intake to release, and ultimately can lead to a smoother patient experience.

“What our product aims to do is help facilities and managers and staff become more efficient, more safe in the care that they’re giving, [and to] have more time to focus on the patient rather than focusing on process or non-valueadded tasks,” McGreaham said.

80 MEDICALDEALER | APRIL 2016

“When you’re working with a high-volume facility, saving multiple minutes on many patients saves a lot of time,” he said. “It helps drive staff in an effective and efficient manner without burning them out. If we can ease up some of that pressure, it ultimately reflects back on the patient.”

For proof of concept, Versus Technology needed look no further than its own backyard, to the Northwest Michigan Surgery Center (NMSC), which is also located in Traverse City. In 2012, Versus “mapped out [NMSC’s] entire process,” McGreaham said, and then built in automated clinician

“We’re so busy that we utilize everything to its utmost capacity...

We truly embrace the whole idea of working smarter, not harder.” alerts that afford “real-time environmental situational awareness,” enabling staff to “get that cadence of the day and control that chaos that they’re so used to seeing.”

“It’s not only monitoring locations, it’s monitoring interactions,” McGreaham said. “Has the anesthesiologist been with the patient? How long has the patient been in the OR? [It’s about] plac-

ing some business intelligence around the information and giving historical information for benchmarking and bottlenecks.”

Within three years, NMSC had shaved an average of 5 to 10 minutes off the time patients were spending in post-operative settings, with 13 minutes coming off post-op time after hand surgeries.

NMSC also lowered the overall length of stay for cataract surgery patients by four minutes, and by 12 minutes for patients underdoing gastrointestinal procedures.

Those numbers are compared further against national benchmarks, enabling NMSC decision-makers to identify details associated with those procedures that don’t hit the mark, whether for complexity of case, patient need, system process or any other variable.

“It’s several minutes per procedure, which then allows you either to add another procedure that day or allows you to re-staff,” McGreaham said.

In a facility that averages 100 procedures a day, from knee arthroscopies to general surgery, that level of insight draws significant interest from leadership.

“We’re so busy that we utilize everything to its utmost capacity,” said NMSC CEO LoAnn Vande Leest. “We truly embrace the whole idea of working smarter, not harder.”

NMSC initially adopted Advantages OR to help limit the number of overhead pages and phone calls broadcast throughout the center, and Vande Leest still numbers MEDICAL EQUIPMENT, PARTS & SERVICE

_Sucess Story

that among the chief triumphs of the system.

“Everybody was in the know without having a behemoth amount of overhead pages and phone calls,” she said. “That’s where the savings occurred. You can look on your computer and see where everybody is at any given minute.”

Doctors at the facility “never bought into the technology,” and still require an overhead page to be tracked down, but Vande Leest considers that a “very minor” circumstance in comparison with having built such a comprehensive tracking system.

“We know where our patients are at all times, and that’s what’s important,” she said. “Communication in every setting that I’ve ever been in is key. It’s really the patient flow and knowing where your staff members are.”

Beyond the initial installation, NMSC has added extra screens that have taken the place of whiteboards in outlining staffing assignments, which Vande Leest described as a time-saving convenience. In the pre-operative room, a similar screen names physicians, their nurses, their specialties, and their locations. Versus Advantages OR is integrated with Vision, the NMSC electronic health record system, which allows anyone waiting for the patient to “watch them go all the way through without having to look at the screen,” Vande Leest said.

But instead of only relying on the intelligence provided by WWW.MEDICALDEALER.COM

Versus Technology software helps Northwest Michigan Surgery Center meet its goals.

the Versus system for the use of NMSC staff, developers at the center have built upon its original functionality to abstract additional information that can be used to keep patients’ loved ones in the loop. With a slight tweak, the same program that transmits staff whereabouts can also broadcast patient information in a HIPAA-compliant fashion (first name, last initial) so that family members can follow along with the procedures in real-time. Anyone who’s offsite or out of town can check in remotely via an app.

“We’ve given it a few extra legs to walk with,” Vande Leest said.

“It’s really the technology and what we’ve built on it, because that’s what we do here.”

The efficiencies driven through the adoption of Advantages OR

haven’t only improved processes, patient throughput, and family communication, Vande Leest said, but they’ve allowed NMSC to reassign one of its two unit coordinators to patient scheduling, effectively saving the cost of an entire full-time employee.

“It’s better efficiency,” Vande Leest said. “She knew the docs, knew the procedures, and she had a good knowledge base.”

In addition to functioning in surgical centers, McGreaham said Versus software and hardware functions in asset management, clinical, oncological, and acutecare functions.

“We’re driving process improvement and visibility for staff for internal matters, but that information can be used in other ways,” he said.

MEDICALDEALER 81

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MEDICALDEALER 91

CATEGORICAL INDEX ANETHESIA Doctors Depot…………………………………………………8 Paragon Service…………………………………………… 44 ASSOCIATIONS IAMERS……………………………………………………… 20-21 AUCTION/LIQUIDATION Government Liquidation………………………………7 BATTERIES Eastern Diagnostic Imaging……………………… 83 BIOMEDICAL AIV Inc.…………………………………………………………… 70 BETA Biomed Services, Inc.………………………… 83 Conquest Imaging………………………………………… 13 Elite Biomedical Solutions………………………… 85 Global Medical Imaging……………………………… 19 iMed Biomedical…………………………………………… 91 Integrity Biomedical Services…………………… 50 InterMed Group…………………………………………… 42 Maull Biomedical Training, LLC………………… 31 Retrieve Medical Equipment……………………… 76 Rieter Medical Equipment………………………… 70 CARDIOLOGY Bionet America, Inc.……………………………………… 64 RSTI Exchange……………………………………………… 50 Southeast Nuclear Electronics………………… 87 Southeastern Biomedical, Inc.…………………… 71 C-ARMS Eastern Diagnostic Imaging……………………… 83 COMPUTED TOMOGRAPHY BC Technical, Inc.…………………………………………… 10 DirectMed Parts…………………………………………… 90 East Coast Medical Systems……………………… 65 Ed Sloan & Associates……………………………60-63 Exclusive Medical Solutions, Inc.……………… 86 International Medical Equipment & Service………………………………………………………… 75 KEI Medical Imaging Services…………………… 70 Metropolis International…………………………… 86 MIT/Medical Imaging Technologies…………… 43 Mobilescan Imaging……………………………………… 85 Retrieve Medical Equipment……………………… 76 RSTI Exchange……………………………………………… 50 Technical Prospects………………………………… 2, 58 Tri-Imaging……………………………………………………… 41 Zetta Medical Technologies, LLC……… 57, IBC CONTRAST MEDIA RieterInjector Support and Service, LLC 2 DIAGNOSTIC IMAGING Eastern Diagnostic Imaging……………………… 83 First Call Parts……………………………………………… 87 RieterInjector Support and Service, LLC 2 Multi Diagnostic Imaging Solutions…………BC

92 MEDICALDEALER | APRIL 2016

ENDOSCOPY Capital Medical Resources………………………… 91 Endoscopy Specialists………………………………… 83 S.H. Medical Corporation…………………………… 84 GENERAL ALCO Sales and Service……………………………30, 91 Eastern Diagnostic Imaging……………………… 83 Government Liquidation………………………………7 PartsSource, Inc.………………………………………………9 RSTI Exchange……………………………………………… 50 IMAGING Cool Pair Plus………………………………………………… 82 RieterInjector Support and Service, LLC 2 Mobilescan Imaging……………………………………… 85 IMAGING/PARTS Ampronix……………………………………………………………6 Diagnostic Solutions…………………………………… 94 Eastern Diagnostic Imaging……………………… 83 InterMed Group………………………………………30,58 PartsSource, Inc.………………………………………………9 Technical Prospects………………………………… 2, 58 Tri-Imaging……………………………………………………… 41 INFUSION THERAPY AIV Inc.…………………………………………………………… 70 Elite Biomedical Solutions………………………… 85 LABORATORY MIT/Medical Imaging Technologies…………… 43 LASER IMAGERS Multi Diagnostic Imaging Solutions…………BC MODULE/TELEMETRY Bio-Medical Equipment Service Co.…………… 31 MOMMOGRAPHY RTI Inc.…………………………………………………………… 64 MONITORS/CRTs Advanced Ultrasound Elec./AUE………………… 73 Ampronix……………………………………………………………6 Technical Prospects………………………………… 2, 58 MRI Bayer Healthcare - MVS……………………………… 77 BC Technical, Inc.…………………………………………… 10 Carolina Medical Parts………………………………… 51 Cool Pair Plus………………………………………………… 82 DirectMed Parts…………………………………………… 90 East Coast Medical Systems……………………… 65 Ed Sloan & Associates……………………………60-63 Exclusive Medical Solutions, Inc.……………… 86 KEI Medical Imaging Services…………………… 70 KOPP Development……………………………………… 40 MIT/Medical Imaging Technologies…………… 43 Mobilescan Imaging……………………………………… 85 Retrieve Medical Equipment……………………… 76 RSTI Exchange……………………………………………… 50

Zetta Medical Technologies, LLC……… 57, IBC NUCLEAR MEDICINE BC Technical, Inc.…………………………………………… 10 Global Medical Imaging……………………………… 19 International X-Ray Brokers……………………… 76 RSTI Exchange……………………………………………… 50 Southeast Nuclear Electronics………………… 87 PATIENT MONITORING Bio-Medical Equipment Service Co.…………… 31 BETA Biomed Services, Inc.………………………… 83 Bionet America, Inc.……………………………………… 64 Doctors Depot…………………………………………………8 Gopher Medical, Inc.…………………………………… 65 Integrity Biomedical Services…………………… 50 Pacific Medical…………………………………………………5 Southeastern Biomedical, Inc.…………………… 71 USOC Medical………………………………………………… 59 PROBES/PROBE REPAIR Conquest Imaging………………………………………… 13 Global Medical Imaging……………………………… 19 ONLINE RESOURCES MedWrench…………………………………………………… 90 RADIOLOGY Eastern Diagnostic Imaging……………………… 83 Engineering Services………………………………………4 First Call Parts……………………………………………… 87 International X-Ray Brokers……………………… 76 InterMed Group…………………………………………… 58 Maull Biomedical Training, LLC………………… 31 Metropolis International…………………………… 86 Multi Diagnostic Imaging Solutions…………BC Radon Medical LLC……………………………………… 85 Rayence, Inc.…………………………………………………… 84 RSTI Exchange……………………………………………… 50 Technical Prospects………………………………… 2, 58 Varian Medical Systems…………………………………3 RADIOLOGY PARTS InterMed Group…………………………………………… 58 Zetta Medical Technologies, LLC……… 57, IBC REPAIR/REFURBISH Advanced Ultrasound Elec./AUE………………… 73 AIV Inc.…………………………………………………………… 70 ALCO Sales and Service……………………………30, 91 Ampronix……………………………………………………………6 Bayer Healthcare - MVS……………………………… 77 Bio-Medical Equipment Service Co.…………… 31 Carolina Medical Parts………………………………… 51 Conquest Imaging………………………………………… 13 Cool Pair Plus………………………………………………… 82 Eastern Diagnostic Imaging……………………… 83 Ed Sloan & Associates……………………………60-63 Elite Biomedical Solutions………………………… 85 Endoscopy Specialists………………………………… 83 Exclusive Medical Solutions, Inc.……………… 86 Global Medical Imaging……………………………… 19

MEDICAL EQUIPMENT, PARTS & SERVICE

Categorical Index RieterInjector Support and Service, LLC 2 Integrity Biomedical Services ………………… 50 International Medical Equipment & Service ……………………………………………………… 75 KEI Medical Imaging Services ………………… 70 MIT/Medical Imaging Technologies ………… 43 MTC/Medical Technologies Co. ………………… 87 Multi Diagnostic Imaging Solutions ………BC Pacific Medical ………………………………………………5 Radon Medical LLC …………………………………… 85 Rieter Medical Equipment ……………………… 70 Southeast Nuclear Electronics………………… 87 USOC Medical ……………………………………………… 59 Zetta Medical Technologies, LLC …… 57, IBC

TEST EQUIPMENT RTI Inc. ………………………………………………………… 64

REPLACEMENT PARTS Advanced Ultrasound Elec./AUE ……………… 73 AllParts Medical, LLC ………………………………… 65 AIV Inc. ………………………………………………………… 70 ALCO Sales and Service …………………………30, 91 BETA Biomed Services, Inc. ……………………… 83 Carolina Medical Parts ……………………………… 51 Classic Diagnostic Imaging ……………………… 42 Conquest Imaging ……………………………………… 13 Diagnostic Solutions ………………………………… 94 DirectMed Parts ………………………………………… 90 Doctors Depot ………………………………………………8 Ed Sloan & Associates …………………………60-63 Elite Biomedical Solutions ……………………… 85 First Call Parts …………………………………………… 87 Global Medical Imaging …………………………… 19 Government Liquidation ……………………………7 International Medical Equipment & Service ……………………………………………………… 75 KEI Medical Imaging Services ………………… 70 MIT/Medical Imaging Technologies ………… 43 MTC/Medical Technologies Co. ………………… 87 Multi Diagnostic Imaging Solutions ………BC PartsSource, Inc. ……………………………………………9 Radon Medical LLC …………………………………… 85 Rieter Medical Equipment ……………………… 70 Southeast Nuclear Electronics………………… 87 Technical Prospects ……………………………… 2, 58 Varian Medical Systems ………………………………3 Zetta Medical Technologies, LLC …… 57, IBC

ULTRASOUND Advanced Ultrasound Elec./AUE ……………… 73 Bayer Healthcare - MVS …………………………… 77 Conquest Imaging ……………………………………… 13 Diagnostic Solutions ………………………………… 94 Endoscopy Specialists ……………………………… 83 Exclusive Medical Solutions, Inc. …………… 86 InterMed Group ………………………………………… 30 Retrieve Medical Equipment …………………… 76

STERILIZERS Government Liquidation ……………………………7

SURGICAL Capital Medical Resources ……………………… 91 Eastern Diagnostic Imaging …………………… 83 Endoscopy Specialists ……………………………… 83 International Medical Equipment & Service ……………………………………………………… 75 S.H. Medical Corporation ………………………… 84 SURPLUS MEDICAL Government Liquidation ……………………………7

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TRAILERS Mobilescan Imaging …………………………………… 85 TUBES/BULBS AllParts Medical, LLC ………………………………… 65 Government Liquidation ……………………………7 International Medical Equipment & Service ……………………………………………………… 75 Ray-Pac. ……………………………………………………23, 77 Technical Prospects ……………………………… 2, 58 Zetta Medical Technologies, LLC …… 57, IBC

ULTRASOUND PARTS Advanced Ultrasound Elec./AUE ……………… 73 AIV Inc. ………………………………………………………… 70 Conquest Imaging ……………………………………… 13 Global Medical Imaging …………………………… 19 InterMed Group ………………………………………… 30 VCR REPAIR/SERVICES Advanced Ultrasound Elec./AUE ……………… 73 Conquest Imaging ……………………………………… 13 VENTILATORS Government Liquidation ……………………………7 VIDEO Endoscopy Specialists ……………………………… 83 Multi Diagnostic Imaging Solutions ………BC X-RAY Bayer Healthcare - MVS …………………………… 77 Classic Diagnostic Imaging ……………………… 42 Diagnostic Solutions ………………………………… 94 Eastern Diagnostic Imaging …………………… 83 Engineering Services ……………………………………4 Exclusive Medical Solutions, Inc. …………… 86 Government Liquidation ……………………………7 Ray-Pac. ……………………………………………………23, 77 Rayence, Inc.………………………………………………… 84 Retrieve Medical Equipment …………………… 76 RTI Inc. ………………………………………………………… 64 Tri-Imaging …………………………………………………… 41 X-RAY PARTS Technical Prospects ……………………………… 2, 58

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MEDICALDEALER 93

ALPHABETICAL INDEX

Advanced Ultrasound Elec./ AUE ………………………………………… 73

Integrity Biomedical Services ………………………………… 50

AIV Inc. ……………………………………… 70

InterMed Group ………… 30, 42, 58

ALCO Sales and Service ……… 30, 91

International Medical Equipment & Service ………… 75

AllParts Medical, LLC ……………… 65 Ampronix ……………………………………… 6 Bayer Healthcare - MVS ………… 77 BC Technical, Inc. ……………………… 10 BETA Biomed Services, Inc. …… 83 Bio-Medical Equipment Service Co. …………………………… 31 Bionet America, Inc. ………………… 64 Capital Medical Resources …… 91 Carolina Medical Parts …………… 51 CIM med GmbH ………………………… 23 Classic Diagnostic Imaging …… 42

International X-Ray Brokers … 76 KEI Medical Imaging Services 70 KOPP Development ………………… 40 Maull Biomedical Training, LLC ………………………… 31 MedWrench ……………………………… 90 Metropolis International ……… 86 MIT/Medical Imaging Technologies ………………………… 43 Mobilescan Imaging ………………… 85 MTC/Medical Technologies Co. 87

Conquest Imaging …………………… 13

Multi Diagnostic Imaging Solutions ……………………………… BC

Cool Pair Plus …………………………… 82

MW Imaging ……………………………… 24

Diagnostic Solutions ……………… 94

Pacific Medical …………………………… 5

DirectMed Parts ……………………… 90

Paragon Service ……………………… 44

Doctors Depot …………………………… 8

PartsSource, Inc. ………………………… 9

East Coast Medical Systems … 65

Radon Medical LLC ………………… 85

Eastern Diagnostic Imaging … 83

Ray-Pac. ………………………………… 23, 77

Ed Sloan & Associates ……… 60-63

Rayence, Inc.……………………………… 84

Elite Biomedical Solutions …… 85

Retrieve Medical Equipment … 76

Endoscopy Specialists …………… 83

Rieter Medical Equipment …… 70

Engineering Services ………………… 4

RSTI Exchange ………………………… 50

ENMET, LLC ……………………………… 40

RTI Inc. ……………………………………… 64

Exclusive Medical Solutions, Inc. ……………………… 86

S.H. Medical Corporation ……… 84

First Call Parts ………………………… 87 Global Medical Imaging ………… 19 Gopher Medical, Inc. ……………… 65 Government Liquidation ………… 7 IAMERS ………………………………… 20-21 iMed Biomedical ……………………… 91 Injector Support and Service, LLC ……………………… 2

94 MEDICALDEALER | APRIL 2016

LENDING A HELPING HAND AT EVERY STEP.

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Southeast Nuclear Electronics …87 Southeastern Biomedical, Inc. …71 Technical Prospects …………… 2, 58 Tri-Imaging ………………………………… 41 USOC Medical …………………………… 59 Varian Medical Systems …………… 3 Zetta Medical Technologies, LLC ………… 57, IBC

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Z-Dose29 Software Was developed by a team of engineers, clinical and applications specialist based on customers’ needs and satisfies the NEMA XR-29 standard. It’s features include: patient dose monitoring and structured dose reporting; integrates with hospital’s paper compliant records, PACS systems and national patient registeries (optional); meets NEMA XR-29 standard; on-site and web-based solutions; lifetime product support and is transferable to future CT equipment!

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