ICE Magazine - January 2019

ADVANCING THE IMAGING PROFESSIONAL

JANUARY 2019 VOL.3 NO.1 THEICECOMMUNITY.COM

Entering the Third

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contents

ICE FEATURES

January 2019

“ It’s an area that has an increasing clinical need over time. The reasons for failure are well-recognized, and we think 3D printing will address that.“

38 Entering the Third Dimension Since the introduction of commercially available 3D printers, the technology has been largely celebrated. In the industrial space, the technology has grown by leaps and bounds in its applications for prototyping and manufacturing. Now that same enthusiasm has reached the health care industry, where imaging-guided surgeons are turning its focus to myriad uses.

The Hudson Valley Imaging Department includes 122 staff members, including full-time, part-time and PD for the Broadway campus and MAC. The group provides imaging services at the Margaretville Hospital, the Mary’s Avenue

Corporate Profile:

Avante is a one-source solutions provider, giving health care facilities across the globe access to quality new and refurbished capital equipment, installation, service, parts, repair and technical support. Through organic growth and targeted acquisitions, Avante continues to be an alternative to major equipment manufacturers.

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epartment D 24 Spotlight

campus and at Saugerties Diagnostic Imaging (part of the Broadway Campus).

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contents

ICE DEPARTMENTS

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23

January 2019

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42

news

people

products

insight

11 Imaging News

22 Professional Spotlight

42 Careers Now

18 Webinar Wednesday

24 Department Spotlight

27 Ultrasound Spotlight

21 People on the Move

45 Imaging Matters

28 Ultrasound Gallery

46 Daniel Bobinski

32 Tools of the Trade

49 Photo Contest 50 Index

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ICE Magazine (Vol. 3, Issue #1) January 2019 is published by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to ICE Magazine at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

For subscription information visit www.theicecommunity.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2019

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ICEMAGAZINE | JANUARY 2019

ADVANCING THE IMAGING PROFESSIONAL

Soluti ons Setti ng the G old Standard i n Ultras ound Solutions

ULTRASOUND SERVICE TRAINING Training Schedule 2019 January 22: Basic Ultrasound Training January 23-24: GE Voluson E8/E8/E10 February 19: Basic Ultrasound Training February 20-21: Philips Epiq 5 / Epiq 7 March 12: Basic Ultrasound Training March 13-14: GE Logiq E9 / Vivid E9 April 16: Basic Ultrasound Training April 17-18: Siemens S1000/S2000/S3000 May 14: Basic Ultrasound Training May 15-16: Philips Epiq 5 / Epiq 7 Sept 17: Basic Ultrasound Training Sept 18-20: Philips IU22 / IE33 Oct 15: Basic Ultrasound Training Oct 16-17: GE Logiq E9 / Vivid E9 Nov 12: Basic Ultrasound Training Nov 13-14: Philips Epiq 5 / Epiq 7

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news

IMAGING NEWS A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

MW Imaging Expands Ultrasound Probe Repair Warranty MW Imaging has announced the expansion of its probe repair warranty from a 6-month to a 12-month warranty. MW Imaging will be offering a 12-month warranty on 98 percent of its probe repairs.

When asked about the expansion of their probe repair warranty Matthew Nafziger, operations manager of MW Imaging said, “It’s an exciting time in our company. We’re delighted to have the opportunity to offer a 12-month warranty on general imaging transducers along with TEE (X7-2t, X8-2t and 6VT-D) trans-

ducers while still providing free loaners during the evaluation and repair process. With the expansion of our probe repair warranty not only can we share the same mission as our customers but also continue to offer the same repair quality at market pricing.” • For more information, visit mwimaging.com

Alpha Source Group Expands Offerings, Celebrates Accomplishments Just a year after its most recent major acquisition of BC Technical, Alpha Source Group – now comprised of Alpha Source, Medical Optics and BC Technical – has made progress toward creating additional value-based medical device maintenance and service solutions for the health care industry.

“As one of the largest independent full service imaging services and equipment solutions companies in the United States, Alpha Source Group spent the past several years solidifying our service delivery foundation through organic growth, strategic acquisition and collaborative integration efforts,” says president Rich Springer. “In 2018, we leveraged our service excellence, deep technical expertise and large-scale program management skills to create an expanded offering around custom outsourced solutions.”

Springer points to the development of customized solutions for OEMs, ISOs, asset management companies and hospital systems as a primary driver for Alpha Source Group growth and innovation.

In addition to expanding the service portfolio, 2018 Alpha Source Group accomplishments include: • Continued growth and scale of a service team of field and

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depot engineers providing service for imaging and biomed medical equipment in all major markets in the U.S. • Ultrasound and densitometry were added to the modalities BC Technical services, expanding service offerings from CT, MRI, PET, PET/CT and SPECT. • An expanded surgical solutions depot space in Fort Lauderdale, Florida – for the repair of flexible endoscopes, rigid endoscopes, surgical instruments, power tools and cameras.

• As part of offering custom solutions, the company built an outsourced depot facility in Milwaukee, Wisconsin. This unique model allows OEMs and other health care customers to outsource their entire service and repair functions, allowing them to focus critical internal resources on product development and innovation.

• Rich Springer was named president and Alpha Source Group hired Vionnta Rivers as chief commercial officer.

“We’ve celebrated some major accomplishments this year, and we will continue to evolve our offerings,” says Springer.

“Our team is committed to seeking innovative solutions that provide value and the highest quality of care for our customers and their patients.” •

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news

Kubtec Launches Mozart Supra Specimen Tomosynthesis System KUBTEC has announced the launch of a new innovation in the and assists them in achieving more pleasing cosmetic outtreatment of breast cancer. The Mozart Supra Specimen Tomo- comes for their patients. synthesis System was on display at the annual convention of “With the introduction of the Mozart Supra System, breast the Radiological Society of North America (RSNA) in Chicago. surgeons and pathologists can now view 3-Dimensional imBuilt on KUBTECs proprietary specimen tomosynthesis ages of specimens of all sizes, from lymph nodes to mastectechnology, the MOZART Supra Specimen Tomosynthesis Sys- tomies, solid organs and bone. What’s more, the system uses tem, is the latest generation of 3D imaging for breast cancer an advanced augmented intelligence to aid the physician with surgery. The Mozart Supra System provides surgeons, radiol- image interpretation and includes voice activation for handsogists and pathologists with the most advanced tools to pro- free usage in the OR,” said John Leach, vice president of marvide the best quality of care for breast cancer patients. keting at KUBTEC. Tomosynthesis has proven to be more effective than traThe MOZART Supra and MOZART Systems from KUBTEC ditional 2-Dimensional imaging at identifying cancer in mam- are the only intraoperative breast specimen imaging sysmography and is now available for specimen imaging in the tems to use tomosynthesis. Other features of the MOZART operating room and pathology lab. This 3D imaging technol- Supra include: Auto-magnification, KUBTEC’s patentogy enables surgeons to reduce the need for repeat surgeries ed Image Blender and a high-definition optical camera. • PROOF APPROVED CHANGES NEEDED

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The new system and its features to enhance workflow were showcased at the Radiological Society of North America (RSNA) annual meeting in Chicago.

“We are committed to offering our customers the premium diagnostic imaging tools they need to deliver accurate, confident and effective patient care,” said Dominic Smith, senior director, CT, PET/ CT, and MR business units, Canon Medical Systems USA Inc. “The Vantage Orian was designed to increase productivity while ensuring patient comfort and delivering uncompromised clinical confidence.” •

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news

Philips Plans Center of Excellence in Cleveland Royal Philips has announced that it will open a new research and development (R&D) center of excellence and headquarters for its computed tomography and advanced molecular imaging (CT/AMI) business in Cleveland, Ohio in the first quarter of 2019.

The move to this modern facility in the Pinecrest development underpins Philips’ commitment to innovation and collaboration, as well as providing a showcase innovation center for its global customers. The new facility will house multiple R&D labs and testing facilities, and will employ around 175 people.

“Diagnostic imaging is at the heart of our health technology strategy, enabling precision diagnosis and enhanced productivity for our customers,” said Kees Wesdorp, business leader diagnostic imaging at Philips. “Our

focus on innovation and customer centricity is paying off, as exemplified by the success of our high performance Vereos Digital PET/CT system, which simplifies the clinical decision making process through a fast, more confident path to cancer treatment. I am convinced that our new CT/ AMI R&D center of excellence and renewed customer services center in Cleveland will be vital for our future success.”

To meet the growing demand for technical and clinical training, Philips is also overhauling its existing Cleveland facility to optimize the learning environment it offers to Philips’ global customers and thousands field service engineers. As a result of this focus on innovation and customer services, manufacturing at the Cleveland site will cease in the first quarter of 2019. •

MediCapture Releases ‘DICOM Made Easy’ App MediCapture, a global leader in medical imaging systems, announced that its next-generation MVR Pro medical video recorders now come with a DICOM app option with new, exclusive features not common to DICOM systems, providing system efficiency, speed and usability benefits to surgical teams, hospitals and medical camera manufacturers.

The new DICOM Made Easy app introduces native DICOM for extensive editing, saving and playback. It turns the MVR Pro into a fully compliant DICOM modality – from worklist retrieval to automatic storage to PACS. It saves recorded images and videos directly to the patient workflow in the DICOM standard, and it comes with over 30 fields for patient and worklist data.

The app is the first embedded, completely non-Windows 14

ICEMAGAZINE | JANUARY 2019

implementation of DICOM. By using an embedded-based versus a computer-based system, MediCapture has streamlined the highly complex way computers process DICOM. “By providing an embedded and native DICOM solution, we have eliminated system memory loss, stability and compatibility issues, while providing a lightning fast and easily managed DICOM experience,” said Frank Magnier, European general manager for MediCapture. “DICOM Made Easy is 100 percent native and just like good surgeons, it operates with speed, efficiency and precision.”

“We have made it very simple to add a DICOM package to any of our MVR Pro recorders for a fully compliant DICOM workflow,” he said. “This new DICOM app is the first of its kind, and it is a game changer.” • ADVANCING THE IMAGING PROFESSIONAL

news

Survey: Half of Patients May Have ‘scanxiety’ Bayer announced results from a global survey involving over 1,000 patients across seven countries to assess the patient experience with magnetic resonance imaging (MRI) and/or computerized tomography (CT) procedures. The findings from the subpopulation of 162 U.S. patients showed that although the majority felt informed leading up to a procedure and satisfied with the overall experience, half of the patients felt anxious. Millions of radiological procedures are performed in the U.S. annually, helping to inform doctor’s decisions and improve the quality of patient care. The survey is part of Bayer’s ongoing commitment to better understand and address radiology patient needs.

In addition, despite feeling well informed, nearly one-quarter of the 162 U.S. patients surveyed specifically stated more face-to-face interaction would be helpful prior to their procedure, with 15 percent wanting more electronic support, such as a video on the procedure.

This is particularly important as properly preparing patients ahead of their imaging procedure has been shown to contribute to a better quality image, thereby aiding detection, likely because patients are more relaxed during the procedure.

“Medical imaging is critical to detecting and monitoring a variety of

diseases, but patients are often nervous when they learn they need an MRI or CT scan, about the procedure itself and the results,” said Jocelyn Rapelyea, MD, professor and residency program director, diagnostic radiology, associate director, breast imaging and intervention, The George Washington University. “These findings will help radiology suites better understand their patients’ needs, help reduce anxiety and better prepare them for their procedure, which may ultimately increase image quality.”

More than three-quarters of U.S. participants said the quality of the consultation with the referring physician, radiologist and/or radiographer/radiology technician was the most important factor during their imaging experience. Additionally, only 18 percent of patients felt comfortable with the concept of having their image results interpreted by a computer instead of by a health care professional (HCP), further highlighting the importance of HCP interaction.

To address these gaps and help improve patient care, Bayer has created materials for children and adults on what to expect around an MRI or CT scan, which are available on Bayer’s radiology resources website. •

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news FDA Clears Cios Spin Mobile 3D C-Arm Siemens Healthineers has announced the Food and Drug Administration (FDA) clearance of the Cios Spin, a new mobile C-arm that delivers precise 3D images for intraoperative quality assurance. By enabling surgeons to perform intraoperative corrections based on 3D images and confirm their results, the Cios Spin can help surgeons work with greater precision, transform the delivery of patient care and achieve optimal treatment results.

Capable of integrating seamlessly into the clinical routine, the Cios Spin provides 3D computed tomography-like imaging for orthopedic, trauma and spine surgery. These 3D images can help reduce the rate of revisions with intraoperative evaluation as well as the need for post-operative computed tomography (CT). Cios Spin provides versatility to support both 2D and 3D imaging for a wide variety of procedures, including vascular imaging. The system’s NaviLink 3D digital navigation provides easy-to-use connectivity to surgical navigation.

Cios Spin is equipped with state-of-the-art flat panel detector technology and is available with a range of optional software packages. The Easy 3D package ensures fast, efficient setup and image acquisition. The Screw Scout package enables system software to recognize and automatically label screws in a 3D X-ray image, saving time and effort for the surgeon.

The system’s high generator power addresses the chal-

lenge of imaging large patients and dense anatomy to enable precise clinical evaluation of images. And the Cios Spin is the first commercially available mobile C-arm with an antimicrobial coating for comprehensive infection control.

“Siemens Healthineers is proud to offer the Cios Spin, a dynamic new mobile 3D C-arm that illustrates our expertise in mobile X-ray imaging,” said Robert Dewey, vice president of surgical solutions at Siemens Healthineers North America.

“This system will help our customers improve the quality of patient care using precision medicine as well as reduce the additional costs imposed by revision surgery.” •

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ICEMAGAZINE | JANUARY 2019

ADVANCING THE IMAGING PROFESSIONAL

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Trisonics Achieves ISO 13485 Certification Trisonics Inc. has earned ISO 13485 certification. The comprehensive system audits covered every aspect of operations.

“Trisonics has always been committed to maintaining the highest level of quality and exceeding our customer’s expectations. Today, I am excited to announce that we have achieved ISO 13485 certification. As an independent company in an ever-evolving, competitive landscape, Trisonics continues to stay in the forefront by having a top-level quality management system and setting the gold standard in ultrasound solutions,” said Jen Riner, CEO. ISO 13485 is a quality management system standard that was developed by the International Organization for Standardization, which is an association of governmental and nongovernmental organizations from many countries. The ISO 13485 standard is utilized to certify quality management systems that focus on continuous improvement, customer satisfaction and the active involvement of both management and employees in a process based approach. • For more information, visit trisonics.com

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news

WEBINAR WEDNESDAY Presentations Provide Free CE Credits

T

he Webinar Wednesday series continues to provide biomeds an opportunity to earn CE credits from the ACI. Four presentations in October and November covered a variety of topics.

QA Testing Shortcuts The Webinar Wednesday session “Efficiency in RTI Solutions” sponsored by RTI was a big hit with imaging service professionals.

This 60-minute webinar featured Erik Wikström, key account manager at RTI AB. He discussed the Ocean Quick Check and how it has helped imaging technicians reduce the time needed for QA testing. He said it does this while also improving the quality and accuracy of X-ray QA reporting. In addition, Wikström demonstrated shortcuts on how to improve QA procedures for users of RTI’s Ocean software.

Webinar attendees gave Wikström’s session positive reviews.

“I think giving the opportunity to get information on the industry delivered to very busy professionals in the Webinar Wednesday format is priceless. I am often pressed for time. As a supervisor, I send my team members out for training only to be left behind. These webinars keep me relevant and informed,” said Biomed Supervisor T. McKenna.

“Fantastic way to stay current with clinical engineering topics even if they are not directly related to your duties. If you’re a gizmo guy this is the best ... and it’s free,” shared H. Tucker, principal field service engineer, Technical Services.

“This webinar was very informative, the application’s ease of use was especially inter18

ICEMAGAZINE | JANUARY 2019

esting. The presenter made using the program seem stress free. Overall, a very good presentation,” said B. Hayes, CBET. Remanufactured Transducers The webinar “How Low Quality Remanufactured Parts Inside Medical Devices Increase Total Cost Of Ownership” was sponsored by Summit Imaging. It delivered information regarding the detection of poor quality ultrasound transducers.

This 60-minute webinar featured Larry Nguyen, CEO and CTO at Summit Imaging, and Summit Imaging Manager of Global Education and Training Kyle Grozelle.

During the presentation, health care facility professionals learned how to protect themselves from counterfeit ultrasound transducers that pose a risk to patient safety and can lower a facility’s quality of care.

The Summit Imaging duo explained how the health care industry is being deceived, as invalidated ultrasound remanufactured components are being hidden inside transducers under the illusion of “repair.” These compromised transducers are exposing health care facilities to severe increases in total cost of ownership and unnecessary liabilities, all while hiding in OEM marked bodies.

Attendees appreciated the webinar.

“This webinar was fantastic in helping determine the problems with short-term fixes versus quality. I was not aware of how some of the parts were hidden inside components.

The poor quality and parts that were not vetted can be a high risk when it comes to patient care as well. I was very interested in all the information presented and look forward to any

contact with Summit Imaging,” said H. Martin, clinical engineer.

Efficiency and Consistency The Webinar Wednesday presentation “Planning for the Future: Using Lean to Address CE Inefficiencies and Interns to Address CE Labor Shortages” provided insights to promote efficiency and consistency. The webinar was sponsored by PartsSource.

Presenter Glenn Schneider, director of clinical engineering at Cincinnati Children’s Hospital Medical Center, Ohio, shared the story of how one clinical engineering department at a children’s hospital went from an immeasurable and untraceable repair process to taking most repairs in-house and greatly diminishing the need to purchase new assets.

Attendees learned how to create a successful intern program to overcome the stresses of a retiring workforce and why targeted projects are more effective rather than large-scale, general changes. He also discussed how applying lean principles and established processes creates efficiency and consistency.

Modern Analytics, Reporting The Nuvolo-sponsored webinar “Modern HTM Analytics and Reporting – Better Decisions and Compliance Without Extra Work” presented by Kyle Holetz was well received by attendees.

Holetz, a senior solution consultant at Nuvolo, showed attendees the value in controlling the way users interact with entering data within the system and the value that can bring to reporting and analytics in various areas like EOC reporting, compeADVANCING THE IMAGING PROFESSIONAL

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NO FUR LOOK TH ER Attendees saw how a modern CMMS allows for a shift in thought and process . when it comes to reporting and analytics. They also discovered how a customer-defined data model collects the information needed at the point of service without extra work. A new way of handling regulatory reporting native in the platform was also discussed.

“I found that the webinar was very informative, learning about Nuvolo, modern enterprise asset management. There were a lot of features, that I felt were useful, such as projecting a team to work more efficiently by looking at the need for cross training, and keeping the time on a job that was completed. Also looking into equipment that needs to be retired due to expenses,” said D. Phillips, biomedical technician.

“Great Presentation. Well spoken and informative. It is always good to know about a program that can do what your current program cannot and keep feeding GE • TOSHIBA that information to administration – especially on the cost-savings front,” said B. SIEMENS • PHILIPS Judah, biomedical technician.

“Today’s Webinar Wednesday session opened my eyes to many reporting and Give us a call at 213-276-8209 analytic opportunities through a robust CMMS platform,” said M. Dowd, HTM unit (844-PMIM-MRI) head. or visit www.pmimagingmgmt.com The Webinar Wednesday series also continues to receive rave reviews.

“This is a great series. It always surprises me how much there is to learn about and this gives working professionals and students the opportunity to learn from a wide variety of experts we would not normally have access to,” shared L. Kosir, instructor/program head.

“Each Friday, I promote Webinar Wednesday to our whole 40-member team OFFERING CONTINUING EDUCATION CREDIT through email as a way for all to: learn a new facet of our business, learn new ways APPROVED BY ACI AND ASRT of thinking, and keep up with changes in the industry,” said D. Mills, CE manager.

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BUYERS GUIDEinformaOTHER “Webinar Wednesdays consistently present up–to-date and relevant NOTES tion to people in the HTM field, both managers and technicians alike,” shared N. MONTH Scholze, BMET training program/instructor. ICE

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J Fincluding M Aa M J For more information about Webinar Wednesday, schedule of upcoming sessions and recordings of previous presentations, visit DESIGNER: JL WebinarWednesday.Live.

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ICEMAGAZINE | JANUARY 2019

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ADVANCING THE IMAGING PROFESSIONAL

news

PEOPLE ON THE MOVE

By Matt Skoufalos

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The Glenview, Illinois-based American College of Chest Physicians has promoted COO Robert A. Musacchio to executive vice president and CEO.

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National community oncology network OneOncology of Nashville, Tennessee has named Erich Mounce its first COO. Mounce was most recently CEO at West Cancer Center.

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Premier Radiology Services of Miami, Florida, named Jonathan S. Luchs its chief medical officer. Luchs began his time with Premier as a medical director, and later was invited to become a partner in the firm. Luchs will continue to be the physician liaison to the marketing and business development team in addition to his new responsibilities.

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Strata Oncology of Ann Arbor, Michigan named Scott A. Tomlins as chief medical officer. Tomlins was an associate professor of pathology at the University of Michigan.

Stanford Children’s Health of Stanford, California named Paul King president and CEO of Lucile Packard Children’s Hospital Stanford and Stanford Children’s Health, effective in 2019. King is executive director at University of Michigan Health System’s C.S. Mott Children’s Hospital and Von Voigtlander Women’s Hospital. He will succeed interim CEO Dennis Lund, who took over from former CEO Chris Dawes. King serves on several boards, including those of the Children’s Hospital Association and the American Hospital Association Maternal & Child Health Council.

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SomaLogic of Boulder, Colorado has named Roy Smythe its CEO. A trained surgeon and former translational scientist, Smythe joins SomaLogic from Royal Philips, where he was chief medical officer (CMO) for strategy and partnerships.

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Silver Hill Hospital of New Canaan, Connecticut has named Andrew J. Gerber its president and medical director, effective November 26. Gerber is currently the medical director/CEO at Austen Riggs Center in Stockbridge, Massachusetts. Gerber is an associate clinical professor in the division of child and adolescent psychiatry at Columbia University, an adjunct associate clinical professor at the Child Study Center at Yale University, and an adjunct associate professor of psychological and brain sciences in the college of natural sciences at University of Massachusetts Amherst. Gerber completed his medical and psychiatric training at Harvard Medical School, Cambridge Hospital, and Weill Cornell and Columbia medical schools, and his psychoanalytic training at Columbia.

GlobalMed of Washington, D.C. has added Dean L. Smith as its chief medical information officer and senior vice president of government relations. Smith, a licensed, board-certified physician, spent the past 18 years with the U.S. Department of State, Bureau of Medical Services. Previous to that, he worked in ambulatory, acute and intensive, emergency medicine, and was a Lt. Commander in the U.S. Public Health Service.

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The Washington, D.C.-based Catholic Health Association of the United States (CHA) will search for a new president-CEO, as Sister Carol Keehan announced her pending retirement at the end of June 2019.

Find weekly installments at theicecommunity.com WWW.THEICECOMMUNITY.COM

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people

By K. Richard Douglas

PROFESSIONAL SPOTLIGHT Ken Luong: Serving Community and Country

S

ometimes, its just a matter of observing what others do for a living that lights the spark for a career readjustment. That’s exactly what happened to Ken Luong, a modality service engineer with GE Healthcare.

Luong was impressed with the field engineers who he encountered. He already knew his way around the operational side of imaging equipment.

“I have always been interested in electronics since I was a child, but I pursued the medical field instead. I was working as an X-ray tech in the hospital and I ran into a lot of field engineers and their work seemed very interesting so I went back to school to pursue it,” he says.

“I was working as an X-ray tech in Tacoma, Washington. It was a tough decision to move on, but I wanted to follow my interest in electronics. This is perfect for me because I am able to do what I love and still able to stay in health care to help out patients,” he adds.

Luong’s training came by way of the respected DoD training program.

“I went to the Department of Defense (DoD) BMET school in Fort Sam, Texas.

I was in the Army Reserve at the time I was looking into this field, and the DoD BMET school is the best one in the world, so I decided to pursue it. I talked to a lot of friends in the military and they guided me onto this path. The school itself 22

ICEMAGAZINE | JANUARY 2019

is 10 months long. After that, I also took a biomed management course with the Army,” Luong says.

He joined the Army in 2001, prior to 9/11.

“I deployed in support of Operation Enduring Freedom and Operation Iraqi Freedom to the Middle East for about 14 months. I took on many duties in the reserves such as squad leader, platoon sergeant and detachment NCO,” he says.

Luong says that he was working as a BMET for a hospital after he graduated from BMET school. After that, he took an externship with GE Healthcare and was hired on as a field service engineer.

“I was working as a BMET for a small hospital in San Diego, California when I received emails from the Army Reserve recruiting qualified BMETs to attend their military externship program with GE Healthcare,” he says.

“I took the opportunity, applied to the program and got accepted. I started out with GE Healthcare in Orange County, California as an extern and got hired at the end of the program. The externship program is one-year long; my experience included one BMET and one imaging rotation,” Luong says.

Today, his territory for GE Healthcare is Orange County and metro Los Angeles.

Going the Extra Mile In Luong’s position, top-notch training

“I have always been interested in electronics since I was a child, but I pursued the medical field instead. I was working as an X-ray tech in the hospital and I ran into a lot of field engineers and their work seemed very interesting so I went back to school to pursue it.”

-KEN LUONG

is all part of professional development.

It is just one component of a trifecta of challenges.

“It’s hard to find balance between a busy work schedule and attending training for new equipment. I’m working on getting my CRES certification for this field,” he says.

He is studying and plans on taking the CRES exam in May. His training has prepared him for the type of detective work that comes with the job. One occasion illustrates this and his willingness to go the extra mile to help a customer.

ADVANCING THE IMAGING PROFESSIONAL

people

Favorite part of being an imaging professional?

“My work is very rewarding. I know that I’m doing my part to help patients in need.”

Top: Ken Luong is seen at the Grand Canyon.

Bottom left: Ken Luong is seen at a game between L.A. Galaxy and Manchester United F.C. Bottom right: Graduation from Military Extern Partnership Program at GE Healthcare Institute was a key milestone in Ken Luong's career.

“I ran into many tough repairs, but this one event is very memorable. I was called into a small hospital to troubleshoot a CT scanner. This place is small so they only have one scanner available.

It was a high-voltage issue and I determined that the X-ray tube was the problem. I found a tube locally and began to install it about four hours later,” he says.

“During calibrations, the system aborted scanning again due to high-voltage issues; at this point I didn’t know if the new tube was bad or if another component in the system was bad,” Luong says.

He returned to troubleshooting to get the repair completed since the customer was under a tight schedule.

“I finally found out that the inverter shorted out during calibrations, but we WWW.THEICECOMMUNITY.COM

don’t have that part stocked locally. I had to order the part with special handling and promise the customer that I would come in to install it as soon as it arrives. Their contract doesn’t cover 24/7, but I decided to come in late at night anyway to help the customer in need,” Luong says.

When not on the job, Luong likes to ride motorcycles, fish and go to the shooting range.

Luong says that he is just a regular guy working hard to achieve the American dream.

“Trying my best to serve my community [and] country while taking care of my family,” he adds.

That commitment has paid off well for the many customers and patients who depend on his expertise. ICE

GET TO KNOW THE PRO Favorite book “The Art of War” Favorite movie “Black Hawk Down” Favorite food Pho (Vietnamese beef noodle) Hidden talent Aquaponic farming What’s on my bench?

Coffee, Coffee, Coffee, Coffee, iPod

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people

By K. Richard Douglas

DEPARTMENT SPOTLIGHT HealthAlliance of the Hudson Valley Imaging Department

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orth of New York City, along the Hudson River, sits Kingston, New York. The county seat of Ulster County, Kingston was New York state’s first capital. The city was burned to the ground by the British army after the Battles of Saratoga in 1777.

The city contains three historic districts, including the Midtown Neighborhood Broadway Corridor, the Uptown Stockade District and the Downtown Rondout-West Strand District. All three areas contain a number of 17th through 19th century buildings.

Tourists visiting the city can take a cruise on the Hudson River, browse museums and antique shops and ride an on antique trolley car. The city is home to the only intersection in America where 18th century homes stand on all four corners.

Three of Kingston’s comprehensive health care providers are HealthAlliance facilities. One is the HealthAlliance Hospital-Mary’s Avenue Campus, a 150-bed acute-care facility. Another is the HealthAlliance Hospital Broadway Campus, which is also a 150-bed acutecare facility. Both campuses are a part of the HealthAlliance of the Hudson Valley. Margaretville Hospital, a 15-bed crit24

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“We are very involved in planning and decision making. We are currently planning an entire new department build. Our organization respects and asks for our input into the development of our department.”

-REBECCA KING

ical access hospital is a third HealthAlliance location serving the area.

They are members of the Westchester Medical Center Health Network. Imaging services to these facilities are provided through the system’s Hudson Valley Imaging Department.

The Hudson Valley Imaging Department includes 122 staff members, including full-time, part-time and PD for the Broadway campus and MAC. Leadership within the department includes Rebecca King, director of ambulatory services; Chris Donaldson, medical imaging manager; Lowell Fley, manager of advanced imaging (for the

Broadway Campus and Mary’s Avenue Campus); Megan Valyou, manager at the Fern Feldman Anolick Center for Breast Health, Mary’s Avenue Campus; and Roberta Scism, manager of medical imaging at Margaretville Hospital.

The group provides imaging services at the Margaretville Hospital, the Mary’s Avenue campus and at Saugerties Diagnostic Imaging (part of the Broadway Campus, but located offsite in Saugerties, New York).

The team operates and provides diagnostic imaging using four CT scanners, one MRI scanner, two angio suites, seven prep and recovery rooms for IR, ADVANCING THE IMAGING PROFESSIONAL

The Hudson Valley Imaging Department provides imaging services at the Margaretville Hospital, the Mary’s Avenue campus and at Saugerties Diagnostic Imaging.

five ultrasound rooms combined, four portable X-ray, five C-arms, two mini C-arms, two fixed DR rooms and one DR Fluoro room.

The group makes use of several modalities for interventional radiology, breast center, CT scan, diagnostic radiography, ultrasound, nuclear medicine and MRI. They do not do PET scanning or 3D mammograms.

Training and Projects To maintain the training needed to stay current with clinical and technical advances in imaging, the department keeps the realm of opportunities open.

“We use any opportunity we can.

When possible we engage with OEMs to provide on-site learning to enhance and maintain skills. We use train-the-trainer opportunities, also,” King says.

She says that GE Tip-ED Online and Onsite Clinical Specialist education is also employed.

WWW.THEICECOMMUNITY.COM

The group’s input is valuable in the planning and construction process.

“We are very involved in planning and decision making. We are currently planning an entire new department build. Our organization respects and asks for our input into the development of our department. We do not participate in third-party labor negotiations,” King says.

Further strengthening the credentials and metric achievements of the team is an important goal of the department.

“We are currently working with the American College of Radiology on their GRID (general information radiology database) database to capture and benchmark ourselves to like organizations,” King says.

“We are also planning to submit our application to be surveyed by the American College of Radiology for the Diagnostic Imaging Centers of Excellence

accreditation. We feel we will do well on this survey as our quality benchmarks are outstanding,” she adds.

Beyond the work the department’s staff performs on the job, they are ACR accredited in all modalities. They participate in NRDR: DIR, GRID and IR Registry and Pledge for Image Wisely and Image Gently.

The Hudson Valley Imaging Department works every day to bring a high level of excellence in diagnostic imaging to the patients in Kingston. They maintain that edge through rigorously attaining the highest benchmarks for quality.

“We have a phenomenal and highly polished team that works together to provide the highest quality health care experience for every patient every time,” Donaldson says. ICE

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by just 1 year?

With 30 plus years experience in MRI coil repair, our proprietary processes result in proven sustainability.

Ever wondered what one more year could mean for your budget, ROI and patient access?

At Innovatus Imaging’s MRI Center of Excellence, we ask ourselves that question every day.

And the answer is really simple. Getting more life out of each MRI coil depends on getting the most out of every coil repair.

As a result, we’re extending the sustainability of repairs by extending the process beyond just the repair itself. Instead of just testing the durability of the repair we make, our engineers and technicians test all elements of the coil, and the mechanical parts we use for the repair, to identify any potential issues that could put your coil out of commission again. Our proprietary repair practices are built upon nearly 30 years of experience, cover cable harnesses, and are backed by one of the largest loaner inventories available.

Check out our 5-steps to Sustainable MRI Coil repairs in this issue of TechNation.

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Centers of Excellence for Ultrasound Probe Repair, MRI Coil Repair, Radiography, and Design and Manufacturing

products

PRODUCT SPOTLIGHT Worldwide Ultrasound Growth Continues

U

ltrasound diagnostic imaging has seen many advances in recent years. The advances are just a few of the reasons market watchers expect ultrasound to continue to grow on a global basis. The market is forecast to exceed $8 billion by 2023.

“The global ultrasound market is projected to reach $8.4 billion by 2023 from $6.3 billion in 2018, at a compound annual growth rate of 5.9 percent during the forecast period,” according to MarketsandMarkets.

Other research firms echo the MarketsandMarkets forecast.

“Ultrasound is a medical imaging modality that uses high-frequency sound waves, to visualize internal organs of the body. It transmits high-frequency ultrasonic sound waves into the body of the patient. These sound waves are then reflected by the organs into the probe and are transmitted to a display that generates the image. The global ultrasound devices market is expected to register a compound annual growth rate (CAGR) of about 4.0 percent during 2018-2023,” according to Mordor Intelligence.

“The governments across the world WWW.THEICECOMMUNITY.COM

are focusing on the promotion and support of the industrial research. Several tax incentives have been provided to industries to establish R&D units, with highly improved imaging facilities, especially in ultrasound. The long-term goal of these initiatives is to develop innovative, disruptive, safe, non-invasive ultrasound technologies that enable or enhance interventional therapies for the treatment of diseases, injuries, abnormalities and other conditions. The types of ultrasound interventional therapies include ultrasound thrombolysis, high intensity focused ultrasound and sonophoresis,” according to Mordor Intelligence.

Additionally, an increasing number of health care providers, technological advancements, and rising incidences of chronic diseases are other factors that contribute to market growth.

“Compared to the old generation of 2D ultrasound devices, 3D technology has added a dimension of depth, and 4D a dimension of depth and time. 3D and 4D ultrasound devices are becoming increasingly popular in Eastern Europe, especially in cardiology and OBN ultrasound. The market for 3D and 4D is

however not yet saturated there, mainly due to financial constraints,” according to a WiseGuyReports.com press release.

“In other regions, such as Scandinavia, the reason for low market penetration of 3D/4D ultrasound is lack of acceptance among doctors. Research shows that doctors in Scandinavia do not consider 3D/4D ultrasound to provide more clinical value during diagnosis and are therefore quite reluctant. Convertors of images in older generation ultrasound units were based on hardware, which was built in the ultrasound device. The new generation uses external computers, which perform the scan conversion. This has resulted in an increase of calculation power of ultrasound devices and has led to major improvements in quality.”

“Currently, the demand for handheld ultrasound devices is on the rise owing to the shifting trend toward home health care and remote patient monitoring to reduce hospitalization cost,” the report added.

Some major manufacturers in the ultrasound market include GE Healthcare, Philips, Siemens Healthineers, Boston Scientific, Toshiba, Canon Medical and Carestream. ICE ICEMAGAZINE

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products

Canon Medical Aplio i-series Expanding its advanced, high-performing Aplio i-series ultrasound platform, Canon Medical Systems USA Inc. introduced the industry’s first 33 MHz ultra-high frequency linear iDMS transducer, providing extremely fine detail in the near field and the highest frequency on the market. The ultra-high frequency transducer uses iDMS technology and a single crystal wide band to provide superb resolution and detail in ultrasound imaging. The new transducer extends the lineup of transducers currently available in the Aplio i-series ultrasound platform and is ideal for superficial subcutaneous imaging, carotid exams in pediatrics and pediatric/neonates, superficial nerves and superficial vascular evaluations such as varicose veins.

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ADVANCING THE IMAGING PROFESSIONAL

products

FUJIFILM SonoSite Inc. SonoSite Synchronicity SonoSite Synchronicity software helps health care organizations optimize workflows, maximize financial return, improve quality assurance efficiency and streamline credentialing processes. Built specifically for POCUS, SonoSite Synchronicity software securely centralizes exam data and standardizes clinical workflow while delivering administrative efficiencies. Features include built-in, customizable worksheets, intuitive dashboards and the ability to access the tool from a computer, tablet or mobile device. Easily installed and scalable, SonoSite Synchronicity software was engineered to meet every organization’s unique requirements for standardization, consistency and compliance across entire medical networks.

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products

GE Healthcare LOGIQ E10 This high-end radiology ultrasound system integrates Artificial Intelligence technology, cloud connectivity and advanced algorithms to acquire and reconstruct data faster than ever before. The same technology that is powering driverless cars and the next generation of 3D video gaming is behind this ultrasound system’s platform – the cSound Architecture. This advanced GPU hardware technology acquires and reconstructs data in a similar way to an MRI or CT system, enabling 48 times the data throughput and 10 times the processing power of previous systems. The system eliminates the need for focal zones, as the entire image is always in focus throughout the exam.

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ADVANCING THE IMAGING PROFESSIONAL

products

SIEMENS HEALTHINEERS ACUSON Sequoia The new ACUSON Sequoia, a general imaging ultrasound system, was developed in response to one of the most prevalent challenges in ultrasound imaging today: the imaging of different sized patients with consistency and clarity. With its new Deep Abdominal Transducer (DAX), a new high-powered architecture, and innovative updates to elastography and contrast-enhanced ultrasound, the new ACUSON Sequoia produces penetration up to 40 cm. With its powerful architecture and innovative features, the new ACUSON Sequoia expands precision medicine by enabling high-resolution imaging that adapts to patients’ size and personal characteristics, contributing to more confident diagnosis.

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products

TOOLS OF THE TRADE BC Group ULT-2000 Ultrasound Leakage Testing Series

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he ULT-2000 Ultrasound Leakage Testing Series (Models ULT-2010 and ULT-2020) were specifically designed to test the electrical safety of all types of diagnostic ultrasound transducers. Although the ULT-2000 Series can be used on virtually any type of ultrasound transducer, it is especially recommended in the testing of TEE (Transesophageal Echocardiography) transducers prior to each use; as recommended by many TEE ultrasound device manufacturers and the IAC published standards. The test not only gives a pass/fail indication, it also provides the leakage level for each probe compared to OEM standards, when available. You can print test results to an optional printer. ICE

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ADVANCING THE IMAGING PROFESSIONAL

WE ARE DEDICATED TO

EMPOWERING THE ENGINEER At Tri-Imaging Solutions, we strive to live up to our name and be a Solution for our Customers and ultimately, helping to Empower the EngineerTM

WHAT WE DO

Tri-Imaging Solutions is a replacement parts, equipment, service support, and technical training company. We provide quality tested imaging parts, buy-sell-move equipment, and provide technical support. All replacement parts come with a 180-day warranty. Available 24/7/365

PARTS

Tri-Imaging’s goal is to carry the replacement parts inventory critical to supporting the imaging service engineer. We appreciate your business and support during this exciting time of strategic investment and growth.

EQUIPMENT

At Tri-Imaging, we have the equipment and connections to help you with all types of purchases, sales, installations and/or de-installations. We have experience with most all modalities, including CT, Digital Labs, R&F and Digital Mammography.

SOLUTIONS

ISO 13485 Certified

TRAINING

The Tri-Imaging Technical Training is a unique and intuitive training program that will prepare the

diagnostic imaging systems.

Completion of our BMET to 73 CEUs from the AAMI Credentials Institute.

VISIT TRI-IMAGING’S EDUCATION

VISIT WWW.TRIIMAGING.COM

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OR CALL 855.401.4888 (24/7/365)

Profile

Strengthens Imaging Portfolio

A

vante is a one-source solutions provider, giving health care facilities across the globe access to quality new and refurbished medical equipment, installation, service, parts, repair and technical support. Avante has amassed a best-in-market breadth of products and services which has positioned it as a cost-effective alternative to major equipment manufacturers.

In 2018, Avante continued to expand its geographic coverage and capabilities by welcoming Equipment Maintenance Solutions (EMS) and Ultra Solutions as new additions to its rapidly growing family of companies. EMS and Ultra Solutions further strengthened Avante’s robust diagnostic imaging and ultrasound product and service offerings.

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“Avante is happy to welcome two additional companies who share our values and commitment to quality products and high-touch customer service,” said Steve Inacker, Avante’s President and Chief Operating Officer. “These recent additions in the diagnostic imaging and ultrasound markets will accelerate growth and allow us to offer even more to our customers.”

ur primary goal O is to continue to be recognized by our customers and the market as a high-quality, lowcost alternative to the OEMs for the product and service solutions that we offer.”

Steve Inacker, Avante President and Chief Operating Officer

ADVANCING THE IMAGING PROFESSIONAL

Profile

SPECIAL ADVERTISING SECTION

Avante Imaging & Ultrasound

One Source

Avante Diagnostic Imaging, formerly Transtate Equipment Company and Equipment Maintenance Solutions, provides high-quality cath/angio lab, CT, MRI and nuclear camera solutions. Its hyper-focused approach has fueled company growth, allowing Avante Diagnostic Imaging to construct a full-service staging facility that houses thousands of replacement parts and a multi-specialty team of experienced engineers offering onsite repair services.

Avante Ultrasound, comprised of Global Medical Imaging (GMI) and Ultra Solutions, is a one-stop-shop for all of your ultrasound needs. With facilities on the East and West coasts, Avante Ultrasound provides customers with the highest quality equipment and parts, probe repair, field service, training and technical support.

Avante’s Advantages One Convenient Source Avante provides its customers with unprecedented access to a complete range of imaging and ultrasound equipment options for any facility type, size or specialty. In addition, Avante offers support throughout the entire equipment lifecycle – from sourcing and installation, to repairs, parts and service.

By relying on Avante as a single point of contact for their health care equipment needs, medical facilities can focus on what they do best: delivering quality care to patients. For a full menu of imaging related products and services visit AvanteHS.com.

Unparalleled Value Beyond offering customers a single source for all their equipment needs, Avante provides the highest product and service quality offering among independent service organizations at a significant discount to the original equipment manufacturers.

“Our primary goal is to continue to be recognized by our customers and the market as a high-quality, low-cost alternative to the OEMs for the product and service solutions that we offer,” Inacker said.

Brand Agnostic Approach Avante utilizes an unbiased, brand indifferent strategy that allows the company to provide its customers with the best equipment and service for their needs. This includes new or professionally refurbished equipment options from leading manufacturers, as well as the technical expertise to service and repair equipment from all major equipment manufacturers.

Forward Thinking Avante’s belief is that in today’s health care environment, doing more with less requires a progressive strategy and a new way of thinking: that better health care starts with seeing a better way forward. Avante strives to be a better partner, budget alternative and total solution. The Avante family of companies unites the best-of-the-best in the industry and allows the group to provide comprehensive quality care to its customers. For more information, visit AvanteHS.com.

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Profile

Additional Avante Companies Avante Medical Surgical has been a provider of operating room equipment for more than 30 years, previously under the DRE Medical brand. Avante Medical Surgical offers new and professionally refurbished lines of anesthesia machines, surgical tables, surgical lighting, procedure chairs, defibrillators, respiratory ventilators, exam and diagnostic equipment and more.

Avante Patient Monitoring, formerly known as Pacific Medical, repairs, services and sells patient monitoring devices, including patient monitors, modules, telemetry transmitters, fetal transducers, infusion pumps, gas analyzers, syringe pumps and corresponding accessories/parts. Avante Patient Monitoring maintains the largest patient monitoring inventory in the industry.

Avante Oncology Services has been a partner to hospitals and cancer care centers since 1985, previously under the Oncology Services International brand. Avante Oncology Services is the leading alternative to OEM service for linear accelerators used in radiation therapy. In addition to its quality service offering, Avante Oncology Services is able to offer fully refurbished linear accelerators, parts and technical support.  

Avante Rental Services, formerly Integrated Rental Services, provides JCAHO compliant medical equipment short-term and long-term rentals to hospitals, clinics, surgery centers, doctor’s offices and other medical facilities.

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ADVANCING THE IMAGING PROFESSIONAL

One source to maximize capital equipment performance Medical Surgical • Patient Monitoring • Oncology Services • Ultrasound • Diagnostic Imaging

Avante Health Solutions provides a single source solution for all your capital equipment needs from one powerful partner. We are a one-stop, brand-agnostic supplier of high-quality, new and refurbished equipment at prices that stretch your dollar. And with best-in-class service, parts and repair, the perfect health solution is one click away.

Learn how easy one source can be at AvanteHS.com

Entering the

Third

Photo: Courtesy of PrinterPrezz, Inc. | Scanner pictured: HP Sprout

By Matt Skoufalos

Dimension S

ince the introduction of commercially available 3D printers, the technology has been largely celebrated for its adoption by makerspaces, as an introductory method of teaching computing to children or

as a novelty gift for gadget lovers. In the industrial space, however, the technology has grown by leaps and bounds in its applications for prototyping and manufacturing. Now that same enthusiasm has reached the health care industry, where imaging-guided surgeons are turning its focus to myriad uses.

Dr. Huie Lin directs the Adult Congenital Heart Program at Houston Methodist Debakey Heart and Vascular Center in Houston, Texas. An interventional cardiologist, Lin sees patients through the multiple procedures required to correct pediatric congenital heart defects all the way into adulthood. The bulk of that work is done through trans-catheter interventions, which Lin described as having become critical to the management of these issues.

“Every single heart is a little bit different,” and so are the surgeons who may operate on them in the repeat procedures his patients undergo as they age and develop, Lin said. Aside from structural differences in their organs, patients react differently to the different procedures they’ve undergone, which are likewise a byproduct of the different surgeons who’ve conducted them. Their treatment relies on the sophisticated imaging that drives surgical planning, and physicians “need the third dimension to take care of them correctly,” Lin said.

“There’s no imaging we can do that’s 3D on the [operating] table,” he said.

“But being able to pre-plan the case with stereoscopic [imaging] is critical.”

The three-dimensional visualization that physicians can get from reconstructed CT, MR, and similar images of the patient’s heart, whether viewed through virtual-reality goggles or a 3D television, helps doctors to better understand the specific cardiovascular structures of the hearts on which they operate, and how those are related to each other. At Houston Methodist, the process starts when that imaging data of the patient’s heart is shipped off to engineers who can model it and send it off to a 3D printer.

“It’s a lot of elbow grease,” Lin said.

“You have to have a scientist do the data modeling to have a data set that you can send to the 3D printer. That’s the cognitive element that’s very painstaking; we’ve had a couple of fantastic engineers who’ve done that for us.”

The next step in the process takes place at 3DPTX, a Houston-based “3D printing service bureau” that produces a patient-specific model of the heart with PolyJet 3D printers. Similar in design to inkjet paper printers, the PolyJet printer

layers liquid photopolymer onto a build tray; when the polymer is exposed to light, it hardens into whatever shape it’s programmed to take.

The technology is precise enough to produce models that are specific to patients’ anatomies, and can include colored cross-sections to identify different tissue in the heart. Doctors like Lin then use the models to preview trans-catheter procedures, and to select and test-fit implantable devices before they go to work inside the patient. That saves time, effort, and can pre-empt complications that may have previously been unforeseen without the imaging-powered test run.

“We’ve taken a combination of trans-catheter devices and an open surgical technique to reduce the use of the bypass machine,” Lin said. “That’s been really powerful. We’re taking [implantable devices] that are off the shelf, and making sure they don’t impinge on other cardiovascular structures. Then we’ll implant it, and make sure it’ll actually work [using the 3D model].”

Lin recalls a case in which the 3D mod

“ It’s

an area that has an increasing clinical need over time. The reasons for failure are well-recognized, and we think 3D printing will address that.

”

Dr. Alexis Dang, Chief Medical Officer, PrinterPrezz, Inc. eling process helped a complicated patient to undergo a successful operation. The 63-year-old had gone through his life with an undiagnosed heart defect that created “severe volume overload,” sending blood flowing from one side of his heart to the other. Typically, the surgeon would have patched it from one side of the heart to another; with the 3D modeling technology, “we started coming up with a different way of approaching it” Lin said.

Using the patient’s heart model, they sourced a stent graft that covered the hole in the left atrium of his heart while also allowing anomalous veins within to drain back into his left atrium normally. The information they gleaned from the trial run with the 3D-modeled heart helped Lin’s team significantly.

“I see this as shifting the paradigm of how you think about treating patients,” Lin said. “To some extent in medicine, there’s a lot of ‘I’ve got this drug,’ or ‘I’ve got this valve; let’s try it and see if it works.’ [3D modeling] lends people like me a lot more confidence in the treatment.”

Likewise, Lin said 3D modeling allows physicians to explore “edgy things in patients who wouldn’t otherwise have any hope” of a solution to their problems.

The modeling approach has also helped the center determine whether it could help prospective patients who didn’t live near their Houston facility. By importing their imaging studies to 3DPTX, where their hearts would be printed, teams at Houston Methodist could examine the models to determine if treatment was possible before inviting people to travel to them. Of course, without the cooperation of agencies like 3DPTX and the Texas Medical Center accelerator, the modeling process wouldn’t be feasible, Lin said. Without a reim-

bursement mechanism to cover the cost of the work involved, physicians must consider innovative approaches to funding the process.

“Right now, there’s no mechanism for the health care industry to say, ‘You spent this many hours, and that went into the planning for this procedure,’” Lin said. “Right now, the next thing to happen in this field is for [3D modeling] to become part of the cost structure. Part of the problem is defining that cost structure.”

Lin believes the potential patient base for 3D-modeling-guided procedures is limitless; it just requires the alignment of the right staff and institutions to promote it.

“Patients and hospitals and technology vendors and scientists can get together; it’s almost shovel-ready,” he said.

“There needs to be a way to pay for it so nobody gets excluded from that option.”

Already, there has been some movement on that front. In November 2018, the American Medical Association (AMA) CPT editorial panel accepted a proposed Category III code for 3D anatomic modeling. Put forth by the American College of Radiology (ACR), that code will be effective July 1, 2019.

Although a Category III code does not guarantee reimbursement for a procedure (only a Category I code does that), the classification supports physicians lobbying their state agencies for its advancement, said Michael Gaisford, director of marketing for healthcare solutions at Stratasys of Eden Prairie, Minnesota.

“There is huge economic incentive and alignment to using 3D printing in a hospital,” Gaisford said. “We need continued engagement with clinicians and continued development of these applications to codify the techniques that generate the most valuable models, and

Photo: Courtesy of PrinterPrezz, Inc.

then communicate them to the physician community.”

“There’s so many different aspects where it intersects with health care,” he said.

Stratasys manufactures the PolyJet printers used at 3DPTX; the technology therein is used for a variety of medical applications, from anatomical modeling to biological printing to implantable devices. In addition to creating patient-specific, imaging-based modeling for procedural planning, Gaisford believes 3D-printing technologies can support surgeons by building a cutting guide from the negative images of patients’ anatomies. Doing so creates a product that he said produces an optimal surgical cut.

“These models become great tools for education training,” Gaisford said; “you pick the model that’s designed to treat a complex case, and you can use that same model to train your residents and fellows so they can practice performing a procedure on a non-patient model.”

3D-printed anatomical models are also used for selecting hardware to be used in plastic surgery, creating apparatus that more symmetrically fit patients, and pre-bending plates instead of doing that reconstructive work during the procedure itself. They can likewise be used in surgical oncology to reproduce patients’ organs to display tumors alongside healthy vascular and nervous tissue, all segmented in different colors.

Gaisford said these models also help improve communication with patients’ families — “here’s your child’s heart, your loved one’s kidney tumor, and here’s how

we’re going to approach it” — as well as educating surgical teams.

“We say a picture is worth a thousand words; a 3D-printed model is worth a million words,” he said. “You’re interacting with the physical space in a way you can’t do virtually or in two dimensions.”

Some of the wait times from scanning to modeling can even be cut back via advanced visualization systems with which some imaging devices are presently equipped, Gaisford said. Models sold

by Philips, GE and Vital Images (Canon) can output a 3D-printable file from the software packages on their workstations.

A variety of third-party and open-source solutions are available, but Stratasys printers are integrated with Materialise Mimics imPrint, an application that translates DICOM raw data into a format usable by 3D printers. Gaisford said the combination of technologies is part of an FDA-cleared process for creating 3D-printed models for diagnostic purposes.

“Many radiologists and clinicians aren’t aware of that feature,” he said.

Gaisford also believes that as 3D printing becomes more common in hospital environments, the wait time from scan to print will decrease. Lin cited a 24- to 36-hour turnaround for models at Houston Methodist, but Gaisford believes procedure-specific modeling can cut that time down to a next-day delivery in some instances, lowering costs as well.

“When I talk to customers that have adopted 3D printing as a very common tool within certain procedures, then the learning curve kicks in,” he said. “As we get to more standard protocols, and we learn exactly where 3D printing is going to have the most value, and direct our resources at those areas, we will get the

efficiencies to very quickly generate the models that will have the clinical and financial benefits to the hospital.”

In the not-too-distant future, orthopedic surgeon Alexis Dang believes that 3D printing technologies will advance beyond ultimately personal modeling tools to helping create medical implants that benefit a wider range of patients. Dang is the chief medical officer of the newly launched San Francisco, California-based PrinterPrezz, which styles itself as a “medifacturing” company. Established to support engineers of next-generation medical devices in advancing their work from theory to practice, Dang believes PrinterPrezz can “get the best fit possible” for devices that interact with the human body.

PrinterPrezz supports the use of longterm medical implants made of titanium alloys that interact with the body “in a secure way,” Dang said. These alloys which are used in orthopedic surgery, spinal surgery and inter-body fusion – offer “longer-term biocompatibility, good integration with bone, and durability,” he said. Dang believes they can be optimized with 3D printing technologies, particularly in the case of spinal fusion surgeries to offer a better anatomic and biomechanical fit.

“These are areas where we have small, complex parts and designs that lend themselves well to 3D printing,” he said. “It’s an area that has an increasing clinical need over time. The reasons for failure are well-recognized, and we think 3D printing will address that.”

Dang believes that 3D printing also faces nomenclature concerns in its evolution; instead, he believes the preferred terminology should be “3D manufacturing” or “additive manufacturing.”

“We like 3D printing on one hand because it lets people know what we’re doing, but the printing is really the last step of the process,” he said. “Everything coming into the printer has to be an integrated process. That process has room for improvement and optimization, which is one of the things we’re focusing on as well. We need to optimize each step for the intent of creating an implant.”

Dang also foresees the challenge of educating clinicians about “to design what’s possible using technology that exists today while we’re building for tomorrow.” He believes that 3D printing offers improvements over traditional manufacturing practices; instead of making oneoffs, he’d like to see health care facilities “make a variety of improved designs that are going to be able to help a lot of people versus one individual.”

“These are called patient-matched devices as opposed to custom devices,” he said. “Having the imaging ahead of time will help you figure out what’s best for the patient in terms of anatomy and biomechanics.”

More significantly, Dang noted that most hospitals aren’t set up for 3D manufacturing; even if they’re doing that kind of work in-house, like Mayo Clinic is, they can’t market the devices they print outside the hospital without undergoing FDA certification. Most hospitals probably won’t approach that level of complexity, but he still believes that university and teaching hospitals will begin offering 3D printing capabilities sooner rather than later.

“The next five years, especially within university and innovation hospitals — they’re all going to have 3D printers in house, if they don’t already,” Dang said. ICE

“ There’s no imaging we can do that’s 3D on the [operating] table. But being able to pre-plan the case with stereoscopic [imaging] is critical.

”

Dr. Huie Lin directs the Adult Congenital Heart Program at Houston Methodist Debakey Heart and Vascular Center

insight

CAREERS NOW

Written by Cindy Stephens Stephens International Recruiting Inc.

Great Leadership Requires Excellent Communication

M

any managers fail in their leadership abilities because of poor communication skills. It is important to have excellent communication skills to be effective in a career. Great leaders successfully inspire, encourage and motivate their teams with effective communication skills.

Leaders must have excellent verbal communication to be effective. Speak as clear and concise as possible, ensuring your message is understood. It is helpful to prepare your message in advance for important conversations or meetings. Think about possible objections or questions that may arise during the discussion and be prepared to answer effectively.

To help improve your verbal communication skills, read often, whether it is a technical journal or your favorite author. Listen to positive speeches and presentations and notice how presenters inspire the audience. You can pick up tips and quickly improve verbal communication skills.

Listening skills have been lost in the era of social media, texting, email and emoticons. Electronic communication is easier, but hinders our ability to really listen during a conversation. You cannot communicate effectively while texting. The message sent can easily be misunderstood and taken negatively. Use effective verbal communication and good listening skills to ensure you understand what is being said.

By listening carefully to conversations, you catch details that may be missed in text or email messages. Eye contact, voice inflections and verbal pauses are lost in elec42

ICEMAGAZINE | JANUARY 2019

tronic messages, which could often mislead the reader.

An excellent way to improve listening skills is to hold back your comments and concentrate on the other person in the conversation.

It is so important to listen carefully to verbal and nonverbal communications to ensure you understand the other person’s message. Comprehend what is being communicated and reflect on what is being stated before forming a response. By listening carefully, you will be able to understand the full message and respond appropriately.

Electronic messages also hinder good writing skills. Many people are so used to sending text messages with shorthand, losing all grammatical and spelling skills. It soon carries over to business communication. You must be able to write well on a daily basis, using correct grammar and spelling. You should also be direct and concise in your written communications, getting to the point of the message.

No one wants to read a lengthy email that loses the message among the unnecessary words. If you are responding to an email, ensure your message is succinct and that it uses appropriate grammar and spelling. Use proper sentence and paragraph structure. Nothing is worse than attempting to interpret an email with run-on sentences and a message that runs on and on before getting to the point. If you feel you lack good writing skills, spend time to improve. There are many online tools to help you improve your writing skills.

Along with having excellent verbal communication skills, it is important to pay at-

tention to nonverbal communication such as body language. Non-verbal signs make it easier to understand the message. Sometimes a person says one thing, but the body language indicates there is something more to the message. Interpreting body language also gives you the advantage during serious discussions, negotiations or meetings. Additionally, once you understand how to read body language and nonverbal signals, you will soon be able to project effective body language to people around you. Projecting confidence and leadership is just as important as seeing these behaviors in others.

As a leader in today’s highly technical world, there is often a need to utilize video conferencing. It is important to present yourself in a quality manner. Find a quiet place to connect and practice ahead of time to avoid technical glitches.

Effective communication skills also involve timely responses to phone calls and messages.

You may not have the ability to answer a call, but it is vital to respond as soon as you can.

Never leave the caller wondering if their call was being ignored or forgotten. Always return calls. Additionally, be sure your voicemail box is cleared out periodically. Nothing is more irritating than hearing that a person’s “mailbox is full” and being unable to leave a message.

Communication is a powerful tool we use every day. It has the ability to motivate and inspire people. Strive to improve your communication skills to improve relationships. Great leadership requires excellent and effective communication skills. ICE ADVANCING THE IMAGING PROFESSIONAL

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ADVANCING THE IMAGING PROFESSIONAL

insight

IMAGING MATTERS Fixing What’s Wrong

Written by John Garrett Director of a Clinical Engineering Department in CHI

T

he on call field service engineer (FSE) gets an after hour page because an X-ray room is down. After a short discussion it becomes apparent that the automatic exposure control (AEC) is not functioning properly. After further discussion, it becomes obvious that the tech working that shift does not know how to enter technique manually.

Another late call comes in for our faithful FSE for a down CT. This time the problem is the computer hasn’t booted up. During a discussion, the tech insists that the unit is down and the FSE needs to come fix it. The FSE shows up 45 minutes later, having come from home, and presses the “on” switch for the computer monitor to fix the problem.

Finally, a call comes to our good mannered FSE with a complaint of no work list. After calling IT, the FSE finds out there is a server issue that will require IT to fix the problem. Yet, the tech insists that the system is down because they do not know how to manually add a patient and match it in PACS. If you have been in the industry for any length of time you have probably experienced something along these lines. There is little any FSE can do to solve any of the previous issues. There is a concern of liability if they take on the role of an applications specialist. There are techs who will not do anything manual. This may be from lack of knowledge and/or ability. It might be due to a sense of entitlement that they shouldn’t have to deal with anything out of the ordinary. Sometimes, something as simple as checking to see if the monitor is on is seen as troubleshooting that a tech should not have to do.

In these cases, there are two competing problems. The first is that the tech is not properly trained on the equipment. There is an operator’s manual that covers the work done by those operating the equipment. This includes basic checks to make sure the unit is on and that it is working. It includes the steps to bring the equipment down and restart it when something seems to be wrong. Yet, too many techs are taught by someone that was taught by someone that was taught by an applications specialist. This is actually a WWW.THEICECOMMUNITY.COM

" Every time you shut it down, show someone. Educate them on what to check.

Share your knowledge." result of the second problem.

The second problem is the culture of too many imaging departments. They do not invest in applications training for off shift employees that actually cover practical use. There is a resistance to perform even a basic shutdown, often because they are unsure how to do anything other than line up a patient and push a button on a specific unit. It is a result of trying to save money that is misguided.

So, what can be done? First, encourage proper applications training. Second, when you shut down the unit show the person operating the system. Every time you shut it down, show someone. Educate them on what to check. Share your knowledge. Do not attempt to teach anything clinical. Simply show them how the machine works, every time. This won’t fix every problem, but it might get a tech to at least check the power button on a monitor. ICE John Garrett has 20 years experience in imaging service including general radiation, mammography, CT and nuclear medicine. He has worked for third-party service companies, manufacturers, sales companies and in-house imaging teams.

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insight

WHAT IS A LEADER? M

y mentor used to say, “Before you can lead others, you must first be able to lead yourself.”

But what is a leader? Sometimes it feels like the people who write dictionaries take the easy way out. For example, look up the word, “leader,” and it says, “one who leads.” Really? Who knew? Look up the word, “lead,” and you get, “be in charge or command of.”

As the saying goes, I’m shaking my head. Will dictionaries ever give us some practical definitions for these words?

I remember a coaching client once asking for a definition of what it meant to be a leader. Granted, it’s kind of a loaded question, and maybe I should give the dictionary writers some slack, because the answer can go so many directions. You can have charismatic, bureaucratic, Machiavellian, democratic, authoritarian and laissez-faire leaders.

You can also have servant leaders, coach leaders and micromanaging leaders.

However, when describing what it means to lead, I believe it’s possible to define the term simply and yet practically. Here’s how I define the word.

Leadership: To see a beneficial end-result in one’s mind, and then take initiative to do whatever actions are necessary to achieve that vision.

Said another way, leadership is taking steps to achieve something without someone telling you to do it. The stronger the leader, the more likely it is those steps will be taken in the face of overwhelming obstacles, or to achieve something worthwhile that others have not yet achieved. It’s not always that cut and dried, but if we analyzed the various people you think of as leaders, that definition would probably apply.

To me, it’s also important to be a principled leader with sound, moral integ46

ICEMAGAZINE | JANUARY 2019

rity. After all, the world has seen some strong, effective leaders whose morals and principles were severely twisted.

But let’s not get sidetracked by that.

Let’s assume you have sound morals and good principles, and let’s go back to that maxim my mentor used to say: “Before you can lead others, you must first be able to lead yourself.” I realize that some will say they don’t want to be leaders, and I get that. But to be successful in any role, a level of self-leadership is still required. Think about it. If you’re a parent, by default you are a leader. Even people working in entry-level jobs require self-leadership skills so they can get to work on time.

Perhaps the most popular framework for establishing self-leadership skills comes from the late Stephen Covey in his phenomenally popular book, “The Seven Habits of Highly Effective People.”

I tend to view his book as more theoretical than practical, but his first three habits created an outline for self-management/self-leadership that is hard to beat.

• Habit One: Be proactive • Habit Two: Begin with the end in mind • Habit Three: Put first things first I firmly believe that if a person can articulate and incorporate the actions that define those habits, that person can strengthen the foundation of his or her self-leadership.

Let’s start with being proactive. No matter where I teach this, someone in the class always defines this (correctly) as taking initiative. It’s like what we said earlier – seeing a beneficial end-result in one’s mind, and then taking initiative to do whatever actions are necessary to achieve that vision. The dictionary defines being proactive as, “Creating or controlling a situation by causing some-

Written by Daniel Bobinski Workplace Consultant

thing to happen rather than responding to it after it has happened.” Now that’s a dictionary definition I can get behind.

In practice, personal leadership means seeing what needs to be done in your life and then taking initiative to get those things done. At the fundamental level this ranges from vacuuming your carpets to washing your clothes to taking out the trash to getting the oil changed in your car.

Covey’s second habit is beginning with the end in mind. For personal leadership, this kicks it up a notch. What do you want to be doing in two years? Five years? Ten years? Think of Covey’s second habit as Goal Setting 101. What are your financial goals? Your career goals?

Your family goals? Your educational goals? There are multiple areas of life in which we can create goals.

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easier it is to create plans to achieve them. And, it so happens that creating a plan is the crux of Covey’s third habit, putting first things first. For example, if your “end in mind” is to have $100,000 in savings by a certain date, you can break down how much you need to put away each month to reach that, then prioritize your actions to make that happen.

If your goal is to attain a certain position in your company, you can create a plan for what knowledge and skills you’ll need to be successful in that role.

Part of putting first things first includes taking the initiative to put those things on your calendar and then following through in doing them.

The examples I’ve provided here are the basics of self-leadership, but Covey’s first three habits are also necessary when serving in a leadership role within an organization. In such roles, the process is the same as if you’re practicing self-leadership. Leaders need to take WWW.THEICECOMMUNITY.COM

initiative (be proactive), set goals (begin with the end in mind), and plan, organize and prioritize the work schedules (put first things first).

My mentor was right. If you can lead yourself, then you have the framework for leading others. But if you can’t lead yourself, then you won’t understand what it takes to lead others. Bottom line, if someone ever asks you what it means to be a leader, I hope you’ll skip over the paper-thin dictionary definition and talk about taking initiative, planning and prioritizing. ICE Daniel Bobinski, M.Ed. is a certified behavioral analyst, a best-selling author and a popular speaker at conferences and retreats. He loves teaching teams and individuals how to use Emotional Intelligence, and his videos and blogs on that topic appear regularly at www.eqfactor. net. Reach him at daniel@eqfactor.net.

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DIAGNOSTIC IMAGING & SURGICAL SOLUTIONS

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Adel Lawrence Associates, Inc. p. 12

MW Imaging Corp. p. 5

Summit Imaging, Inc p. 3

TECHNICAL

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Ampronix p. 4

Technical Prospects p.48

Nuvolo p. 10

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Tri-Imaging Solutions p. 33

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InterMed Group p. 48

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