TechNation Magazine - July 2019

1technation.com

Vol. 10

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

JULY 2019

12 Professional

of the Month Charlotte Threlkeld

14 Company Showcase

oneSOURCE

26 News and Notes

Industry Updates

44 Roundtable

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CONTENTS

FEATURED

44

ROUNDTABLE: ULTRASOUND SYSTEMS

TechNation reached out to original equipment manufacturers and third-party service providers to quiz them about ultrasound systems.

The result is insightful information regarding a variety of issues, including cybersecurity and parts procurement.

Next month’s Roundtable article: Training

52

REACHING FOR THE STANDARDS: UPDATED GUIDANCE FOR SAFETY AND SECURITY

In this month’s cover story, TechNation explores standards. The health care industry has a variety of regulations and standards to contend with in today’s world. Whether it be mandatory requirements from the FDA or voluntary standards like ISO 9001, HTM professionals play an important part when it comes to the delivery of quality health care.

Next month’s Feature article: New Technology: Robots, 3D Printers and More

TechNation (Vol. 10, Issue #7) July 2019 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to TechNation at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

TechNation magazine is dedicated to providing medical equipment service professionals with comprehensive, reliable, information concerning medical equipment, parts, service and supplies. It is published monthly by MD Publishing, Inc. Subscriptions are available free of charge to qualified individuals within the United States. Publisher reserves the right to determine qualification for a free subscriptions. Every precaution is taken to ensure accuracy of content; however, the information, opinions, and statements expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. ©2019

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

JULY 2019

TECHNATION

9

CONTENTS

INSIDE

Departments

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley

Karlee Gower

Amanda Purser EDITOR

John Wallace

EDITORIAL

Roger Bowles Jenifer Brown K. Richard Douglas Jim Fedele Joe Fishel Inhel Rekik Manny Roman Cindy Stephens Steven J. Yelton

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

CIRCULATION

Lisa Lisle Melissa Brand

WEBINARS

Linda Hasluem

ACCOUNTING

Diane Costea

EDITORIAL BOARD

Manny Roman, Business Operation Manager, AMSP Salim Kai, MSPSL, CBET, Clinical Safety Engineer University of Michigan Health System Jim Fedele, Sr. Program Director, Clinical Engineering, BioTronics, UPMC Susquehanna Izabella Gieras, MS, MBA, CCE, Director of Clinical Technology, Huntington Memorial Hospital Inhel Rekik, Clinical Engineering Manager, Medstar Georgetown University Hospital

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

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JULY 2019

Proud supporters of

P.12 SPOTLIGHT p.12 Professional of the Month: Charlotte Threlkeld, BMET1 p.14 Company Showcase:oneSource Biomed/ HTM Document Database p.18 Department of the Month: The Cook Children’s Health Care System Clinical Engineering Department p.20 Biomed Adventures: Writing and Consulting; HTM Phase II P.25 p.25 p.26 p.30 p.32 p.34

INDUSTRY UPDATES Welcome to the TechNation Community News & Notes Ribbon Cutting: KWIPPED AAMI Update ECRI Institute Update

P.37 p.37 p.38 p.40 p.43

THE BENCH Biomed 101 Webinar Wednesday Shop Talk Tools of the Trade

P.58 EXPERT ADVICE p.58 Ultrasound Expert

Sponsored by Avante Health Solutions p.61 Career Center p.62 The Future p.64 20/20 Imaging Insights

Sponsored by Innovatus Imaging p.66 Cybersecurity p.69 The Other Side p.71 Roman Review P.72 BREAKROOM p.72 Did You Know? p.74 The Vault p.77 Scrapbook: HTM Week Contest p.78 MedWrench: Bulletin Board p.80 Service Index p.85 Alphabetical Index p.86 Flashback Like us on Facebook, www.facebook.com/TechNationMag Follow us on Twitter, twitter.com/TechNationMag WWW.1TECHNATION.COM

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Charlotte Threlkeld, BMET1: Acting on Good Advice

BY K. RICHARD DOUGLAS

A

bout 32 miles north of Dallas, in northeast Texas, is the city of McKinney. It is part of the Dallas-Fort Worth metroplex.

One of the health care facilities serving the city’s 164,000 residents is Baylor Scott & White (BSW) Medical Center - McKinney.

The medical center is a full-service hospital.

Charlotte Threlkeld, BMET 1, works in the healthcare technology management department for BSW in McKinney. However, she had her sights set on a different occupation when she finished high school about two hours southwest of McKinney.

“I graduated from Valley Mills High School and started in game programming, and two semesters in, realized that I couldn’t sit behind a computer the rest of my life. I left college and began working at Home Depot,” Threlkeld says.

“During this time, I did a lot of volunteer work. I volunteered with the band boosters at Valley Mills High School. A family friend was in the biomed program and she always talked about how much she enjoyed the field. I took a tour of the program. I knew when I took the tour that this was my calling. I’ve been in love with the biomed field ever since,” Threlkeld adds.

Threlkeld graduated from Texas State Technical College (TSTC) with an associate of applied science-biomedical equipment technology in April of 2017.

“I am the OR biomed for Baylor Scott & White Medical Center-McKinney. I take

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JULY 2019

care of all PMs and repairs in the OR. I also specialize in Fresenius Dialysis and Vyaire Avea, ventilator,” Threlkeld says.

BAPTISM BY FIRE On-the-job challenges can often serve as the best teaching experiences and Threlkeld learned that first-hand.

“I have overcome my shy nature by working within a hospital. When I was hired on to Baylor Scott & White Health, I told Carol Wyatt, my director, that I wanted to become a manager sometime in the future and that I wanted to be the OR tech. Most OR techs are BMET II, which is about three years of experience or more,” Threlkeld says.

“I started with Baylor Scott & White Health in May 2017 fresh out of TSTC. In August 2017, Carol moved me to the McKinney campus to be the OR tech. I was also back-filling one of the best techs at Baylor Scott & White Health. It was a huge learning curve to adjust to the needs of an OR. I was not ready for it at all. After a few ‘come to Jesus’ meetings with the OR management, I understood what they needed from me. It made me a better tech to have to step up to the plate like that.

Looking back, I wouldn’t change it for the world,” Threlkeld adds.

She says that Wyatt and James Swandol, her manager, recommended her for BSW’s Professional Development Fellowship (PDF) class.

“This was a class designed to help employees develop skills and [the] mindset that is needed to become a successful

manager. The PDF was a nine-month long class including a four-hour monthly meeting, reading assignments, written reports and a capstone project that I presented at the graduation. I also, during this time, would listen to leadership-based videos on YouTube to further my understanding of the topics covered in class,” Threlkeld says.

She says that for her capstone, she created an online guide for the biomeds within Baylor Scott & White Health.

“I made the guide because when I first started my career, it was hard for me to send equipment out for repair, as I was not familiar with what vendor repaired what equipment. I also found it hard to find vendors that sold things like light bulbs and video cables. I started with the on-call notes given to me by James (Swandol). It was passwords, tips he had collected and info about the hospitals we covered during on-call as we cover seven hospitals,” Threlkeld says.

After this was completed, she collected the most common links in use, like their database link and time card link.

“Next, I collected data from different vendors that did flat rate repairs. I organized it by manufacturer, model and then vendor. This section is updated as needed as pricing does change from time to time. I moved on to the CBET study guide section afterwards,” she says.

“Scott Gillet, senior BMET, assisted me with this as he had taken the CBET within the last year. I placed all this info into OneNote. OneNote is a web-based system

WWW.1TECHNATION.COM

SPOTLIGHT Left: Charlotte Threlkeld is seen with manager James Swandol. Below: Charlotte Threlkeld made a quilt for her grandfather.

FAVORITE BOOK

“The One-Minute Manager” by Kenneth Blanchard and Spencer Johnson

FAVORITE MOVIE

“Beauty and the Beast” (Live Action)

FAVORITE FOOD

Pizza; I will literally eat it for every meal.

HIDDEN TALENT

Sewing quilts. It was a skill passed on to me from my great-grandma Charlotte.

FAVORITE PART OF BEING A BIOMED

I get to help those in need and make a difference in the world.

WHAT’S ON MY BENCH • • • •

Bubble gum 4-in-1 screwdriver Stress ball Chocolate candy (M&Ms, Mr. Goodbar, Kisses, etc.)

• “To do” List

that allows the user to access it at any location. I was able to share the OneNote with every biomed within Baylor Scott & White. This meant that every biomed could use this [despite] whatever campus they may be at,” Threlkeld adds.

She says that one of the challenges that she faced was simply gathering the information, especially since other obligations could not be put on hold.

“Most of the information I needed was in different locations within Baylor Scott & White Health. It was like herding cattle from the field into a barn. I also found it challenging to balance the everyday work with this project. We had a network upgrade that I spent 7 p.m. to 7 a.m. assisting, then verifying that all my medical equipment connected successful to the network again,” Threlkeld says.

Another project that Threlkeld was involved with was a Philips upgrade.

“We upgraded half of our tele from Philips Classic to IX. Most of the tele that was on Classic was tele boxes and not bedsides. We had to coordinate with hospital staff and Philips throughout each step. We are currently replacing all of our asset tags with the new style. Hunting down over 5,000 pieces of equipment is harder than it sounds,” she says.

Threlkeld says that one of the greatest

assets she has had has been her manager; James Swandol.

“James was a senior tech at Carrollton before he became my manager. I had only been a biomed for about five months when he became the manager, so I was still pretty green. He has been a well of knowledge and guidance. James has this amazing talent of driving people to be their best tech. He doesn’t allow his techs to settle for just OK. If it’s not the best it can be, then he has us working to make it better. I know I don’t say this enough but thank you James for all you’ve done for me and all you continue to do for me,” she says.

Apparently, the guidance and expectations have paid off. Threlkeld won a 5-Star Spirit award for taking call for a sick tech. She has also received several EnCore Awards for different repairs or on-call assistance.

AWAY FROM WORK Threlkeld’s approach to work and life comes from her parents.

“When I was little, my mom worked days as a manager in a computer company.

My dad stayed at home with my sister and I during the day, then would work nights at the police department. They taught me what it means to be a team. They have been together for 40 years now and they are

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

proof that the best things in life are a lot of work, but always worth it in the end,” she says.

She says that her mom taught her how to be strong and independent.

“My father taught me to help and protect others through his 23 years as a police officer. They taught me to love who I am and that if I didn’t like something about the world or myself to go out and change it.

Without them, I wouldn’t be the person I am. My younger sister is currently enrolled in the biomed program at TSTC,” Threlkeld says.

As a pastime, Threlkeld enjoys sewing and making quilts. She had taken a break from sewing after taking some courses in it when she was younger.

“I started back up when my grandpa got sick with Alzheimer’s. Grandpa was always kind and gave endless love to our family. He was always a prankster and he always had a young heart. He was an amazing man. He was related through marriage and not by blood. I made him a purple and green quilt for his birthday. His face lit up when he saw it for the first time. He was like a kid in a candy store. Of all the awards and accomplishments I’ve made, seeing grandpa’s face lit up was the best by far and I’ve had awards from Homeland Security and DPS. He didn’t always remember who made it for him, but you couldn’t get it away from him,” Threlkeld says.

Threlkeld is still happy about her decision to go the HTM route.

“No matter what challenges I may face, there isn’t another job in the world I’d rather be doing,” she says.

With the right outlook on life and work, and a focus on making it into management, this BMET 1 is certainly going places.

JULY 2019

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

oneSOURCE: A Technology Solution for Managing Critical Biomed Equipment Information

COMPANY SHOWCASE

THE ONESOURCE BIOMED/ HTM DOCUMENT DATABASE The Most Complete Online Collection of Manufacturers’ Biomedical Equipment Maintenance Documents

W

ith oneSOURCE’s Biomedical Database, Biomedical Equipment Technicians (BMETs) and engineers will spend far less time and energy obtaining, verifying and managing biomedical equipment preventive maintenance (PM) and related documents. Instead, they’ll be able to focus on their true mission – efficiently repairing and maintaining this equipment to promote optimal patient care and safety.

“ The oneSOURCE Biomed Database is very helpful to our clinical team. The oneSOURCE interface with AIMS is a huge time saver for our technicians.

We don’t have to search at our site or request manuals from the manufacturer. All the data we need for compliance is there at a click of the mouse.”

DATA INTEGRITY TEAM MANAGER, ONESOURCE CLIENT

THE ONESOURCE BIOMEDICAL DATABASE: SAVING TIME. PROMOTING COMPLIANCE. PROTECTING PATIENTS. BMETs will have 24/7 access to service and PM manuals/documentation from thousands of manufacturers. The database is continually expanding as 14

TECHNATION

JULY 2019

our team obtains new and updated material on behalf of our customers.

With this kind of critical information at their fingertips, BMETs and engineers can quickly refer to the most recent information about the complex biomedical equipment in their care –

information related to: • Maintenance • PM frequency • Testing • Parts breakdowns • Troubleshooting • End of life equipment documentation • Repair Facilities also can use the Biomedical Database to securely store their alternative equipment maintenance (AEM) program guidelines or the manufacturer documents they’ve purchased, making this a secure, customized repository for all their biomedical equipment maintenance information.

No more central storage headaches. No more time spent contacting manufacturers for manuals and updates. It’s all online, ready for review or download.

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SPOTLIGHT

• Center for Improvement in Healthcare Quality (CIHQ) • Occupational Safety & Health Administration (OSHA)

USER-FRIENDLY FEATURES The database interface is carefully designed with intuitive user features and functionality.

• Search by model number, manufacturer or equipment description • Maintain lists of frequently/ recently used documents for even quicker access • Establish favorites lists • Sort by technician, equipment type, maintenance schedule and other fields • Enter notes and customized instructions that will be shared throughout the facility • Click on the Table of Contents links in the manuals to go directly to that section • Access summaries of the pertinent cleaning, decontamination, assembly and sterilization information contained in the original documents • Download material from the database in Adobe files for emailing and printing • Interface with CMMS companies such as AIMS®, HEMS/EQ2, MaintenanceFirst™ and MediMizer.

Major hospitals such as Trinity, Mayo Clinic and New York Presbyterian Health Systems subscribe to the oneSOURCE Biomedical Document Database to support their BMETs and protect their patients.

We work with each customer, large and small, to customize their database’s content and features. One subscription provides access to BMETs, engineers and other users throughout the facility.

PROMOTING COMPLIANCE Adhering to manufacturers’ preventive maintenance guidelines, and documenting your technicians’ ready access to this information, can be a key element in meeting the compliance, certification and professional standards established by organizations such as: • Centers for Medicare and Medicaid Services (CMS) • The Joint Commission (TJC) • Joint Commission International (JCI) • Accreditation Association for Ambulatory Healthcare (AAAHC) • Association for Advancement of Medical Instrumentation (AAMI) • Det Norske Veritas Healthcare (DNV)

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

PARTNERSHIP WITH MANUFACTURERS More and more manufacturers are seeing the value of working with oneSOURCE to efficiently provide new and updated biomedical equipment documentation to their customers.

We upload their documents exactly as we receive them. Manufacturers have complete control of their information, working through their own secure portal to verify and review their material.

If you’d like to manage your critical responsibilities more efficiently with 24/7 access to the oneSOURCE Biomedical Document Database, please contact us at 800-701-3560. For information on a free webinar, you can email us at contact@ onesourcedocs.com.

ABOUT US Formed in 2009, oneSOURCE Document Management Services also offers these other ISO-9001:2015registered database services: • Surgical Instruments & Equipment – IFUs for reusable instruments, devices and equipment • Tissue & Implant – IFUs for biologic and nonbiologic tissue, devices and other material • Dental – IFUs and SDS/MSDS sheets for reusable dental equipment and consumables At oneSOURCE, we work with outstanding BMETs every day – from our own employees who manage this document service to the facility-based professionals who use this information every day.

COMING SOON

The Facilities Maintenance Database, with manufacturers’ service manuals for non-medical equipment and systems used in healthcare facilities.

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TECHNATION

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SPOTLIGHT Members of the Cook Children’s Health Care System Clinical Engineering Department include Asset Manager/ Contract Administrator Rebecca Vega, Work Control Technician Catina Hendrix, and Michael Porter BMET I.

DEPARTMENT OF THE MONTH The Cook Children’s Health Care System Clinical Engineering Department

BY K. RICHARD DOUGLAS

C

ook Children’s is a not-for-profit Health Care System based in Fort Worth, Texas. It is one of the largest freestanding pediatric health care systems in the country. In addition to a medical center, it includes pediatric offices, specialty clinics, urgent care clinics and surgery centers.

More than 100 years ago, Cook Children’s started as a 30-bed hospital in Fort Worth.

Today, Cook Children’s has more than 1 million patient encounters each year.

The health care system offers locations across the state of Texas with primary service areas focused on Denton, Hood, Johnson, Parker, Tarrant and Wise counties.

The large health care provider requires a precision team to maintain and repair medical equipment and the clinical engineering department at Cook Children’s

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Health Care System answers the call.

The team is led by Director Salvador “Sal” Cruz, CBET. Leo Velasquez, CBET, is the team’s operations manager. Rebecca Vega serves as the asset manager/contract administrator. Catina Hendrix is the work control technician.

The department is divided into several teams; general biomed, radiology team, surgery team, electronics team and central equipment team. There are 26 biomeds and lead technicians among the five groups.

“We perform all of the standard CE/ HTM medical equipment management jobs and duties. Our HTM teams are split into five different teams,” Cruz says.

He says that the seven-member general biomed team handles all the patient room and general biomed equipment areas including NICU, PICU, CVICU medical/ surgery, hematology/oncology, psychiatry, physical therapy and emergency departments.

“Additionally, we service the medical equipment for our Teddy Bear Transport of ambulances, fixed wing jets and helicopters,” Cruz adds.

Cruz says that the surgery team is a dedicated three-man team covering all the surgical, peri and post-operative equipment for 25 surgical suites and two CVORs and four GI/special procedure suites. “[The] radiology/imaging team is a three-member team managing the service for all the imaging equipment both onsite and off-campus. Modalities include MRI, CT, radiology, ultrasound, cath lab, interventional and echo/stress lab equipment,” Cruz says.

The electronics team is specialized to maintain specialty electronics systems such as nurse call, audio video systems, gaming systems and special effects systems in place around the hospital. This team also repairs beds, cribs and stretchers.

It takes this diverse team of HTM

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SPOTLIGHT

professionals to handle the vast amount of medical equipment in the health care system’s inventory.

“Cook Children’s Medical Center is one of the largest children’s hospitals in the nation, covering more than 530,000 square feet with 430 licensed beds. Our professional staff of nurses, technologists, therapists and other clinicians work alongside more than 500 physicians and dentists who provide primary, secondary, tertiary and quaternary levels of pediatric care,” Cruz says.

There are also specialty clinics, an ear, nose and throat center as well as five standalone urgent care centers in Fort Worth, Hurst, Alliance, Mansfield and Southlake.

What is the team’s integration with IT look like?

“We work with a special Epic integration team to migrate the physio data from selected medical devices into the patient EMR,” Cruz says.

“Our team is currently responsible for integrating our Philips physio monitoring, anesthesia, NIRS monitoring and ventilators into the patient electronic medical record,” he adds.

equipment is tracked and removed from service when no longer needed and returned to the vendor. The RTLS program is a valuable tool that makes the central equipment team highly effective and efficient with managing these assets,” Cruz adds.

In addition to special projects, the group has accommodated a growing workload and facility expansion.

“Over the last four years, the hospital has doubled in both physical size and bed count. Among the areas that were added are completely new surgery, CVOR, cath lab, cardiovascular ICU, cardiac stepdown unit, emergency department, laboratory and GI/special procedures area. Each unit posed their own set of special needs to be addressed at the last minute,” Cruz says.

He says that the CE department worked around the clock to complete installations, modify work areas, install equipment, run specialty cabling and power in order to make sure that all areas were opened on time and completely functional.

“This was an intense period of activity and the team was fully up to the task,” he says.

“The hospital is now expanding again to build another hospital over the next two years in adjoining communities and we are already gearing up to assist in these projects as well,” Cruz adds.

Cruz says another project the team undertook was helping the bone marrow transplant department and the hematology/ oncology departments get in-room gaming with new Xbox 1 and PS4 units in each room.

“This project entailed set-up and wiring to make these games available in order to cheer up and help occupy those kids who will be hospital-bound for extended periods of time,” Cruz adds.

The pediatric patients in Fort Worth, Texas may be aware that there are clinicians trying to make them well again, but what is equally important, is that there is a team of biomeds who are focused on making those kids well too.

Steve Garcia, CBET, serves as a BMET III and Imaging Team Lead

SOLVING PROBLEMS AND SPECIAL PROJECTS The CE team recently took steps to be aware of the location of its inventory.

“Our department has taken the lead for implementing and administering an asset tracking system and is in the process of tagging medical equipment with Real Time Location System (RTLS) tags. We currently have all of our Alaris pump infusion fleet tracked on the RTLS tracking system. All of the central equipment devices used in our facility are tracked with RTLS as well,” Cruz says.

He says Philips MP30 monitors, specialty beds, shower chairs, bariatric chairs, Stryker Mistral air warmers, SCDs, T-Pumps and rental equipment are also tracked.

“The system allows our central equipment team to properly deliver medical equipment to the floors when needed.

Recovering equipment for recalls, disinfecting, cleaning and reissue is the key for great patient outcomes. Since implementing the RTLS process, rental

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

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19

SPOTLIGHT

BIOMED ADVENTURES Writing and Consulting; HTM Phase II

BY K. RICHARD DOUGLAS

A

fter working in leadership for a major health system, one HTM professional discovered that there can be a second phase to a biomed career.

business, http://BraeutigamEnterprises. com, that goes into detail on all of these areas,” he says.

Braeutigam says that going solo continues to have its ups and downs.

“You are responsible for developing your website, your business cards, David W. Braeutigam, president of developing a logo for your business, your Braeutigam Enterprises LLC in brochures, paying for conferences and Arlington, Texas, has parlayed his years memberships, and finding customers that of HTM knowledge and a love for could use your expertise. It is a slow writing into a fulfilling calling. process and you always have to be looking “I decided to start a consulting for new business when you finish projects,” company to utilize my many he explains. years of experience in the He says that he has decided HTM field. Not knowing to write a book on how to be an how to consult or how to HTM consultant. start a business, I bought “I’ve had numerous people numerous books on the approach me at conferences to subject. Those books, along ask me how to get into with talking with other consulting. So, I think the book consultants, helped me start can help those looking for a new my business. My local career change. I have several consulting friends people reviewing it now, so I David W. Braeutigam recommended an attorney hope to have it done in a couple and a CPA for my business. of months,” Braeutigam says.

They are the ones who walked me through To stay current on information for his the process of getting the tax identification business, he attends AAMI and MD Expo and set up with the government,” conferences and joined several Braeutigam says. organizations such as The Joint He says that he does consulting for Commission, ACCE, ACHE and ASHE. hospitals, businesses and AAMI on topics He also reads numerous magazines and such as leadership development, regulatory articles that cover the HTM field. compliance, staffing analysis, budget “I stay active with our local HTM design and analysis, benchmarking, organization and speak at the conferences equipment assessment, strategic planning, when I can. I also sit on several committees cost analysis and contract analysis. with AAMI so that helps me network and “I developed a website just for my stay on top of the latest issues and

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concerns. I also stay in contact with other consultants and HTM leaders to share ideas and expertise. It has really been a life changer from working a typical corporate job and the benefits of the flexibility to set my hours has allowed me the extra time to write,” he adds.

TALES FROM THE TRENCHES In 2017, Braeutigam published his book “Tales of the Biomed: A Collection of short stories from biomed techs from around the world as told to the author.”

He also started a companion website to the book; TalesoftheBiomed.com.

“We all have stories we like to tell at conferences, at parties and at work about our field. I especially like the funny stories and decided I should write a book about it,” Braeutigam says.

“I contacted lots of my friends and they added to my stories in the book. I was on LinkedIn one day and saw a posting of a funny sticky note attached to a piece of equipment. I had forgotten that everyone gets these notes on their equipment. So, I went about contacting others to share those funny sticky notes and added it to my book, Tales of the Biomed,” Braeutigam adds.

How does someone add “author” to their repertoire of skills after several years in the HTM profession?

“I love to read and I read a book several

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SPOTLIGHT Opposite Page: David W. Braeutigam has written several books. Left: Biomeds shared funny sticky notes they have encountered for the book “Tales of the Biomed.”

years ago about funny stories that reporters could not tell during WWII. After I read that book, I decided to do the same with the biomed ‘war’ stories we all have,” Braeutigam says.

“I have also published (self-published) two books on World War II. One book is on my second-cousin, SSG Elgin Luckenbach, who was missing in action in the Pacific in April 1944. They found his plane in 2002 and, after recovery and identification; he and his crewmates were buried in the United States in 2006,” he says.

Braeutigam shared the story with friends and they were insistent that he write a book about it.

“During the research of that book, I came across a diary of a first-Lieutenant who was a bombardier in the same outfit as my second-cousin. I got permission from the family to publish the book and just finished it in April of this year,” he says.

Publishing a book can be a complex, involved process that relies on publishing companies, literary agents, illustrators and marketing campaigns. Braeutigam did his homework and chose the road of least resistance.

“I researched the Internet for lots of ways to publish books. Most are expensive and involve purchasing lots of inventory.

Amazon has a self-publishing company and you write the book, develop the cover and upload it to them for publishing. They tell you the minimum price to charge and you decide if it is just for the United States or everywhere. You select the paper, design the cover and determine if you would like to print in black and white or color. They

assign the ISBN to the book also. You do not purchase inventory — unless you want to have books to sell at conferences — since the books are print on demand. If you never sell a book you are only out the time and effort you put into writing the book. There is no inventory to be concerned with,” Braeutigam explains.

He says that beyond this, he did have to go online to determine how to lay a book out with page numbering, developing a table of contents, inserting references, etcetera.

“I also looked at lots of books for examples of the layout,” he says.

Braeutigam says that another important factor, when self-publishing, is to selfpromote.

“I created a webpage for my books https://BraeutigamPublishing.com for a central place to see what books I have completed and others I am working on. I even ‘advertise’ what conferences I will be at so I can bring books to sell and sign. I usually give a book away anytime I speak at a conference. I have also created Facebook pages for my books and post on several Facebook pages that are of special interest,” he says.

Braeutigam says that he created a webpage so people can send funny stories, amazing stories and funny pictures for future books, (http:// TalesOfTheBiomed.com).

“I even designed a business card to hand out at AAMI and MD Expo so people have a way of easily contacting me to have their stories or pictures featured in a new book. A good friend of ours developed the logo,” he says.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

PROJECTS ON THE HORIZON “I also enjoy researching and writing about the 408th Bomb Squadron during World War II. During my research on the book about my cousin, I determined my wife’s second-cousin’s husband was the navigator on the same plane as my 2nd cousin that crashed. What are the odds of that?” Braeutigam asks.

He says that he recently found out that the day his second-cousin went down in the New Guinea jungle, that about 35-50 other planes went missing along with the men.

“They called it ‘Black Sunday.’ Some have been found, but most are still missing. I found a plane that was flying next to my second-cousin’s plane, which was damaged by the storm they encountered, so the men parachuted from 18,000 feet into the jungle. Of the 10 men that jumped, eight men made it out alive.

One took almost a month to get out. That is my next book to write on the 408th.

That is another amazing story,” Braeutigam says.

Writing and consulting aren’t enough for Braeutigam. He is thinking of adding another line of business.

“I have almost thought that maybe I should start a company to develop websites. I do the one for our local HTM group, my family history, my consulting business, my publishing company, the one for ‘Tales of the Biomed’ and I am working on one for my brother-in-law on his new energy consulting business,” he says.

Has writing books revealed anything about the HTM profession to Braeutigam?

“I guess writing the book helped me realize how many funny things happen in our field. But, of course, we have our share of ‘hero’ moments when the BMET or CE comes in and saves the day. That is another book I am working on that will highlight the incredible stories of HTM. I have decided to call it ‘Incredible Tales of the Biomed,’” he says.

There is life after the more traditional work of a biomed system director. The HTM field offers a part deux for those willing to use their resources.

JULY 2019

TECHNATION

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TECHNATION COMMUNITY! AGILITI Q: CAN YOU SHARE SOME INFORMATION ABOUT AGILITI? A: Every day, we work side-by-side with clinicians, biomeds, supply chain experts and health care executives in over 7,000 health care facilities across the country. In every hospital, we see our customers looking for new ways to lower their cost of care while improving patient safety and outcomes.

Facilities like to hone in on medical equipment to solve these challenges.

Typically, the main focus is on getting the best purchase, rental or service price for the equipment. What we don’t see is a focus on the entire end-to-end equipment management process, and the impact it can have on things like utilization, equipment availability, technician productivity and the cost burden of maintaining equipment over its life cycle. These inefficient processes can cost hospitals millions of dollars and tens of thousands of wasted hours.

At Agiliti, our focus is on working

closely with our customers to recapture wasted cost and time by rethinking equipment workflows – and establishing how much equipment they actually need to meet patient volumes. When done right, they need a lot less equipment than they own today.

The key to this is partnering with HTM teams – who are often understaffed and overburdened with non-value-added work – to reduce the cost of service through flexible clinical engineering programs. At the same time, we work with supply chain teams to improve utilization of the equipment they own and align their equipment mix with patient volumes. This ultimately frees up nurses to spend more time with patients by ensuring they can quickly access essential equipment – exactly when it’s needed.

Combined, this process cuts out waste and variation in the equipment management process, resulting in lower overall costs and more efficient operations.

Q: WHAT IS THE BIGGEST THING THAT MAKES AGILITI DIFFERENT THAN OTHER INDEPENDENT SERVICE ORGANIZATIONS (ISOs)?

A: Success in this industry is all about people – talented, committed and experienced teammates who function as an extension of the staff in the hospitals we serve. Biomed talent, for example, is becoming harder for hospitals to identify, hire and retain. Yet, HTM teams are being asked to do more than ever. They’re not just repairing devices.

They’re making critical technology recommendations, managing capital service plans and integrating softwareenabled devices.

To help our customers address these challenges, we’ve developed a workforce of highly trained, experienced biomed professionals and made them readily accessible in our 86 local service centers across the U.S. Our local market availability ensures that our customers have quick access to the technical talent they need. •

KWIPPED also delivers a steady stream of online equipment demand to its network of qualified suppliers.

Uber, Airbnb), has transformed a tedious, timeconsuming equipment sourcing Robin Salter process that once Chief Marketing Officer took days or weeks into a simple online task that can be completed in minutes. More simply, there are businesses that need equipment and suppliers that have equipment and we’ve developed the online platform to empower them to find each other and do business together…with extreme efficiency.

KWIPPED Q: TELL US ABOUT YOUR COMPANY. A: KWIPPED is an online B2B equipment marketplace where businesses can rent, lease or buy a vast range of equipment from a global network of thousands of equipment suppliers. KWIPPED customers submit a single Request for Quote (RFQ) and receive multiple quotes from competing suppliers. By aggregating supply on a single website, KWIPPED enables businesses to gather and compare competitive rental, lease/financing and purchase options and make smart business decisions with unprecedented efficiency.

Q: WHAT IS THE ONE QUALITY THAT DIFFERENTIATES YOUR COMPANY? A: Innovation. Equipment sourcing and procurement are not new business functions, but the methodology for matching supply and demand and facilitating transactions has been slow to evolve and leverage today’s technology.

KWIPPED technology, combined with the proven marketplace model (i.e. Amazon,

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

JULY 2019

TECHNATION

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INDUSTRY UPDATES

NEWS & NOTES

Updates from the HTM Industry STAFF REPORTS

NEW ESU-2400 SERIES AUTOSEQUENCE AVAILABLE FOR COVIDIEN FX8 Testing with the ESU-2400 and ESU2400H just got easier! The new FX8 User Triggered Autosequence is now available for the ESU-2400 Series. With the FX8 Autosequence, users can save time on preventive maintenance procedures through the automated testing built into the autosequence.

Simply download from the online store onto your ESU-2400/H and follow along with the autosequence steps as shown on

the ESU-2400/H, according to a press release.

The new autosequence requires the BC20-03050 Footswitch Port Adapter. The BC2003050 is used to adapt the footswitch port adapter to a standard fourmillimeter safety jack cable that comes with the standard accessory kit for BC Biomedical ESU analyzers.

IMT ANALYTICS AG CELEBRATES MILESTONE On May 1, 2019, Switzerlandbased IMT Analytics AG celebrated its first birthday. It has been a year since it took over imtmedical ag’s measuring device and test lung business aimed at medical technicians.

The young enterprise has recorded successful figures for the first four months of this year.

Sales increased year on year by 8% to $2.9 million, while sales of test lungs also rose, as did the number of measuring device calibrations according to standard ISO 17025.

IMT Analytics has continually invested in the development of its measuring devices. For the mobile gas flow analyzer CITREX H5, additional test sequences have been integrated.

“This way, respirators and anesthesia machines can be tested more quickly and with greater certainty. Following on from Phillips-Respironics and Vyaire,

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close collaborations with further globally operating respirator manufacturers were agreed in the first quarter of 2019,” according to a press release.

“IMT Analytics AG is speeding up the expansion of its measuring device calibration locations. The annual calibrations need to be carried out as quickly and cost-effectively as possible, hence the Singapore location will begin operations to the benefit of Asian customers in the third quarter of 2019,” the release added. •

Users can download the autosequence for free from BC Group’s online store under the more details tab for the ESU-2400 or ESU-2400H, at BCGroupStore.com/Biomedical-BC_ Biomedical_ESU-2400H.aspx. •

SAGER ELECTRONICS AND POWER SONIC SIGN DISTRIBUTION AGREEMENT Sager Electronics, a North American distributor of Interconnect, Power and Electromechanical components and provider of value-add solutions, and Power Sonic, a leader in battery technology for nearly 50 years, have announced a distribution partnership.

“Sager Electronics’ specialized group, Sager Power Systems, is a perfect fit for the Power Sonic portfolio.

Their focus on power and thermal solutions with a highly experienced team of power systems engineers, field sales representatives and a dedicated inside sales organization across North America will provide our customers the application expertise and delivery execution needed in today’s competitive market,” Power Sonic Battery Division President Brian D. Crowe said.

“We are very pleased to be aligned with this world-class operation and the people that sustain Sager’s stellar and long-standing reputation in the market.”

“The addition of Power Sonic into our power and thermal program expands our ability to provide customers with world-class battery solutions, including sealed lead acid and lithium iron phosphate batteries, for their unique application demands,” said Paul Kopp, director, supplier marketing and product management at Sager Electronics. “As a leader in innovative battery solutions, Power Sonic is a natural complement to our IP&E line card.” •

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INDUSTRY UPDATES

US MED-EQUIP ACQUIRES MEDICAL SUPPORT PRODUCTS Houston-headquartered US Med-Equip has acquired Medical Support Products.

The acquisition will accelerate US Med-Equip’s national expansion and bolster its capability to provide services to a larger footprint of hospital providers.

“US Med-Equip partners with top hospitals across the nation to collectively provide more than 35,000 of the highest quality equipment – including respiratory, neonatal, infusion and other devices – to improve patients’ health. The Medical Support Products acquisition marks a planned $100 million investment over the next five years in US Med-Equip’s growing movable medical equipment fleet value and technology to support it,” according to a press release.

Lancaster, Pennsylvania-based Medical

Support Products is a provider of hospital respiratory device sales, movable medical equipment rentals and biomedical repair services to hospitals and long-term acute care centers in the Northeastern U.S. “Medical Support Products’ team shares US Med-Equip’s mission to provide the best devices to support hospital and homecare partners in their life-saving work,” US Med-Equip Co-Founder and Chief Development Officer Greg Salario said.

Medical Support Products’ headquarters will serve as US MedEquip’s Northeast hub, its 30th facility to support an expanding number of hospital partners across the nation.

“US Med-Equip’s company culture is driven by their leadership and employees’ shared purpose to support

the important work health care providers do every day to help patients heal. We couldn’t be more excited to be a part of this extraordinarily committed team,” said Nelson Shertzer, Medical Support Products founder and CEO. “As part of the US Med-Equip family, we are significantly expanding our infrastructure, technology, resources and health care solutions – all to do more for health care providers who entrust us to support them and patients in their care.”

“We’re excited to welcome Medical Support Products’ dedicated team and together help hospital systems and the purchasing organizations which support them set patients on the road to recovery,” US Med-Equip President Gurmit Singh Bhatia said. •

Doctor is Buying Medical equipment and disposition is the cornerstone of our business. We purchase medical equipment that is no longer being used from hospitals, surgery centers and third-party providers, offering comprehensive documentation and full disclosure of how the equipment is to be distributed.

The Doctor is in, and Buying. Buying@MedicalEquipDoc.com

2749 East Regal Park Drive • Anaheim, California 92806 • 800-285-9918 • medicalequipdoc.com

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

JULY 2019

TECHNATION

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INDUSTRY UPDATES

ACERTARA EXPANDS INTO NEW FACILITY

RIGEL LAUNCHES NEW DEFIBRILLATOR ANALYZER Rigel Medical has launched the UniPulse 400, an easy-to-use defibrillator analyzer with built-in pacer functionality designed to provide a comprehensive solution for quick and efficient testing.

Compatible with all defibrillators, the UniPulse 400 is built to display highly accurate results in exhaustive detail.

“A compact ergonomic design and rechargeable battery make the UniPulse 400 the ideal solution for busy engineers testing multiple machines on the go, while Rigel’s Med-eBase software allows results to be downloaded quickly via USB,” according to a press release.

The UniPulse 400 also features

an easy-to-use interface with intuitive navigation and dedicated fast keys to ensure a seamless user experience – with an LCD screen displaying clear and detailed results.

“The UniPulse 400 is our most comprehensive and advanced defibrillator analyzer to date. We know time and efficiency is a key issue for our customers – and we’ve designed the UniPulse with this in mind. Features like instant digital results transfer and user-friendly navigation allow busy engineers to work efficiently without compromising on accuracy,” Michael Walton, category manager at Rigel Medical, said. •

Acertara Acoustic Laboratories, an independent ISO/IEC 17025:2005 accredited medical ultrasound acoustic measurement, testing, and calibration laboratory, and ISO 13485:2016 certified probe repair and new product development company announced the completion of its Acertara-owned facility and relocation of its headquarters.

“We are very excited to bring Acertara to the next level with our new headquarters,” Acertara CEO G. Wayne Moore said. “The new facility gives us the room to expand our operations and introduce new products to the market. Furthermore, it was important to complement Acertara’s position as a privately-held business by building a facility we own so we could provide our customers with further flexibility and support assurances in what has recently become a volatile market.”

Acertara operations were opened in Longmont, Colorado in late June 2011 by industry veterans G. Wayne Moore and James Gessert, who previously founded Sonora Medical Systems. The Acertara team are pioneers in Quality Assurance Test Products and are widely viewed as the creators of the worldwide third-party ultrasound market including the modern probe repair paradigm, according to a press release. •

HTM INDUSTRY VETERAN DAVID FRANCOEUR JOINS TECH KNOWLEDGE ASSOCIATES David Francoeur has joined Tech Knowledge Associates (TKA) as senior vice president of marketing and sales.

Francoeur’s technology and leadership roles in clinical engineering and health care industries span 30 years.

He most recently served as senior corporate director of brand & quality of clinical technology management for Sodexo in Brentwood, Tennessee, where he built the CTM corporate infrastructure for Sodexo leadership.

Previous to this role, Francoeur served as

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regional vice president of healthcare technology solutions for Crothall Healthcare in Charlotte, North Carolina. He also served in leadership roles for CREST Services; ARAMARK; TriMedx; Fisher Consulting; Baystate Health Systems; and Contraves Medical Instruments.

“We are excited to have this industry expert onboard,” said George Hampton, president of TKA. “David brings a wealth of experience to our TKA team, with a broad background in healthcare technology management, having worked for many of our competitors, from TriMedx to Crothall.”

In addition, Francoeur has served on multiple boards and governing agencies in the HTM industry, and is currently a director on the board of the Association for the Advancement of Medical Instrumentation (AAMI).

Francoeur lives in the Nashville area, where he says he plans to strongly boost TKA’s presence through marketing efforts throughout the middle of the country.

“David has the talent and background we need to carry out TKA’s growth goals and marketing focus across the U.S. We welcome him as part of our leadership team,” said Joe Randolph, president and CEO, The Innovation Institute.

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EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

JULY 2019

TECHNATION

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INDUSTRY UPDATES

RIBBON CUTTING KWIPPED

R

obert Preville, CEO and founder of KWIPPED, is an entrepreneur at heart. “I’m passionate about solving business problems with smart, tech-driven solutions,” said Preville.

During the development of his last two start-ups, a major business problem, or opportunity, presented itself to him.

“Practically every business and profession, across every industry, requires some kind of equipment to produce and deliver their products and services. In fact, many businesses and professionals simply couldn’t perform their jobs without the proper equipment.

But, equipment is often expensive, eventually breaks down, needs servicing and quickly becomes obsolete as technology rapidly advances. Access to the right and best equipment is critical and constant for business success, but gaining access creates questions and challenges,” Preville said.

Preville began to wonder … what if we could leverage technology to develop a B2B equipment marketplace where businesses that need equipment can rent, lease or buy from a network of suppliers that have equipment? This idea became KWIPPED. KWIPPED is a two-sided online marketplace that facilitates B2B equipment rentals, leases and purchases across a wide range of industry verticals including: biotech and pharma, engineering, aerospace, environmental test, power utility, construction, restaurant and many more.

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“However, TechNation readers may be interested to know that medical equipment is among our largest, most active markets. I’d have to look at the data, but medical equipment may be our number one market today. Our medical customers include hospitals, health care organizations and private practitioners looking to rent, lease or buy medical equipment,” Preville stated.

TechNation found out more about KWIPPED through a question-andanswer session.

Q: WHAT IS THE MAIN FOCUS OF KWIPPED? A: Well, let me use an analogy or two to explain. There are people that need rides and people with cars willing to give rides, and Uber leveraged technology to connect them and facilitate transactions between them very efficiently. There are travelers looking for lodging and people with rooms available for lodging, and Airbnb leveraged technology to connect them and facilitate transactions between them – also very efficiently.

Furthermore, there are businesses that need medical equipment and medical supply businesses that have equipment, and KWIPPED is leveraging technology to connect them and facilitate transactions between them with unprecedented efficiency. So, to answer the question more directly, we are focused on delivering a very efficient way for businesses that need medical equipment to access it in the smartest possible way.

ROBERT PREVILLE CEO and founder of KWIPPED

Q: CAN YOU TELL US A LITTLE ABOUT THE SERVICES KWIPPED OFFERS? A: We’ve proactively sourced, vetted and recruited hundreds of reputable and reliable medical equipment suppliers, mostly in the U.S. and a few internationally, to join KWIPPED’s supplier network. Collectively, this network offers rentals, leases and purchases of virtually every make, model and category of medical equipment imaginable. Some of our suppliers offer rentals, others offer leases through KWIPPED’s special leasing program, and many offer rentals, leases and purchases. So, here is how the simple process works: 1. KWIPPED customers submit a single Request For Quote (RFQ) to rent, lease or buy a piece of medical equipment (they can also ask to compare rent-versus-lease-versus-buy quotes to help in their decision making).

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INDUSTRY UPDATES

WE BUY AND SELL PRE-OWNED MEDICAL IMAGING EQUIPMENT. TOSHIBA • GE • PHILIPS • SIEMENS AND MORE! 2. The RFQ is automatically sent to those KWIPPED medical equipment suppliers that can fulfill the request, and those suppliers are invited to return quotes to the customer through KWIPPED’s user-friendly platform.

3. Customers are notified as supplier quotes arrive and the customers can compare multiple quotes from competing suppliers, side-by-side and easily select the equipment solution and payment method that aligns best with their needs at that time.

KWIPPED’s platform provides an end-to-end solution that accounts for every aspect of rental, lease and purchase transactions including: rental scheduling, lease applications and approvals, shipping logistics, security deposits, payment management and customer service.

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Professional OF THE Month SPOTLIGHT

FAVORITE BOOK “The Romance of Photogen and Nycteris” by George MacDonald FAVORITE MOVIE “Blazing Saddles”

FAVORITE FOOD My wife’s Mulligatawny soup and pecan pie

Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT KWIPPED TO ACHIEVE IN THE NEAR FUTURE? A: The efficiency that KWIPPED delivers is particularly attractive to organizations that have frequent equipment needs. We have a goal to become the go-to resource for purchasing and procurement directors at organizations in the medical industry, such as hospitals, emergency clinics and other health care and medical facilities.

Ultimately, we want KWIPPED to be the most recognized and trusted brand in the medical equipment procurement industry.

FOR MORE INFORMATION, visit www.kwipped.com.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

HIDDEN TALENT Problem solving/troubleshooting ability Favorite part of being a biomed “The satisfaction of completing a repair and knowing that a patient will receive the care they need. I also like working with our interns to make sure they

SPOT

begin their careers off right.”

LIGHT

NAL ESSIO PROFHE MONTH ck OF T glio

WHAT’S ON MY BENCH? Coffee, my favorite soldering iron, a book of 19th and 20th Century paintings from the Art Institute of

We’d love to feature you or your colleague in one of TechNation’s monthly features! Send in your nomination for Professional of the Month!

Chicago, flash drives with equipment documentation and notes, my Day-

Timer to keep track of activities for documentation purposes

Nathan Burks enjoys being outdoors.

When not working on medical equipment, Gravel Grinder. seen participating in the Lowell 50

Above he is

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20

TION TECHNA

APRIL

My completed her first half marathon. son loves to play Minecraft and harass are our cats. The Toledo Metroparks of awesome, so you will find us at one says. them at least once a week,” Burks the For his efforts on the job, he won Shining Star, an award given to outstanding UTMC employees.

There’s little doubt why Burks was nominated for the award and to be that featured in TechNation; he proves when you set your sights on something, you can achieve it.

FEBRUARY 2018

TECHNATION

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1/5/18 11:19 AM

1

Think of a Biomed/CE Professional who deserves appreciation.

2

Visit 1technation.com/nominations and fill out the nomination form.

3

We will contact you for additional information if your nomination is accepted!

2018

SUBMIT YOUR NOMINATION Advancing the Biomedical/HTM Professional

JULY 2019

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INDUSTRY UPDATES

AAMI UPDATE

BY AAMI

AAMI OFFERS THREE NEW HTM RESOURCES AAMI has published three new resources for healthcare technology management (HTM) professionals to help enhance their careers and bring greater value to their organizations.

The BMET Study Guide is an indispensable resource for professionals preparing for the certified biomedical equipment technician (CBET) exam. The newly revised version features more than 100 additional questions that address new topics included in the latest version of the test.

The BMET Study Guide has evolved, said author Ethan Hertz, a clinical engineer at Duke University Health System, who has participated in the revision of the guide since the 1980s, and led the team that wrote the last two revisions.

Today’s study guide is much more than a quiz with questions and right answers. “Instead,” Hertz said, “it has become a true learning resource to help those preparing for the CBET exam – and a demonstration of AAMI’s continuing commitment both to maintaining a relevant CBET certification process and helping those interested in becoming certified by developing study materials that provide a good basis for reviewing material likely to be on the exam.” Hertz emphasized that a large team of question writers is responsible for the guide’s success. The study guide also has become much more comprehensive over the years. It started with about 150 questions in the early 1980s and now has more than 950 questions – almost six times as many questions as are on the exam.

The recently published Healthcare Technology Management Manual is the successor to the Medical Equipment Management Manual. Although previous editions, which were published under a different title, focused on regulatory compliance, the eighth edition covers “all aspects of running a successful HTM department,” from accreditation and standards to HTM operations, personnel, and services, according to author Al Gresch, vice president of client success at Accruent. “Financial pressures in health care today require greater business acumen and good people management concepts to be successful and bring maximum value to your organization,” Gresch said. “In addition to information about regulatory compliance, this edition also provides guidance on department operations and lays the foundation to achieve a higher level of financial and operational performance.”

In the not-too-distant past, acquisition decisions and processes rested with a limited group of participants, and the

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processes varied widely across health care organizations.

Today, there is a better understanding that technological systems interact within a larger, diverse ecosystem of people, practices, environments, and organizations, causing a shift in acquisition processes and strategies. AAMI’s new Acquisition Guide for Clinical Technology Equipment lays out seven stages and a set of concentrated activities in the acquisition process. It is intended to help organizations make optimum decisions that will serve them well throughout the equipment’s life cycle by taking a wide variety of stakeholders into consideration.

“The guide was written inclusive of all perspectives to encourage greater levels of collaboration,” said author and AAMI Board member Carol Davis-Smith, president of Carol Davis-Smith & Associates. “As such, the guide will support experienced clinicians along with HTM, facilities, IT, supply chain, and finance professionals to enhance support of their organization’s effort to acquire medical devices and systems more strategically and effectively. Additionally, new professionals will find the guide to be a comprehensive introduction to the acquisition process regardless of their position or organizational size.”

AAMI intends for the guide to serve as a baseline document for a future voluntary national standard on the acquisition of healthcare technology and would like to receive feedback on its content.

For more information about these resources, please visit the online AAMI Store at www.aami.org/store.

NEW MEMBERS SELECTED FOR HTM LEADERSHIP GROUPS AAMI has appointed new members to its Technology Management Council (TMC) and Healthcare Technology Leadership Committee (HTLC). The TMC represents thousands of biomedical equipment technicians (BMETs), clinical engineers and other professionals who manage and service medical technology around the world. The new members are: • Wesley Reid, CHTM, CBET, SEC, healthcare technology manager and Army service lead for the Department of Defense BMET Training Program at the Medical Education and Training Campus in San Antonio, Texas.

• Jojo Gonzales, CBET, CHTM, lead BMET at Kaiser Permanente San Diego Medical Center and the AAMI and GE Healthcare 2019 BMET of the Year.

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• Mark Manning, division chair of healthcare technology management at the Mayo Clinic in Rochester, Minnesota.

• Joseph Deater, CBET, BMET III at Munson Healthcare in Traverse City, Michigan, and adjunct instructor in biomedical engineering technologies at Northwestern Michigan College.

• Blake Collins, director of clinical engineering at Christiana Care Health System in Newark, Delaware, and adjunct lecturer at Indiana University-Purdue University Indianapolis (IUPUI) School of Engineering.

• Nader Hammoud, biomedical engineering manager at John Muir Health in Walnut Creek, California.

• Lucas Marsh, chief of healthcare technology management service at the Department of Veterans Affairs (VA) Charleston (South Carolina) Medical Center.

• Colleen Haugen-Ortiz, CBET, site lead and client service technician at GE Healthcare for Sharp Memorial Hospital

in San Diego, California.

HTLC members play a vital role in advancing the professional interests of clinical engineers, promoting the importance of the field, and serving as an important resource to AAMI staff. The new members are: • Larry Hertzler, CCE, vice president of technical operations at Healthcare Technologies, a TRIMEDX company.

• Samantha Jacques, PhD, FACHE, director of clinical engineering at Penn State Health.

• Shelly Crisler, CCE, biomedical engineer for the VA Center for Engineering & Occupational Safety and Health in St. Louis, Missouri.

• Angela Ferguson-Bennett, director of clinical engineering at TRIMEDX for Ascension Borgess Hospital in Kalamazoo, Michigan.

• Cory Blacketer, HCISSP, CISSP, CAHIMS, medical device security consultant at CynergisTek.

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ECRI UPDATE

Penn Medicine’s Award-Winning App to Promote Faster Weaning

K

nowing when to begin weaning patients from sedative medications and mechanical ventilation is not easy or precise. Evidence shows that well-designed assessment processes can help improve patient outcomes.

Translating such evidence into clinical practice, however, can be a challenge.

Rising to that challenge, a multidisciplinary team at Penn Medicine developed a computerized dashboard and clinician alert system to promote more rapid weaning. The computer application (app) converts data stored in the electronic health record (EHR) into actionable information. The ABC app, as the program is called, enables continuous screening of patient eligibility for a reduction in sedative medications and for weaning from the ventilator, and it prompts staff when actions are needed.

This innovative initiative earned the Penn Medicine team ECRI Institute’s 2019 Health Devices Achievement Award. Presented each May, the award recognizes exceptional initiatives to improve patient safety, reduce costs, or otherwise facilitate better strategic management of health technology.

“Penn Medicine’s project shows how technology teams can impact patient care,” notes David Jamison, executive director, selection and evaluation, ECRI Institute. “The proactive use of EHR data to improve patient outcomes highlights what’s possible and provides a blueprint for other health systems to follow.”

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THE CHALLENGE: PROMOTING FASTER WEANING Several years ago, Penn Medicine found that its patients remained on mechanical ventilation for 12 to 24 hours longer than expected, compared with external benchmarks. Contributing factors included delays by nurses in reducing sedative medications, and delays by respiratory therapists in assessing patient readiness for a ventilator weaning trial, due to an inefficient and complex screening process.

The extended duration of mechanical ventilation had patient care implications, as well as financial ones: • Mechanical ventilators are a lifesustaining technology, but their use is not without risks for the patient.

Patient complications include ventilator-associated pneumonia, ventilator-induced lung injury, deep venous thrombosis, pneumothorax, gastrointestinal bleeding and sepsis.

Clinicians seek to wean patients from mechanical ventilation as soon as

possible to minimize the risk of such complications.

• Additionally, the longer a patient remains on a ventilator, the longer that patient needs to stay in the ICU. Longer stays increase costs – ICU care is expensive to provide – and they reduce ICU bed access for other patients requiring this level of care. A lack of available ICU beds can affect other patients within the hospital, and it can prevent the hospital from accepting patients from referring institutions.

By promoting faster weaning, the organization could both improve patient care and positively impact the bottom line.

THE SOLUTION: MAKING MEANINGFUL USE OF EHR DATA Penn Medicine clinicians teamed up with colleagues in their Data Science, Center for Health Care Innovation, and Information Services departments to devise a solution that could help reduce the duration of mechanical ventilation.

The result was an app that leverages information stored in the EHR to provide clinicians with real-time access to meaningful sedation and ventilation protocol data.

Named the ABC app – for awakening and breathing coordination, which are core components of an ICU bundle of care used at Penn – the app includes two key components: • A dashboard that reflects the real-time status of patients based on current vital signs, ventilator settings, sedative depth, and medications – and that highlights the screening results.

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INDUSTRY UPDATES Physician’s Resource Network

• An alert system that relies on current data to provide respiratory and nursing staff with relevant and actionable alerts, notifying them when interventions are required to move patients through the weaning process.

For instance: The respiratory therapist is alerted when a patient meets criteria to undergo a ventilator weaning trial. If that same patient is oversedated (based on the documentation of sedative infusions and their sedation score), the nurse and provider are alerted with advice to stop the sedation.

Core to the functioning of the app are real-time data streams from the EHR. The EHR vendor enabled real-time streaming of HL7 clinical data, which was stored in a time series format and aggregated and normalized.

This database was leveraged for the in-house development of the web dashboard and notification system.

Similarly, the app relies on clinical decision support (CDS) rules to guide the data analysis, display and transmittal.

These rules are based on Penn Medicine’s complex ICU treatment protocols and on input from clinical experts.

After implementing the ABC app, the health system observed a statistically significant reduction in the duration of mechanical ventilation. The duration was reduced by more than 24 hours, compared with the baseline period. A corresponding significant reduction in ICU length of stay was also observed, as was a trend toward a significant reduction in hospital length of stay.

Nurses stopped sedative medications faster during the intervention period, and respiratory therapists performed ventilator liberation trials sooner, both of which contributed to more rapid extubation and ICU transfer.

The app’s ability to provide immediate feedback about the documentation of, and adherence to,

ICU protocols was judged to be a key feature in improving the outcomes of ICU patients. The health system found tremendous power in having meaningful, real-time data and CDS available to bedside clinicians, quality administrators and the entire team.

Whereas most EHRs function as data repositories for documentation of the care process, Penn Medicine’s ABC app makes use of that technology – real, meaningful use – to facilitate the delivery of care.

ALSO DESERVING RECOGNITION . . .

In addition to honoring the team from Penn Medicine, ECRI Institute commended teams from the following organizations for their efforts to improve patient safety, reduce costs or otherwise facilitate better strategic management of health technology: • Banner Health (Chandler, Arizona) • John Muir Health (Walnut Creek, California) • Memorial Sloan Kettering Cancer Center (New York, New York) • Parkview Health (Fort Wayne, Indiana) • St. Luke’s Health System (Boise, Idaho) • U.S. Department of Veterans Affairs (VA), New England Healthcare System, Clinical Engineering Consolidated Program For details about all the honorees and their projects, see https://www.ecri. org/components/HDJournal/Pages/ hd-achievement-award.aspx.

If your organization has engaged in a health technology management project that deserves recognition, ECRI Institute wants to hear about it.

Submissions for next year’s award will be accepted starting in November. To learn more, visit https://www.ecri.org/ health-devices-award-winners, or contact ECRI Institute by telephone at 610-825-6000, ext. 5891, or by email at clientservices@ecri.org.

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BIOMED 101

Four Reasons to Attend Conferences John Wallace TechNation Editor

BY JOHN WALLACE

T

here is no shortage of professional conferences for HTM professionals. Whether you consider yourself to be a clinical engineer, a biomed or an HTM professional conferences have a lot to offer.

when each individual returns to work after the conference. Every MD Expo I have attended has been busy and lots of work, but it has also been fun! So, attend a conference for all the right reasons and don’t forget to have fun.

The AAMI Exchange is one of the largest conferences for the men and women who repair and maintain medical devices. However, it is far from the only conference for HTM professionals. MD Expo is held twice a year and provides many of the same benefits seen at the AAMI Exchange. Local and/or state associations also have meetings and conferences worth attending.

Professionals from hospital in-house biomedical departments as well as those who work for third-party service companies and original equipment manufacturers can benefit greatly from attending conferences. There are several reasons to attend, but I want to share the top four reasons. The first reason might be a surprise – fun!

REASON #2 Continuing education is always a huge reason to attend a professional conference. Earning CE credits for certification, re-certification or to reach an individual goal are all important reasons to attend a conference. I suggest looking at the education schedule to determine which classes you plan to attend ahead of time. Look to see if the continuing education is accredited and how many credits you can earn for each session. When you attend the session, arrive early and introduce yourself to the presenter. Sit toward the front of the classroom and take notes. After the presentation, ask any questions you have about the topic. You may even want to set an appointment to discuss the information more in depth later in the day.

REASON #1 It is difficult to list these in order of importance because people have different motivations and objectives. However, the #1 reason to attend a professional conference, in my opinion, is fun! There are some other more traditional reasons to attend, which I will get to soon, but having fun is important! Having fun and being entertained while at a professional conference can provide a reboot. A high energy level helps motivate everyone to hit the ground running when they return to work. Ideas will be shared during the fun times and those same ideas will be shared with a great deal of enthusiasm

REASON #3 Expand your horizons by spending some time in the exhibit hall. It is easy to get comfortable with one company and stop researching what the market has to offer. The exhibit hall has the latest and greatest products and solutions from throughout the nation.

Technology is ever evolving. New features and brand-new products could offer a perfect solution to your facility’s latest issue. Also, a new company or a merger of two companies can create opportunities for new expanded offerings.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

REASON #4 Networking, networking and networking! A professional conference like MD Expo is the perfect place to connect with peers, re-connect with colleagues and add a few experienced mentors to your list of contacts. I have heard stories of people making lifetime friends with a person they meet in the hotel bar at a MD Expo. However, MD Expo doesn’t leave things to chance. It provides countless ways for attendees and vendors to interact via a keynote address, workshops, educational sessions, exhibit hall hours, a happy hour, final night party and more. Bring a big stack of business cards to hand out, but do more than just shake hands and hand off a card. Make connections.

Have conversations. Interact. The rewards that come from a network of peers are amazing.

So, those are my top four reasons to attend a professional conference. The largest MD Expo ever was held earlier this year in Houston, Texas. The first ever AAMI Exchange just wrapped up in Cleveland, Ohio. More opportunities are coming soon. Find out when your state HTM association is having its next meeting and be sure to attend. Also, check out all that MD Expo has to offer in Baltimore this October. We even have a few “tools” to help convince your supervisor that you need to attend. You can find the Attendee Toolkit online at MDExpoShow.com/toolkit and you can find out more about the conference at MDExpoShow.com.

JOHN WALLACE is the editor of TechNation magazine. He joined MD Publishing in 2013 and has more than five years of experience covering the HTM industry.

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THE BENCH

WEBINARS

Session Sets Attendance Record STAFF REPORT

T

he recent webinar “Anesthesia Systems: Understanding the Key Components” sponsored by Avante Health Solutions was eligible for 1 credit from the ACI.

Matt Cameron, CBET, Manager of New Product Development at Avante Medical Surgical, discussed anesthesia systems and understanding the key components.

The webinar set new highs for the 2019 Webinar Wednesday series with the highest number of registrations with 528. It also boasts the highest number of attendees for a Webinar Wednesday presentation in 2019 with 365. A recording of the webinar is already online where even more people are watching the presentation.

The webinar also received great reviews from attendees via a post-webinar survey.

“I have little to no knowledge of anesthesia machines so the webinar was a wonderful introduction to the parts, operation and maintenance,” said D. Nitinthorn, TCF Biomedical Engineer.

“I recently started anesthesia machine PMs and repairs so I thought this webinar was very well done and full of good information ... a good refresher,” said A. Bronkema, Biomedical Technician.

“Excellent 101 on anesthesia for new techs, great refresher for seasoned techs,” shared P. Graham, Director of Clinical Engineering.

“Great basic introductory webinar on anesthesia. Nice refresher,” echoed E. Hudy, MSET III CBET. “The webinar was very important for me, I have updated my knowledge about anesthesia devices,” said P. Goleta, Biomed III. “Great info. I was an anesthesia engineer for years, and could tell he knew his stuff,” said D. Barnes, Area Service Manager.

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“Very good overview of anesthesia machines. I love that your website has several years of past webinars available; I can see myself reviewing this one a couple more times in the future,” said K. Lusty, BMET III. “Really useful, we can’t just sit in a desk and sign papers we need to refresh our technical knowledge everyday,” said C. Gonzalez, CTO. “This was a fine instructional for techs getting into the basics of anesthesia service, as well as an introduction of different types of equipment that may not be seen by more experienced working in a limited service area. Fresh and relevant to service at our facility. Keep ’em coming,” said T. Johnson, Tech III CBET. “Very informative, I also forwarded the webinar to our surgery department. I thought it would be good for the anesthesia techs,” shared E. Villanueva, Biomed Co-ordinator.

“This was having my cake and eating it too. I have been a biomed technician 32 years and found this webinar so delightful.

The presenter did a fantastic job not only showing 112 slides, but explaining things in such a constricted time restraint. It was refreshing knowing I understood everything he presented. I would have paid to attend this webinar. My goal is to get other techs to take these seriously and attend them. This particular webinar today could be life changing for so many techs looking to work with anesthesia machines.

I simply cannot thank everyone enough for presenting this today,” said B. Hayes, CBET III. LEADERSHIP ROUNDTABLE WEBINAR A HIT A special ICE Leadership Roundtable Webinar sponsored by Summit Imaging drew imaging professionals from throughout the nation to discuss parts,

cost savings and more.

The roundtable webinar included a panel of imaging directors from the leading health care systems as they collaborated, shared best practices and answered questions from attendees.

This session was a rare opportunity to learn from the best and brightest in the industry. It was also a chance to gain invaluable knowledge that can help imaging professionals and departments grow and prosper.

The roundtable panel included Kyle Grozelle, Manager of Global Education & Training for Summit Imaging; Jessica Chambers, Director-Imaging, Vascular Lab/Procedure, Neurodiagnostics & Pain, SSM Health Saint Joseph Hospital; Mario Pistilli, Director, Childrens Hospital Los Angeles; Greg Williams, Director of Medical Imaging and Special Testing, Summerville Medical Center; Kelsey Mach, Imaging Services Director, CHI St. Luke’s Health Brazosport; and Seema Mislmani, Director of Imaging Services, Las Palmas Medical Center.

Attendees provided great feedback after the session via a post-webinar survey. They shared information about the information they learned during the webinar that they can apply to their specific role at their facility.

“Interesting information about OEM and remanufactured parts,” is what Supervisor O. Jarrin took away from the presentation.

“Great discussion about cost savings,” commented J. VanDyke, Senior Biomedical Technician.

J. Thielen, Account Manager, said the presentation provided insights to help with “understanding the perspective of the imaging manager.”

The webinar “helped to reinforce the in-house model we currently have in place and hybrid relationships we employ with

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THE BENCH

“ Great presentation. Very informative. I learned a great deal on the types of equipment and the functions. I also learned about the testing criteria and testing parameters and how results are obtained,” J. HARWOOD, SENIOR BIOMED TECH certain vendors both OEM and third-party [suppliers],” R. Green, Director of HTM Imaging, said.

DEFIBRILLATOR TESTING EXAMINED The Webinar Wednesday session “An Introduction to Defibrillator Testing” sponsored by Rigel Medical was eligible for 1 credit from the ACI. Brittany Schmidke, national business development manager at Rigel Medical, provided great insights and advice in the presentation.

She did a great job of familiarizing the audience with the defibrillator, the heart and how it works, and the importance of electrical safety testing for defibrillators.

Her work with Rigel Medical makes her a thought leader on the subject matter.

Rigel Medical is a manufacturer of biomedical test equipment including electrical safety analyzers, vital signs simulators, infusion pump analyzers, electrosurgical analyzers and Med-eBase asset management software.

Attendees appreciated her insights and shared positive feedback via a postwebinar survey.

“I enjoyed learning about the defibrillator tester,” said K. Knight, Director of Biomedical Engineering.

“All of the details and graphs about how the heart works were great,” said M. Kommers, CBET II. “A good refresher. I generally get into a PM routine and never take the time to review the whys,” shared D. Gordon, Biomed.

“Even though I work with defibrillators frequently and understand the operations, performing routine PMs is just that, routine. It was nice to get a refresher in how defibrillators work with the body’s anatomy. I want to get back into several textbooks in which I learned so much about the heart and defibrillator interactions to save human lives,” said B. Hayes, CBET III. “It was a nice refresher. Need more like this one,” said S. Nitto, Biomedical

Equipment Technician.

“It was informative and added to my previous knowledge of the defibrillator,” said P. Samal, Senior Biomedical Engineer.

“It was mostly a refresher. I knew the information, but some I had forgotten over the years so it was a good presentation. I believe this type of material is good for the average biomed because of this,” said S. Milletics, CBET. LAB EQUIPMENT EXPLORED The Career Institute of Technology sponsored the Webinar Wednesday presentation “Automated Laboratory Equipment” presented by Bill Bassuk.

Attendees are eligible to receive 1 credit from the ACI. Bassuk, owner of the Career Institute of Technology, discussed the different types of departments in the lab and the various types of equipment and theory of operations, as well as how to keep the laboratory in compliance with the CAP inspection.

The session proved popular among attendees with a 4.2 rating and garnered positive feedback via a post-webinar survey.

“Today’s presentation was a very thorough introduction to the differences and complexities of lab analysis systems. It is great information for a biomed who’s career to date has been spent in critical care and surgery,” said K. Runkel, CBET. “I am currently a biomed and this presentation will help me better understand the laboratory at my hospital,” said S. Hayslip, BMET I. “I am a new biomed hired specifically for the lab. It was extremely helpful,” said M. Davidson, Senior Biomedical Technician.

“There was a lot of information about lab analyzers that I was unaware of. It was nice to have the visual aides to go along with the lecture,” said A. Ramsey, Radiologic Technologist.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

“Exceeded my expectations. First presentation in a very long time that clearly described the clinical purpose and function of the technology rather than just ‘chasing electrons’ for repair,” said C. Davis-Smith, President/Owner.

“The presenter really knew his stuff and was extremely knowledgeable. I don’t deal with the types of equipment in the presentation but it is always good to learn something about them,” shared A. Stetzer, Biomed.

“I think it was a very good webinar, from a knowledgeable instructor,” said M. Mortensen, CBET. “Great presentation. Very informative. I learned a great deal on the types of equipment and the functions. I also learned about the testing criteria and testing parameters and how results are obtained,” said J. Harwood, Senior Biomed Tech.

“I feel that it met my expectations and surpassed them. I learned several things about the equipment in the lab and got information about where to go for information and education for the lab equipment,” said T. Martin, Biomedical Technician I. “Bill’s presentation was one of the most informative presentations that I have witnessed,” said G. Lee, Biomed Tech III. “The lab has always been kind of a mysterious area and this webinar was a great outline of what they do and how they do it,” shared M. Kommers, CBET II. “I have attended many [webinars] and this was the best presentation so far. I would love to hear more about the laboratory environment/equipment from Mr. Bussak. He is extremely easy to understand. Thank you TechNation for an outstanding webinar,” said E. Petrea, CBET, Senior Technician III. MORE THAN 2,000 people have attended live webinars thus far in 2019 and more presentations are on the way. Stay up to date on the Webinar Wednesday series, and watch previous webinars, at WebinarWednesday.Live.

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JULY 2019

TECHNATION

39

THE BENCH

SHOP TALK Q:

A:

A:

A:

STERIS SURGIGRAPHIC 6000 I’m having trouble with an STERIS SurgiGraphic 6000. It doesn’t have any power coming in.

What can I check other than the fuses and transformer which I have already checked?

Make sure your switch is good on the end of the table. There are two power outlets on the table and the switch has to be in the right position or it will not charge up and power.

A:

Verify the “table lockout” on the palm control is not active.

MEDRAD MARK V PROVIS Does anyone know how to program Mark V Provis? There is a message saying, “enter values or arm?” It will not let me go forward.

Q: A:

Ensure values are programmed for volume, flow rate and pressure. Then, you should be able to press the single arm button on the console (orange button) and answer “yes” to the air removed question. This should arm the unit for injection.

I don’t think that is the exact message, but I believe you may not be entering all the parameters of the protocol you are trying to shoot.

You need to, at minimum, enter a Flow Rate, Volume and Pressure Limit. I’m guessing one of those was not programmed.

I suspect the mechanical stop plate is not moving properly – it may be jammed, the motor may be bad, or the mechanical stop drive board which supplies said voltage motor may be bad. Open the head and inspect the plate is not jammed and check for voltage at the mech stop motor leads (purple and yellow leads to small brass motor) when you attempt to arm.

Otherwise, I recommend sending the head and unit into a depot center for thorough diagnosis.

A:

We’ve had several motors fail in a way that they get so hot the plastic gear on the motor melts. I believe it gives you a ‘check head or cable’ message. I think what happens is that every time the power is cycled the mechanical stop motor moves a little and it can get jammed against the plate for the piston, overheating the motor.

HILL-ROM CAREASSIST ES Bed was in up position with patient in it. Made a weird sound then quit working on everything. No lights, no side power on either side, no lockout controls or relock is working – nothing at all will work. Bed is stuck in a high position now close to the ceiling and can’t be used. Please help. I can’t find a single tech to work on the bed because we didn’t buy it from them and many more excuses. Did change a small fuse but noticed it was blown.

Clueless and manual I ordered hasn’t helped at all.

Q:

A:

Does the bed “brake not set” alarm sound when bed is plugged into wall power? Look for LED lights at top left of side rail interface board, if not you might try replacing the power cord and work your way out from there.

A:

Like he said, just work your way through and see where you’ve lost power. Hopefully, the manual you have includes schematics, which make it fairly straightforward.

SHOP TALK

is compiled from MedWrench.com. Go toMedWrench.com community threads to find out how you can join and be part of the discussion.

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JULY 2019

TECHNATION

43

ROUNDTABLE

ROUNDTABLE Ultrasound Systems

T

echNation reached out to original equipment manufacturers and third-party service providers to quiz them about ultrasound systems.

The result is insightful information regarding a variety of issues, including cybersecurity and parts procurement.

Participating in the roundtable article are Avante Ultrasound Vice President of Purchasing Bryan Carlin, Head of Siemens Healthineers Ultrasound North America Sabine DuffySandstrom, MW Imaging Senior Customer Service Engineer Tom Hanak, Ampronix QC and Service Manager Albert Maldonado, GE Healthcare Clinical Care Solutions Chief Marketing and Commercial Officer Neal Sandy, and Innovatus Vice President Ultrasound Center of Excellence Matt Tomory.

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Q: WHAT SHOULD HEALTH CARE FACILITIES LOOK FOR WHEN PURCHASING AN ULTRASOUND SYSTEM? CARLIN: When purchasing ultrasound equipment health care facilities should always look for reputable companies.

For instance, Avante Ultrasound is ISO 13485:2016 in refurbishing ultrasound equipment. We have not only a domestic standard, but an international standard for our equipment. The equipment should be fully QA’d and tested before purchasing, both functionally, as well as cosmetically.

DUFFY-SANDSTROM: First and foremost, it is important that health care facilities look for a trusted partner that understands their specific challenges and can look at their organization as a whole to provide, in addition to the best possible system to meet their needs,

consultation services that offer a complete ultrasound solution. Health care facilities will also want to ensure that their provider is equipped with reliable, certified 24/7 service and support both in the field and through remote connectivity for quick resolutions to avoid any interruptions to patient workflows. In terms of the performance of an ultrasound system, critical capabilities include impeccable image quality to help with accurate diagnosis, portability of the system to meet a broad range of imaging requirements, and a full range of advanced applications that can adapt to all patient sizes and characteristics.

HANAK: When searching for an ultrasound system the facility should first look at what type of application they will be using the system for. The most typical applications include OB,

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ROUNDTABLE

care facility is an obstetrics clinic, there are ultrasound systems specifically designed for this use case. It is the same in radiology, cardiology and more recently in point-of-care environments like the emergency room and operating theater.

Bryan Carlin Avante Ultrasound

cardiac and vascular. Each OEM specializes in different applications, though some have closed the gap between the other OEMs. The second should be the availability of parts and probes in the third-party market. You want to make sure you’re not tied down to just going directly to the OEM for a part or a probe outside the standard warranty they are providing to you when you buy the system.

MALDONADO: They need to determine if a portable or console version will best fit their needs. Once they determine which version, they can begin researching on the budget and the options (software, 3D/4D, probes, etc.) that will best fit their application. We have seen the portable version to be cost effective and popular with customers.

SANDY: It is important to consider several things when purchasing an ultrasound system. Is the system specifically designed for the work I do, and does it provide a high level of diagnostic confidence? Does the company provide both applications and service support?

Are the workflow features saving me time? Is the system known to be dependable? Ultrasound systems should be a reflection of the care providers’ daily activity. For example, if the health

TOMORY: There are multiple facets to this question, one being the wants versus the needs of the clinical side of the equation. What capabilities/features are needed to deliver optimum patient care and return on investment versus what is new and cool? On the clinical engineering side, it is critical to understand long-term cost to support the device and transducers. The system may come with a great warranty, but all warranties eventually end. There needs to be a plan in place to support the system whether continuing with the OEM, utilizing third-party service or bringing service in-house. You must negotiate – on the front end – system training, diagnostics access and service documentation to have the option of migrating away from the OEM post warranty.

parts are essential, the most important factor to consider is access to service engineers that are experts in ultrasound and dedicated solely to this unique modality. The Siemens Healthineers dedicated ultrasound field and remote service engineers are not only experts on our specific systems, but they also have a complete understanding of the customer’s department needs, workflow and clinical applications. Collaboration and shared knowledge between the remote diagnostics team and the dedicated ultrasound onsite service engineers are indispensable when it comes to service for an ultrasound system. It is important that health care facilities look for a trusted partner that is committed to a long-term relationship and offers this level of support throughout the entire life cycle of the system.

Q: WHAT ARE THE MOST IMPORTANT THINGS TO LOOK FOR IN AN ULTRASOUND SYSTEM PROVIDER IN REGARD TO SERVICE AND PARTS? CARLIN: Some of the things customers would want to look for is what type of service and parts (if any) does the vendor provide? Will the company provide field service engineers, replacement parts? When purchasing equipment, it is very important to find a vendor that will offer after-sales support. Most of our customers are in hospital, or emergency settings, and it is very important that a system is not “hard down” because the vendor failed to offer service.

DUFFY-SANDSTROM: All ultrasound system providers will be able to offer certified factory parts for their systems. While

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Sabine Duffy-Sandstrom Siemens Healthineers

HANAK: I would look to negotiate some other types of service when purchasing the system; i.e. training. Knowing how the system works and how it is disassembled is key when the system comes off contract with the OEM. Asking the provider for a list of the service parts and the cost for those parts could also factor in choosing the right provider for the facility. This will give

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ROUNDTABLE

them a better idea of costs associated with the system when the warranty ends.

replacement more frequently but as with the transducers, this also depends on the usage and volume of portable exams being performed.

MALDONADO: The turnaround time when the unit is in for service. Some manufacturers have their parts made overseas and may delay the service of the ultrasound. Find out if the manufacturer has loaners or an exchange program.

SANDY: Customers should look for a provider who understands their service demands so the appropriate relationship can be established around responsiveness and parts availability.

For customers, working with a certified OEM ensures the quality and efficacy of their parts, along with well-trained service technicians.

TOMORY: There are many options for parts, service and probe repair – so how do you choose? Price is always a part of the equation but what about performance, safety and longevity?

With regards to ultrasound parts, I consider them somewhat binary – they function, or they do not but with probes, many “repaired” probes will work but do they perform as the OEM intended? Will you or the ultrasound technologist notice an increase or decrease in acoustic power? Loss of sensitivity? Lack of focus? Without sophisticated acoustic instruments, possibly not. Utilizing a provider who has demonstrated a commitment to quality by being ISO 13495:2016 certified is a good start. Ask your provider how they ensure their work restores OEM form, fit and function to ultrasound probes and systems.

Q: WHAT ARE THE MOST COMMON REPAIRS ULTRASOUND SYSTEMS REQUIRE? CARLIN: The most common repairs for ultrasound equipment are due to misuse or neglect. For example, we at Ultra Solutions often see a lot of probes that

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Tom Hanak MW Imaging

have what we call “drop out.” This is because of the probe being dropped. We also see a lot of repairs for re-lens on the probe, this is a direct cause of not using the proper cleaning solutions for probes.

We highly recommend customers get their machines looked at twice a year for preventative maintenance. This is a routine checkup, if you will, and this often allows our engineers to catch something that may be happening, before a major repair is needed.

DUFFY-SANDSTROM: Service repairs to ultrasound systems and components depend on many factors including the volume of patient exams, proper care and cleaning of the system and transducers, as well as adhering to the factory-recommended planned maintenance scheduled to proactively address any worn or damaged components before they fail. With that in mind, transducers, being a key imaging component for ultrasound, need to have optimal performance in order to obtain diagnostic and reproducible images. As transducers are hand-held devices, they are more prone to damage caused by human error such as drops and other concussive contact when moving the system. Built-in batteries in portable ultrasound systems are another component that can require

HANAK: The most common repairs are typically related to the control panel/ user interface. Most often, the sonographer is constantly adjusting the gain controls or the temporary gain controls to optimize the image for each patient. We constantly see ultrasound gel get into these controls. Buttons can break or become missing causing a need to repair or replace.

MALDONADO: We seen minimal problems.

Mainly with the probes, this is due to the wear and tear the probes are put through. The probe is not a part that sits at rest, it is constantly being moved, pulled and stretched. Also, we have seen the hard drives become full and needing to replace it. Not because the hard drive is defective, but the end user wants to keep the data.

SANDY: Periodically, there are challenges with probes and other hardware like monitors and roller balls on the keyboard. One area that customers should be prepared for these days is software reloads to ensure they are protected against cybersecurity threats.

TOMORY: Ultrasound systems have continued to get smaller and have fewer parts with each new release and generation. When I began service in the industry on the Acuson 128 in 1986, the system had over 80 circuit boards, 6 different power supplies and miles of wire. Today there are a few boards, a computer and power supply. The largest cost, and highest number of failures, are the probes. They are delicate and are handled (and mis-handled) constantly.

One of the most common issues we see is the use of improper chemicals (or the proper chemicals used improperly) to clean and disinfect transducers. There are many chemicals out there for

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ROUNDTABLE

probes, but the OEM manuals must be checked for compatibility. When using a probe repair provider, are they performing proper chemical testing on their plastics, lenses and even adhesives to ensure the OEM recommended chemicals are compatible for that make and model?

Q: WHERE DO YOU SEE ULTRASOUND TRENDS GOING? CARLIN: Our industry is constantly changing. I believe the refurbish market is trending in the right direction due to improved service and repair capability.

The refurbish system offers customers on a budget a chance to receive a beautiful, like new condition system for one third the price of new.

DUFFY-SANDSTROM: As technology advancements continue to evolve, I think we will see a tremendous increase in the use of Artificial Intelligence-based capabilities that could lead to the expansion of the patient population that can be diagnosed with ultrasound.

These increased capabilities could offer a more quantitative image instead of a potentially subjective image which could reduce unwanted variability and increase clinical confidence.

Albert Maldonado Ampronix

HANAK: Ultrasound trends are going to follow the same trends as PC or laptop computers. Just as they have become smaller and more powerful so will ultrasound systems. You are starting to see more portables and handhelds become available in the market.

Wireless ultrasound transducers and systems are becoming more popular, but I always wonder about the image quality with them.

MALDONADO: The trend is going to our smartphones. Nowadays our phones are equal or better to a computer. An ultrasound is technically a computer (internally) running Windows or Linux in the background. This will give the end user an easy way to diagnose a patient and the data can be sent via the phone.

SANDY: Artificial intelligence has become more and more prevalent, and the best examples are those that solve a very specific clinical or operational use case.

At GE Healthcare, we’ve introduced various AI-powered ultrasound systems to improve the consistency and accuracy of the diagnostic information provided to clinicians and providers. Handheld ultrasound is proving useful in many clinical departments and is becoming incredibly popular amongst clinicians.

Primary care facilities are also starting to see the benefits as well.

TOMORY: Systems keep getting smaller and more powerful and the portable market continues to grow as ultrasound expands into more areas of health care facilities. Ultrasound probes are getting more sophisticated as matrix arrays and single crystal technology becomes more common. The newest technology, Capacitive Micromachined Ultrasound Transducers (CMUT) like the new, and very cool, Butterfly IQ are starting to enter the market and I expect to see more development of this technology.

These transducers use a machined chip instead of a traditional piezo-electric

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

material which makes them more versatile and less expensive to produce.

Q: WHAT ARE IMPORTANT THINGS TO CONSIDER REGARDING CYBERSECURITY WHEN IT COMES TO ULTRASOUND SYSTEMS? CARLIN: There is always a risk when dealing with customer confidentiality and exporting data, however the majority of ultrasound systems use DICOM which communicates with what’s called a Picture Archiving and Communication System (PACS). This is a medical imaging technology that provides economical storage and convenient access to images from multiple modalities through a secured network. This is very safe and universal option in the imaging world.

DUFFY-SANDSTROM: Cybersecurity continues to be a growing concern for the health care industry, and keeping patient data safe and secure is a top priority for all health care institutions.

An ultrasound system’s security infrastructure should be a main determination in purchasing an ultrasound system. Always ensure that you are partnered with a provider that engineers systems to include fully integrated cybersecurity technology.

HANAK: Making sure your ultrasound system’s software is up to date is always crucial with regard to cybersecurity.

OEMs will always release a newer version of software that includes patches to fix bugs or any other issues related to the software. Does your facility have an old or outdated system that the OEM no longer supports? If so, we recommend updating the system to ensure the safety of data on your system. The OEMs have taken steps to ensure that their current line of ultrasound systems tackle the cybersecurity issues by adding features such as whitelisting to their software, and encrypting the patient information on the hard drive.

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MALDONADO: Make sure the ultrasound software is up to date. The manufacturers are updating and making patches for bugs in the software. If the ultrasound is going to be connected to a network, the network’s firewall is another security blanket to avoid any attacks from the outside (Internet).

patches for Windows with new security features. Unfortunately, there are people in this world who through malice, greed or boredom are constantly trying to get into hospital systems so make sure your ultrasound systems are always up to date.

Q: WHAT ELSE DO TECHNATION READERS NEED TO KNOW ABOUT PURCHASING AND SERVICING AN ULTRASOUND SYSTEM? CARLIN: Do your research before purchasing from any company or person. Make sure the company is ISO certified, and can provide quality equipment. Don’t look at just price, look at resale value as well. It’s one thing to buy for price but quality standards and brand names hold value.

It’s a safer and smarter purchase for the end user.

Neal Sandy GE Healthcare

SANDY: Ultrasound systems are and will continue to be connected. This is a good thing as new software and service enhancements become easier to deploy. Connected systems do pose cybersecurity risk, yet ultrasound providers are rapidly moving to protect clinicians, facilities and patients leveraging the latest cybersecurity technology. Ultrasound customers should review the cybersecurity features on their systems and understand how those capabilities fit in to their overall cybersecurity plan.

TOMORY: Like most devices these days in a hospital, ultrasound systems are networked and most run Microsoft Windows. It is critical to ensure you work with the OEM to provide the latest software updates on a regular basis. Software updates usually contain modifications to the ultrasound system software and also

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DUFFY-SANDSTROM: Meeting clinical imaging ultrasound needs requires a complete solution from a trusted partner that is interested in a longterm relationship from selection and installation, to training and 24/7 dedicated support. It is also important to understand the value of investing in connectivity solutions with the ability to push online updates and provide service through remote assistance.

HANAK: When purchasing a new ultrasound system for your facility we recommend getting the CES/HTM and IT departments involved in the decision as well. Try and work into the purchase agreement some type of training so that the specified departments can perform preventative maintenance and assist when the system goes down. We always recommend negotiating a copy of software with the system. Improper shut downs can and will corrupt the software or can cause damage to the system hard drives.

MALDONADO: Make sure the

manufacturer supports the product over the phone or by email. We have experienced end user calling for support on “how to” issues. Although the user manual might have the answer, some end users learn better if they are taught step-by-step over the phone or email.

SANDY: No matter your price point or expertise level, there is an ultrasound system that will fit your needs. The latest technologies are only making ultrasound easier and more efficient.

It’s critical to consider reliability, the company pedigree and your individual needs when selecting an ultrasound system.

Matt Tomory Innovatus Imaging

TOMORY: Ultrasound technology has gotten very good over the years and the modality continues to penetrate additional areas of health care facilities. When you begin procuring parts and probes/probe repair, look beyond the immediate cost and determine the best value for you and your patients. After all, when I need a specialist for a health problem, I do not call around looking for the lowest price – I look for the best for me and mine and you should as well for you and yours.

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694A

BY K. RICHARD DOUGLAS

S

tandards are a form of published or codified guidance. As such, they can be voluntary or based on enforceable regulations. Objective advice, solidly based on historical data or experience and evidence, is the best source for guidance. A standard then provides a goal, baseline or minimal acceptable level for proceeding.

You cannot have a standard until you set a standard. You cannot set a standard until you have evidence that provides guidance for that standard. The standard can be set unilaterally by a government agency, accreditation authority or standards-setting organization. The standard can also be developed with input from those in the field who are pledged to its precepts, when implemented.

This collaboration, to develop standards, utilizes the expertise of professionals and non-professionals in every field of work.

This collaborative effort, which is a frequent source of standards, seeks consensus from those with expertise in the field.

A perfect example of a source of standards is the International Organization of Standardization (ISO), which relies on “groups of experts that represent every sector imaginable from soaps to spacecraft, MP3 to coffee,” according to the group’s website. ISO depends on experts who work in the field and have first-hand experience, on a daily basis, in the sector that they work. ISO also depends on consumers for feedback.

Risk-based standards, like ISO 9001, provide a quality management system with an eye on continual improvements. Underwriters Laboratories Inc. (UL) is another example of a developer of standards that come through consensus.

There is also a difference between standards and regulations. Regulations have the force of law behind them. Standards alone are voluntary.

Regulations take precedence when considering both.

Health care requires its own standards and depends on several professional organizations and government agencies for those standards. To acquire and maintain accreditation, health care facilities have to meet, or exceed, certain standards. The Joint Commission (TJC) and Det Norske Veritas Germanischer Lloyd (DNV GL) are two examples of accrediting organizations. Health care facilities, which depend on government reimbursements for much of the care they provide, must maintain compliance with the Centers for Medicare and Medicaid Services (CMS) to continue to receive reimbursements.

In addition to TJC and DNV GL, there are approximately 15 other organizations that can accredit hospitals, many with “deeming” power for Medicare and Medicaid. The Joint Commission accredits more than 4,000 hospitals.

Also, the medical devices used to diagnose and treat patients, are monitored by the FDA. The FDA regulates device manufacturers. At some point, there are standards that must be met and maintained, around every corner.

Another source of guidance for health care

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facilities is the National Fire Protection Association NFPA 99, which is going through a revision process, with more than 200 revisions made to the code. The next edition will be available in 2021.

The public-input stage ended in May. For any imaging service professional or company that services medical imaging equipment, there is the NEMA/MITA 2 standard. MITA says that it developed this standard because; “Until now, there have not been any QMS Standards developed specifically for servicing of medical imaging devices. MITA saw this as a critical gap that needed to be filled in order to protect patient safety and device integrity.”

In the health care environment, standards provide guidance for the safety and security of patients, staff and visitors.

FDA STANDARDS UPDATE The FDA regulates more than 190,000 different devices, which are manufactured by more than 18,000 firms in more than 21,000 medical device facilities worldwide.

The FDA is considering if further regulations are necessary as they apply to the servicing of medical devices. In particular, whether or not there is a compelling distinction between servicing by the OEM versus servicing by a third-party and any impact the results would have on the public.

There are several stakeholders who have provided the agency input into this exploratory discussion, with interested parties expressing their analysis and data to bolster their position on the matter. In its resulting response, the FDA has drawn the distinction between servicing and remanufacturing, to address data on clinical adverse events and deaths that have been reported pursuant to the discussion.

The agency has recognized that regulations can become over-burdensome when there is not a clear public safety hazard and when both OEM and third-party service providers appear to provide an effective outcome.

The agency also recognized the important role of third-party service providers to the efficacy of the U.S. health care system.

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In the January 2018 issue of TechNation, it states that the FDA “has the role of regulating the companies that design, manufacture, repackage, relabel and import medical devices through its Center for Devices and Radiological Health (CDRH).”

The FDA also is one of the watchdogs over the cybersecurity of medical devices along with the Department of Homeland Security (DHS), OEMs, end users and security experts.

“Since our May 2018 report to Congress, FDA Report on the Quality, Safety, and Effectiveness of Servicing of Medical Devices, the FDA issued the Medical Device Servicing Remanufacturing – White Paper, opened a Docket for public comments on it, and held the December 10-11, 2018 Public Workshop - Medical Device Servicing and Remanufacturing Activities,” says Deborah Kotz, press officer in the Office of Media Affairs/Office of External Affairs at the U.S. Food and Drug Administration.

“ [The FDA] also plans on issuing a servicer versus remanufacturere draft guidance sometime this year. It’s on CDRH’s A-list for issuance.” -Deborah Kotz “We also plan on issuing a servicer versus remanufacturer draft guidance sometime this year. It’s on CDRH’s A-list for issuance,” Kotz says. (https://www.fda.gov/medical-devices/ guidance-documents-medical-devices-andradiation-emitting-products/cdrh-fiscal-year-2019fy-2019-proposed-guidance-development).

For the agency’s latest efforts regarding cybersecurity, Alison Hunt, MPH, press officer in the Office of Media Affairs at the FDA, suggests these resources: October 2018 Commissioner Statement: Statement from FDA Commissioner Scott Gottlieb, M.D. on FDA’s efforts to

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strengthen the agency’s medical device cybersecurity program as part of its mission to protect patients.

The FDA provides guidance to medical device manufacturers and health care delivery organizations to help mitigate cybersecurity risks.

“Our cybersecurity page includes updates such as safety communications, final and draft guidance’s, Memorandums of Understanding, meetings/workshops, and other news: https://www. fda.gov/medical-devices/digital-health/ cybersecurity,” Hunt says.

The statement, from FDA Commissioner Scott Gottlieb, M.D., last fall, outlines the agency’s steps to work with all stakeholders in a proactive approach to mitigating the cybersecurity threat in health care.

An excerpt from that statement shows the agency’s approach to dealing with the threat to medical devices.

“Our efforts have yielded tools to advance cybersecurity awareness and readiness.

For example, we’ve supported the development of a tool to help health care delivery organizations (HDOs), such as hospitals, better respond to medical device cybersecurity incidents. Following recent cybersecurity attacks, the FDA recognized a need to close a gap in HDO readiness and response tactics to incidents or exploits affecting medical devices. Today, I’m pleased to announce that the MITRE Corporation, with support from the FDA, released a Medical Device Cybersecurity Regional Incident Preparedness and Response Playbook.”

THE JOINT COMMISSION The Joint Commission offers the publication: “2019 Environment of Care Essentials for Health Care” as an “easy-to-use compendium of environment of care (EC), emergency management (EM), and life safety (LS) standards and elements of performance for all health care settings” and a guide that can help prepare for a survey.

Today, The Joint Commission is looking at

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“ This NWIP is proposing to include [quality management] principles in the new standard’s scope, including an effort to align with concepts in ISO 20000.” -Patrick Bernat suicide prevention, sterilization and preventing needle sticks, along with evaluating the frequency and completeness of preventative maintenance programs or AEMs. Hospitals with deficiencies have been on the rise in recent years.

AAMI UPDATE AAMI offers a number of publications that cover the topic of standards. One of those standards is EQ56.

EQ56 has been around for a long time, but is in the midst of updates. The benchmarking guidelines for medical equipment management have set the standard for HTM departments for 20 years.

According to AAMI’s Patrick Bernat, director of HTM standards, the information below is from the approved New Work Item Proposal (NWIP) outlining anticipated updates to EQ56. Bernat says he expects the revision to be completed by yearend, although it’s difficult to say with certainty because it has to go through balloting, public comment, etcetera.

“The scope of the previous EQ56 did not include quality management principles or processes. Recently, the FDA report on device servicing recommended that service providers adopt quality management principles and systems.

This NWIP is proposing to include these principles in the new standard’s scope, including an effort to align with concepts in ISO 20000,” Bernat says.

“Additionally, the EQ Committee conducted a gap analysis to identify other gaps that need to be addressed in an EQ56 revision. As a result of that exercise, the EQ Committee is also proposing to

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address the items below in a revision,” he says.

Bernat says there were six critical gaps in the existing EQ56 document that were identified as needing to be addressed. There are currently no requirements in EQ56 addressing these six items: • Quality Management: Standardized quality management principles across the patient care continuum will allow for analysis and consistent delivery of quality services.

Quality management includes service measurement, trending and reporting.

Service measurement identifies, quantifies and collects information on how healthcare technology services are contributing to client requirements as well as measuring any trends and indicators of service risks, issues, and improvement opportunities.

Service reporting documents strategic, performance and operational results including any developments related to achieving targets related to service level agreements (SLAs), availability, capacity, finance, etc. made to stakeholders and decision makers in a manner that facilitates action.

The current EQ56 is silent on CAPA and a continuous improvement loop (e.g Plan, Do, Check, Act).

• Service level management: Existing gaps include operational agreements developed to satisfy SLAs, and associated costs of services.

• Capacity Management: Identifying, planning and managing the resources required to meet client’s healthcare technology related requirements at agreed upon service levels. This includes capacity forecasting, planning, monitoring and performance analysis.

• Information security management: Identifying sensitive information (data) created by, transmitted and/or stored in healthcare technology and establishing policies, procedures and processes necessary to safeguard that information from compromises to data availability, integrity or confidentiality.

This was identified by FDA and in public comments as being a gap in the current EQ56.

• Service Continuity and Availability Management: Identifying and managing risks

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that could adversely impact the ability to deliver a healthcare technology service over a period of time. The risk assessment process includes severity and probability of adverse impact.

• Change (Including Release and Deployment) Management: The current EQ56 does not include a change management process. The change management process prioritizes and documents all planned and requested changes (including to assets, policies, infrastructure, etcetera) and obtains approval from those clients/users — and others as appropriate — that may be affected before implementing any change. It is also a process used for controlled distribution of updates/changes to healthcare technology assets across the organization’s infrastructure in a manner that maintains agreed upon service levels.

SECONDARY GAPS Bernat also points out that there are Secondary Gaps. “The following five issues are partially addressed in the existing EQ56. They have been identified as needing additional attention in the next version,” he says.

• Budgeting and accounting for services: Enhancement of the budgeting section is needed.

• Relationship management: The current document is limited to communications

Oc t ob er 1 7 - 1 9 , 2 0 1 9

between HTM and service providers. It is recommended that the revision include clinical input in the discussions about the HTM program.

• Incident and service request management: The gap analysis identified a lack of management process for prioritizing service requests and reporting key performance indicators (KPIs) corresponding to the agreed upon service levels to the client and management.

• Problem management: The existing EQ56 does not include a process addressing the identification and resolution of the root cause of one or more healthcare technology related incidents.

• Configuration management: Although the current EQ56 addresses inventory, that section does not include a process to identify and define healthcare technology asset version, the relationships between different assets and services, configuration, connectivity and current status.

Bernat says that, in conclusion, the EQ Committee proposes incorporating the above items into a revision of EQ56.

Continued vigilance in maintaining and reviewing standards, and revisions to these standards, allows the biomed shop to operate in a safe and secure environment, while protecting patients, staff and visitors.

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EXPERT ADVICE

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ULTRASOUND EXPERT

BY LYLE CMEREK

I

n the course of working with ultrasound systems in the field, there will inevitably be a time when a system experiences catastrophic software corruption and will no longer boot up.

To successfully repair these systems, it’s important to gather all pertinent data about the ultrasound system and create a system backup. In this article, I will offer some tips for collecting and storing this information so it’s ready to use when needed.

Each ultrasound system make and model varies as to what is needed to perform a software load and restore system settings. For example, on the Philips iU22 and iE33 you must log into “techadmin” or “service” to create a backup of the license options file. On the Philips Epiq and Affiniti, the license option file is included in the backup without having to login. However, on the Epiq/Affiniti and iU22/iE33, you must log into “service,” “techadmin,” or “support” to restore the licensed option file after a software load.

On some GE machines, you have to manually input encryption strings to restore the purchased options. Other GE models store the purchased items on a dongle that is plugged into the BEP. If this is the case, don’t forget to swap this option dongle over to your new BEP if you are replacing the BEP. These are a few examples of what is needed to bring back the purchased license options, but the necessary items after a software load vary from machine to machine. It is beneficial to know what is needed on each machine for a software load. I personally like to keep

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backups and vital information on the machine somewhere, in the event that a customer or coworker is working on this machine instead of me.

It is also a good idea to identify and take note of your system’s hardware and software revisions. For Philips systems, the hardware revision is typically indicated by a letter and sometimes a letter followed by a number; i.e. A cart, F.3, or G.1. Hardware revisions are important to know if you need to order a part for your particular system.

On GE ultrasounds, how the software revision is indicated depends on the make, model, and when the unit was manufactured. Sometimes it is noted as a BT/breakthrough level such as BT09 or BT12. Whereas on other machines, the hardware revision of that machine is dependent upon the BEP you have and the circuit board make up of the front end; GFI versus MRX or 1 GTX board versus 3 GTX boards.

For most machines, software and hardware revision information is also included in the system’s error logs. I typically save a copy of the error logs from each machine, so I can look up hardware information from that machine if needed in the future. I also take pictures of all unique information that is specific to that machine. This includes, but isn’t limited to, the serial number, hardware revision, software revision, every page of the network configuration, specific button configuration information, wireless network information, etc.

Taking a picture of all of this information may sometimes seem like overkill, but I personally prefer to have more information needed on a machine

Lyle Cmerek Avante Ultrasound

than not enough. Having hardware and software information specific to each machine is vital so you can order the correct part for your machine or troubleshoot your machine. This information is also good to have when reaching out for technical support. I like to keep all of this information on my computer, so that I can use it when needed.

The examples I used and information provided in this article reference just a few different models from GE and Philips product lines, but getting in the habit of properly documenting and backing up the ultrasounds you service will always be beneficial. If you take on a new ultrasound machine that you are unfamiliar with, I highly recommend formal training, doing some research or reaching out to a trusted multi-vendor ultrasound expert to help guide you.

LYLE CMEREK is an Customer Service Engineer for Avante Ultrasound. For 24/7 Technical Support, call 800-958-9986 or visit www.avantehs.com/ultrasound.

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CAREER CENTER

Increase Productivity by Managing the Chaos

BY CINDY STEPHENS

I

n today’s fast-paced environment, it is easy to feel overwhelmed, especially when there is so much demand placed on Healthcare Technology Management (HTM) professionals.

Productivity expectations are high, and it is easy to accept the daily demands as part of a daily routine. Occasionally, though, a person begins to feel the stress of being pulled in so many directions.

The emotional drain and tension of a chaotic environment can lead to disorganization and a sense of a lack of control over your life. Productivity eventually begins to decline and impacts overall performance expectations.

It is easy to become trapped, working in a continuous cycle of chaos while attempting to accomplish the myriad of daily responsibilities and tasks. To increase productivity, it is important to first determine how the chaotic environment impacts you. Then, decide to step out of the fixed, overwhelming daily routine and create a more positive approach to managing the chaos.

Consider what contributes to the chaotic environment that impacts accomplishing your responsibilities.

What influencers dictate your daily routine, such as unnecessary interruptions and other factors that interfere with your focus.

If you have allowed yourself to become overwhelmed with unrealistic tasks, think seriously about what is important to accomplish and put the unimportant tasks aside until the most important tasks have been accomplished.

Next create a detailed list of your

responsibilities and the tasks necessary to accomplish each one. Create a list of timelines and deadlines. Understand that there may be critical problems that interrupt your daily responsibilities and remain flexible in moving your planned activities to accommodate the urgent issues. Know your personal limitations and focus on your strengths and outline solutions to problems.

Utilize your organizational skills to identify efficient methods to accomplish tasks and focus on priorities. Handle email, voicemail and text messages based on importance. Act on them appropriately and put personal messages on hold until outside of work hours (lunch, break or end of the day).

Remember to focus on what is important.

Whether it is professional or personal, it is not always easy to make a change. However, the good news is that it is never too late to start improving yourself. Make the choice of either continuing with the “old” habits that do not allow focusing on what is important or working toward a new, improved self and routine.

The most successful people are those who made a choice to be successful, established goals and set out to accomplish them. Ultimately, achieving success in anything requires having a plan – setting goals and actions to carry them out.

The key to achieving success is to motivate yourself to making a positive difference by focusing on what is important. Therefore, if you want your life to change, you must set your goals into a plan and take the necessary steps to be successful. Manage the chaos and

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Cindy Stephens Stephens International Recruiting, Inc.

increase productivity with organizational skills and by focusing on priorities.

It sounds easy enough, but studies show a majority of the people don’t take the time to identify their goals and make a plan for reaching them. Goals give you a starting place and a destination. Knowing where you are going will help you get there.

You may just want to simplify your life, manage your time better or find the time to do the things that are more important in your life. Maintain a good work and personal life balance with your family and friends.

Stay motivated even in the face of obstacles or setbacks. Remain flexible and willing to adjust your plan when necessary. Sometimes you may need to take a detour along the way, but don’t get discouraged and let this throw you completely off course. Stay committed and keep going.

Reduce stress, manage chaos and increase productivity by taking control of your daily routines and responsibilities.

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EXPERT ADVICE

THE FUTURE

How Do We Supply Enough HTM Graduates?

BY STEVEN J. YELTON, P.E., CHTM

I

enjoy reading posts in the AAMI Educator’s Discussion Group. Recently, a popular topic is the placement of graduates. It seems that a growing problem is that students are accepting positions prior to graduation. Many, and I expect most, programs are experiencing 100% placement. It seems that employers are competing for graduates of some HTM programs. This is a good problem for college programs to encounter since it helps with recruiting, funding from the institution and more.

However, it is a difficult situation for employers looking for qualified applicants to fill openings.

At Cincinnati State, we have had this problem off and on for many years. We always have a good number of students and 10 to 15 graduate each year. This has varied somewhat but has basically been in this range for years. This seems to be a comfortable number of graduates for our program to place each year.

Educators have discussed ways to attract more students into existing programs as well as help develop new HTM programs. If we could make this happen, we could provide more graduates to “needy” employers. The interesting part is that we seem to have similar issues no matter where we are in the country. One idea is that rather than make programs larger, there should be more programs available in numerous locations throughout the nation? We have found that graduates, for the most part, want to stay close to home.

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Cincinnati State is a cooperative education (co-op) school and as such requires students to have work experience directly related to their field of study in order to graduate. Our program requires a minimum of one semester (15 weeks of 40 hour/week work) of cooperative education to graduate in addition to the academic requirements. Most employers would prefer at least two semesters of co-op experience prior to hiring them full time. The majority of our co-op employers are local to the college. The co-op positions at Cincinnati State are paid productive positions. The co-op student employee is productive and is a possible full-time employee upon graduation.

Why don’t all employers require two semesters of experience in order for applicants to be hired full time? The short answer is “they would if they could.” Some of our students are being hired full time before graduation because the employer has a need. I have heard this from other educators, too. A hospital has an open position and there may not be available experienced applicants available at the time. A co-op student may be working with them that they really like and they want to bring them on full time right away. Usually the stipulation is that the student will finish their degree in a timely manner.

Sometimes this goes according to plan and sometimes it doesn’t.

What are we all doing to help fix this problem? Believe it or not, we are working very hard to remedy this problem and provide ample graduates

Steven J. Yelton Cincinnati State Technical and Community College

for everyone. As I mentioned earlier, additional programs could be part of the answer.

For an educational institution’s administration to consider adding a new program, it must be convinced that there is a need, support is available, there will be enough students interested to justify the program and graduates will be placed are a few criteria. We are working hard to provide this support for anyone interested in starting a new program. I believe that the first step is for anyone interested in entering this endeavour to get involved with AAMI. There are numerous networking opportunities and lots of help within the AAMI family.

AAMI is made of many constituents who are willing to help support established and new programs. The Healthcare Technology Accreditation Activities Committee (HTAC) is

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lecture in the HTM programs, etc.

Lastly, I suggest that employers set high expectations for new hires. Don’t settle. I know that isn’t as easy as it sounds, but if educators and employers can work together it will be attainable.

Support your local programs, create alliances and accept interns or co-op students. Please try to fund HTM scholarships. It will pay off.

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responsible for the program-specific accreditation activities associated with The Accreditation Board for Engineering and Technology (ABET).

The group strives to strengthen the academic experiences of HTM professionals, and promotes collaboration among educators. The HTAC committee is also working to improve the number and quality of HTM programs.

Educators, employers and working HTM professionals can find more information at https://www.aami.org/ professionaldevelopment/content. aspx?ItemNumber=4798.

I have found that the key to success of any program is cooperation between employers and educators. I often read in discussion groups about how established professionals in the HTM field work together with educators to attend job fairs, visit local high schools, guest

STEVEN J. YELTON, P.E., CHTM; is a Senior Consultant for HTM in Cincinnati, Ohio and is a Professor at Cincinnati State Technical and Community College where he teaches biomedical instrumentation courses. He is the Secretary-Treasurer of AAMI’s Board of Directors, AAMI’s Foundation Board of Directors, Chair of AAMI’s Technology Management Council (TMC), Chair of AAMI’s HTAC Committee and is a member of the Accreditation Board for Engineering and Technology (ABET), Board of Delegates.

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20/20 IMAGING INSIGHTS How Accreditation for Imaging Departments Affects Your Facility, Your Patients and You

BY MATT TOMORY

T

he importance of being ISO 13485:2016 certified has been a popular topic in the medical device service industry for several years. Organizations that commit to the rigorous and costly process are signaling their commitment to operate at the highest possible quality level.

In the clinical environment within medical imaging, there is a standard similar to that of ISO. Radiology, cardiology and other departments which utilize imaging within a hospital or clinic have the option of becoming accredited for radiology practices and quality assurance systems by the American College of Radiology (ACR), the American Institute of Ultrasound in Medicine (AIUM) and the Intersocietal Accreditation Commission (IAC).

Accreditation requires demonstrating adherence to established standards for image quality testing, equipment maintenance, quality systems and that your medical personnel meet standards for interpretation of diagnostic examinations. It also shows you have audited your strengths and weaknesses and have taken any needed corrective

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actions to streamline efficiencies and operations to better serve patients. You may be unaware, but a portion of the responsibility for complying with these standards is dependent on clinical engineers.

DOES THIS REALLY MATTER? More than you think. Patients are highly informed consumers and review performance studies on hospitals and caregivers provided by reporting organizations such as Health Grades and other sites which allow consumers to compare hospitals on many factors such as patient experience, timely and effective care, overall value and the use of medical imaging. Hospitals that don’t follow best-practices for imaging services are often flagged as conducting unnecessary services or missing vital diagnoses. Protecting reputations is just one of the important outcomes of accreditation for radiology departments, in addition to achieving greater efficiencies, operations and potentially reimbursements.

Clinical engineers play a vital role in achieving and maintaining accreditation, covering quality assurance and accountability for several

Matt Tomory Innovatus Imaging processes and outcomes, including: • Providing full service histories, which document not only PMs and repairs, but also other activities associated with a device.

• Performing frequent image quality assessments in much greater detail than the OEM. • Assessing and documenting performance on accessory devices such as ultrasound probes, MRI coils and hard copy devices.

• Acquiring and assembling Quality Control data for the department applying for accreditation.

Even if your imaging departments are not currently accredited, aligning your teams’ activities with accreditation requirements can help avoid costly mistakes, downtime and other issues that can impact clinicians, diagnostic efficiencies, and patient satisfaction, all of which can impact your hospitals’ quality ratings and potentially

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EXPERT ADVICE

CYBERSECURITY Creating the Plan

BY JOSEPH E. FISHEL, CBET, MBA

I

f you don’t know where you are, you don’t know if you are moving forward, sideways or backwards. Fred Bear was an early pioneer in archery.

He was known for his accuracy. He could even hit moving targets out of the air with a single arrow. He could see his targets. If he were blindfolded and unable to see his target, his chance of success would drastically decline. He might even hit a bystander. Hitting the target in cybersecurity doesn’t have to be hit or miss. And, I think we are heading in the right direction.

Establishing and creating a strategic plan is critical for success and to keep from wasting time, money and effort.

Knowing your facility’s current standard plan used by IS/IT for cybersecurity is and what the future will be is critical. A plan can be developed in conjunction with your IS/IT team to protect, identify vulnerabilities as well as how to respond to attacks. Policies and procedures that are enforced along with Know Do Shares (KDS) on what can, should or will be happening for communication is a great way to prepare.

When I am preparing for a Joint Commission inspection, I list all of the Joint Commissions Standards on a spreadsheet. I then look at each standard and compare it to my Medical Equipment Management Plan (MEMP) and identify the section that addresses how I meet the standard. Beside each standard, I enter the section of my MEMP and create a crosswalk. If the standard isn’t under my direction I list a policy/procedure or where documentation can be found. I may find with a new standard that I have not yet created a policy/procedure or that it

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falls short and needs to be updated to adhere to the new standard.

So, what standards can I use to build on a cybersecurity plan? There are several sources for guidelines that can be used to develop a plan. Here are a few: National Institute of Standards and Technology Special Publication 800 (NIST SP 800), COBIT 5, CIS Critical Security Controls and ISO/IEC 27001.

Using a standard or a combination of standards are great for developing a cybersecurity program. I would suggest finding out which guidelines the IS/IT team uses.

As you identify a standard, you may find that the IS/IT team already has a standard/procedure or policy in place that covers everything except biomedical equipment. Some tweaks or inserts may be needed to incorporate biomedical equipment or a separate plan may need to be implemented. For example, most IS/IT departments have a policy against plugging a cellphone or tablet into system-owned computers.

Adding biomedical equipment to the policy puts everything on one page and shows unity. There will be some things that are unique to biomedical equipment that can be addressed separately.

So, where are you with your plan?

How mature/developed is it? Once you identify “the standard” then measure the plan on a scale using colors and numbers.

Many professionals use the Plan Do Check and Act cycle. This can use colors and numbers with meanings. For example: 0 Maroon – nothing is in place.

1 Red – something is being done but it’s not documented in a process.

2 Orange – there is a managed process, but it’s not fully documented.

3 Yellow – there is an established policy and procedure but little history.

4 Light Green – a process is in place and data is being examined to see if it can be improved.

5 Dark Green – an optimized or complete process is in place that provides measurements and improvement information.

Once the program is scored a baseline is created to work from and metrics can be generated to measure progress for reports to administration.

Developing run books for situations

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EXPERT ADVICE or incidents is one way of identifying who, what, when, where and how to react to viruses, malware, infection and other situations. This includes escalation plans, communication plans, remediation plans as well as who does what and when.

IS/IT may have a Joseph E. Fishel, CBET, MBA vulnerability scanning HTM Manager for Sutter Health program that can be eQuip Services used as a helpful tool.

Identifying when this is run and the remediation of vulnerabilities on medical equipment can be a run book in itself. Every situation should be listed and it should be determined if it is a new situation or if it mirrors an existing one and needs to be added to the run book.

Sitting down and doing tabletop exercises can help define and refine procedures.

Remember, the next vulnerability is right around the corner.

As I was writing this “Microsoft Wormable Vulnerability” appeared on my monitor.

JOSEPH E. FISHEL, CBET, MBA, is a Healthcare Technology Systems Manager for Sutter Health eQuip Services.

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EXPERT ADVICE

THE OTHER SIDE An Injustice for Small Hospitals

BY JIM FEDELE

I

am almost reluctant to state that health care is in a state of change, because it always seems like it is changing. However, there is a lot of activity today around mergers and acquisitions. Hospitals in my region have not been left out. This activity has increased the number of hospitals that I am responsible for now. As we bring these hospitals into our program, their service contracts are more expensive than I expected. I feel like these small hospitals are being taken advantage of

by OEM service contract salespeople.

In the past year, I have added three small hospitals to my program. None of them had their own biomed guy, so the duties of medical equipment management were shared by various people. These hospitals were using an ISO for general equipment checks and PMs, along with OEM contracts for mission critical equipment. The service model did not surprise me. These hospitals do not have the resources to have their own biomedical engineering technician. Although the ISOs providing service provided a bit of medical equipment management, it was at a low level of involvement. In most cases, the oversight of the program was left to the maintenance manager, the support services executive and director of nursing.

Converting hospitals to a new program isn’t too complicated; we get the inventory and service histories uploaded into our system. We verify the inventory. We gather all service contracts for review and renegotiation if possible. For me, the gathering of service contracts has been the most

challenging part of the process. The hospitals we converted did not have any contract management. The departments using the equipment negotiated and executed service contracts. I am not criticizing the use of service contracts by these hospitals; a service contract provides a fixed fee for repairs that can be budgeted easily. What surprised me was the cost of some of the service contracts.

Being part of a large health system, I experience firsthand the service contract savings that are negotiated with OEMs. There is nothing like volume to entice an OEM to work with you. A small hospital doesn’t have too much horsepower to negotiate like a big system. It makes me sad to think that the small hospital is being taken advantage of by the OEM. They do not have a lot of leverage to negotiate a contract when you are only managing one device. However, I do feel they could have some leverage if they look at utilization.

I feel this way because the equipment is not used as hard as it is in larger and busier facilities. The four small hospitals I manage have less repairs per piece of equipment than my large hospitals. Our small hospitals don’t do every service every day. If the equipment isn’t being used it is less likely to break. This is also illustrated by looking at the average age of equipment. I know that the average age of the equipment in these small facilities is high and the repairs are still less.

Which is contradictory to the statement that older equipment needs to be repaired more. This is certainly true in my larger and busier facilities but not in the smaller ones. Finally, there are the users in these facilities. They take care

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Jim Fedele, CBET Senior Program Director, UPMC and BioTronics

of the equipment like they purchased it with their own money. They know if they are lucky enough to get a new piece of equipment that it is going to be a long time before they can get another one. I wish I could get all my users to take care of equipment like they do.

So, knowing that the utilization is going to be less, why would an OEM price a service contract more for a small hospital? I wonder if anyone has ever tried to get a service contract priced by utilization? I think a contract based on utilization would at least be fair for these small facilities. As I think about service contracts for my smaller facilities, I will be trying to at least get them reduced to preventative maintenance only contracts so we aren’t paying for parts coverage for underutilized systems.

In closing, I feel like many small hospitals are overpaying for service contracts. It is the perfect situation for OEMs. They are likely dealing with a person who has little knowledge about service contracts. The utilization is less than a larger facility and the equipment is cared for properly. The service contract is never written with an adjustment for utilization. This means big profits for the OEM as the user pays to protect a device that isn’t used all that much.

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EXPERT ADVICE

ROMAN REVIEW Bragging or Complaining

BY MANNY ROMAN, CRES

A

while back, I had a few friends over for some refreshments and conversation. One of the friends was visiting from another state so he was relatively new to my usual crowd of neighbors. He was talking with my neighbor about problems he has had with his boat’s engine.

Now, my neighbor builds engines so he is what I would consider an expert. The conversation became technical with my neighbor asking relevant questions and providing likely causes and solutions to the issues. Since I know nothing about engines, I hastily retreated and joined a group with a less technical discussion regarding unimportant issues. Now this is a subject where I hold considerable expertise.

After my out-of-state friend left town, I asked my neighbor if he had provided adequate information for fixing the boat’s engine issues. My neighbor said, “I don’t think he was listening.” I replied, “Then he was not complaining, he was bragging.”

I have employed numerous ways of irritating people over the years. One was to often ask, “So, are you bragging or complaining?” I cut back on this a long time ago so I was a little surprised at my reply to my neighbor. I decided to explore the “bragging or complaining” topic and share some insights with you.

Humblebrag is an actual word that describes “an ostensibly modest or selfdeprecating statement whose actual purpose is to draw attention to something of which one is proud.” It is a fake modesty. People do this all the

time. They brag in a complaining way to extract a compliment or self-backpat.

Harvard and UNC conducted studies on humlebragging. Some findings are: Those who humblebrag on social media are perceived as less likable, less sincere and less competent. Seventy percent of job applicants humblebrag with a negative effect on hiring.

Humblebraggers have a more negative impression than actual braggers and complainers. Humblebraggers are seen as less honest than actual braggers.

Humblebragging takes two forms: complaint and humility. The complaint sounds like this line from a TV show, “…No matter how haggard you look at the gym, some guy is gonna hit on you.”

The humility is when I say, “Why do I always get asked to speak at conferences when I don’t like doing it.”

Bottom line: Humblebragging is counterproductive. False modesty doesn’t really fool anyone since it is easily recognized. So just go ahead and provide people with an actual brag.

They still will not like you, however they will respect you more. Better yet, get someone else to brag on your behalf.

I suggest that when someone is humblebragging in your general direction, the best response is to allow it to happen. Look interested, nod your head and speak only in agreement with their emotion, not their words. This allows them to vent their false modesty.

At an appropriate pause, redirect the conversation by asking a question or contributing a redirecting statement.

Actual complaining is also easily recognized because it will not contain

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Manny Roman, CRES AMSP Business Operation Manager

the elements of false modesty.

Complaints may be factual or fabricated. Real complaints contain specific information and generally are devoid of generalities and broad speculation.

I suggest that a real complaint should be addressed with an end solution in mind. This, of course, assumes that you have the capability to assist in the solution or have some specific relevant information.

A fabricated complaint is full of inaccuracies, generalities, speculation and emotional bias. I suggest that this complaint be acknowledged without agreeing with the words, only the emotional state. A great question that generally brings reality to light is, “What would you like to see happen?”

The complainer is now forced to look at solutions that are attainable.

I am humbled that thousands each month eagerly await my small tidbits of wisdom in the Roman Review.

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o you consider yourself a history buff? Are you widely regarded among coworkers as an equipment aficionado? Here is your chance to prove it! Check out “The Vault” photo. Tell us what this medical device is and earn bragging rights. Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/ vault-july-2019. Good luck!

SUBMIT A PHOTO Send a photo of an old medical device to editor@mdpublishing.com and you could win a $25 Amazon gift card courtesy of TechNation!

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SCRAPBOOK HTM Week Contest

T

echNation’s 2019 HTM Week Contest was a way to celebrate with biomeds everywhere! The contest featured “Biomeds Making a Difference” and winners earned a $50 pizza party for their department!

A winner was selected each weekday of HTM Week. One grand prize winner received a TechNation prize pack for up to 12 members of their department.

We simply wanted to spotlight biomeds and how they and/or their departments help their facilities. Thank you to everyone who took time to participate in the contest.

The winners of the 2019 HTM Week Contest are: 1. Ken Mylar, System Director, HTM at Summa Health: The HTM staff at Summa Health has had a busy couple years. On top of the normal daily activities of maintaining medical equipment, there have been several projects lately that added a number of activities to our routines. Over the last few years, we have replaced all of our patient monitoring equipment, completely gutted and renovated various departments, removed and replaced more than half of our imaging equipment and we are a opening a new seven-floor patient tower at our Akron City campus.

2. Richard Collins, Biomed Tech at DH Biomedical: I work for a great company, a great boss, supervisor and crew. DH Biomedical covers the state of Florida with sales and service including PMs, equipment repair and upgrades. We are a full-service company for small hospitals, surgery centers, endoscopy centers, clinics and nursing homes (skilled nursing and rehab). “I have 40-plus years of biomed equipment service with many hospitals and service companies, DH Biomedical is one of the best I have worked with.”

3. Joie Marhefka, Assistant Teaching Professor and Biomedical Engineering Technology Program Coordinator at Penn State New Kensington: At Penn State New Kensington, we are preparing the next generation of biomeds to make a difference. I am confident that our graduates will make a difference!

4. Linda Jones, Biomedical Equipment Support Specialist, Kernersville VA Health Care Center: Being an employee of the Kernersville VA Health Care Center, which is a part of the W.G. “Bill” Hefner VA Medical Center, in Salisbury, North Carolina, already gives you great pride in giving back to the veterans of this region. But recently, myself and two have been working

overtime hours at another VA Healthcare System in Fayetteville, North Carolina to assist with scheduled maintenance while they are short staffed. It has been very rewarding to complete these services to ensure the medical devices are ready for the care of our veterans in that region.

5. Max Goldtooth Sr, Lead Biomedical Technician, Tuba City Regional Health Care Corporation: Our biomedical department survived our hospital transitioning from an IHS hospital to a Self-Determination Tribal 638 corporation. We like to thank all the HTM professionals for their recommendations and support. Some have come out to take a look at our department and programs. We have come far trying to keep up with technology and making our hospital a Level 3 Trauma Center. We have a great team of administrators that supported us through the transition – especially, our biomedical manager.

Thank you to all in the HTM world.

Joie Marhefka was selected as the grand prize winner.

TechNation applauds all of the HTM professionals who do so much for the heath care industry – especially the patients!

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BULLETIN BOARD

A

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

Career Opportunities CONTINUING EDUCA TION

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Reference the career section: https://www.medwrench.com/bulletin-board/careers

Company: Edge Biomedical Position Title: Edge Biomedical is hiring a BMET II in the Edison NJ Territory Description: Edge Biomedical is looking for a highly motivated Biomedical Equipment Technician BMET for Field Service work in the NJ/NY/Philly area.We are looking for a person that enjoys different projects and working with a nationwide team of technicians. The ideal candidate has hands on experience with medical equipment repair and calibration.

More info on how to apply here: http://bit.ly/Edge_jobpost

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BREAKROOM

JOINT COMMISSION AND THE 100% PM COM

Follow Ben Calibrating!

PLETIONS

One of the relatively recent changes to The Joint Comm ission Accreditation standards that directly impacted the HTM comm unity is the requirement for 100% PM completion. Although this has been out for a couple of years, there is still some questions and confusion as to what const itutes 100% completion.

I wanted to give a personal interpretation and a sugge stion on how it can be accomplished.

ow Want to kn C. is? n where Be on Follow us Facebook nch and @MedWre ge! like our pa

When I first heard of this change, I panicked. I thoug ht it was absurd since there are almost always items in the hospital enviro nment that are unable to be located. Once I read several articles, asked quest ions directly to The Joint Commission, and consulted Mega-Gurus in the HTM field, I felt comfortable that 100% was achievable. I learned “Completion” doesn’t mean performed.

Read more here: http://bit.ly/MW_JointCommissio n

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Coro Medical

SERVICE

aiv-inc.com • 888-656-0755

PARTS

AIV

Company Info

AD PAGE

Infusion Pumps

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

29

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

P P

42

Refurbish AIV aiv-inc.com • 888-656-0755

51

JULY 2019

TECHNATION

81

SERVICE INDEX CONTINUED avantehs.com •

www.radcal.com • 800-423-7169

2

Repair Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328

Avante Ultrasound avantehs.com/ultrasound • 800-958-9986

www.eng-services.com • 888-364-7782x11

sebiomedical.com/ • 828-396-6010

P P

Career Institute of Technology

49

P P

ECRI Institute

admissions@cit-texas.com • (512) 807-8300 www.ecri.org • 1-610-825-6000.

Tri-Imaging Solutions 17

P

Respiratory

www.triimaging.com • 855-401-4888

www.ambickford.com • 800-795-3062

67

P

Software

www.cadmet.com • 800-543-7282

Tri-Imaging Solutions www.triimaging.com • 855-401-4888

Phoenix Data Systems www.goaims.com • 800-541-2467

60

Sterilizers www.spbs.com/ • (800) 713-2396

P P

68

P

3

P

73

P

76

P

70

P

76

P P

4

P P

Ultrasound Ampronix, Inc. www.ampronix.com • 800-400-7972

SPBS, Inc

41

Tubes/Bulbs Cadmet

A.M. Bickford

42

Training 24

Replacement Parts Engineering Services, KCS Inc

Southeastern Biomedical, Inc

ATS Laboratories

Surgical

www.atslaboratories-phantoms.com/ • atslaboratories@yahoo-com

Healthmark Industries

Avante Health Solutions

HMARK.COM • 800-521-6224

36

Telemetry

avantehs.com • avantehs.com/ultrasound • 800-958-9986

aiv-inc.com • 888-656-0755

Avante Patient Monitoring avantehs.com/monitoring • 800-449-5328

Biomedical Repair & Consulting Services, Inc. www.brcsrepair.com • 844-656-9418

BMES www.bmesco.com • 888-828-2637

Multimedical Systems www.multimedicalsystems.com • 888-532-8056

RepairMED www.repairmed.net • 855-813-8100

Southwestern Biomedical Electronics, Inc. www.swbiomed.com/ • 800-880-7231

USOC Bio-Medical Services www.usocmedical.com • 855-888-8762

51 24 33 16

P P

Innovatus Imaging

P P

MW Imaging

P P

Summit Imaging

P P

Ventilators

22

P

41

P P

11

P P

7

P P

Test Equipment A.M. Bickford www.ambickford.com • 800-795-3062

BC Group International, Inc www.BCGroupStore.com • 314-638-3800

PRN/ Physician’s Resource Network www.prnwebsite.com • 508-679-6185

Pronk Technologies, Inc. www.pronktech.com • 800-609-9802 82

P

Avante Ultrasound

AIV

TECHNATION

JULY 2019

TRAINING

Avante Health Solutions

SERVICE

Radcal Corporation

PARTS

Rental/Leasing

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

www.innovatusimaging.com • 844-687-5100 www.mwimaging.com • 877-889-8223 www.mysummitimaging.com • 866-586-3744

SPBS, Inc www.spbs.com/ • (800) 713-2396

88

P P

35

P P

2

P P

49

P P

8 23

P P

6

P P P

68

P

X-Ray Brandywine Imaging www.brandywineimaging.com • 800-541-0632

Engineering Services, KCS Inc www.eng-services.com • 888-364-7782x11

Innovatus Imaging www.innovatusimaging.com • 844-687-5100

67

68

International X-Ray Brokers internationalxraybrokers.com/ •

Tri-Imaging Solutions

68

P P

17

P

8 31 76

P P P

www.triimaging.com • 855-401-4888

5 WWW.1TECHNATION.COM

SAV E THE

DA TE!

FEBRUARY 9-11, 2020 HI LTON SCOTTSDALE

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www.MedWrench.com DISCUSSION FORUMS // FREE TO JOIN // BUY & SELL EQUIPMENT

ALPHABETICAL INDEX A.M. Bickford……………………… 67

Master Medical Equipment……… 59

AIV………………………………… 51

Maull Biomedical Training………… 65

ALCO Sales & Service Co.………… 63 Ampronix, Inc.……………………… 4

Medical Equipment Doctor, INC.………………… 27, 29

ATS Laboratories…………………… 68

Medical Imaging Technologies…… 29

Avante Health Solutions…………… 2

MedWrench……………………… 84

Avante Patient Monitoring………… 24

Multimedical Systems…………… 22

Avante Ultrasound………………… 49

MW Imaging……………………… 23

BC Group International, Inc……… 88

NCBA……………………………… 50

Biomedical Repair & Consulting Services, Inc.………… 33

Ozark Biomedical………………… 60

BMES……………………………… 16 Brandywine Imaging……………… 68

PRN/ Physician’s Resource Network………………… 35

Cadmet…………………………… 70

Pronk Technologies, Inc. ………… 5

Career Institute of Technology…… 3

Radcal Corporation………………… 42

Coro Medical……………………… 16

RepairMED………………………… 41

Crothall Healthcare Technology Solutions……………… 67

Select BioMedical………………… 22

ECRI Institute……………………… 73 Engineering Services, KCS Inc…… 17

Southwestern Biomedical Electronics, Inc.…………………… 11

Healthmark Industries…………… 36

SPBS, Inc………………………… 68

Injector Support and Service……… 59

Stephens International Recruiting Inc.……………………… 42

Innovatus Imaging………………… 8 inRayParts.com…………………… 65 InterMed Group…………………… 63 International X-Ray Brokers……… 31 Interpower………………………… 87

Phoenix Data Systems…………… 60

BALTIMORE

SAVE THE

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Southeastern Biomedical, Inc…… 41

Summit Imaging…………………… 6 Tri-Imaging Solutions……………… 76 USOC Bio-Medical Services……… 7 Webinar Wednesday……………… 75

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

m d ex p o sh o w.c o m

JULY 2019

TECHNATION

85

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If You Need Just One, Order Just One The Interpower® solution for hospital-grade replacement cords: if you need just one, order just one. Made-to-order to your specifications, we offer both replacement cords and special orders. We have no minimum order or dollar requirements, so this empowers you to order just what you need—whether it’s 1, 5, 100, or more.

We provide value-added options, such as special labeling and packaging. For example, you can mark your cords with labels that contain identifying information (e.g. Operating Room 1, ER 2, etc.).

With your cords specially labeled, hopefully they will stay in the correct location. If you need to replace one, you only have to order one.

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Secure Connections Are Essential To help prevent accidental power interruptions, secure your cord set to a power inlet or outlet with the new Interpower Connector Lock. This design is available in two different versions and does not require tools for use.

Before selecting your connector components, you should consult the appropriate medical equipment standards for connection security requirements.

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INTERPOWER | P.O. Box 115 | 100 Interpower Ave | Oskaloosa, IA 52577 | Toll-Free Phone: (800) 662-2290 | Toll-Free Fax: (800) 645-5360 | sales@interpower.com

WHY BUY AN ESU-2400?

THERE ARE MANY GREAT REASONS TO PURCHASE AN ESU-2400:

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WAVEFORM GRAPHING

PDF REPORTS

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The ONLY all-in-one analyzer able to detect Pulsed Waveforms Phone: 1-888-223-6763 Email: sales@bcgroupintl.com Website: www.bcgroupintl.com ISO 9001 & 13485 Certified ISO 17025 Accredited

Biomed Support Services: Simplifying the Complex Quality training is essential for the Biomedical profession, but it’s often hard to find. BC Group is proud to endorse and recommend this new and innovative option for our industry. Dale Munson, a popular training instructor in the biomedical community, has launched his own business; Biomed Support Services. Biomed Support Services strives to build technical competence in biomedical technicians and clinical engineers. Biomed Support Services include creating simple-as-possible training materials, presenting customized courses, recommending process improvements and performing a variety of technical support functions (calibrations, output verifications, PMs, etc.).

Biomed Support Services Training Curriculum Includes: • Principles of Electrosurgery • Force FX™ –C Electrosurgical Generator • ForceTriad™ Energy Platform • Valleylab™ FT10 FT Series Energy Platform & more Learn more about Biomed Support Services at www.biomedsupportservices.com. You can also reach Biomed Support Services at 303-525-3393, or by email at dale@biomedsupportservices.com.

Join Biomed Support Services for ESU Courses from July 15-19, at BC Group Headquarters in St. Charles, MO.