TechNation Magazine September 2020

1technation.com

Vol. 11

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

SEPTEMBER 2020

HTM’S ROLE IN CONSTRUCTION PLANNING Best Practices Make for Smooth Sailing PAGE 62

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CONTENTS

FEATURED

HTM’S ROLE IN CONSTRUCTION PLANNING Best Practices Make for Smooth Sailing

56

HE ROUNDTABLE: CMMS T A quality CMMS is a tool that benefits every biomed. It provides assistance with everything from preventative maintenance schedules to equipment disposition. Experts from CMMS providers share insights regarding the newest features, capabilities and cybersecurity concerns.

62

HTM’S ROLE IN CONSTRUCTION PLANNING With mechanical, electronics and even technology acumen, biomed technicians and leadership are the go-to resource for any process that may occur in health care, including new construction or renovation projects.

HTM brings a perspective that capitalizes on knowledge that other stakeholders in the project may not possess. ext month’s Feature article: N Medical Device Service’s Collaborative Community

Next month’s Roundtable article: AI/Machine Learning

TechNation (Vol. 11, Issue #9) September 2020 is published monthly by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

POSTMASTER: Send address changes to TechNation at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

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. ©2020

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

SEPTEMBER 2020

TECHNATION

9

INSIDE Departments

CONTENTS

PUBLISHER

John M. Krieg

VICE PRESIDENT

Kristin Leavoy

ACCOUNT EXECUTIVES

Jayme McKelvey Megan Cabot

ART DEPARTMENT Jonathan Riley

Karlee Gower

Amanda Purser EDITORIAL

John Wallace Erin Register

CONTRIBUTORS

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

DIGITAL SERVICES

Cindy Galindo Kennedy Krieg

CIRCULATION

Lisa Lisle Jennifer Godwin

WEBINARS

webinar@mdpublishing.com

ACCOUNTING

Diane Costea

EDITORIAL BOARD

Manny Roman, CRES, Business Operations Manager, Association of Medical Service Providers Jim Fedele, CBET, Senior Director of Clinical Engineering, UPMC Carol Davis-Smith, CCE, FACCE, AAMIF, Owner/ President of Carol Davis-Smith & Associates, LLC David Francoeur, CBET, CHTM, Senior Vice President Marketing and Sales, Tech Know Associates - TKA Jennifer DeFrancesco, DHA, MS, CHTM, System Director, Clinical Engineering, Crothall Healthcare Rob Bundick, Director HTM & Biomedical Engineering, ProHealth Care

P.12 SPOTLIGHT p.12 Company Showcase: Nuvolo p.14 Department of the Month: VHSO Biomedical Engineering Department p.18 Professional of the Month: Nicholas “Nick” Grecco, CBET p.20 Company Showcase: Phoenix Data Systems, Inc. p.24 Biomed Adventures:This Biomed is On Track p.26 Company Showcase: Ordr P.30 INDUSTRY UPDATES p.30 News and Notes: Updates

from the HTM Industry p.38 Ribbon Cutting: Collin College Biomedical Equipment Technology Program p.40 AAMI Update p.42 ECRI Update p.45 MedWrench Anniversary p.46 Welcome to TechNation P.49 p.49 p.50 p.52 p.54

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

P.66 EXPERT ADVICE p.66 Career Center p.68 How to Retain Vacuum on an Elekta Linac During a Power Outage, sponsored by Avante p.70 View on Value p.73 The Future p.74 20/20 Imaging Insights, sponsored by Innovatus Imaging p.76 Cybersecurity p.79 The Other Side p.81 Roman Review P.82 BREAKROOM p.82 Did You Know? p.85 The Vault p.86 MedWrench: Bulletin Board p.94 Flashback p.90 Service Index p.93 Alphabetical Index

MD Publishing / TechNation Magazine 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290 800.906.3373 • Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE Nuvolo H

ave you heard about The Connected Workplace for Healthcare?

It’s the modern, cloud-based alternative to a legacy CMMS.

Nuvolo, with the help of veteran healthcare management specialists, built a powerful software platform to support Healthcare Technology Management (HTM) teams. We understand that innovative healthcare organizations need a modern, mobile-first, scalable, and cyber-aware platform.

We work with some of the largest hospital systems in the country. Our mission is to consistently improve and innovate our platform to help HTM teams in their mission - delivering better patient care while ensuring all hospital facilities and medical devices are safe, compliant, and operational.

NUVOLO DELIVERS THE CONNECTED WORKPLACE TO HEALTHCARE ORGANIZATIONS Eliminate those department silos! The

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Connected Hospital is where support teams, like HTM, IT, Real Estate, Maintenance, Supply Chain, Pharmacy, Clinical Care, and more, work together on one platform to support the doctors, nurses, and all care team staff.

Nuvolo is built on ServiceNow, one of the world’s leading enterprise cloud platforms. Nuvolo’s built-on-ServiceNow strategy provides unprecedented availability, security, flexibility, and performance.

Nuvolo’s Connected Hospital expands the ServiceNow platform into Facilities and HTM. We deliver solutions for Maintenance, Space, Projects, Real Estate, Sustainability, Capital Planning, and OT Cyber Security to cover all areas of Healthcare Technology Management.

Hospital staff can quickly report a problem anywhere on the hospital campus through our mobile application or self-service website. Then, IT, HTM, and Facilities Technicians use Nuvolo’s mobile app to work quickly and efficiently throughout the hospital campus.

Technicians have instant access to the work order, device service history, service manuals, knowledge bases, spare parts inventory, and training videos.

They complete the assigned work directly from the mobile application and track their performance.

The Connected Hospital platform tracks each medical device, keeps them secure, manages existing inventory, resolves any technical issues that arise, and shares the platform with IT for comprehensive medical equipment management.

The Connected Hospital platform also: • Organizes work orders and preventative maintenance (PM) schedules that can be accessed anywhere on any device and shared with anyone in the hospital.

• Uses smart dispatching to automate and auto route work orders based on location, device type, model, vendor, and many more.

• Identifies better ways to maintain clinical devices while ensuring safety

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

and regulatory compliance with Nuvolo’s Alternative Equipment Maintenance (AEM) workflows.

• Provides visual interactive color-coded floor plan maps so staff and technicians can see and navigate all hospital rooms, devices, and work orders.

• Uses the same floor maps to track mobile devices with sensor technology in real-time.

• Measures energy, water, and air quality, ensuring hospitals comply with industry standards and patient comfort.

• Manages cleanliness, noise level, lighting, call buttons, beds, room temperature, all aspects of the physical hospital setting.

• Enables work checklists or “rounds” for comprehensive Joint Commission or DNV compliance and reporting.

• Provides project software that tracks the delivery of high-quality, cost-effective hospital renovations and new building development.

And so much more.

With Nuvolo’s connected hospital platform, the actionable analytics for clinical device inventory, work orders, space planning, and more is invaluable.

All this data on one platform transforms the level of service your hospital provides.

Your support teams have the data to make better clinical and business decisions. For example, • Your HTM and Facilities teams can answer critical device questions like: Is the device service contract

needed? Should we repair or replace the device? What devices have alerts and recalls? How many ventilators do we have? Where are they located?

Are they patient ready?

• The data will uncover any recurring problems with medical devices or facilities equipment so you can quickly fix them and create a more comfortable and safer environment for patients.

• Your Real Estate team can track and evaluate projects to deliver high-quality, cost-effective hospital renovations, and new building development.

Whether you’re building a new hospital, planning expensive equipment purchases, creating compliance dashboards, or tracking space utilization – use Nuvolo’s connected analytics to make better business decisions.

device data into the ServiceNow platform, where IT, security, and HTM teams share visibility. IT knows where the medical device is, knows what it is, and can act on threats and vulnerabilities.

Nuvolo’s Connected Hospital provides an improved technician experience, better real-time reporting, compliance tracking, and process simplicity. In the Connected Hospital, high standards, collaboration, and safety are built-in and automated, keeping your hospitals and medical centers safe and reliable so doctors and nurses can focus on improved patient outcomes.

For more information, visit www.nuvolo.com or scan the QR code below:

MEDICAL DEVICE CYBER SECURITY – YES, THAT’S CONNECTED TOO As more medical devices connect to the network, the risk of cyber security becomes a real challenge for IT and HTM teams. Nuvolo brings medical

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

SEPTEMBER 2020

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SPOTLIGHT Members of the Veterans Health Care System of the Ozarks (VHSO) Biomedical Engineering Department are, from left to right, Sergio CruzCamacho, Ralph Newman, Tom Chapman, Jane Lacson, Mike Alf, Robert Casey, Gerald Williams and Russ Powell.

DEPARTMENT OF THE MONTH VHSO Biomedical Engineering Department

BY K. RICHARD DOUGLAS

T

he Ozarks is a region of the country that includes the Ozark Mountains and spans 93 counties in four states: Missouri, Arkansas, Oklahoma and Kansas. The region offers many attractions for tourists.

Lake of the Ozarks, in the heart of Missouri, offers boating, golfing, fishing and shopping. Resorts, cottages, parks, caves and waterparks are just some of the area’s attractions.

Serving the health care needs of veterans in this beautiful area of the country is the Veterans Health Care System of the Ozarks.

Serving the medical equipment management needs of the system is the biomedical engineering department. The team serves facilities in three states.

“The Veterans Health Care System of the Ozarks (VHSO) consists of one Veterans Health Administration (VHA) facility located in Fayetteville, Arkansas, and seven community-based outpatient clinics (CBOCs) in Fort Smith, Harrison, and Ozark, Arkansas;

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Branson, Springfield, and Joplin, Missouri; and Jay, Oklahoma. All clinics are VA staff, except for Harrison, Arkansas, which is contract staff,” says Jane Lacson, MS, CCE, CHTM, chief of biomedical engineering for the system.

Lacson says that the seven CBOCs serve veterans in north and west Arkansas, southwest Missouri and east Oklahoma.

“There are two Vet Centers in VHSO’s catchment area, one located in Fayetteville, Arkansas and the second in Springfield, Missouri. There are also two State Veterans Homes in the VHSO catchment area: one in Mt. Vernon, Missouri; and one in Fayetteville, Arkansas,” Lacson says.

VHSO is a 78-bed acute care facility classified as a Level 1C on the VA Complexity Model.

“Comprehensive health care is provided through primary and secondary care in areas of medicine, surgery, mental health, physical therapy, neurology, audiology and speech pathology, dentistry, ophthalmology,

oncology and women’s health. Referrals are made to tertiary care facilities.

VHSO is part of the South-Central VA Health Care Network (VISN 16), which includes facilities in Arkansas, Alabama, Louisiana, Mississippi, Texas and Florida,” Lacson explains.

Besides Lacson, the team is composed of Biomedical Equipment Support Specialist (Information Technology) Ralph Newman and biomedical equipment support specialists Michael Alf; Robert Casey, CBET; Tom Chapman, CBET; Sergio Cruz-Camacho; Russ Powell and Gerald Williams.

The department manages service contracts with the help of the contracting office.

“The period of performance for these contracts are managed so as to not have a lapse in coverage. Each of the staff members in the biomed department have their contracting officer’s representative (COR) certificate and they manage their individual contracts,” Lacson says.

She says that the major responsibilities and duties of the COR are to

WWW.1TECHNATION.COM

SPOTLIGHT

manage the activities of the work conducted by the contractor, overall contract performance, to financially accept/reject invoices made against the contract and to create procurement packages for the contract.

Data collection is accomplished using Maximo, which is their CMMS. They have utilized this system for the past three years.

“All this data is pulled into a central database where the VHA Analytics team creates tools and reports, available on a local, VISN and national level that are used to monitor key performance indicators and benchmark performance data against like sites. A site has the ability to look at the KPI Dashboard which includes categories of safety and risk management, process and quality, employee learning and growth, and customer satisfaction,” Lacson says.

MAKING FACILITIES COVID-READY AND SAVING MONEY The team has tackled several special projects in addition to its daily accomplishments. One of those was the department’s CIS/ARK project.

“Ralph implemented both PICIS’s Critical Care Manager and Draeger’s ARK (Anesthesia Record Keeper) solution. It involved working with clinical staff, contractors, IT over multiple months from imaging workstations to servers to creating the cabling/ hookups to the computer workstations

from bedside monitors and other ICU equipment,” Lacson says.

She says the team also worked on an RTLS project. It involved working with logistics to implement RTLS for all non-expendable equipment at VHSO. “Over a year was spent in implementing the infrastructure necessary to provide real-time tracking of equipment, as multiple wires and access points had to be run throughout the hospital. An entire network backbone had to be created, working with IT. Working with clinical staff to access and tag all the equipment of over 6,000 assets,” Lacson says.

They have also worked on a virtualization/storage infrastructure project.

“A growing amount of networked medical equipment requires a client/ server set-up. Each physical server purchased became more and more costly, requiring many hours to procure, receive, install and set-up. The virtualization of servers and storage was a large project that proved to be very beneficial,” Lacson says.

She says that working in collaboration with IT, the biomed virtual servers were installed and spun-up.

“There are currently 15 virtual servers and more will be added into the future; system upgrades are a breeze as servers can be placed on a different ESXi host without any service interruption,” Lacson says.

Like so many of their counterparts

Tom Chapman and Robert Casey work on an infusion pump.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

nationwide, the team had to dive into COVID-19 readiness. Lacson explains that the preparation had many facets.

“Performing ahead of time all preventive maintenance on ventilators so that they would not need to be pulled should they become in-use. Helping other VA sites within the region to complete their PMs. Bedside monitoring expansion for different areas of the hospital for COVID/clean ICU. Having to run new cable for APs for telemetry expansion. Working on additional ventilator equipment procurements. Using 3D printing to print PPE and comfort mask tension bands. Making sure all PMs/CMs were done and corrected as soon as possible for equipment in critical areas,” she says.

The expertise on the biomed team has allowed the group to save money and to prevent patients from having to reschedule appointments.

“A vendor quoted a cost for an additional monitor at $23,000 and we were able to find all the parts necessary for $1,000,” Lacson says, pointing to one example of cost savings.

She recalls another time the team came through because of quick thinking.

“Ventilators needed to be plugged into different med gas outlets in the new clean ICU but not all of the outlets were standardized. (The department) was able to create a quick disconnect adapter that allowed for vents to be moved anywhere in new surge units,” Lacson says.

She says that another time, a camera in a microscope used in an operating room was damaged and would have resulted in canceled cases if not for the work of the department.

“Through diligence and problem solving, we were able to order the camera in overnight and get it installed without cancelling patients,” Lacson says.

The VHSO Biomedical Engineering Department has made life a little more enjoyable for the many veterans living in the area by maintaining the equipment needed to deliver quality health care when it is needed.

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Nicholas “Nick” Grecco, CBET: Recognized for Dedication

BY K. RICHARD DOUGLAS

F

Nick Grecco enjoys traveling and spending time with family.

or all of the reasons why 2020 may be a year that many people would want to forget, there have still been some big achievements that will make 2020 memorable for some.

Winning the AAMI and GE Healthcare’s BMET of the Year Award is not least among them. For 2020, that honor went to Nicholas “Nick” Grecco, CBET, team lead in Clinical Engineering Services at Morton Plant North Bay Hospital and Mease Dunedin Hospital; both a part of the Baycare Health System in central Florida.

Grecco says he has always had an interest in technology.

“I attended college and received a bachelor’s degree in electrical engineering.

My first job was performing circuit-level repair of medical devices. Back then, component-level repair through schematic-level reading and digital logic troubleshooting was the daily occurrence. I learned then what it feels like to accomplish something through tedious troubleshooting, which was followed by the reward of the repair and return to service.

The satisfaction of knowing we truly have an impact in every patient’s care is what first interested me in the HTM/biomed profession,” Grecco says.

Grecco’s education in electrical engineering was supplemented with HTM-specific training and business education.

“I have a bachelor’s degree in electrical engineering and a bachelor’s degree in

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business. I also graduated from the U.S. Army’s Biomedical Equipment Technician course. I enlisted after a company layoff in 2008,” he says.

Since entering the field, Grecco has held many positions and responsibilities, including repair technician, senior repair technician, technical support specialist, contracts specialist, product manager, marketing manager, biomedical tech II, biomedical tech III, clinical engineering team lead and clinical engineering interim manager.

GRATEFUL TO WORK IN HTM It goes without saying that every HTM professional faces a number of challenges throughout their careers. Many can be remedied through troubleshooting and others may require increased hours or working under special circumstances.

Grecco reflects the thoughts of many in the field when dealing with a pandemic that has challenged all of health care.

“The COVID-19 pandemic has been

the biggest special challenge that we’re all facing. We’re living in a very different world now. I have always taken pride in the personal relationships I have made with team members, vendors and patients.

With social distancing, I have had to adjust to a ‘new normal’ of professional interaction. That said, it is truly for the greater good to protect the patients, the team members and myself,” he says.

Outside of the challenges posed by the pandemic, there is the mission of protecting hospital equipment and patient information from bad actors.

“One of the biggest special projects I have been involved in has been related to cybersecurity. The HTM teams are working around the clock to protect our equipment from cyber threats like malware and other viruses. As an HTM professional, it is my responsibility to ensure the medical equipment is fortified with every safeguard,” Grecco says.

The hard work and dedication have not gone unrecognized for Grecco’s more

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SPOTLIGHT

than two decades in the profession. The AAMI/GE Healthcare award was a big surprise.

“I first heard of the AAMI/GE Healthcare award in the military during school. This award is like the Stanley Cup of HTM. I was ecstatic, honored and humbled,” Grecco says.

He had been recognized previously with regional and statewide awards, which included the 2018 Bay Area Association of Medical Instruments (BAAMI) Biomedical Technician of the Year and the 2018 Florida Biomedical Society (FBS) BMET of the Year.

Away from work, Grecco enjoys anything that has to do with being on, or near, the water. That includes swimming, fishing and boating.

He is happily married and has five kids.

Asked what TechNation readers should know about him, Grecco reflects on a perspective that many biomeds embrace.

“I have been in the HTM/biomed field for over 23 years. I am the technician who finds joy disassembling things, but will meticulously place the parts in a manner so everything is reassembled fully. I will see things at 10,000 feet, but can still zoom in and analyze things at a micro-level too. I truly have fun in this job, and you should too,” he says.

Grecco says that fun begins with your surroundings.

“Build relationships with your follow team members, and it doesn’t matter if they’re in biomed, maintenance, food service, EVS, or they are doctors or nurses; having allies in the workplace is important. They will help you when you really need it one day and you will be thankful for it,” he says.

Grecco says that he has been to college and tech school, numerous vendor trainings, and the military, and he is still learning.

“So never be complacent. Our field is ever-changing and you have to change with it. Lastly, in today’s professional environment, and living in the COVID pandemic, I am extremely thankful and grateful to not only be employed, but also be employed in this wonderful HTM field,” Grecco adds.

At a time when a positive outlook is most needed, it takes the important members of the HTM field to support clinicians and equipment. Nick Grecco has met that challenge and has been recognized for the value he brings to his team.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

LEFT: Nick Grecco received training in the U.S. Army. BELOW: Nick Grecco is married with five children

FAVORITE BOOK:

“Walden” by Henry David Thoreau

FAVORITE MOVIE:

I like all the Marvel and “ Star Wars” movies because they are entertaining. I like “The Shawshank Redemption” or “Cast Away” for inspiration, and “Ferris Bueller’s Day Off” and “The Goonies” for fun ’80s classics.

FAVORITE FOOD: Italian food

HIDDEN TALENT:

“I’ve been an artist since I was young. I love to draw, paint, draft and sculpt. I have a relatively new passion for building furniture.”

FAVORITE PART OF BEING A BIOMED:

“When clinical team members are inhibited from doing their job due to equipment malfunction, I can assess the equipment and either get it back up and running or provide a loaner. This makes the clinician’s job easier. It’s a humbling feeling.”

WHAT’S ON MY BENCH?

• Multitool, flashlight • Reading glasses (because I’ve hit that age) • Notebook pad • YETI full of water (it’s always filled with water)

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SPOTLIGHT

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE Phoenix Data Systems, Inc.

P

hoenix Data Systems, Inc. was formed in the early days of specialized software based on the urgent need for Michigan hospitals to have a modern maintenance work order system. In 1984, after two years of design and development, the first AIMS system was delivered to eight Michigan hospitals. Today, AIMS is used in 3,000 facilities in 18 countries. Phoenix Data Systems, Inc. recently launched its fifth platform to carry AIMS users well into the late 2020s and beyond.

“Our most exciting product is our fifth generation CMMS, called AIMS 3,” President and CEO Ben Mannisto says.

“This is not just a facelift of our current product, AIMS.NET, but rather a culmination of 35 years of experience in the industry listening to our customers’ needs and requirements, and putting all of that into a rewrite using the latest technologies. The product will still feel

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familiar to our existing customers so there will be little to no training needed to make the transition to AIMS 3.”

“With built-in metrics and machine-learning algorithms, we can instantly alert users when they are drifting from acceptable performance levels, costs, task results, compliance or other trackable metrics. AIMS 3 will provide improved workflows and more

information at your fingertips, so technicians can spend less time using the software and more time out on the floor taking care of medical equipment and maintaining facilities,” he adds. “AIMS 3 will be browser agnostic with built-in dashboards, and can be installed locally or hosted by Phoenix Data Systems, Inc. at one of our offsite data centers (cloud), in either the U.S. or Canada.”

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SPECIAL ADVERTISING SECTION

Q: HOW EASY IS IT TO CHANGE FROM OUR CURRENT CMMS TO AIMS 3? WE HAVE HEARD SOME VENDORS DON’T CONVERT CURRENT DATA EVEN THOUGH WE ARE REQUIRED TO KEEP THOSE RECORDS AND WILL STILL NEED ACCESS. A: Phoenix Data Systems, Inc. completes a full database conversion to move all of your current data into AIMS 3. Our Implementation Team works with your team to ensure all data is accurately converted for full access and usability in one system. We set real delivery dates for every step of your implementation and consistently meet customer expectations.

Full implementation can be achieved in as little as 90 days, with some completed in even less time.

Q: WE HAVE MULTIPLE DEPARTMENTS (HTM, CE, FE, IT, ETC.) THAT ALL NEED TO BE ON THE SAME SYSTEM. HOW WOULD THAT WORK IN AIMS 3 SO THAT EACH DEPARTMENT ONLY SEES THEIR OWN INFORMATION, BUT THE SYSTEM CAN STILL BE MANAGED AT THE GLOBAL LEVEL? A: All opportunities to filter, secure and assign data in AIMS 3 work at the service department level. This provides a unique experience when a technician from any department logs into the system. The tech will only see the data they are permitted and required to access based on their security level and their assigned service department. This includes equipment, work orders, contracts, parts, etc., and also the fields that make up those records. If an equipment type is assigned to FE only, then only FE employees will have the ability to see that equipment type when accessing that field. When an HTM tech accesses the same field, they will view a set of information relevant to HTM. Customized screen layouts are set at the security level, so each service department can have a unique set of fields visible that are relevant to the user. Administrators have rights across all service departments to efficiently manage the system from a

global level. This includes reports that can be executed with combined hours, costs, material dollars, purchase orders, etc. across a service department, facility or the entire organization.

Q: WHAT OPPORTUNITIES ARE THERE TO USE AIMS ON A MOBILE DEVICE? CAN TECHNICIANS ACCESS THE FULL APPLICATION OR A SUBSET OF FUNCTIONALITY? A: AIMS 3 is designed for use on any browser and on any device. AIMS 3 full functionality is accessible using a smartphone, tablet, laptop or workstation. This provides the opportunity for a technician standing next to a piece of equipment in the field to view any attached documents, create new work orders, complete open work orders, view contract information, call vendors and even chat online with other technicians or managers if they need assistance, all from inside the AIMS 3 application.

Q: OUR HOSPITAL NEEDS THE CMMS TO INTEGRATE WITH MANY OTHER APPLICATIONS. WHAT INTERFACE OPPORTUNITIES ARE THERE WITH AIMS 3?

A: AIMS 3 was designed to interface with any system in the world. It is fully API driven, so every field in the system can be pulled or pushed into the database through the API. Assets, work orders, contracts, parts, purchase requests/orders, etc. can all be interfaced to other systems.

Our current interfaces and partners include ServiceNow, ECRI, Lawson, PeopleSoft, ZingBox, AeroScout, ANSUR, BC Group, Datrend, Kronos, McKesson, oneSOURCE, PartsSource,

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Versus, StrataJazz and Meditech to name a few. AIMS 3 can also interface with custom software. Some integrations are very simple, where the data is either pushed or pulled in one direction, while others involve data moving in both directions, such as our interface to ServiceNow. Asset, IT information and work orders can flow in either direction, and can be completed in one system and updated in the other, so reports and metrics can be pulled from both systems.

If APIs are not available in the other third-party system, AIMS is also capable of using flat files, EDI files, web service calls, punch outs or any other method of connecting for full integration.

Q: WHAT REPORTING OPTIONS ARE THERE IN AIMS? CAN WE CREATE OUR OWN CUSTOM REPORTS OR DO WE HAVE TO HAVE PHOENIX DATA SYSTEMS, INC. CREATE THEM? ARE THERE ALSO CHARTING OPPORTUNITIES? A: AIMS 3 is the least restrictive CMMS when it comes to getting your data out for reporting purposes. Phoenix Data Systems, Inc. understands that any system is only as good as the data you can get back out when necessary. AIMS 3 includes built-in reports, but they are not hard-coded and can be quickly edited by the user to meet management needs. There are numerous charting opportunities, including a customizable home screen that allows the user to select which charts are applicable to them. The full dashboard component can be used to set up a suite of charts available to a wide variety of users, or specific to just one person. All charts auto-refresh, so

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users see the latest data at all times.

Custom reports can be written by the end-user or by Phoenix Data Systems, Inc., and can then be imported into the system for quick access. Custom SQL scripts can be written from within the software to pull any data directly from the database. This data is presented in Excel for easy sorting and reporting.

AIMS 3 also offers a full export feature for every field in the system, including the unlimited number of user-defined expansion fields. For data exports and SQL scripts that require more than a single run, users can save the setup as a macro so it can be called in the future.

Q: WHAT ARE SOME FEATURES THAT SEPARATE AIMS 3 FROM OTHER CMMS SYSTEMS ON THE MARKET? A: A few of the features that make AIMS 3 unique include: • Chat! Although most users have internal chat programs, this has become one of AIMS 3 most used features.

Conversations are saved in the database, so the history is available in AIMS 3, and it is accessible while the user is on the record requiring discussion. No need to leave the window to find your other chat program.

• Calculated Downtime. AIMS 3 has the ability to calculate downtime on equipment automatically. This calculation even takes into account the equipment or cost center’s hours of operation, so your calculated downtime is accurate and easily reportable. Users can instantly find all equipment items that are currently down to ensure techs are quickly dispatched to those items.

• Detailed security at the field level. This allows you to fully define security for every role in your organization. One example is that a user can be given the rights to update an equipment record’s location and condition, but can also lock them out from changing the model number or equipment type. This will help keep your data quality higher while still giving them the ability to

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input information to complete their specific responsibilities.

• Images on screen. Users can add a default image at the asset, work order and part levels. This helps the user or clinician identify that they are servicing the correct equipment, or that the correct critical parts are being used to repair or maintain that equipment. Equipment images are also visible in our web request system, EasyNet, so your customers are ensured they have assigned the correct equipment to the work request.

• Custom Critical Messages. In addition to the built-in critical pop-up messages such as Under Warranty, Under Contract, Equipment Down and Critical System, users can also define their own criteria for critical messages to be displayed at the top of user-de-

fined equipment and work order records. The criteria, wording and text color can all be setup by the user. This can be used to quickly identify equipment that needs to be replaced or is retired when creating work orders.

• Multi-Language. AIMS is used in 18 countries, many for which English is the secondary language. Every label and message can be changed to any language or wording by the user, which also means every label and message can be customized by any customer without any involvement from Phoenix Data Systems, Inc. Users simply access the built-in label change feature or export the entire language file, make their updates and upload all labels at once.

For more information, visit www.goaims.com.

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SPOTLIGHT

Dennis Duck’s biomed training comes in handy when working on his model trains.

BIOMED ADVENTURES This Biomed is On Track

BY K. RICHARD DOUGLAS

I

n 2011, TechNation featured Dennis Duck as the Professional of the Month in the October issue. While the focus was on Duck’s work and experience as an HTM professional and his experience with the ham radio, not as much was said about his passion for model trains.

Today, Dennis Duck, CBET, is a certified senior biomedical equipment technician in the Healthcare Technology Management department at Baylor Scott & White Healthcare-Grapevine, in Grapevine, Texas.

Like many others, who have a fascination with model trains, Duck first had his interest piqued when he was a child.

“I got my first model train when I was eight. My brother helped me build a simple layout on a sheet of plywood with plastic buildings and streets that were spray painted on it. This was what got me started with HO scale model trains,” Duck says.

He says that he began expanding the layout in junior high school.

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“I took that sheet of plywood, and again my brother helped, by building a table frame for it in our basement laundry room. I ran under-table wiring to power the tracks and the switch track motors to switch them remotely. I made power poles out of leftover plastic rods, strung wire on them with miniature Christmas tree bulbs and powered them with a doorbell transformer mounted to the tabletop for a power substation. I also made an aircraft parts factory from wood paneling and its loading dock from popsicle sticks,” Duck adds.

He says that the layout had to be disassembled and stored when he joined the U.S. Navy in 1987.

“While I was in the Navy, I never lived anywhere I could set up a layout, so I went to model train shows whenever I could. This gave me the opportunity to gather ideas for my next layout and to buy pieces for it here and there since it can be a very expensive hobby to get into,” he says.

Model trains have remained a passion of the many baby-boom generation hobbyists who owned them

A section of the train layout is seen. as kids. The trains come in many scales, from the smallest Z-scale to the largest G-scale. The HO-scale is 1:87. The tracks come in different gauges to fit the different train scales. The HO scale is the most popular today.

Duck explains that there are quirks

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SPOTLIGHT

and potential mishaps that come along with the hobby.

“One of the biggest challenges of this hobby is patience. It takes planning as well as trial and error.

Just because the train cars are similar and all the same brand, that doesn’t guarantee they will all roll smoothly on the track. One car might need its coupler height adjusted, or its wheels realigned if it keeps derailing. And even with planning, the layout may have to be modified due to size or dimensional restrictions. Pets can also affect the planning – especially cats,” he says.

After his previous experience laying out interesting set-ups, his current efforts are going into a landscape that reflects his past surroundings, making it more personal. Duck’s description of its features makes clear the seriousness that real model train enthusiasts go to in order to recreate real life.

“My current setup is still a work in progress, a year after I started building it. The main focus of the layout is a one-block section of my hometown, set in the late 1970s to mid-1980s,” Duck says.

“The co-op grain elevator my mom worked at, the other grain elevator in town, and the pole yard for the power company my dad worked for, with two directional tracks for mainline rail traffic and two side tracks, one for the elevators and one for the pole yard. I have the main lines going through this section, then to a loop on both sides of it, with multiple spur tracks to park unused rail cars and engines. I have yet to add ground texture, gravel, lights, signals and plants to it, as well as finishing wiring the spur track sections,” he adds.

THE INTERNET BRINGS NEW OPTIONS Social media and Internet marketplaces did not exist when many of today’s model train enthusiasts started practicing their hobby. It has changed many of the dynamics of the pastime.

“I don’t currently belong to any model railroading clubs or organizations, but I am a member of some of the model railroading groups on Facebook. I’ve used many ideas and suggestions to build my layout as well as repair some of the engines and cars from my teenage layout,” Duck says.

He says that the majority of the components in his current layout were purchased from vendors on eBay. “I have spent over a thousand dollars for the components of this layout, and with the right research, I got most of these items for less than retail cost,” he says.

“I don’t have any antique or rare engines or cars, but two of my engines have preinstalled digital command control (DCC) with sound, meaning they have sound, movement and light features that are controlled by the different function buttons on the power controller. Engine revving, a bell ringing, horns, talking, directional lighting, etcetera. The rest of my engines are either DCC capable (just add the controller chip) or need a controller board and chip installed,” Duck says.

What would he suggest someone new to model trains consider?

“As far as advice for someone getting into model railroading, start with planning your layout according to the space you have available for it.

If your space is limited, a smaller scale (N or even Z scale, the smallest I know of) might be the best scale for you,” Duck says.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Dennis Duck, CBET, enjoys constructing a model train layout that features his hiometown.

He says to pick the era you want to model – steam, early diesel, modern diesel, passenger, freight or both.

“The layout can be of an actual area/location, or whatever you want it to be. Many people have outdoor or garden layouts using large scale trains.

If you have the funding, time, space and patience; the only other limit is your imagination,” Duck adds.

While mobile video games and virtual reality may be satisfying to some, the simple joy of watching a model train snake through an elaborate layout is hard to beat. This biomed has discovered that what was a fulfilling pastime decades ago can be the perfect escape today. All aboard.

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COMPANY SHOWCASE Ordr

B

y some estimates there are more than 31 billion IP-enabled devices, collectively known as the Internet of Things (IoT), connected to the Internet. That number is expected to increase to 35 billion by 2025.

Connected devices are a significant part of today’s enterprise IT architecture, and no industry has embraced IoT more than health care. In health care organizations, specialized Internet of Medical Things (IoMT) perform patient monitoring, treatment and diagnostics, while additional IoT and operational technology (OT) devices control facilities, improve operations and enhance communications. All are a critical part of the patient care experience.

The challenge is that these devices can be difficult to secure. They cannot be taken out of service, even to be patched, and typically have an expected service life of many years (far more than typical managed endpoints). Many support rudimentary operating systems and are susceptible to failure during scans. They can be difficult to discover via traditional security solutions and cannot support corporate endpoint security agents. Left undiscovered, unmanaged and unsecured, these devices put hospitals and the patients that rely on them, at risk.

“Today’s health care networks consist of IoT, IoMT and operational technology devices, all of which may reside under different operational owners, creating a wide attack surface if not properly managed,” explains Greg Murphy, CEO of Ordr. “You need one

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“ When I first saw Ordr I said, ‘I’ve got to find the money for this tool,’ and now we use it every day to monitor what’s going on in our environment, see what risks we have, and help us mitigate those risks.”

– CLINT PERKINSON, DIRECTOR OF INFORMATION SYSTEMS, BEEBE HEALTHCARE common platform that can deliver visibility and security for all these devices, not just medical devices.”

ONE COMPREHENSIVE SECURITY PLATFORM FOR HEALTH CARE Ordr was founded in 2015 by industry veterans from Cisco and Aruba Networks who recognized an urgent need to address the visibility and security of unmanaged IoT, IoMT, and OT devices.

Whether the threat is being commandeered as part of a botnet by malicious actors, or used as a vector for infecting networks with ransomware, IoT and IoMT adoption introduces a new attack surface.

To counter the threat, Ordr developed the Systems Control Engine, the industry’s most comprehensive platform for IoT, IoMT and OT discovery, management and security. Engineered to be easy to use while closing the security gaps common with connected device deployment, the Ordr SCE delivers the following: • Discover all devices in the network.

Ordr can discover and classify every device in the customer’s network within a few hours of installation.

Based on the devices classified, Ordr then identifies devices with vulnera-

bilities, weak ciphers and passwords, and active exploits. Ordr SCE integrates with a suite of industry threat intelligence feeds, network vulnerability databases, manufacturing and FDA databses, and ICSA– ICS-CERT advisories. Ordr SCE can also be integrated with asset inventory solutions like computerized maintenance management system (CMMS) and configuration management database (CMDB) solutions, increasing its value as an IT management platform and making Ordr a preferred platform among security vendors in the health care market.

• Behavioral profile devices and risks.

Visibility and classification isn’t enough. Next, Ordr analyzes device behavior and risks using the Ordr Flow Genome. As the name implies, the Flow Genome maps each device’s unique, customer-specific communications patterns, and profiles exactly how it should behave. Unlike users, IoT devices have specific and predictable communications patterns. For example, video cameras need to connect to a camera management system; medical imaging devices need to communicate to a central PACS or DICOM server.

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“ We need more than simple medical device inventory management. We need very granular detail on every connected device in order to understand exactly what it is doing, what it’s supposed to be doing, its potential risks and its vulnerabilities.

Ordr not only delivers that detail, it gives us the power to use that data to automatically generate and implement sophisticated regulation and security policies using our existing infrastructure,” – JEFF CASH, CIO, MERCY MEDICAL CENTER Ordr Flow Genome profiles the behavior of devices and identifies anomalous and malicious communications. The Flow Genome also provides deep insight into device utilization, so teams can identify areas of over or under use, to ensure data-driven moves, adds, and changes as teams scale their capacity.

• Automated Action. Real-time discovery, monitoring, and behavioral analytics only matter if IT and security teams can act on the resulting insights quickly and effectively. This is where Ordr shines.

Ordr enables practical segmentation that actually works. Based on

the device profiling information from Ordr Flow Genome, Ordr dynamically creates policies to segment devices and “allow” only the appropriate “sanctioned” communications. Ordr then enforces these policies automatically on existing infrastructure, like firewalls, switches, network access controls and wireless LAN controllers. In the event of a security incident, policies can also be generated to quickly isolate an infected device.

“When we built the Ordr SCE, we created a robust AI platform to secure all connected devices. However, we knew that was not enough. We also focused on automating the critical job of securing these devices, not only reducing the burden on security and networking teams, but making previously complex management tasks simple,” says G. Pandian, chief product officer and co-founder, Ordr.

Ordr has been effectively implemented at scale to secure connected devices in large, complex networks, and is the preferred IoT vendor for health care organizations. A recent Series B funding round included investment from Mayo Clinic and Kaiser Permanente Ventures.

RANSOMWARE THWARTED When investing in an IoT security and management platform, it’s good to know it will work as advertised when called upon in an emergency. Ordr does.

Earlier this year, a partner hospital to an Ordr health care customer was hit by a ransomware attack. After the initial infection, the malware tried to spread from the partner’s network onto the customer over a pre-established VPN tunnel.

Some of the first systems affected by the malicious file were devices that were unprotected by the customer’s endpoint antivirus solution, nor included in their SCCM inventory.

Using Ordr, however, the customer’s cybersecurity team was able to identify the at-risk systems, take them off line, then clean, repair and update the systems. Ordr closed the security gap and made it possible for their customer to stop the spread of the malicious file, mitigate and subsequently eradicate the ransomware threat.

For more information about adopting IoT and IoMT as a key part of your IT strategy and how you can better monitor, manage and protect those devices, visit www.ordr.net.

“ We need to know exactly what’s connected, how and when it’s being used, and how to protect it. And we need to be able to do all of that quickly and easily, as our focus must remain on delivering quality care. The Ordr solution gives us the detailed insights we need and the power to take control of the regulation, utilization and security of our connected health care systems.”

– ROBERT BUNDICK, DIRECTOR OF BIOMEDICAL ENGINEERING, PROHEALTH CARE

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

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INDUSTRY UPDATES

NEWS & NOTES

Updates from the HTM Industry

CROTHALL, ASIMILY FORM STRATEGIC PARTNERSHIP Crothall Healthcare Technology Solutions (HTS) and Asimily recently announced a strategic partnership.

“For many health care systems, the rapid adoption of connected medical device technology expands the potential cyber-attack surface, and creates a significant cybersecurity gap, therefore making it difficult to scale device security,” said Shankar Somasundaram, Asimily’s founder and chief executive officer. “All of our clients will now have access to a world-class service portfolio that provides for the management and oversight of a hospital’s entire life-cycle of connected medical devices and clinical technologies. This management and oversight include safety, cybersecurity, asset and risk management, technical support and financial stewardship.”

“With the strategic partnership in place, Crothall and its clients will have laser sharp visibility into the client’s connected medical device profiles,” according to a news release.

“Asimily’s state-of-the-art machine learning will then assess risk, prioritize actions and allow for the development of mitigation strategies to reduce security vulnerabilities.”

“Our partnership will enhance Crothall’s medical device security offering with Asimily’s technical expertise in medical device security while Asimily will have the opportunity to access Crothall’s on-site expertise for identified vulnerabilities and risk mitigation,” said Jim Cheek, president of Crothall HTS. This offering will allow Crothall and its clients to manage a full spectrum of capabilities: asset utilization; FDA recall notification; device vendor tracking; and user defined policy alerts in the environment. The partnership enhances the abilities of Crothall and its clients to manage devices from initial capital planning to end-of-life. •

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FORBES: MEDIGATE AMONG ‘TOP 20 IoT STARTUPS TO WATCH’ Forbes magazine has recognized Medigate, a dedicated medical device security and asset management solution firm, as one of the “Top 20 IoT Startups to Watch in 2020.” This designation notes the health care industry’s demand for the Medigate platform to protect against the rising tide of cybersecurity threats while protecting patient privacy and information.

“In the past few months, we have seen cybersecurity attacks increase as firms move to a remote operations model and implement new technologies, procedures and devices onto their network at a rapid rate,” said Jonathan Langer, CEO of Medigate.

“Medigate has risen to the challenge to assist our health care customers and partners in protecting every clinical network from cyberattacks. Our placement on the Forbes list recognizes how Medigate’s clinically specialized platform is disrupting the way assets connected to clinical networks are managed and cyber-secured.”

“Medigate is revolutionizing health care cybersecurity by adding medical device and clinical workflow expertise to traditional IoT security. From its close relationships with leading partners and health care firms, Medigate is continually gathering input to enrich its solution to incorporate advanced security practices into established clinical workflows,” according to a press release. “Medigate fuses knowledge and understanding of medical devices, protocols and identities with the reality of today’s cybersecurity threats, ensuring providers can deliver critical treatment and protect patient data.” •

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INDUSTRY UPDATES

HTM MIXER COMING TO DOWNTOWN MILWAUKEE The Wisconsin HTM Mixer will be held in downtown Milwaukee! The HTM Mixer will be held at Hyatt Regency Milwaukee (333 West Kilbourn Avenue, Milwaukee, Wisconsin, United States, 53203).

WBA is joining forces with TechNation to host the 2020 HTM Mixer in place of the annual meeting the association held in previous years.

The 2020 HTM Mixer will be held October 1-2. Following a WBA members meeting, attendees and exhibitors are

invited to attend a welcome reception featuring hors d’oeuvres and beverages in a setting ideal for networking. The second day of the mixer features continuing education sessions, an exhibit hall and a special happy hour event.

Registration is free for all hospital employees, active military members and students. Exhibitors are encouraged to reserve a booth early as space is limited. • For more information and to register for the mixer, visit HTMMixer.com.

ATMOSAIR SOLUTIONS HVAC TECHNOLOGY NEUTRALIZES CORONAVIRUS AtmosAir Solutions of Fairfield, Connecticut, a provider of continuous indoor environmental sanitizing technology for health care organizations, has announced that its patented bi-polar ionization (BPI) HVAC technology has tested more than 99.9 percent effective in neutralizing coronavirus.

Tests performed by Microchem Laboratory, one of the world’s preeminent laboratories for testing sanitizing products registered by the EPA and FDA, confirmed that the presence of coronavirus was reduced by 99.92 percent within 30 minutes of exposure to AtmosAir’s bi-polar ion technology.

The testing replicated realistic conditions, exposing the virus only to the concentration of ions that would be present in an occupied building. The results prove that AtmosAir’s public health solution, effective in stopping the spread of pathogens and contaminants, directly impacts and neutralizes coronavirus in medical and health care facilities.

AtmosAir’s patented BPI devices, which easily fit into new or existing

HVAC systems, continually emit ions into the air that seek, attack and neutralize coronavirus, germs, bacteria, mold and other contaminants. The ions attach to contaminants and neutralize them in the air and on surfaces rendering the contaminants inactive, even if inhaled or ingested.

“We are delivering a cost-effective, environmentally and socially sustainable public health product that can

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

deliver results so that we can start coming together again safely,” said Steve Levine, president and CEO of AtmosAir Solutions. “We’re immensely proud to verify, independently through a leading testing facility, that our technology is effective against the world’s most pressing global health concern right now.” • For more information, visit www.atmosair.com.

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INDUSTRY UPDATES

RTI COVID-19 KITS DONATED IN U.S. In May, RTI Group North America invited nominations for three U.S.-based medical facilities to receive an RTI COVID-19 Kit containing the Cobia FLEX with mAs, RTI Dose Probe and RTI MAS-2 probe.

From across the country, RTI Group North America was inundated with inspiring success stories from diverse organizations and individuals working in quality assurance and patient safety.

Steve Holmes, vice president of sales North America at RTI Group, said, “Every nomination we received was a testament to the frontline biomed, clinical engineering and medical physicists ensuring patient safety and care during this unprecedented period.”

“RTI is immensely proud to contribute to this life-saving work, and will continue to do so with significant discounts

to support your department,” he added.

A press release reads, “We are delighted to announce the following facilities who will be receiving one of our COVID-19 kits: • Maimonides Medical Center – Brooklyn, New York • Homestead Hospital – Baptist Health South Florida, Homestead, Florida • West Penn Hospital – Allegheny Health Network, Pittsburgh, Pennsylvania “With this kit in place, we provide a tool for doing essential checks and measurements – radiography/fluoroscopy, intraoral and CBCT – on all vital X-ray machines used in the virus struggle,” the release adds. “We look forward to catching up with these three facilities in the near future!” •

DRAEGER OFFERS INNOVATIVE MEDICAL HEADWALL SYSTEMS Draeger has leveraged its 100+ years of critical care expertise to develop a new solution designed specifically to address the needs of the long-term acute care (LTAC) environment. With Draeger’s solution, LTAC facilities can maintain quality throughout the continuum of care with the convenience of a single vendor.

Along with Dräger’s proven critical-care equipment and high-quality accessories and consumables, the company is offering innovative medical headwall systems, a specialized LTAC team, an interactive design center and onsite support to help LTACs address the complexity and costs associated with caring for higher acuity patients outside of the intensive care unit (ICU).

“Administrators and clinical leaders in LTAC facilities often

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struggle to balance cost and quality given the evolving patient case mix, payer reimbursement restructuring, workflow design complexities and continued vigilance for patient safety,” said Steve Menet, Draeger’s senior vice president of sales for hospital solutions in North America. “With this new solution we are leveraging our extensive expertise in the critical care space to improve outcomes and reduce costs among the rapidly growing long-term care patient population.”

Draeger’s LTAC solution offers health care organizations the patient care technology, services and solutions they need to support high quality care from admission to discharge, and the convenience and cost savings that comes with the ability to rely on a single vendor, according to a press release. •

MULTIMEDICAL SYSTEMS ADDS NEW ACCOUNT MANAGER MultiMedical Systems (MMS), a national Innovation Institute subsidiary that specializes in healthcare technology management (HTM), has announced Chyrill Sandrini as account manager for Southern California. Chyrill is also the national director of surgical services for MMS. According to Mike McRoberts, MultiMedical System’s senior vice president of business development, Sandrini leads the team in both customer and patient care, while educating others in the medical industry. She prides herself in displaying the MMS core values of teamwork, honesty/ integrity and excellence. •

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INDUSTRY UPDATES

NEMA SHARES GUIDE FOR DISINFECTING ELECTRICAL EQUIPMENT The National Electrical Manufacturers Association (NEMA) published NEMA GD 4-2020 COVID-19 Cleaning and Disinfecting Guidance for Electrical Equipment. Managing the SARS-CoV-2 (COVID-19) virus requires proper cleaning and disinfecting of equipment, so members of NEMA have developed specific guidance to answer common questions for how to maintain cleanliness while preserving the functionality and integrity of electrical equipment.

“As government social distancing restrictions are lifted, and workplaces of all types reopen, the focus will be on how to protect workers and keep facilities clean and disinfected,” said Kevin J. Cosgriff, president and CEO of NEMA. “This may include cleaning and disinfecting electrical equipment. The first consideration is worker safety, so following documented safety procedures is essential. Electrical Safety Foundation International (www.ESFI.org) is a good source for general safety information. Beyond that, all cleaning and disinfecting steps must bear in mind the need to protect electrical equipment from inappropriate cleaning and disinfecting products and methods. In most cases, the original equipment manufacturer is the best source of authoritative information regarding products

made by them.”

“Disinfectant solutions and solvents can harm electrical equipment and components, causing severe damage that can result in outages and potential physical injuries. We specifically caution against the use of fogging and spraying disinfectant solutions on and around electrical equipment because this can create invasive electrical hazards,” explains Steve Sacco, vice president of safety and environment at Schneider Electric.

“When cleaning and disinfecting electrical equipment and components, we recommend following the manufacturer’s instructions. If you have a specific question, contact the electrical manufacturer for guidance. While performing routine maintenance or operating the equipment, we recommend taking all possible steps to avoid contamination by following CDC recommendations on thorough hand washing and the use of personal protective equipment, including face coverings.”

NEMA GD 4-2020 is available as an electronic download at no cost on the NEMA website. • For more NEMA COVID-19 resources, visit www.nema.org/about/covid19-response.

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SUMMIT MEDICAL DELIVERS ONE MILLION FDA-COMPLIANT FACE SHIELDS Summit Medical, an Innovia Medical company has delivered over one million FDA-compliant face shields – designed, engineered and manufactured in the United States in just eight weeks.

Summit Medical face shields meet the critical need for personal protective equipment (PPE) for front-line health care workers and returning business employees to limit the spread of COVID-19 as the country reopens.

As the demand for the company’s elective surgical products declined with the onset of the coronavirus, Summit Medical’s successful pivot to manufacture face shields has also met a critical economic need to protect its 65 employees with job security.

“Our team’s innovative design and dedication to meet the urgent demand to protect health care workers as well as employees returning to the workplace has been outstanding,” said Kevin McIntosh, president of Summit Medical.

McIntosh mitigated employee losses by cross-training staff to assemble face shields.

“Every staff member has been involved in production and is working overtime, including weekends, to make it possible to deliver face shields with quality and speed,” he said.

Unlike masks, Summit Medical’s Face Shields protect all facial mucous membranes – including the eyes – from splashes, sprays, droplets and fine aerosol contamination of the coronavirus. Easy to see through and breathe in, the clear plastic shield enables full-face coverage (9-inches long). In addition, shields are usually more comfortable to wear than masks and they form a barrier that keeps people from easily touching their own faces.

“Our engineering team adjusted an open-source design from Maker Space at the University of Wisconsin-Madison

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to meet requirements for Summit Medical’s face shields to be registered and sold as a medical device,” said Tim Butina, Summit Medical’s engineering and operations manager. “More importantly, we did extensive research and testing of materials to ensure Summit Medical was providing a high quality, safe product.”

Beyond his leadership for Summit Medical’s home office in Minnesota, McIntosh, coordinated supply networks for production of its face shields at Summit Medical’s sister companies under the Innovia Medical umbrella at Eagle Labs in Rancho Cucamonga, California

Innovia also leveraged Summit Medical’s face shield design for production at Innovia’s facilities in the United Kingdom, where they are producing over 1.3 million Innovia Face Visors to protect front-line health care workers in UK’s National Health System.

Summit Medical’s quality and regulatory team is currently pursuing a CE for the face shields. This would allow Summit Medical to support customer demand in Europe and beyond. • For more information, visit www.innoviamedical.com.

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JAKE KECK JOINS TENACORE LLC Tenacore has announced Jake Keck as its new vice president of engineering and service operations. Keck will lead the operations and quality teams in the implementation of a new service operating model and quality management system. Keck will serve as a member of the Tenacore executive leadership team reporting to CEO James Willett.

Keck’s team is responsible for daily service and repair operations, in addition to the quality function. His team will be leading the company’s transition to a new service operations management platform, enabling Tenacore to reengineer current service and repair processes and transform service line capabilities.

The transition to T-Connect will position Tenacore with best-in-class service and repair systems infrastructure, allowing customers to better manage asset repair costs.

“Jake is an outstanding addition to the Tenacore team, bringing a diverse base of experience in medical product design and operations leadership that will enable Tenacore to broaden and strengthen core service and repair capabilities,” says James Willett, CEO. He is the final addition to the new senior management team recruited to Tenacore to grow its focus in the service and repair of healthcare technology. Other senior leadership team members include Barbara Bitzer, CFO; Brandon Anaya, vice president of sales and marketing; and Willett, the new CEO for Tenacore as of February 2020.

Keck most recently served as senior director of research and development with Vyaire Medical. He was responsible for new product development and design control of capital equipment.

“I am excited to join the leadership team at Tenacore and lead the operations and quality organizations as we expand the company into a leading force in the medical equipment service depot market,” said Keck. “This role provides an opportunity to apply a range of engineering and quality practices that are commonplace in the OEM market and make certain they are part of our standard operating practices at Tenacore. We want to ensure we are delivering for our customers and the patients they serve each day.”

Keck holds a bachelor’s degree in mechanical engineering technology from Purdue University. •

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INDUSTRY UPDATES

VA MAKES INTEROPERABILITY ADVANCEMENTS MITA: POSTING SERVICE MANUALS RAISES PATIENT SAFETY CONCERNS The Medical Imaging & Technology Alliance (MITA) recently sent a letter to the U.S. Food and Drug Administration (FDA) alerting the agency that the company iFixit, which bills itself as having “replacement parts for every gadget,” has inappropriately posted proprietary service manuals for use by unregulated medical device service providers.

“Uncontrolled release of these materials to unregulated entities that are not required to have appropriate processes or safety controls in place raises the risk of improper servicing of medical devices,” said Patrick Hope, executive director of MITA and the letter signatory. “These actions raise the question as to why unregulated third parties continue to deny any responsibility for adopting appropriate quality and safety controls.”

As the letter notes, “Adequate performance of medical device servicing activities is not dependent only on possession of certain materials. Knowledge of and compliance with FDA regulatory requirements is essential to the performance of these activities in a way that results in the safe and effective operation of the medical device. We request that FDA take immediate action to implement consistent quality, safety and regulatory requirements for everyone who services a medical device, including requiring all servicers to register with the FDA, file Medical Device Reports, and implement a quality management system.”

The letter also emphasized the MITA view that operating within a quality management system is essential to performing servicing activities in a way that consistently results in the safe and effective operation of the medical device. A quality system is necessary to ensure that medical devices reliably meet applicable requirements and specifications.

“Safe and effective servicing is not merely the acquisition of certain documentation or materials—it is the implementation of and adherence to a set of policies, practices, and procedures which consistently return the device to a state of safe and effective operation. Why won’t unregulated servicers even register and make themselves known to the FDA? What is it about their business practices that warrants this degree of opacity?”

Hope concluded. •

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To streamline care for the nation’s veterans, the United States Department of Veterans Affairs (VA) has launched Veterans Data Integration and Federation Enterprise Platform (VDIF EP) to produce a longitudinal patient record by aggregating and normalizing clinical data across its existing electronic medical record systems, enabling interoperability. This has been a goal of VA for more than a decade because a longitudinal patient record enables clinicians to immediately use veterans’ clinical data from both VA and external providers, directly improving care for our nation’s veterans.

Based on InterSystems HealthShare, VDIF aggregates and normalizes data from 130 different electronic medical record instances supporting 172 VA medical centers and 1,074 outpatient clinics. With VDIF, veterans’ longitudinal patient records are available to providers within Veterans Health Administration (VHA) as well as to external providers delivering care to veterans. The latest version of HealthShare is built upon InterSystems IRIS for Health, the world’s first and only data platform specifically engineered to extract value from health care data.

A longitudinal patient record also enables veterans to take their entire care history with them when they seek care outside the Veterans Health Administration system – at a private hospital, for example. This is a realization of the 2018 MISSION Act, a law that streamlines veterans’ access to health care from outside providers.

The VDIF project was led by the VA Office of Information Technology (OIT), in conjunction with the Veterans Health Administration (VHA) together with Cambridge, Mass.-based InterSystems Corporation, with implementation by Ready Computing. VA now plans to connect dozens of clinical applications to VDIF. With VDIF in place, clinicians can now access a veteran’s entire medical history from a single view, rather than sifting through multiple sites to find all the relevant clinical data. This streamlined ability to see a complete view of the patient, without wasting time searching for it, enables clinicians to keep their focus on their patients – exactly where it needs to be.

“InterSystems is proud to build on its 40-year partnership with VA to improve the delivery of care for veterans and their families,” said George Hou, head of solutions for the Department of Veterans Affairs at InterSystems. “During this unprecedented health care crisis, providers are actively relying on clean, accurate and complete health care data to deliver care to veterans.”

OIT’s goal is to provide veterans with a seamless and beneficial VA experience. The implementation of VDIF is part of OIT’s Digital Transformation Strategy to maximize the impact on veteran lives by providing unparalleled services and support.

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RIBBON CUTTING Collin College Biomedical Equipment Technology Program

BY ERIN REGISTER

A

bout three years ago, Collin College, with campuses located throughout Texas, made the decision to expand its offerings in the workforce area. “We examined multiple programs and industries in our area, and we selected programs where our graduates could earn a good wage and have a life-long career in their selected field,” said the college’s Technical Campus Dean of Workforce Programs Michael Coffman. “The HTM area showed up consistently in all of our research, so the decision was made to pursue the addition of an HTM program at Collin College.” Collin’s Biomedical Equipment Technology Program is offered on its technical campus in Allen, Texas.

The addition of the Biomedical Equipment Technology Program began like any other new program at Collin College.

“We gather representatives from the area in which we want to start a new program, in this case the HTM area, and meet with them to determine if they will hire graduates with an Associate of Applied Science (AAS) degree,” stated Coffman.

“Once that is established, this advisory committee helps us determine the knowledge, skills and abilities that a graduate of the program should possess and helps us with the selection of the equipment for the program’s laboratory.

This is an iterative process, as we meet

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several times to refine this information and develop the courses for the program.”

After approval from the college’s Curriculum Advisory Board and Executive Leadership, the program went to the state for approval, as well as the college’s accrediting body, the Southern Association of Colleges and Schools Commission on Colleges (SACSCOC).

Coffman himself has a background in the HTM area. While he was in graduate school pursuing an electrical engineering degree, he took several biomedical instrumentation classes that involved the design of medical devices and instruments. “As the dean for the program, it is my job to ensure that we have highly qualified faculty with strong experience in my field,” Coffman noted.

TechNation learned more about the college’s new BMET program in a question-and-answer interview.

Q: WHAT IS THE MAIN FOCUS OF THE NEW BMET PROGRAM? A: The main focus of the program is biomedical equipment installation, calibration, maintenance and repair. It follows the Association for the Advancement of Medical Instrumentation (AAMI) standards in alignment with their Certified Biomedical Technician (CBET) guidelines.

Q: WHAT COURSES ARE INCLUDED IN THE NEW PROGRAM? A: Our program has courses in anatomy,

Michael Coffman Dean of Workforce Programs medical terminology, electronics fundamentals, networking fundamentals and a wide variety of general, clinical, physiological, respiratory and imaging equipment. Additionally, there are classes in general education that fulfill the state requirements for an AAS degree.

Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT THIS PROGRAM TO ACHIEVE IN THE NEAR FUTURE? A: Our immediate goal is a successful launch of the program, which began in August. An ongoing goal is to ensure that the program meets the needs of the field, so having regular advisory committee meetings and staying current with the standards are critical for us. In two years, when we produce our first graduates, we would like to achieve 100% placement. Overall, we hope to have a great program that students will be interested in completing and that the health care industry in our area wants to hire our graduates.

For more information, visit www.collin.edu.

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AAMI UPDATE

BY AAMI

WINNERS OF AAMI’S HIGH SCHOOL ESSAY CONTEST This year’s three winners of AAMI’s annual high school essay contest shared moving stories about the positive impact healthcare technology has had on their lives and the lives of their families.

The essay contest is part of AAMI’s Healthcare Technology Management (HTM) Week festivities and is designed to help spread awareness about HTM to and encourage students to consider pursuing a career in the field. AAMI’s Technology Management Council (TMC) selected the three winners from nearly 100 applicants: Ashlin Pfeifer-Winborn, first place, $500; Morgan Reupke, second place, $300; and Shiven Balaji, third place, $100.

“Members of the TMC were very impressed with this year’s submissions. The essays were thoughtful and covered many different types of healthcare technology and devices.

AAMI staff will follow up with all students to encourage them to consider HTM as a career option,” said Danielle McGeary, vice president of HTM at AAMI. ‘MUST-HAVE’ TIR24971 COMPLEMENTS RISK MANAGEMENT STANDARD A long-awaited technical information report (TIR) that provides state-of-the-art guidance on applying a fundamental risk management standard has just been published.

Already, AAMI/ISO TIR24971:2020, Medical devices— Guidance on the application of ISO 14971, has been a hot seller as a draft document. The TIR offers guidance on management responsibilities, components of a risk management plan, and the risk analysis and evaluation process. It is a companion piece intended to be used and applied together with the standard, ANSI/AAMI/ISO 14971:2019, Medical devices—Application of risk management to medical devices, which establishes a process for medical device manufacturers to identify, evaluate and manage risk.

However, the standard and its guidance report aren’t just useful for medical device manufacturers – they can be used to manage all risks, including those related to security and usability.“This standard and TIR contain a very clear concept of systematic risk management. Any user of medical devices can use this process to develop a risk management system for their organization when the focus is on patient, user property, or environment safety,” said Tina Krenc, principal consultant for KTA Compliance Consulting, lead instructor for AAMI’s industry training course on Integrating Risk Management into the Product Life Cycle, and a member of the joint working group.

For more information, visit www.aami.org/TIR24971.

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AAMI MOURNS LOSS OF NOTED CLINICAL ENGINEER GEORGE PANAGIOTOPOULOS George Panagiotopoulos, dedicated clinical engineer, passed away on May 24 at the age of 60.

Panagiotopoulos started his professional life in banking but found his true calling in clinical engineering. He earned bachelor’s and master’s degrees in clinical science from California State University, San Francisco, and spent more than two decades working in biomedical and clinical engineering, including several positions within Kaiser Permanente’s National Clinical Technology Program. After taking early medical retirement two years ago, he remained active professionally by partnering with colleagues to start AdaptivMD, a telehealth and biometric data company.

“George was welcoming to newcomers and forever supportive of his friends and colleagues. He exemplified the concept of lifelong learning more than anyone I’ve ever met,” shared Carol Davis-Smith, vice chair of clinical engineering on AAMI’s Board of Directors. “George shared ideas freely and listened intently to the ideas of others. He was a dedicated and compassionate son, father and husband. I know because we spoke often about our families and raising our kids in a complicated world. I am a better person for having known him.”

Panagiotopoulos was a member of AAMI’s Healthcare Technology Management (HTM) Benchmarking Task Force, which published the second edition of the HTM Benchmarking Guide in 2018. He also contributed articles to AAMI publications, including the peer-reviewed journal BI&T. Panagiotopoulos was involved with technology standards-setting groups and was a past member of the American College of Clinical Engineering (ACCE) Board of Directors.

AAMI FOUNDATION AWARDS 2020 RESEARCH GRANTS The AAMI Foundation has named the 2020 recipients of the Mary K. Logan Research Award Program. Two grants, worth a total of more than $119,000, will support research initiatives that focus on improving patient safety and eliminating morbidity and mortality associated with the use of healthcare technology. The awards include: • A $69,565 grant to a research team at George Washington University, led by Ekundayo Shittu, assistant professor of engineering management and systems engineering. The group will explore the potential impact of utilization-based alternative equipment maintenance (AEM) programs. With the funding received by the AAMI Foundation, Shittu and his team are developing a software tool that will enable others in the HTM community to evaluate the effect their AEM programs have on patient safety, equipment availability and cost reduction.

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DeLaurentis and her team aim to design and implement an infusion safety dashboard on the community-supported Regenstrief National Center for Medical Device Informatics (REMEDI) web portal (CatalyzeCare.org). It will be powered by computational algorithms that evaluate infusion data from smart infusion pumps. DeLaurentis expects that the research will influence future smart pump management as well as device design and requirement.

“The AAMI Foundation is pleased to

support these important research initiatives this year, and anxious to share the results of the researchers’ work with the entire health care community,” said Steve Campbell, executive director of the AAMI Foundation. “Competition for this year’s research funding was strong, but these two grant submissions stood out because of the depth and importance of the topics and the impressive proposals put forth by the researchers.”

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ECRI UPDATE

Breathing Better: Understanding Non-Invasive Ventilation Systems in an Era of COVID-19 In the early days of the COVID-19 pandemic, most physicians treated critically ill coronavirus patients with mechanical ventilation to support damaged lungs. When it became apparent that many mechanically ventilated patients were dying in spite of these measures, research began showing that some patients recovered more quickly using noninvasive positive airway pressure devices, including single-level, continuous positive airway pressure (CPAP) and bi-level (BiPAP) units. This article provides an overview of these technologies, along with safety and purchase considerations.

N

oninvasive positive airway pressure units are specialized devices designed to apply continuous, bi-level, intermittent or expiratory positive airway pressure to non-intubated adult, pediatric or neonatal patients. They are commonly utilized on spontaneously breathing patients who require short-term mechanical assistance; however, they are not designed to be life support devices and are not intended to replace basic or advanced mechanical ventilators.

These devices are also referred to by a variety of names, such as bi-level positive airway pressure units, BiPAP units, continuous positive airway pressure units, CPAP units, EPAP units, expiratory positive airway pressure units, intermittent positive air pressure units, intermittent positive pressure breathing units or IPPB units.

CPAP DEVICES CPAP units deliver air or a mixture of air and oxygen (O2) at high flow rates through tubing to a nasal or oral-nasal mask affixed to the patient’s face. These devices use an airflow generator to deliver a continuous supply of gas to the patient at a set pressure, typically between 3 and 20 cm H2O. CPAP units are commonly used to treat patients with obstructive sleep apnea (OSA) or

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sleep apnea/hypopnea syndrome (SAHS).

Hospitals use specialized CPAP units with advanced functions and features to treat patients with other types of breathing problems, such as acute asthma, cardiogenic pulmonary edema, cystic fibrosis, chronic lung disease and, most recently, COVID-19. When exacerbations of these conditions make breathing more difficult and decrease blood oxygen levels, CPAP with supplemental oxygen may be utilized to facilitate the opening of small airways and improve oxygenation.

BIPAP DEVICES While CPAP units deliver pressure continuously at a single previously set level throughout the period of use, BiPAP units can deliver two different levels of pressure during the inspiratory and expiratory phases of a breath.

BiPAP allows clinicians to adjust pressures more precisely for maximal benefit.

For most patients, a slightly lower pressure is set during the expiratory phase to reduce the effort required to exhale. By adjusting inspiratory and expiratory time variables, BiPAP units can also synchronize with the patient’s breathing. This can significantly reduce the work of breathing for patients who are struggling.

In hospitals, BiPAP is commonly

used as a first-line treatment for patients who need temporary ventilatory support. When effective, BiPAP can noninvasively improve both oxygenation (delivery of oxygen to the blood) and ventilation (removal of CO2 from the blood). If treatment with BiPAP is not effective, intubation and mechanical ventilation is usually necessary.

PRINCIPLES OF OPERATION CPAP and BiPAP devices consist of a flow generator or “blower,” a length of tubing and a patient interface (typically a tight-fitting mask). Masks come in three varieties: those that seal against the nostrils, those that cover the entire nose and those that cover both the nose and mouth. Elastic bands that go around the patient’s head hold the masks in place. Commercially available CPAP face masks are pre-formed and available in various sizes and contours.

They are made of a hard plastic outer shell with a soft inner-flap seal of vinyl or silicone. Most CPAP and BiPAP units can be used with a variety of mask types as long as the mask allows for passive ventilation of exhaled CO2 through some form of vent. Non-invasive ventilation masks are not safe to use with CPAP or BiPAP since they do not allow for passive venting. Masks may be included with the equipment purchase or sold separately. The mask is attached to plastic tubing, which runs to the flow

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generator. High flow from the generator acts as a pneumatic airway splint by using gentle pressure, ranging from about 3 to 20 cm H2O. Most CPAP units are simple to operate and only have controls to set pressure levels. Some CPAP units offer a “pressure ramp” option that starts pressures at a low level (which is more comfortable for the patient), then slowly increases the pressure to the final prescribed level over a period of time (e.g., 15 to 30 minutes) as the patient falls asleep. BiPAP units are more complex than CPAP units. Most have controls to set inspiratory time and pressure, expiratory time and pressure, cycle rate and trigger sensitivity. These settings are specifically prescribed by a physician. Common accessories for CPAP and BiPAP units include humidifiers, O2 analyzers and tubing support arms or stands.

REPORTED PROBLEMS Noninvasive positive airway pressure devices are generally considered safe.

No serious problems with long-term use have been documented. Many of the reported problems involving CPAP and BiPAP units arise from air leakage that can cause a lack of pressure, discomfort or irritation related to the fit of the mask, nasal congestion or dryness and loud noise coming from the unit.

Nasal obstruction, increased age, higher body mass index (BMI), central fat distribution and male sex are associated with increased risk of air leakage. Full-face masks are more likely to leak air than nasal masks due to the increased size of the seal. Air leaks are typically fixed by changing the mask type or size and adjusting it properly.

For infection control, CPAP units and masks require regular cleaning and microbiological monitoring. These units can accumulate bacteria and viruses from the patient’s face, hands and environment, which can cause respiratory infections, especially in high-risk

populations like low birth-weight infants. Proper cleaning includes cleaning the interface, humidifier and tubing as well as changing water and filters.

Nasal trauma is a frequent complication of CPAP, especially in preterm infants. Nose injuries can range from skin irritation to septal necrosis. They are increasingly common with low gestational age, low birth weight and longer CPAP use.

PURCHASE CONSIDERATIONS 1. Users should look for units that are easy to operate. The primary controls should be located on one side of the unit. Labels and displays should be clear and visible. The controls should be protected against accidental setting changes; this is especially important in homes in which young children are present.

2. Alarms should allow quick assessment and correction of the alarm condition. Devices that monitor use and alarms and automatically upload data to the cloud are advantageous.

The priority of the alarm should be indicated by different audible tones and visual indicators. Audible alarms and visual indicators should activate when switching from line to battery power. The unit should also have low-internal-battery, power failure, overheat, fault and mask alarms.

3. CPAP units should be able to operate in a variety of environments and should not be affected by electromagnetic interference and electrostatic discharge. Power-surge protectors are advisable, especially if the unit is used in an area that experiences frequent power surges or thunderstorms. Devices that can be easily modified to work with different plug configurations and electrical power delivery (e.g., voltage and frequency) are extremely convenient for users who frequently travel overseas. Servicing by a skilled

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technician should be easy; the operator’s manual should provide adequate information for clinicians, users and caregivers.

STAGE OF DEVELOPMENT Newer generations of CPAP units have built-in software that can monitor usage patterns and patient compliance. Some modern devices monitor the time the devices are used each night and transmit the data to the cloud. At least one manufacturer offers a CPAP device that is completely self-contained and will function without the need for an external power or water source.

Some manufacturers offer facemasks constructed from either cloth or leather that are designed to be more comfortable. Additionally, at least one manufacturer offers a mask that allows the cushion and frame to move independently, to adapt to a user as they change position in sleep and avoid air leaks. Masks with quick release clips are becoming more available; these are designed to make it easier to remove the mask should the patient need to use the restroom or leave their bed during the night. Latex-free masks are now also readily available, as many potential users may be allergic to the material.

This article is adapted from ECRI’s searchable database of technology overviews and product specifications for capital medical equipment.

The source article is available online to ECRI members. Learn more at www.ecri.org/ components/HPCS. Many additional resources are available through ECRI’s COVID-19 Resource Center, a free public resource to help hospitals protect healthcare workers and patients during the COVID-19 pandemic. Access that site at www.ecri.org/coronavirus-covid-19-outbreakpreparedness-center. To learn more about ECRI’s technology decision support solutions, visit https://www.ecri.org/solutions/technologydecision-support, or contact ECRI at (610) 825-6000, ext. 5891, or by e-mail at clientservices@ecri.org.

SEPTEMBER 2020

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INDUSTRY UPDATES

MEDWRENCH CELEBRATES FOUNDERS ON 10-YEAR ANNIVERSARY STAFF REPORT

M

edWrench would not be where it is today without each of its founders and their dedication to this medical product support community. This month, MedWrench is highlighting Myron Hartman, former BMET program coordinator and senior instructor at Penn State University.

“Considered one of the pillars of the biomedical engineering technology community, Myron Hartman helped build one of the foremost biomedical training programs at Penn State University. His instruction, curriculum and leadership paved the way for his graduates to succeed in the clinical engineering industry and become future leaders,” according to MedWrench.

Hartman’s personal experience in the healthcare technology industry began in 1978 when he graduated from Penn State University with associate degrees in electrical engineering technology and biomedical equipment technology. He later received a bachelor’s degree in electrical engineering technology and a master’s degree in health services administration.

“He was active and instrumental in presenting and sharing his knowledge from the very first MD Expo, where he

Myron Hartman, MedWrench co-founder. was able to spread his technical expertise and colorful speaking style that attendees came from all over the country to see firsthand,” said MD Publishing President John Krieg.

“When we were launching MedWrench, we needed a partner who could provide expert advice and much needed guidance, and we knew Myron was the

perfect fit,” Krieg added. “Myron deployed his students to assist with the building of the original equipment database, researching and uploading over 5,000 items, pictures, dimensions, manuals and other pertinent content. It was this rock-solid foundation that MedWrench is still built upon today.”

In addition to his commitment to the HTM industry, Hartman was the ultimate family man. He and his wife, Amy, loved to travel. He was also an avid Pittsburgh sports fan, especially his beloved Pittsburgh Penguins. He could be seen at many a MD Expo proudly sporting a Sidney Crosby jersey during the playoffs. Myron passed away in 2015 of cancer.

“It is safe to say, MedWrench would not be the success it is today without the incredible contributions Myron made,” concluded Krieg. “His legacy will live on, and we hope everyone knows how vital and inspirational he was to the MedWrench community.”

For more information, visit MedWrench.com.

“ It is safe to say, MedWrench would not be the success it is today without the incredible contributions Myron made.” – JOHN KRIEG, MD PUBLISHING PRESIDENT

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

SEPTEMBER 2020

TECHNATION

45

INDUSTRY UPDATES

NEW ADVERTISERS:

WELCOME TO THE

TECHNATION COMMUNITY! TRUASSET Q: TELL US ABOUT YOUR COMPANY. A: TruAsset is a CMMS software that was born and bred in the health care field. We are continuously improving our product based on the ever changing regulatory requirements and customer feedback. We focus on a user friendly product for all comfort SEE levels of technology without OUR AD PG. 69 sacrificing the features needed for maximum efficiency.

Q: WHAT DIFFERENTIATES YOUR COMPANY FROM OTHERS? A: There are a great many areas that are customizable to suit the individuality of our customers’ varying policies. We also do not charge when new features or upgrades are incorporated so our customers are always on the latest version without having the hardship of budgetary constraints where upgrading is concerned. We are also the first

company to be able to interact with the Pronk Safe-T-Sim through the LinxIT App on IOS directly moving the readings from the app to the work order so you don’t have to. •

For more information, visit truasset.com.

COLIN CONSTRUCTION Q: TELL US ABOUT YOUR COMPANY. A: Our values of Community, Communication and Commitment encompass the foundation of who we are and what we do.

Community represents our connection with people, current and future relationships that we continue to build in the healthcare industry. We take ownership and pride in our work assisting clients that advocate for better care for the communities we all serve. Communication is vital with a daily hands-on approach to our processes. Navigating and overcoming challenges is achievable with clear constant verbal and written communication. Commitment encompasses all we do. Our commitment to our staff is recognizing the importance of investing in our work family and therefore is reciprocated back with many decades of employment dedication. This is turn, enhances our strong commitment to clients; whether a Design Build, turnkey or contracted for a specific portion of the design, management or building project, we approach each job with full commitment and accountability, a partner you can trust.

Q: WHAT DIFFERENTIATES YOUR COMPANY FROM YOUR COMPETITION? A: In every industry there are experts that inspire and elevate others within the industry to forge ahead in new ways. In 1981, Mark Colin developed a dedicated service model to medical facility design/build and healthcare construction

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Jason Byers President

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specializing in: Emergency & Operating Room, Pharmacies, Clinical Laboratories, and Diagnostic Imaging. With nearly 40 years in business and over 150 years of collective knowledge, Colin Construction Company has developed its expertise to become a leader in the design-build process. Our Kevin Cook multi-disciplinary team understands our Chief Operating profession and what it takes to successfulOfficer ly navigate OSHPD and jurisdiction healthcare projects resulting in exceeding client expectations and the ability to complete extraordinary construction endeavors. The greatest opportunities for innovation, quality and competitive pricing on some of the most complex projects for healthcare are produced when collaboration springs from one team. The Colin Construction team is who you call for technical expertise with high attention to detail within the specification and requirements needed for healthcare. In addition to having the trust of Hospital representatives, Colin Construction also has the respect and confidence of all the major medical equipment manufacturers. • For more information, visit colincc.com.

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INDUSTRY UPDATES

MEDICAL EQUIPMENT SOLUTIONS Q: TELL US ABOUT YOUR COMPANY. A: Medical Equipment Solutions started in 2007 when a need was recognized for hospitals to have a reliable solution for their retired equipment needs, one that worked for them and didn’t take advantage of them. So, our team came together and put a process in place for that to happen, a team and a process that’s still working today and being received well wherever we go. Hospitals can trust knowing that when they call us, whatever kind of retired equipment they have from small overbed tables, to imaging systems that take up an entire room, to warehouses full of retired equipment taking up space, we’ve got a solution for it and we’re going to take care of it to their standards. Our service really is their solution, and that’s where our name comes from.

Q: WHAT DIFFERENTIATES YOUR COMPANY FROM YOUR COMPETITION? A: Some companies’ cherry-pick, only buying equipment with the most value. Medical Equipment Solutions offers top prices for the sought after equipment AND we are willing to take the less desirable equipment as well, freeing up space and time for the hospital. Other companies present auctions as an alternative. They add costly fees, show up at inconvenient

SEE OUR AD PG. 2

times, and payment to the hospital often takes months.

Medical Equipment Solutions never charges any fees, we use our own trucks and our own professional staff. We work on the hospitals’ schedule and respect the time and space of the staff and patients.

Our bid is offered up front, so there are no Dennis surprises. We diligently base those bids on Robert Kirk fair market values.

Procurement Working with us is incredibly easy. All we Manager need from the hospital is a phone call or email telling us where to go and when to be there. We add the equipment to a detailed inventory and promptly submit a bid.

When our offer is accepted, we show up at a convenient time.

Our team is ready to do all the physical labor with a check in hand for the equipment. We’ve never had complaints on our process, because it’s entirely based on what the hospital needs and wants. It’s that simple. • For more information, visit medequipsol.com.

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INJECTOR SUPPORT & SERVICE

• On-Site Repair • Depot Repair • Parts Sales and Parts Identification • Loaner Availability • Technical Support • Training • Injector System Sales • Preventative Maintenance Tools To learn more visit www.WeAreISS.com or call 888.667.1062

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obilize is a complete wireless solution that connects Safe-T Sim速 Safety Analyzer, SimCube速 and OxSim Flex速 Vital Signs Simulators and FlowTrax速 IV Pump Analyzer to your smart device. This provides complete flexibility to control all these products from one user interface, set up your own test protocols or run your CMMS procedures right from your Apple iOS device.

Key features include: instantaneous wireless synchronization to Mobilize products, including all simulations, as well as full control of all IV pump and electrical safety analyzer testing functions via the Mobilize Apps; capture all tests performed, measurements are recorded automatically while you work or simply tap pass/fail, add images of device under test into a complete detailed electronic report; app integrated Barcode Scanner and user-configurable wireless PM sticker printing; use app autonomously or integrate to a CMMS. Stores up to 1,000 detailed test records with no monthly/annual license fee required.

For more information, visit www.pronktech.com/mobilize.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

SEPTEMBER 2020

TECHNATION

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THE BENCH

SHOP TALK POWERED BY

GE HEALTHCARE MAC 5500HD

ELLMAN INTERNATIONAL SURGITRON FFPF EMC

Q:

Q:

Hi everyone, I have a printing issue. Only half the page is being printed, not the top half or bottom half so not suspecting the printer assembly. Its only printing the first quarter of the page in full and the rest of the page is entirely blank. Any suggestions are appreciated in advance.

A:

Without seeing the actual print. It could be the print head, battery or even the paper. The diagnosis would be based on what it looks like.

I have above mentioned product and the problem is 1.6A fuse blowing as soon as I connect to the main power. What could be the problem?

A:

It could be that a larger capacity fuse is required, check the manual. Or, you have a short somewhere, start investigating, also plug into a GFCI outlet so it trips first.

A:

A:

A: A:

A:

Might suggest that the print head could be dirty with paper lint. You start with an alcohol pad and swipe it back and forth then do the same with a soft cloth along the orange plastic film flat bar – not the roller. Let it set open for 5 minutes to insure that it is dry. The print head is on the top part of the paper tray at the upper front edge. Do not rub hard on the orange strip.

If you replaced the print head, you need to enter in the resistance that is on the label of the print head.

If the paper is wrong, it will do that. There must be a hole in the print paper about 3 inches down and 3 from the left top. If the wrong paper is used it will not detect the beginning of the paper and will give you a paper out error and only print about 4 inches. The paper sensor will also cause this. As for the battery, if it were dead or bad it would not print. If it is not either of those, it is a mainboard issue that needs components replaced.

If you are plugging in to 120v power a 3.0A fuse is required, otherwise if 220v, a 1.6A fuse is correct. If it blows the fuse it is likely that T1 is shorted. The windings can be quick-checked with a multimeter if disconnected from the surrounding components. It should read anything, but a direct short. More than likely this is where you will find the problem. It may have visible evidence or smell like burned varnish.

It sounds like you definitely have a short. You’re going to have to crack open the case. I’ll help you as much as I can. The hospital I’m working in now doesn’t have any of those units. So, I can’t mirror you.

Remove and disconnect the various components until you narrow it down. Start by disconnecting the rectifier from the transformer (two red wires) and see if it blows the fuse, yes this may take a few fuses to test. I suggest 1.3 to 1.6A maximum for testing like this. I don’t know what your skill level is so please be careful. Have you disconnected the external probe devices? After that, try removing the power amp tube. The most common failure items are diodes, vacuum tubes, transistors, resistors (usually fail open), and transformers (less often and due mostly to overheating from shorted circuits). Integrated rectifiers are a common failure item. Good hunting.

SHOP TALK

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

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TECHNATION

51

THE BENCH

WEBINAR WEDNESDAY

Series Delivers ACI Credits STAFF REPORT

T

he TechNation Webinar Wednesday Series continues to provide sessions eligible for 1 credit from the ACI. The credits and insights combine to prepare healthcare technology management (HTM) professionals with knowledge that helps them do their job better.

CONNECTED HOSPITAL The Webinar Wednesday presentation “Enabling the Connected Hospital: How to Solve Coordination Between HTM, IT, Facilities, Supply Chain and Clinical Care Departments” was eligible for 1 credit from the ACI. It was sponsored by Nuvolo.

Leveraging technology to connect hospital support functions improves efficiencies, ensures regulatory compliance, lowers costs and enables better patient care. The convergence of HTM, facilities, IT and supply chain helps hospitals improve the care of their patients, while streamlining and simplifying work. This 60-minute webinar – moderated by Nuvolo’s Heidi Horn, vice president, global enablement-healthcare, and featuring Kyle Holetz and Dustin Smith, senior solutions consultants – described specific health care scenarios where using a connected health care software system assists health care support organizations to better work together.

During the webinar, the presenters showcased some of the advanced capabilities in Nuvolo’s Connected Workplace system that optimizes clinical device maintenance and

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coordinates support activities. Attendees were shown how they can improve operational performance at their health care organization and drive departmental collaboration for the business.

There were 142 attendees for the live presentation and a recording of the session is available online. Timothy Wade of UVM TSP was the winner of a Webinar Wednesday T-shirt given away during the live webinar. Fernando Trujillo of DHA-MEDOG won an Amazon gift card.

Attendees provided feedback via on a post-webinar survey that included the question, “What did you like most about today’s webinar?”

“Interesting information, I can see a lot more companies putting out a system like this – much needed,” Biomed A. Bronkema said.

“It was very interesting how Nuvolo integrates all of the HTM, IT and Facilities work requests in its software.

We use something similar in the DoD, so it is always interesting to see how our civilian counterparts are tackling the same issues,” shared F. Trujillo, HTM consultant/advisor.

“The entire presentation was on point, as the toughest portion of outfitting a hospital or clinic is establishing the connectivity of various Wi-Fi medical devices that seem to be growing in quantity each year,” Senior Project Manager A. Laviers said.

“The expertise of the presenters, their knowledge and understanding of the inner workings of hospitals were impressive,” Chief Strategist R. Busacca said.

“The topic was obviously broad on purpose which was helpful from seeing it from a single perspective,” said A, Whyte, BMET. X-RAY TUBE ARCING The presentation “How Can You Decrease X-ray Tube Arcing? What You Should Know About Its Causes and Prevention” was also eligible for 1 credit from the ACI. The Dunlee-sponsored webinar was presented by Rolf Behling, founder and owner of XtraininX. X-ray tube arcing can cause image artifacts and system damage. Understanding its causes and how to prevent them can help increase uptime and get the most out of CT scanners. In this webinar, attendees were able to learn about how arcing (high-voltage discharges in X-ray tubes) affects a CT scanner. Behling discussed the most important components and technologies impacting arcing and introduced the physics and material science behind this phenomenon. He helped attendees understand how to prevent arcing and how to mitigate the effects of an arcing incident. And, they were able to gain understanding about how to assess equipment and technology in terms of how they impact arcing.

The popular webinar drew 165 attendees for the live presentation and secured the best rating of 2020 with a 4 out of 5 with 5 being the highest possible rating. Two lucky attendees won prizes during the webinar. Dick Lee of Hawaii Pacific Health won a Webinar Wednesday T-shirt. Penn State Health Imaging Engineer James Bassler

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THE BENCH

won an Amazon gift card.

Attendees provided feedback via a post-webinar survey that included the question: “Why did you attend today’s webinar? And, was it worth your time?”

“The presenter was brilliant in his knowledge of tubes and the explanations of how arcing occurs,” said F. Wasnowski, CE quality analyst.

“I was interested in the topic, and thought to check it out, didn’t expect it to be this incredible! Absolutely worth the time,” said A. Salam, senior sales and field service engineer.

“I wanted to learn more about X-ray tubes and arcing since it has happened a few times to us. The time was really worth it because it was easy to understand, the slides helped a lot to understand what the presenter was saying,” said A. Negron, imaging group leader.

“Yes, the presentation was very informative and well worth my time. I have a much better understanding of some of the processes I use when working on cath labs and CT,” said Bassler.

SECURING CONNECTED MEDICAL DEVICES The June 24 webinar “Securing Connected Medical Devices: The New Hippocratic Oath” was sponsored by Armis and eligible for 1 credit from the ACI. Armis CISO Curtis Simpson discussed how hospitals and clinics are adding more and more new connected medical devices. From infusion pumps to MRI machines, X-ray machines, heart monitors and communication badges, these connected medical devices help clinicians deliver faster, higher quality care. But they also create an attack surface that most health care facilities can’t secure. How do you secure medical devices that can’t take an agent or be scanned? How do you detect and stop ransomware attacks? How do you ensure patient safety and hospital operations?

Simpson addressed these challenges and how health care organizations can protect themselves and their patients.

The webinar drew 278 attendees for the live presentation and more have viewed a recording of the session online.

Every attendee gained valuable knowledge and a couple of lucky individuals won a prize. Michael Swango of Parkview Health, Indiana won a Webinar Wednesday T-shirt given away during the live webinar. Robert Resnicoff of Medstar Union Memorial Hospital in Maryland won a gift card.

Attendees provided feedback via a post-webinar survey that included the question “How much new information did you receive from today’s webinar?”

“Very informative, the presentation was a great source of information,” said G. Benjamin, systems analyst.

“Enough that I’m contacting our IT security team and forwarding the webinar link to leadership above me.

Just want to make sure we are doing enough,” Biomed Supervisor S. Keeny said.

“Quite a bit of interesting information about the Alaris pumps that we currently have and are connected wirelessly to the hospital network,” Senior Biomed CBET J. Ribic said.

“I learned a couple of things I didn’t know about medical devices and cyber attacks,” shared J. Medina Melendez.

“Very good presentation, impressed with the product presented,” said F. Yasnowski, CE quality analyst.

“Some very useful information provided today, especially some of the Urgent 11 information,” HTM Director K. Forsythe said.

CONTACT TRACING ESSENTIALS The Sonitor-sponsored Webinar Wednesday presentation “Contact Tracing Essentials: RTLS Provides Critical Data to Help Regain Confidence & Safety by Automating Contact Tracing” was eligible for 1 credit from the ACI. In a world where contact tracing is now essential, real-time location systems (RTLS) can provide the necessary insights and data needed to seamlessly trace the path and reduce the

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

spread of infection. Teams from Sonitor, Infor Location Based Intelligence (formerly Intelligent InSites) and Sanford Health focused on how RTLS can automate contact tracing and the value it is bringing to Sanford Health to help ensure staff and patient safety.

The webinar was popular with HTM professionals with 245 registrations and 167 attendees for the live presentation.

Attendee Mary Coker of Cone Health in North Carolina won a gift card during the presentation.

Attendees shared feedback via a post-webinar survey that included the question “How well did the content that was delivered match what you were promised when you registered?”

“It was as stated, but information started me thinking in a direction that I had not considered before which was good,” Project Manager M. Coker said.

“Interesting to learn about the technology used in contact tracing,” shared Biomedical Engineer O. Canna.

“The presenters were well prepared and informative,” said Biomed II J. Clark.

“Informative especially now, as it’s really useful to trace those affected by the pandemic,” said Biomedical Engineer E. Gonzales.

“Great blend of practical use of everything included in the webinar,” Field Service Engineer K. Saager said.

“Good insight on using tracking for COVID/staff tracking,” said F. Yasnowski, CE quality analyst.

For more information about Webinar Wednesday, including upcoming webinars and recordings of previous sessions, visit WebinarWednesday.Live.

Thank you to our sponsors:

SEPTEMBER 2020

TECHNATION

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THE BENCH

BIOMED 101

Synergies Between Industry and Academia

BY TED LUCIDI

I

t’s been 34 years since I graduated from Penn State’s Biomedical Engineering Technology program.

I’ve been fortunate enough to be an instructor within that same program for the last 20 years. One of the challenges within this role is maintaining the curriculum at the speed at which technology is changing. In 2001, we still were teaching component level troubleshooting, even though many technicians would seldom repair to that level. The concept of online resources, such as MedWrench, webinars or even YouTube, were just dreams. I recently read an article that claimed that technology is now doubling every 3.4 years.

Within our curriculum at Penn State, fortunately, we have always focused on fundamentals versus maintaining the most up-to-date, technically impressive equipment which would lure any potential college student’s parents toward our program. Our students learn how bio-electric signals and information is acquired and processed, the procedures to verify that the information is accurate, the methods to assess equipment safety and how to both identify and address common modes of failure. As technology advanced, medical devices became more complex.

Devices became more software driven and relied less upon hardware, firmware and proprietary operating systems. PCs became integrated into medical devices and then OEMs developed custom networks which eventually transitioned to the interconnectivity that we have today. The biomedical technician of today not only needs to be a master at electronics, mechanics, pneumatics and

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hydraulics, but now has to wear two new hats … PC hardware specialist and network analyst. So, how do we get from A to B? How can we remain current and, more importantly, how does the academic world remain current with industry needs? Only having limited time to expose students to hundreds of medical devices, how do we choose on which devices and on what concepts to concentrate efforts?

The engineering technology programs at Penn State are Accreditation Board for Engineering and Technology (ABET) accredited, which can be loosely compared to a continuous quality improvement program. One of the requirements of ABET is to solicit feedback from the industry and former students and to consider modifying course activities and curriculum to meet current needs. Fortunately, Penn State’s BET program has great relationships with surrounding health care systems, device manufacturers and its alumni.

Also, over the years, it has formed an Industrial Advisory Committee (IAC).

The IAC is comprised of representatives from local health care systems, OEMs, ISOs as well as former students. Twice per year, our faculty meets with the IAC to assess the current state of the program, understand the current and future needs of the industry and to provide feedback on prior suggestions for improving the program. Following is an example of how this unique relationship works. Although our curriculum already includes theory and lab activities surrounding PCs integrated into medical devices, recent suggestions from the IAC included adding additional exposure to PCs, networking and PACS. The following academic year, we

Ted Lucidi Innovatus Imaging integrated additional lab exercises to include PC hardware and software diagnostics, techniques for using common network troubleshooting tools and designing physical and virtual layouts of an ICU and a radiology network. Major changes to any course curriculum at the university level take years to implement, but these minor modifications to the lab activities resulted in a quick response to an imminent pressing need.

Another valuable tool within the PSU BET program is the guest lecturer program. Pulling from our members within the IAC, the goal is to invite one guest lecturer per week to speak on a topic relevant within the HTM field.

Popular topics are customer service skills, introductions to specialized medical devices, cybersecurity and employment options within the HTM industry. One of our former students is an OEM service engineer specializing in anesthesia systems. He spends most of one full class-day taking the students through a PM of an anesthesia machine complete with disassembly/reassembly.

For success to occur in either area, industry and academia must have a synergetic relationship … each giving and taking from the other. It’s researchers, either academic or industrial, sharing their expertise, testing methodologies and results with manufacturers and academia relying upon industry to provide feedback into what is needed from the next generation of engineers and technicians.

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LEARN, GROW

AND BE INSPIRED. TechNation has the resources you need to sharpen your skills and stay in the know, no matter where you’re working from.

LIVE WEBINARS: SEPTEMBER 2 | ALTHEA Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

SEPTEMBER 9 | ARMIS Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

SEPTEMBER 16 | MEDIGATE Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

SEPTEMBER 23 | RTI GROUP Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

SEPTEMBER 30 | SUMMIT IMAGING

Save the date for this live webinar.

Participation is eligible for 1 CE credit from the ACI.

ON-DEMAND WEBINARS:

sponsored by EQ2 Los Angeles County Case Study on Enterprise Solutions for Managing Assets David Chambers and Rich Sable

sponsored by EQ2 Inter Department Information Visibility and Lifecycle Management Decisions Jon Kocurek and Vishal Malhotra

sponsored by oneSOURCE Breaking Barriers: Promoting patient safety through a comprehensive database of preventative maintenance - Travis Horstman, Biomedical Advisor at oneSOURCE Document Site

sponsored by ACCRUENT Instituting the New Risk Management Strategy and Connectiv - Al Gresch and Mike Zimmer

ON-DEMAND PODCASTS: SERIES 1 EPISODE 1 In this episode Summit Imaging’s CEO, Larry Nguyen sits down with Randy Snelling, Chief Physical Environment Officer at DNV Healthcare, to discuss Hospital Standards and how ISO, Vendor QMS and Engineers play a roll in the future of accreditation to increase the quality of care and reduce total cost of ownership.

webinarwednesday.live

SERIES 1 EPISODE 2 In this episode Al Gresch, VP of Healthcare Strategy, Accruent and Mike Zimmer, Senior Solutions Engineer Accruent, sit down with Jason Tessari, Senior Client Success Manager at Accruent, to discuss how automating the Request Management process transforms risk management, safety management and the delivery of care.

WE’LL KEEP YOU CONNECTED.

ROUNDTABLE

ROUNDTABLE CMMS

A

quality CMMS is a tool that benefits every biomed. It provides assistance with everything from preventative maintenance schedules to equipment disposition. In this issue of TechNation, experts from several CMMS providers share insights regarding the newest features, capabilities and cybersecurity concerns.

Among those sharing expert knowledge regarding the latest CMMS offerings are TruAsset President Jason Byers, Agiliti Director of Modality Services Russ Lang, Phoenix Data Systems Inc. President and CEO Ben Mannisto, EQ2 LLC Product Manager Rich Sable and Nuvolo Senior Solution Consultant Dustin Smith.

Q: HOW CAN CMMS HELP HTM PROFESSIONALS WITH CAPITAL PLANNING AND PRIORITIZING WHAT EQUIPMENT SHOULD BE RECOMMENDED FOR REPLACEMENT? BYERS: TruAsset can assess usage/abuse levels of equipment based on work order history and give feedback to administration about assets that may be end of life sooner than originally expected. This can utilize age, labor hours, downtime, usage level of the equipment, equipment abuse

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components, HTM can provide the capital planning committee with a 3- to 5-year plan for replacement based on age, support and repair trends. This allows department managers to make fact-driven decisions on where to apply their limited capital.

Jason Byers TruAsset and parts cost to give an overall picture of what that asset is costing the facility and the trends for the unit.

LANG: Assisting with capital equipment budgeting is one of the best ways HTM can show their value in a health care facility. A well-designed CMMS system will have fields to collect date of manufacture, date of installation and end of service dates. It should also be able to track service costs annually and compare those costs to the estimated acquisition value of the medical device. With those

MANNISTO: The CMMS must have a robust life cycle component, providing the ability for the user to enter not only the date the equipment was purchased and put into service, but also the manufactured date.

This assists with a more accurate baseline for the expected life and replacement date.

The ability to analyze past and projected costs to repair assists with capital replacement planning, as some equipment may cost more to repair than to replace over the expected lifetime. Reporting using a combination of standard replacement projections with repair versus replace analyses provides a solid capital replacement program for management.

SABLE: First, a CMMS captures all the necessary metrics to perform capital planning such as purchase date and cost, life expectancy and all service costs over the asset’s lifespan. Armed with this data, HTM leaders can review the cost of service ratio (COSR) for the asset, failure

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ROUNDTABLE rates, total cost of ownership and device obsolescence. Finally, the CMMS provides the necessary reports and analytic tools to make informed decisions for capital planning and not just “agebased” replacement models.

enough to add to or remove these fields.

In the case your operational technology (OT) monitoring vendor, like Medigate, Ordr, Zingbox and others can pass you other automated data that needs a new field to be held.

SMITH: A CMMS should give the ability to identify your assets that are not performing well and start to be less cost effective.

It should also assist you in identifying the assets that are going to be ineligible to get parts or receive service. With this information you should be able to serve as a consultant to not only clinicians, but also to capital planning teams to get the appropriate capital funds to ensure your medical equipment inventory serves your clinical needs. Additionally, it should help you with the utilization of equipment and the integrity of what you own. Also the CMMS can help determine the need to relocate devices to areas or departments where they could be better utilized and potentially avoid the need to purchase new devices.

Q: DOES YOUR CMMS SYSTEM INTERFACE WITH THE OTHER SOFTWARE APPLICATIONS ON THE MARKET? IF SO, WHAT DOES YOUR SOFTWARE INTEGRATION OFFER AS A BENEFIT?

Q: WHAT NETWORK INFORMATION CAN BE DOCUMENTED VIA YOUR CMMS OFFERINGS? BYERS: Any parameters of the network for a device can be recorded in custom tabs within the views for the asset. Any parameters that are not in the default configuration can easily be added by the onsite administrator.

LANG: Today, CMMS systems need to track more than just service events. We need to identify devices capable of storing PHI and network security data. The Agiliti system tracks the type of data stored, how it can be transmitted and what security options are in place to keep it secure. We also track network settings, patch levels and operating systems for items that connect to the hospital network.

MANNISTO: AIMS included Equipment Information Services Tab helps users easily manage IS related information and IS devices associated with an equipment tag, including sub-devices for complete parent/child relationships. With more than 200 fields for hardware, software,

Ben Mannisto Phoenix Data Systems Inc.

BYERS: We currently have integrations with Pronk Technologies test equipment, and oneSOURCE document. All our integrations have been built to accommodate customer requests at no charge to the customers.

network, security, recovery, location and support for both main and sub-devices, users and IT have all information required to ensure security for networked equipment.

SABLE: HEMS is EQ2’s product name.

HEMS Enterprise provides over 100 IT fields to document network information.

First, we provide a wide range of network information such as multiple IP Addresses, MAC Addresses, Subnets, Host Names, wireless information (SSID), and VLANS to name a few, for imaging devices or sophisticated medical devices.

Second, we provide fields for device software, including operating systems, installed software, and antivirus applications for determining critical programs and versions. Third, HEMS contains fields for additional asset specific data elements such as wall jacks, vendor site IDs, storage locations, and additional device, network, and computer specific data. Finally, we provide an equipment IT Fields report that allows the HTM leader to quickly filter their data to identify critical devices based on security alerts.

This data can also be made easily accessible for technicians from within all products.

SMITH: IP, Mac, Hostname, Discovery Location, OS, Software Revision Level, Security Risks (assessment information), PHI, and additional network adapter information (DHCP, connection type, i.e.). CMMS’s should also be flexible

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Russ Lang Agiliti

LANG: Several years ago, Agiliti integrated our CMMS system to RTLS/RFID systems. Since then, we have integrated to ERP systems and other CMMS systems.

These integrations benefit us by allowing direct links for service information, inventory changes and contract updates.

MANNISTO: AIMS can interface with any third-party software, including ServiceNow. Many customers utilize a variety of interfaces for cybersecurity, document management, parts, purchasing, RTLS, device testing, and IT work orders, creating efficiencies by removing the necessity of entering duplicate information into multiple applications.

SABLE: Yes, we have several Application

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ROUNDTABLE Programming Interfaces (APIs) that we use to interface with other information systems such as OneSource, Lawson, PeopleSoft and Glassbeam to name a few.

Also, EQ2 is one of the only CMMS vendors with Integrating the Healthcare Enterprise – Patient Care Domain (IHE-PCD) interface capabilities, for connecting to numerous systems and smart medical devices including RTLS. Using this interface, the HTM team can easily determine the “current” physical location of medical equipment, order parts directly from within their work orders and seamlessly locate service manuals from their desktop or mobile device using HEMS Enterprise or Web Enterprise (a module for HEMS). With IHE-PCD and Glassbeam, the medical devices can create their own utility-based maintenance or corrective work orders providing a more proactive versus reactive maintenance program.

SMITH: Our software can be easily integrated to ERP and RTLS offerings.

These can produce tremendous efficiencies in accurately tracking cost and locations. RTLS integrations can save large amounts of time when trying to find mobile medical equipment and can assist in mitigating unnecessary capital purchases. An open API architecture is critical to a modern CMMS as most third-party applications that benefit from CMMS integrations, or visa versa, use a variety of different integration mediums.

Q: WHAT FEATURES DOES YOUR CMMS USE TO HELP MANAGE THE CYBERSECURITY OF THE MEDICAL DEVICE INVENTORY? DO CMMS PRODUCTS HAVE ANY INTEGRATIONS WITH VENDORS OF IOT/IOMT TOOLS? BYERS: Our current system does not have a method to manage IoT/IoMT. We are currently developing a module to better support scanning networks and devices and collecting information in a more active fashion.

LANG: In order to manage cybersecurity within the medical device inventory your CMMS needs to first store all the relevant communication and software information. You can also associate your

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CMMS to any number of interrogators that will alert you of excessive traffic on the network. This will only provide you with potential risks. In the end, you need cooperation between IT security and HTM to develop and implement a risk-based approach to cybersecurity.

MANNISTO: The included Equipment Information Services component manages all aspects of cybersecurity by providing complete network information for every device. Integration with cybersecurity applications provides the opportunity for AIMS to automatically create a work order and notification for any found issues. This enables the user to immediately take compromised equipment offline. All CMMS applications with an API can integrate with IoT/ IoMT third-party software.

supports integrations with IoT/IoMT vendors which will further enhance your cybersecurity program for medical devices, especially when interfacing with network-based cybersecurity “appliances” using the CMMS’s API. SMITH: Nuvolo provides an OT cybersecurity solution that enables security orchestration and automated response workflows for all connected medical devices which includes our Intelligence Hub with prebuilt integrations to all the major OT security providers on the market. It enables additional visibility to all needed support teams (IT, HTM and Facilities) and automated actions which make it much easier to get appropriate hands on deck for particular alerts, hazards and even recalls.

It also allows for seamless asset creation and review when new devices are discovered on the network.

Q: WHAT FEATURES, TOOLS AND DESIGN ERGONOMICS DOES YOUR CMMS PRODUCT HAVE TO MAKE IT AS EASY AS POSSIBLE FOR TECHNICAL STAFF TO DOCUMENT ALL ACTIVITIES ON A DAILY BASIS, INCLUDING DATA ENTRY, WORK ORDER OPENING/CLOSING, PURCHASE ORDER REQUESTS, ETC.?

Rich Sable EQ2 LLC

SABLE: HEMS Enterprise devotes an entire section in the inventory module to documenting network information, which makes it easy to identify assets with reported symptoms of malicious activity from your network security team. Additionally, the CMMS allows HTM managers to define a network risk level for a model or set model specific network IT fields, and this is displayed on the equipment inventory dashboard or within the mobile products. By documenting and reporting this type of information, the HTM manager can partake in the organization’s cybersecurity program. HEMS Enterprise also

BYERS: The entire system was designed with portability in mind. Users can finish data entry immediately on a handheld device. This includes direct links to purchase orders, field service reports and service requests. The implementation of the AEM module has allowed us to make PM frequencies and procedures even easier to manage.

LANG: A CMMS needs to record all relevant service information, be simple to understand and easy to use. Beyond that, it needs to be mobile and fast. We are working with software providers to deliver a mobile solution that allows us to document our services with the least number of clicks. By tracking the documenting effort, we are able to reduce the burden on HTM professionals and drive record keeping closer to real time than ever before.

MANNISTO: AIMS is known in the industry as the most robust feature-function

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ROUNDTABLE CMMS available. It is a tab-based system that allows users to quickly tab through data entry screens, with each “tab” auto-filling numerous defaults of valid entry fields. This valid entry philosophy provides more accurate data and reporting. All system components are fully integrated, removing duplicate data entry (i.e., ordering a part while on a work order automatically adds the on-order part to parts inventory and to a purchase request). Global features allow users to change large groups of information across equipment with a single click, and batches of work orders can be opened and closed for inspections and incoming equipment in a few simple steps.

SABLE: To simplify the day-to-day documentation for technicians, EQ2 provides two mobile products: Web Enterprise and HEMS Remote. Both products read barcodes and provide a simple single-page interface to perform daily tasks. In fact, Web Enterprise and HEMS Remote let the technician open/ close work orders in the field, procure parts, attach documents, record testers, record PM measurements, review warranty and contract information, access vendor and parts information, and create on-demand work orders. Additionally, HEMS Remote does not require a connection to the organization’s network (offline) to function. With our modular model, it’s easy to add products to your existing HEMS Enterprise system as your workflow needs evolve.

SMITH: Our product is made to enable HTM groups to be able to quickly and efficiently complete work orders while still upholding a high standard of data integrity. We have an offline capable mobile offering that is designed for the day-to-day work of engineers and an intuitive workflow to make it easy for clinical engineers to perform their work.

We also have a PartsSource integration to assist in the procurement of parts and to decrease variation in parts suppliers while also creating efficiencies for non-HTM groups such as buyers and AP workers.

Additionally, an intelligent system can always inherit data from related records to minimize data entry. For example, a lot

of information of an asset can be inherited from the model and type of the device.

Q: HOW DOES YOUR CMMS PRODUCT MINE DATA AND PRESENT REPORTS? BYERS: Our system was started in the HTM field and the reporting reflects this fact. The reports are designed around what inspectors from the primary standards organizations are looking for. As those standards have changed, such as the implementation of AEM, we have updated and adjusted the system to accommodate. Like most systems we have the set of canned reports and regularly add new reports based on user requests. There is the ability for users to create their own reports as well.

technician dashboards that provide a “live view” of your CMMS data using data mining. When HTM leaders identify the “taboo” devices in the inventory for an alternate equipment maintenance/ management (AEM) program and set the risk level for different device types – critical and non-critical – fully configuring the inventory, the dashboard will mine the data, present important information and provide guidance for placing devices on an AEM program while using the device history, failure rate and backup count.

Finally, our Performance and Benchmarking Analyzer program provides a direct link to your data using an Online Analytical Processing (OLAP) cube to data mine the CMMS for PM performance, failure rates, COSR by device types, workloads and productivity to name a few.

LANG: While our CMMS does allow for some reporting in the field, we have found that reports from the data warehouse provide a more robust view to our hospitals and HTM leaders.

Having customizable reports in your CMMS does allow for individuals to pull their own reports and configure as needed. In our business, we need consistency in reporting. Operating out of more than 90 locations nationwide, we rely on the BI suite of reports for understanding the performance of our HTM teams.

MANNISTO: AIMS has numerous included reports that utilize all data fields. Every included report offers numerous filters, sorts, sub-sorts, and data parameters, to meet management and regulatory requirements. Users can also export data to Excel for data mining purposes. The Report Designer Optional Component provides an opportunity for customers to set up unlimited user defined reports across any data points using simple drill down and drag and drop.

SABLE: Many of the management reports in HEMS Enterprise are pre-configured to data mine the correct data elements without requiring additional filtering from the HTM manager. In addition to the reports, EQ2 provides manager and

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Dustin Smith Nuvolo

SMITH: Our CMMS has robust reporting capabilities that can use data from any table that is being utilized in the system. It is quite easy to pull information from multiple tables through a join like concept called dot walking. You can also share reports and even schedule them to be pushed out at predefined times. Our reporting capabilities are very quick and fluid to make it easy to report on all aspects of the HTM business. For additional reporting benefits, many customers also set up automated data sources from within the CMMS system to be used in third-party BI tools like Tableau, Oracle BI and others.

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HTM’S ROLE IN CONSTRUCTION PLANNING Best Practices Make for Smooth Sailing

BY K. RICHARD DOUGLAS

T

he broad skill sets that HTM professionals possess make them ideal sources for decision-making input.

With mechanical, electronics and even technology acumen, biomed technicians and leadership are the go-to resource for any process that may occur in health care, including new construction or renovation projects. HTM brings a perspective that capitalizes on knowledge that other stakeholders in the project may not embrace or possess.

One reason that HTM can be an important voice and stakeholder in construction projects is that biomeds can point out pitfalls that others may overlook.

These insights can include valuable input in the areas of cybersecurity, connectivity, interoperability, space, environ-

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mental conditions, utility requirements, ease of use, warranty coverage, clinical and technical training and consumables.

The construction or renovation of health care facilities has evolved and there is a much greater emphasis today on health IT resources, modular and prefab options and sustainability.

Projects have to be carefully planned so there is uninterrupted patient care and safety is always maintained. With an aging population, expansion of facilities is necessary.

With all of the construction and renovation-specialty companies and contractors, architects and engineering consultants, who might be involved in any project, those tasked with equipment management know about considerations that might otherwise be overlooked.

While HTM has much to offer that comes out of organic knowledge and experience, there is always something more to

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learn from those who have stared down the challenges of large or complex projects.

To that end, we have assembled some tips and considerations that should prove useful the next time a new construction or renovation project presents itself and HTM is called in for consultation.

It is easier to employ knowledge going into a challenging situation than having to learn it through mistakes, missteps or learning through experience. As Benjamin Franklin once said, “An ounce of prevention is worth a pound of cure.”

KNOWING WHAT YOU ARE WORKING WITH In a 2018 story titled “Construction Excitement and Pitfalls,” TechNation interviewed Matt Royal, MS, CTM, CHSP, CHFSP, CHEP, CHTM, CLSO-M, CHC, CHFM, CBET, director or biomedical engineering for Eskenazi Health.

“Get the inventory of all new equipment correct, this is the time where you have all the purchase orders, pricing, PM schedules, warranties, etcetera,” Royal said in 2018.

This is an important part of the process and requires an effort by HTM or the services of a third-party provider.

At the time, Royal also said that, “Additional resources are needed. It takes a toll on the team when they are required to not only continue to support an old facility but oversee the installation of new equipment and the movement of existing equipment to the new hospital.”

That sentiment is echoed by Tim Michener, vice president of sales and marketing at Asset Services in Kansas City.

Michener says that there are some considerations during a renovation or new construction project that revolve around an accurate assessment of inventory.

“HTM departments need to evaluate the equipment that they have in their current spaces and determine if any or all of the equipment can be used in the new or renovated areas. They need to perform a detailed equipment inventory

to have an accurate understanding of the types and quantity of different assets they currently have on-hand,” he says.

“They also need to perform space planning to determine that the new spaces are large enough to accommodate their large equipment and ensure the proper power requirements have been taken into account. Even if equipment is functional and can be used in the new area, it may not be feasible because the equipment may be needed in the current facility right up until ‘moving day,’ and there will not be time to relocate larger or non-mobile equipment,” Michener adds.

Michener’s firm provides an initial outfitting and transition (IO&T) equipment inventory to aid in determining assets that can be re-used during these projects.

He says that IO&T inventories provide an accurate snapshot of what is located in the current facility/area.

“It will identify the type of equipment as well as details such as manufacturer, model, serial number and physical condition of the equipment. It can also identify dimensions of equipment in order to assist the architects in designing storage locations for items such as crash carts, laundry baskets, etcetera.

This detailed inventory provides information for the HTM department in order for them to determine what equipment they can reuse or what equipment they will need to purchase in order to be ready to operate efficiently when the newly constructed or renovated area is ready to be operational,” Michener says.

Colin Construction Company Chief Operating Officer Kevin Cook shares his outlook.

“After having served 20 years in the Air Force as a biomedical equipment technician, starting one of the first HTM programs at David Grant Medical Center (Travis AFB) and now running a construction company that specializes in health care construction for the past 15 years, give me a strong perspective on how instrumental the HTM role is in any equipment replacement or hospital remodel project,”

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Cook says. “HTMs are key to understanding the hospital infrastructure of installed real property (HVAC, electrical) and installed medical equipment.

They also understand the technical specifications of the new equipment being purchased. The general contractor hired to do the design and build of the project area to accommodate the new equipment works directly with the HTM to understand the as-built conditions through record construction documents and HTM’s corporate knowledge attained from sometimes years of work at the facility. The more the HTM understands the as-built condition or can share the documents attesting to that condition the more comprehensive the design and construction documents. This effort pre-construction mitigates the challenges and delays during construction and greatly improves the opportunity for an on-time and on-budget project ending with equipment delivery per the scheduled delivery date.”

THE INVALUABLE HTM PERSPECTIVE Two years later, Royal still has views to share from experience with construction projects. He points to the importance of the knowledge that HTM professionals maintain that allows for consideration of the cost of ownership, throughout the life cycle, when commencing a renovation or new construction project.

“Two areas that have always been an area of high maintenance is radiology and sterile processing. Often minimum specifications for utilities are planned for to keep costs low during a construction project. However, that may keep the costs of the project lower, it can increase the cost of ownership of a piece of equipment and also threaten the availability of critical equipment for hospital operations,” Royal points out.

He says that for sterile processing, equipment such as sterilizers and

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SAMANTHA JACQUES, Ph.D., FACHE, vice president of McLaren Clinical Engineering Services at McLaren Health

KEVIN COOK, Chief Operating Officer of Colin Construction Company

washers, quality water and steam is extremely important for the reliability of the equipment and the quality of the instruments being processed.

“Providing quality water might include softening, reverse osmosis water systems, water filters and constant testing of water quality. With poor water quality, you can have more frequent equipment failures and discoloration of instruments. This could lead to reprocessing, unavailability or delay of instruments to a surgical area.

Poor steam quality can impact sterilized instruments with wet packs which would again result in reprocessing, unavailability and delays,” Royal says.

Royal says that for an area like radiology, power quality is extremely important; this equipment is one of the biggest investments for a hospital.

“Having power conditioning or power protection can improve reliability to highly sensitive equipment. Many construction projects don’t account for this and larger investments such as UPS units to support high-voltage cabinets, gantries and MRI equipment. Although large UPS systems are expensive there is a return on investment for these systems. The radiology equipment is critical for operations of a hospital, but it can also be considered high revenue,” he says.

Not only is it important for HTM to provide important considerations for

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MATT ROYAL, MS, CTM, CHSP, CHFSP, CHEP, CHTM, CLSO-M, CHC, CHFM, CBET, director or biomedical engineering for Eskenazi Health

equipment reliability and longevity, but security issues and the choice of vendors require HTM input as well.

“Construction projects tend to not include HTM in vendor selections, which have implications downstream.

Projects may not even include end users in some of these decisions. Architects don’t have to operate the business after the construction is done, so they don’t often think about operational issues such as contract terms, usability, maintainability or cybersecurity. Setting roles/responsibilities in your project early to ensure the right team players (including IT and HTM) are included in decision about the technology they will need to support after go live is key,” says Samantha Jacques, Ph.D., FACHE, vice president of McLaren Clinical Engineering Services (MCES) at McLaren Health in Michigan.

She says that in construction projects the term “equipment planner” doesn’t just mean that they only plan the medical equipment. Depending on scope, the equipment planner may plan all IT equipment and facilities equipment such as trash cans and sinks. Even though these aren’t typically medical equipment, HTM departments can provide insights to the locations for things such as hand washing sinks, PPE closets and even trash cans.

“I would always recommend the end users get a quick lesson in reading

TIM MICHENER, vice president of sales and marketing at Asset Services in Kansas City

blueprints. It’s easy to sit in a meeting and determine which equipment needs to go into a room to meet clinical needs, but it’s much more useful if the end users are able to point equipment out on documents as they work through actual workflows. Noting the distances between patient rooms and a clean supply or med room is almost as important as ensuring the right equipment is located in that room,” Jacques says.

She says that HTM can contribute to construction projects and renovations in several ways.

MEDICAL EQUIPMENT PLANNING During a construction project, architects often outsource the equipment planning function to a third party. This third party has to learn the organizational standards and workflows, which always takes time and effort as well as significant money. Some forward thinking HTM departments have insourced this function as they are the equipment and workflow experts in their hospital.

She says that this way, equipment standards are kept up while costs can be removed from the project. The only caveat for insourcing is to discuss roles/ responsibilities with your project manager to assure the architect can cover any tasks the department can’t perform.

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Jacques also says that HTM can provide help in right sizing the amount of equipment purchased.

“HTM departments can aid in analysis of how many pieces of what types of equipment are required during projects. They can conduct inventories of existing equipment to recommend what can be re-used versus what must be replaced,” she says.

There is also the consideration of new technology assessments.

“Projects are often times for hospitals to look at new technology and systems to streamline workflows and enhance patient safety. HTM department involvement in RFPs and vendor assessments can help clinicians and supply chain departments make the right decisions on selection and implementation of new technology,” Jacques says.

HTM BEST PRACTICES There is no better teacher than experience and “baptism by fire” often instills lessons not soon forgotten. Even when emergencies or mistakes are not a part of the process, the experience gleaned produces knowledge of every possible consideration to do the project right in the future.

“There are new lessons learned in each project, but I have a few best practices I like to bring with me to each project,” Jacques says.

She says it is important to clearly define roles/responsibilities as early as possible.

“With so many players in projects with architects, construction managers, sub-contractors, project managers, end users, leadership, support services, etcetera, it can be hard to know who is working on what or who is responsible for what,” Jacques says.

“Early on, the project manager should develop a document that outlines whose role is what. It should also outline the decision-making process – who has authority to make what type of decisions and who needs to be informed or consulted in that decision. Finally, a defined communication plan also has to be outlined. How issues are raised, prioritized and resolved needs to be clearly understood as well as how decisions are communicated back down once finalized,” she says.

She says that in addition to roles and responsibilities, it is important to clearly define the scope.

“Scope creep is a part of every project, but having a clear understanding of what scope is and what the process is to add or change the scope needs to be understood up front. Also, all members of the team need to be able to speak up about scope creep and be able to raise their concerns at any time,” Jacques says.

Jacques says that workflow analysis is key.

“Ensure that during the design process, the end users run through their workflows to assure the design meets the needs of the users. This should be done at least twice during the project: 1. During schematic design (when room placement is finalized and equipment is getting placed in the rooms) 2. After installation but prior to go live. At this point, full simulation of workflows should provide any last issues that need to be resolved prior to first patient use,” she says.

THE LONG-TERM PERSPECTIVE Royal says that the biggest disconnect for design and construction and HTM is that design and construction is short term for projects and HTM is longer term for operations; these two conflicts need to meet in the middle as many construction project bids will go to the lowest bid that might sacrifice the investment in quality utilities to the equipment.

“Often these are considered after a project has set a projected budget

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

during the rough estimate planning. If HTM is involved in the capital budgeting with a design and construction team, they can account for these investments. However, HTM can’t expect to always be included in a strategic planning of construction projects, so it is important that a collaborative relationship is built with the design and construction team and they meet and compare notes on capital project proposals,” Royal says.

He says that often, HTM programs managed by third parties struggle with this involvement due to terms of a contract agreement; HTM contract agreements may be limited in their scope to just operational-type activities.

“However, it can be a success for a third-party HTM program to offer these as value added services to assist with capital planning. Engineering and architectural companies will sometimes offer these services to their customers, but much of their information that is valuable comes from the HTM team that has the experience with the equipment and vendors to add procurement input,” Royal adds.

As TechNation pointed out in 2018, new construction and renovation projects allow HTM to “prove their value outside of inventory, PM and repair activities.” The goal is that the considerations outlined in this article can be employed to reduce the risk of baptism by fire so that all stakeholders will be happy with the long-term results.

“As essential partners, the HTM and general contractor need to work hand in hand on any remodel or construction project. The more complex the project the more this relationship affects outcomes. HTM should be involved throughout the entire process; from equipment acquisition, through funding, into design and construction and finally equipment installation and staff applications and training. An HTM that can navigate relationships and milestones is key to the success of any hospital remodel or construction process. As a general contractor, I can speak from direct experience that we interact almost daily with HTM during construction,” Cook adds.

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EXPERT ADVICE

CAREER CENTER Preparing for Uncertain Times

BY TIM HOPKINS

A

s a society, we are living in incredibly stressful and uncertain times.

The COVID-19 crisis has dominated the headlines and, unfortunately, many experts are expecting the pandemic to continue for quite some time. While we as individuals have been impacted, so have businesses. Across the country, more and more employers are being forced to make tough financial decisions that will affect the livelihood of many individuals and, ultimately, their families.

So, how should you cope with all the insecurity? I will harken back to the days of my youth as a Boy Scout and say this, it is all about being prepared. While times were certainly easier, the lesson still holds true today.

1. Know the difference between a furlough and layoff. A furlough is a temporary layoff from work or a reduction in hours worked. In most cases, employees are not paid during the furlough but benefits such as health insurance are maintained. For many companies, the goal is to position themselves to retain their staff once business “gets back to normal.” For the business, this is a smart choice as they are positioned to fill job openings with current staff without the need to start over. For the employee, this is not a guarantee of work, but the odds are significantly in your favor. A layoff takes place when an employee (or more frequently a group of employees) are officially released from their position.

Like a furlough, layoffs are not associated with job performance and the employee may be rehired in the future. For the business, this often takes place when paying salaries and benefits is difficult and/or a business is no longer able to generate revenue.

When possible, businesses will offer a severance package that may include

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health insurance for an allotted time in addition to a dollar amount to help the employee transition. However, severance packages are not guaranteed.

2. Update your resume. It might seem pre-mature and even discouraging to update your resume now but think of it as a necessary step in preparation.

Updating your work history to accurately reflect the work you have been doing will take time. You may not even need to use it, but if down the road you find yourself presented with the need – you will be ready.

3. Consider budget cuts. I know … the dreaded budget cuts. Just as businesses are adjusting their budgets, you should too. This is especially true if you suspect a furlough or layoff coming your way.

4. Talk with your family! Although I have it listed here as number four, it really is the most important step. As a recruiter, I see candidates far too often who go down the road of employment decisions only to discover a very unhappy spouse or family member who was shocked! Keep your significant other in the loop from the beginning and lean on each other to make decisions together.

So, you feel prepared but then the dreaded conversation happens … you have been furloughed or laid off. Do not panic!

1. Don’t take it personally. Remember that if you face a furlough or layoff, this is not a reflection of your job performance. I know … that is easy for me to write and for you to read, and yet quite different to live through. But it is extremely important that you maintain your confidence and know your worth.

2. Ask about your options. Ask for a severance package or the opportunity to keep your benefits.

3. Get letters of recommendations. Ask

Tim Hopkins Stephens International Recruiting Inc.

for written letters of recommendation from your direct supervisor and other leadership within the organization.

4. File for unemployment. Yes, employees can file for unemployment if laid off or furloughed. The amount of unemployment benefits furloughed workers are eligible for varies in each state. There may also be other unemployment programs your state is offering to help through this pandemic. Look at your local workforce commission and do your research right away.

5. Use this time to update your education.

Discover ways to update your skill set while on furlough or laid off. Take this opportunity to increase your education and advance your career.

You have many resources at your fingertips and certainly are not alone in these challenging times. If you need support finding a position give us a call at Stephens International Recruiting Inc. We are always happy to help!

TIM HOPKINS is the vice president of operations and executive recruiter for Stephens International Recruiting Inc. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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Nuvolo’s modern solution provides extensive reporting and analytics with customizable dashboards already built for HTM professionals.

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HOW TO RETAIN VACUUM ON AN ELEKTA LINAC DURING A POWER OUTAGE

BY ANDREW WOODBURY

T

emporary power outages in a medical facility are never convenient, but lengthy outages can result in more than just postponed cases and lost revenue. If proper precautions aren’t taken to preserve equipment during power outages, major equipment systems can require some work to restart once power has been restored.

This is especially true when it comes to LINAC systems. In this article, you will learn how to preserve the vacuum on an Elekta LINAC in the event of a power outage.

If an Elekta LINAC is without power for more than four hours, power should be maintained to the ion pumps by using a backup generator. Losing vacuum in the waveguide could possibly cause days of unwanted downtime. The easiest way to avoid this is to incorporate backup power outlets running from a generator.

Connect a standard computer power cord with IEC C13 and NEMA 5-15 connections to an extension cord from the backup power outlet to the ion pump power supply unit (PSU).

Most Elekta machines power the ion pumps with a single Agilent Technolo-

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gies model switching PSU which uses a 100-240V input. Do not attempt this backup power installation process with older PSU models (Edwards or similar) as they only operate on 230V. Begin by rotating the gantry to -45°angle. Next go behind the left door of the machine and turn to your right to see the ion pump PSU at eye level inside the gantry drum.

Shut off the rocker switch and unplug the ion pump PSU power cord directly to the right.

Rocker switch and power cord indicated in blue.

Next, plug in the computer power cord to the ion pump PSU and the extension cord to the backup power outlet. Flip the PSU rocker switch back on. On the opposite side of the PSU, two blue lights should blink, and then go solid.

Ion pump power supply unit indicated in blue circle.

Solid blue lights indicate power is connected correctly to the ion pump PSU.

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Operate Efficiently, Perform Real Time, Simplify Compliance A CMMS Solution that offers • • • • • After you have secured backup power to the ion pump, be sure to shut down the LINAC computer all the way by clicking Power Off at the standby screen. Make sure the XVI, iView, iGuide, Sequencer and any other computer systems are shut down as well.

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After backup power has been routed to the ion pump PSU, be sure to shut down all computer systems.

Taking the above steps will help to ensure that your Elekta LINAC will safely weather the power outage and avoid costly downtime. Once power has been restored to your facility, do not rotate the gantry until the external power cord is disconnected. Flip off the rocker switch on the ion pump PSU and remove the computer power cord.

Plug in the original power cord and flip the power switch back on. Once again, the blue LED lights should blink and then go solid. If these lights continue to blink, or do not turn on at all, contact your local LINAC service engineer for assistance.

ANDREW WOODBURY is a field service engineer for LINAC systems at Avante Health Solutions. For more information on oncology equipment and service options from Avante, visit https://avantehs.com/oncology.

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EXPERT ADVICE

VIEW ON VALUE Breaking Down Barriers

BY PATRICK FLAHERTY AND JOSEPH HADUCH

L

ast month’s column, “Barriers to Change,” discussed the many obstacles HTM professionals, as well as countless other health care professionals, are needlessly forced to navigate when purchasing medical equipment, parts and service.

The article touched on four major factors that inhibit providers from efficiently and effectively serving patients with value-based technology solutions that deliver objectively proven outcomes or substantiated savings. The four barriers addressed in the article were: 1. Divide and Conquer 2. Marketing 3. Research and Development (R&D) 4. GPO and Government While we identified why these are problematic, we did not address how to break through these barriers. At the request of many of you, this month’s article will share some tactics and techniques that will help you better navigate these burdensome supplier sales methods and strategies.

DIVIDE AND CONQUER This supplier strategy involves isolating the physician or administrator, believed to be the most politically powerful in the purchase of medical equipment, from the provider’s internal selection process. This is where HTM and their supply chain colleagues can make major contributions. It is vital that every health care provider have a stringent and inclusive equipment review process that involves ALL facets of the clinical selection process. This would include facilities, HTM, supply chain, finance, clinicians

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and ISD. Equipment purchases affect many aspects of the health care continuum. There needs to be collaboration and input from all stakeholders. In addition, we are often asked as HTM professionals, “How can I contradict our physicians when we evaluate and select medical equipment?” The answer; data, data and more data. It’s hard to argue with factual data, no matter your title or job description, and HTM departments should have volumes of it. Total cost of ownership, uptime, service costs, utilization and service hours are all critical components of evaluating equipment. Include ECRI data or other third-party, independent clinical evaluations as part of your analysis.

Lastly, once you’ve established your equipment selection process, make sure your suppliers are aware and adhere to it.

Sadly, we have, on more than one occasion, had to ban sales representatives from our organization because of their lack of respect for our internal processes.

MARKETING Keep in mind that marketing departments for medical suppliers are no different than those promoting the Shake Weight and the Snuggie. They provide all the reasons, substantiated or not, why you need their specific product, no matter the product. We’ve discussed clinical equipment marketing with several different OEMs with the intent of directing marketing strategies toward clinical impact, however we’ve seen little change. Suppliers need to stop leading with better, faster and smarter in favor of substantiated and guaranteed metrics related to system performance, objective outcomes and economic affordability. As an example, new

imaging products may work faster, see more and improve current workflows, but does that translate into better outcomes? Instead of touting improved image quality, suppliers should address improving false positive and negative rates, the improvement of which would result in fewer follow ups, quicker diagnosis and lower costs. These claims can easily be measured and, more importantly, suppliers could easily determine the level of objective value this device would provide a care provider. If marketing claims are valid, suppliers shouldn’t have any issues with warranting metric-based performance as part of a purchase agreement.

Currently, providers pay premium prices based on marketing claims, not guaranteed performance. This needs to change.

HTM departments can help drive this change in collaboration with clinical teams to determine how clinical metrics are evaluated and drive overall system performance as part of supplier purchasing agreements.

RESEARCH AND DEVELOPMENT R&D is the most taboo topic we are raising as it should never be part of a commercial decision. Supplier strategies which inappropriately incorporate R&D target physicians directly in order to convince them a better product is imminent and, more insidiously, draw a connection to the imminent sale in one of two ways: timing of access to the new product (buying now moves them up in the queue) or opportunity to be a investigator on the new product (physician believes commercial relationship increases odds of being selected). In both scenarios, the R&D process is leveraged for a sale as opposed to how

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effective R&D can better serve clinical needs. The taboo nature of R&D also creates another problem … it is generally divorced from the practical business elements like affordability and economically aligned outcome improvements, leading to differences which may or may not provide a material improvement in care delivery. Suppliers need to align R&D with value-based engineering to find solutions for real world problems rather than developing technology in search of a problem. How often have we seen new product technologies fail to gain reimbursement approval? Who should assume the risk for payment where no evidence of benefit is warranted by the supplier? Are providers refunded when newly developed technologies are not supported by insurers due to unsubstantiated benefit?

What’s the point of the technology if payers will not reimburse and patients cannot afford? You may be wondering what HTM has to do with R&D. In her book “Managing Medical Devices within a Regulatory Framework” Beth Ann Fiedler suggests: “CE (clinical engineering) participation earlier in the technology introduction/product life cycle has the potential to improve clinical trial data premarketing and promote the collection of longitudinal information.” Clinical engineering’s involvement early in the development process would help avoid unnecessary technologies and improve equipment safety and ease of use for end users based on the engineer’s experience in a clinical environment.

GPO AND GOVERNMENT Perhaps the biggest fallacy in all of health care with respect to equipment and service purchasing is the, “We cannot do better than our government contracts.” Anyone involved in any equipment contract negotiation has no doubt experienced this tactic. For some, it means the end of the line. “I’m getting government pricing, that’s the best they can legally do.” This is untrue. Suppliers are only obligated to government

pricing based on the exact conditions of that contract. If a care provider is including any other considerations within their agreement or are offering any additional benefit to the supplier other than the purchase, it is highly likely that an argument can be successfully made that it cannot be compared to the government contract. Suppliers are free to negotiate at will, but frequently use government contracts as reason not to negotiate in good faith.

General Purchasing Organizations (GPOs) are another veil suppliers will hide behind to avoid local provider negotiation. GPO contracted pricing is based on the GPO’s ability to provide volume for suppliers, while leveraging lower costs for smaller providers. It does not prevent suppliers from contracting at a local level, nor does it set a “pricing floor” for independent providers. Don’t be fooled.

We are transitioning to a new era in health care that has yet to be defined.

Many will go kicking and screaming as they try to protect gross profit margins and high revenue streams while continuing to employ age old sales strategies.

Though they may portray themselves as partners or collaborative, any supplier that implements any of the common tactics described here are nothing more than transactional companies driven purely by what they can get from you today. HTM can help providers define this new strategic era in health care by better understanding supplier obligations, providing essential clinical and service data to the equipment purchasing and evaluation process while collaborating with key stakeholders across their own organizations to standardize their purchasing process and maximize their medical equipment spend.

PATRICK FLAHERTY is the vice president of operations for UPMC BioTronics. JOSEPH HADUCH, MBA, MS, is the senior director of clinical engineering for UPMC BioTronics. The views expressed here are those of the authors and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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THE FUTURE

Education and Continuing Education in 2021 and Beyond

BY JOIE N. MARHEFKA

C

OVID-19 has changed work, schooling and everyday lives all over the world. Like most other universities, we have been teaching all our courses online since March. This has been particularly challenging in a hands-on program like our biomedical engineering technology major, and we quickly had to shift to virtual courses, including labs. We’ve found ways to teach PMs and troubleshooting using videos and manuals rather than actual equipment. We have conducted class lectures, discussions and guest lectures online using Zoom. Students were forced to use online platforms to collaborate on projects, and many changes had to be made since our classes were no longer able to meet in person. Resources from AAMI, GE and Fluke, as well as from other schools, have been extremely helpful in making this transition. While we are looking forward to returning to in-person classes in the future, this pandemic has clearly changed the future of education.

The future of continuing education for HTM professionals will certainly look different as well, at least in the near future. The present environment has changed the way professionals keep their certifications current and stay up to date with developments in the industry. Many conferences, including AAMI Exchange, which typically offer numerous opportunities for continuing education, have been cancelled. We have turned to virtual continuing education offerings such as webinars and online training courses. Other conferences have pivoted

to virtual formats, providing various online learning opportunities for attendees. MD Expo replaced its large spring conference and trade show with a series of smaller HTM mixers, designed to allow for valuable continuing education, networking and vendor engagement to be maintained with reduced travel and fewer people in one place. In addition, other online training opportunities, which allow participants to stay current in the field without traveling or gathering in large groups, are being developed. For example, AAMI’s online summer education series provides education and training related to a number of important topics facing health technology, sterilization and regulations. Also, Innovatus Imaging recently launched a program to provide a virtual classroom with live webinars on ultrasound probes, MRI coils and more through Innovatus University and is partnering with local and regional HTM organizations to host virtual meetings for their members.

TechNation also continues to offer the Webinar Wednesday Series. These are just a few examples of online continuing education opportunities that are being developed.

The pandemic has also forced us to change the way that we network with others in the field. Without being able to meet face to face at conferences and other meetings, tools such as LinkedIn and Zoom have become invaluable.

LinkedIn provides an opportunity for making new connections with people in the field and for staying in touch with current connections. It is a great way to make introductions when in-person events are not possible. Zoom meetings

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Joie N. Marhefka, Ph.D. Penn State New Kensington have become a popular way to catch up with peers, as well as for mentors and mentees to stay in touch. I’ve even seen speed networking sessions, networking happy hours and other types of networking events conducted over Zoom. Online discussion boards, such as the AAMI connect forum, are another effective way to share ideas virtually.

The last few months have certainly brought big changes to education for HTM professionals, both at the college level and in continuing education. Many classes, trainings, conferences and other events were quickly pivoted to virtual formats. These changes, of course, were necessary due to the pandemic, but also created some opportunities that would not have otherwise been available – including learning from and networking with people who live far away. While I hope that we will regain some sense of normalcy in the not-too-distant future and will be able to return to some of our traditional, in-person education and networking, I believe that some of the increase in and emphasis on online learning and networking opportunities will remain and will help to shape the future of education.

JOIE N. MARHEFKA, Ph.D., is the biomedical engineering technology program coordinator at Penn State New Kensington. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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EXPERT ADVICE

SPONSORED CONTENT

20/20 IMAGING INSIGHTS The Road Less Traveled

BY MATT TOMORY

“T

wo roads diverged in a wood, and I, I took the one less traveled by, And that has made all the difference.” – Robert Frost

As I reflect on the synergy of our FDA registered Ultrasound Manufacturing and Engineering Center of Excellence in Colorado and our Ultrasound Repair Center of Excellence in Oklahoma, the inspiring phrase above from Robert Frost comes to mind. Years ago, our founders paved a new path for probe repair and manufacturing by developing technology and processes no one had heard of before, let alone applied.

Many in the industry then, and today, don’t understand the full rationale behind all the testing, processes and instruments we use to produce worldclass ultrasound probe repairs which perform as the OEM intended and are designed for maximum longevity and ROI. However, as I’ve further developed and refined my knowledge of probe repair processes that increase sustainability while lowering cost of ownership, I’ve come to realize that the technology journey we take for repairs as a result of the tandem efforts by our

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manufacturing and repair facilities is what leads to the ultimate goal imaging professionals seek – reliable, sustainable and affordable repairs. When vetting out partners to repair and maintain your valuable probe inventories, its important to know how manufacturing and repair facilities work in tandem to inform one another and produce processes that deliver the performance and ROI needed for you to deliver safe and effective patient care.

Consider the following: As a transducer manufacturer, we utilize very sophisticated instruments for the design, manufacturing, and verifications and validations of finished ultrasound transducers and transducer arrays. The majority of these instruments and processes are applied to engineering and implementing solutions for probe repair.

Let’s discuss just a few of the devices we use for both repair and manufacturing.

Matt Tomory Innovatus Imaging

Acoustic Intensity Measurement System ACOUSTIC INTENSITY MEASUREMENT SYSTEM The first device is an Acoustic Intensity Measurement System. This device allows us to map acoustic fields, measure acoustic power, focal areas and a host of other acoustic measurements to ensure a transducer or transducer array performs as intended. This helps to assure proper function, accuracy and safety for patients.

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EXPERT ADVICE

Advancing the Biomedical/HTM Professional

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PULSE ECHO TESTER When an array is manufactured, we test every element to ensure it is performing as intended in the Design History File using a custom designed and manufactured Pulse Echo Tester. This robotic device pulses each element which is then measured by a hydrophone also designed and built by Innovatus Imaging engineers. This ensures consistency and accuracy across the entire aperture of the array.

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ensure it will perform as intended mechanically. We stress test our cables, cable jackets and strain reliefs to ensure performance and longevity using yet another custom designed and manufactured device we affectionately call Tic-Toc. This machine oscillates a probe 180 degrees while twisting the cable 90 degrees in opposite directions and counts each cycle. This allows us to verify and quantify the durability of our materials and assemblies.

Where does this path of technology and engineering lead next? To our state-of-the-art repair center in Tulsa, Oklahoma where thousands of customers’ probes per year are repaired and returned for years of additional patient service.

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TIC-TOC CABLE STRESS TESTER When we think of cables, we typically believe they are just a conduit for signals or voltages and current but have you ever thought about the complexity of an ultrasound cable? There are many variables to consider including characteristic impedance, resistance, capacitance, materials and even length, diameter and jacket color. Once you have engineered a cable, you need to

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Beyond the technology featured above, Innovatus Imaging continues to choose the road less traveled through ongoing research and testing to develop new technologies that also will make a positive difference for the quality and longevity of probe repair. I personally invite you take an Innovatus Imaging “Technology Journey” tour through video or in person to see more of what’s behind the repairs we perform that are proven to extend the life of the transducers we service.

AM

MATT TOMORY is the Vice President of Ultrasound Center of Excellence for Innovatus Imaging. Contact Matt directly at matt.tomory@ innovatusimaging.com for more information.

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EXPERT ADVICE

CYBERSECURITY Essentials: The CIA Triad

BY CONNOR WALSH

E

ncryption, hacks, ransomware, auditing, backups, permissions.

These are just some cybersecurity terms that are undoubtedly heard on a consistent basis by the modern HTM professional, but the importance or meaning behind them may not fully be understood. Now more than ever, data protection of medical devices and systems must be considered for any new system deployed into your environment. Installing insecure, obsolete devices can have a crippling impact on your organization.

At the beginning of this year, the HIPAA Journal reported a 196% increase in total health care data breaches between 2018 and 2019. This amounted to a total of 41,335,889 breached records, which was the largest amount in recorded history. Protecting your organization’s data and proper data handling techniques can be traced back to understanding three core concepts: confidentiality, integrity and availability. Together, these principles form a security model that is arguably the most important terminology in cybersecurity. Let’s explore each of these topics, relating their importance to HTM. Confidentiality can closely be related to privacy, that is, ensuring data is only seen by those who need to see it.

Imagine for a second you have a cardiology PACS workstation in a high traffic area. How do you make sure that only the approved cardiologists are able to login? Do they login with a user-

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name/password or a smart card? If someone were to steal that workstation, is the hard drive encrypted to ensure the data cannot be read? Common techniques in today’s health care for ensuring confidentiality are encryption (both encryption at rest and in transit) and improved authentication techniques, such as two-factor authentication (i.e something you know, such as a password, and something you have, such as a smart card). As more medical device manufacturers start taking cybersecurity principles more seriously during new product development, these features are often offered, and should be considered when rolling out new medical equipment. Unfortunately, even with the strongest controls in place for ensuring confidentiality, the weakest links in any organization are the employees. Security awareness training for different medical systems while on environment of care (EoC) rounds and constant security education of staff are other methods for ensuring that confidentiality is maintained in your organization.

Integrity is centered around guaranteeing the accuracy of data and making sure that there are no unauthorized changes to a system or data. In HTM, some examples of protecting data integrity are file share permissions, work order documentation and audit logging. For example, let’s say you had one file share location that housed data for both pathology and radiology. You would not want to allow permissions for pathologists to access the radiology data unless there was a valid reason. Allow-

Connor Walsh, CISSP VA Boston Healthcare System

ing this opens the risk for a pathologist to accidentally (or maliciously) delete/ modify the radiology data, which would impact its integrity. Work order documentation is also a form of ensuring integrity of medical systems.

Keeping a detailed record of equipment maintenance tracks all major changes to that device, allowing this history to be referenced if there was an issue with that system in the future. Audit logging is another means for protecting data integrity and is one that is often overlooked by HTM and manufacturers. If you have an agreement with a vendor for remote access into your servers, are you alerted when they remote in? If they were to remote in, do you have an audit trail of all changes made on the server to hold individuals accountable? When users access a system on which they know their actions are tracked, they are less likely to misuse the equipment.

The final corner of the CIA triad is “availability.” This is the idea of ensuring data is readily accessible when needed. In HTM, preventative maintenance is a form of availability, as it serves to ensure the function of medical systems for the long term. Other forms of availability are system backups, which act to preserve data in the event

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EXPERT ADVICE

of a hardware failure. Are you prepared in the event of a disaster? Do you know who to call and what needs to happen if your GI PACS system were to crash? A common technique to protect availability of data is to run proactive table-top exercises for disaster recovery. Set up a meeting of all necessary parties and run through a fake scenario as if you just arrived at your facility and a critical server was down. Typical cyber-attacks a health care organization may see on its systems, which affect availability, are distributed denial of service (DDoS) and ransomware attacks. Both prevent users from accessing data where and when they need it. Earlier this year, the largest private hospital operator in Europe, Fresenius, was hit by the SNAKE

ransomware. The assault held Fresenius IT systems hostage, directly impacting system availability. The cyber criminals behind the attack demanded payment via digital currency in order to restore access. They gave Fresenius a deadline of 48 hours before they would publish all data on a public online forum, which ultimately would result in a major loss of confidentiality as well.

The overall idea of the CIA triad is that one cannot operate successfully without the other two. You cannot have data confidentiality and integrity if the system crashes and all the data is lost (i.e no availability). Data availability and integrity controls deteriorate if you have a medical system in a high traffic area holding sensitive informa-

tion that is set to autologin (i.e. no confidentiality). And data confidentiality and availability controls are weakened if you have a medical device using a file share with “everyone” set as full read/write permissions (i.e. no integrity). It is of utmost importance for HTM professionals to take into consideration all three of the CIA principles when procuring and installing new medical equipment, especially in today’s ever-evolving cybersecurity landscape.

CONNOR WALSH, CISSP, is a supervisory clinical engineer for the VA Boston Healthcare System. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

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EXPERT ADVICE

THE OTHER SIDE Are Sweeps the Answer?

BY JIM FEDELE

H

ospital-based biomed shops are often under a lot of scrutiny to save labor and find ways to be more efficient. One area that insidiously erodes labor is the support of offsite office practices. For us, and I would imagine other facilities, we have a hospital entity that recruits and manages physicians’ practices to support our hospital-based operations. This entity provides operational support to the physician practice in the form of IT systems, supply contracts, capital equipment needs, repair services, insurances, etc. We include these practices in our management program as if they are a hospital-based department, however I am rethinking that strategy due to some good growth in recruitment that is now taxing our labor resources. I am wondering how other biomed programs manage these differently.

We are charged with supporting these practices for equipment repair services, in general, we simply get a call to add a practice to our inventory. We are not usually consulted until after the deal is done. In most cases, the equipment is relatively minor, dated and in fair condition. However lately, we have added some specialty clinics that have had many expensive issues with their equipment. In most cases we don’t know the age, condition or service history of any of the equipment we are adding from these office practices and clinics. In general, the equipment is minor, like otoscopes, thermometers, scales, and possibly an EKG machine and hyfrecator. However, the specialty clinics we recently added had flexible scopes and video equipment. Most of it is very old and in need of repair.

Which creates some unique budgeting issues when we normally develop budgets

around run rate, and these are new expenses. My point is that the way the office practices repair services are managed before they join us is very different once they are part of us.

Another issue we contend with is the managing entity of these office practices also adds, removes and redistributes equipment without informing us. This causes us to spend a lot of time looking for that equipment trying to match it against a PM list. Between the driving time to and from these practices and the effort needed to find the equipment it feels like a lot of wasted time.

As I step back and look at the situation, I feel like I should consider a different equipment management approach. The equipment we are managing doesn’t really get preventative maintenance, we are merely doing functional tests. We are not performing tasks that extend the life of the device.

Before we took over the service duties at the practice, they were likely running a run-to-fail model because of the service costs. Also, the office practice is doing preliminary diagnostic work, they basically prequalify patients for the more comprehensive and accurate testing they would get from a hospital or specialty service. Some do minor procedures, but these are generally low-risk procedures that do not rely heavily on medical equipment. I am thinking that an annual sweep of the practice might work better.

Sweeps could save time as we would not be chasing an equipment list and looking for specific equipment. We could schedule the sweeps after the practice closes, inspect the entire space, and document the equipment that was found and inspected and move on. This would at least save some time from trying to find everything that is on a PM inspection list.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Jim Fedele, CBET Senior Program Director, UPMC and BioTronics

Another idea I had is to just put them on a run-to-fail schedule. Don’t schedule anything and fix things when they are broken. However, there may be issues with regulatory compliance. And, in general, there isn’t an appetite to try this because people fear litigation and don’t believe it is safe. Even though before we took over that is likely what was occurring.

I am sure there isn’t a one-size-fits-all solution, I know some places have a field service team. Also there are third-party companies that sell inspection services to office practices. With our present growth and expanding geographical distance (some of our practices are two hours away), we will soon need to add labor if we keep our current plan. I am interested in how you manage the equipment, what are your considerations when deciding how to service these outside entities? As always, I am interested in your thoughts and opinions.

JIM FEDELE, CBET, is the senior director of clinical engineering for UPMC. He magazines six Susquehanna Health hospitals. He has 30 years of HTM experience and has worked for multiple service organizations. The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

SEPTEMBER 2020

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EXPERT ADVICE

ROMAN REVIEW Expectations

BY MANNY ROMAN

B

eing a sensitive modern male, I always do as told. My lovely wife, Ruth, told me to include the following in this column. I know that this is not as you have come to expect in this column and I will get to that.

THE DINNER GUEST I was having a nice dinner outside while enjoying the beautiful sunset. I felt a little itch on my shin. I looked down to see a little black spot that in the low evening light may be a small spider. I slapped at it and it landed on the deck, shook its head and wandered away towards the grill area.

Now, I am fond of telling people that there are few bugs in Vegas so I was annoyed by this incident. I decided to terminate the offender. I took my dinner knife and began chasing this little guy around. It would have been a very amusing vision to anyone watching: A big guy with a steak knife chasing and stabbing at an unseen entity.

Well, I was unsuccessful in my quest to punish the aggressor so I consoled myself with the remainder of my glass of wine. As I refilled, the ridiculousness of the situation fully hit me.

There I sit enjoying dinner. This little whatever-it-is wanders by looking for supper (let’s call him Emilio). Emilio sees me and thinks, “Thanks be to the Bug Gods! I am about to eat for months! I think I will start right here.” He then takes a relatively giant bite out of my shin.

Imagine Emilio’s surprise when the would-be dinner slaps him in the left compound eye and chases him for hundreds of bug miles with a giant steel fang. Emilio had a hell of a story to tell

his bug buddies. As for me, I just scratched and finished my wine.

There … definitely outside your expectation, correct? Now to the expectations discussion.

We tend to remember those instances when expectations are not met more often than when they are met. An example is when poker players believe that they are unlucky and their opponents have all the luck. In Texas Hold ’em, a pair of aces statistically will lose the hand 20% of the time. Poker players know this and yet fall for the bad luck scenario. We remember the pain of losing 20% of the hands more than we remember the joy of winning 80% of the time.

There is a disconnect between reality and expectation. We expect to win with two beautiful aces in our down cards.

When reality shows its ugly face, we feel the pain of having lost and place greater importance on it than is warranted. The good of winning is never better than the bad of losing. The pain of losing is more memorable than the joy of winning.

In life this means we are more failure conscious than we are success conscious.

Fear of failure can be devastating and paralyzing. Many of us would rather not attempt something than take the risk of failing and the accompanying pain, especially judgment from others. We will actually make failure the expectation and thus meet that expectation without even trying. Sometimes the expectation of the pain is even worse than the pain. Think of getting a flu shot. The pain, the possibility of getting the flu from it, maybe even dying from it becomes a real fear that causes anxiety and pain.

So, what to do? First accept the actual facts. Evaluate the situation as unemo-

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Manny Roman, CRES AMSP Business Operation Manager tionally as you can. Recognize any unrealistic expectations for what they are: A puff of smoke to be blown away so that reality can be seen. Do not get married to unrealistic expectations. This is the best way I know to reduce the pain of unmet expectations. Be realistic and when the situation does not go as you wanted it will be one of the expected outcomes. The pain will be lessened and you will be able to move on from it to the next challenge more easily.

In the aces example above, we know that we will lose one of five times in the long term. When the board cards show a possible flush, a possible straight, a pair and someone is betting their entire life savings on it, fold. You expected to lose sometimes and this is probably one of those times. You expected it and your expectation is met, unwanted but met.

You got that one out of the way.

Let’s clarify trying. When we choose to try, we automatically have an expectation of failing a portion of the time.

Children are great at trying and not doing because they are told to at least try. Adults should realize that failure might be an acceptable expectation but not the goal.

Remember Yoda saying, “No, try not. Do or do not. There is no try.”

The views expressed here are those of the author and do not necessarily represent or reflect the views of TechNation or MD Publishing.

SEPTEMBER 2020

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DID YOU KNOW? Science Matters

Ancient coal fires and ‘Great Dying’ Burning coal deposits heated the atmosphere 250 million years ago – a major disaster at the time of the Permian Extinction, the worst biological catastrophe in Earth’s history.

Siberian Traps

Siberian Traps erupted, burned Henrik Svensen photo

PA NG AEA

Traps’ lava layers

Land formed the ancient supercontinent of Pangaea

354

4 After millions of years,

ecosystems rebuilt and species recovered

Millions of years ago Age of Amphibians

Permian period

1

Massive eruptions began in vast volcanic region in Siberia, the Traps (Swedish for steps); continued for 2 million years

2

Magma and lava burned plants and ancient, buried coal deposits in the Traps

3

Earth underwent lethal global warming; ocean temperatures exceeded 42°C (104° F) – as hot as a spa hot tub

The Permian Extinction wiped out 96% of all ocean species 70% of land-living vertebrate species 252

GREAT DYING

65 Age of Dinosaurs

0 Age of Mammals

Finding the burned evidence The hypothesis of volcanic fires in the Traps has long been considered, but evidence was scarce Researchers had found microscopic remains of burnt coal on a Canadian arctic island

Burned coal from the ancient fires found in a quarry near Ust Ilimsk Scott Simper photos

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SEPTEMBER 2020

Cliffs of volcanic rock

Then new searches along Siberia’s rivers found burnt wood and coal among the volcanic rock “prisms” there – major evidence that the coal fire-global warming theory is correct

Source: Lindy Elkins-Tanton of Arizona State University; Steve Grasby of Geological Survey of Canada; Geology (journal); National Geographic Graphic: Helen Lee McComas, Tribune News Service © 2020 TNS

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Fetal Monitoring Multimedical Systems

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72 60

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

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Ultrasound

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ECRI Institute Fluke Biomedical

EQ2

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84

Phoenix Data Systems………………

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BC Group International, Inc…………

96

Infusion Pump Repair…………………

72

Pronk Technologies, Inc. ……………… 5

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

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48

SalesMaker Carts……………………

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28

Innovatus Imaging……………………… 8

Select BioMedical……………………

37

Biomedical Support Systems…………

72

Integrity Biomedical Services…………

51

Southeastern Biomedical, Inc………

83

Cadmet………………………………

28

InterMed Group………………………

80

Colin Construction Company…………

33

International X-Ray Brokers…………

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

17

College of Biomedical Equipment Technology………………

11

Interpower……………………………

95 80

77

Crothall Healthcare Technology Solutions…………………

Master Medical Equipment…………

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

Maull Biomedical Training……………

16

Tri-Imaging Solutions…………………

23

35

69

37

Medical Equipment Solutions………… 2

TruAsset, LLC…………………………

D.A. Surgical…………………………

61

47

88

Medigate………………………………

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ECRI Institute…………………………

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60

MedWrench…………………………

89

Engineering Services, KCS Inc………

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Midmark RTLS………………………… 3

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55

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Free & Knowledgeable Technical Support

Our U.S.A.-made cords soar past quarantines with FAST shipping, and our cords are compliant with North American and International standards, helping you design for global markets. All Interpower cords are rigorously tested. We provide the end user with the correct connections to the local mains power supply which helps reduce production schedule bottlenecks.

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Order Online! www.interpower.com

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Business Hours: 7 a.m.–6 p.m. Central Time

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

IPA-3400 Infusion Pump Analyzer

Now Patented

The High Accuracy, Easy-to-Use System with Full Touch Screen Control of All Processes The IPA-3400 is the most compact, fully featured four channel analyzer on the market. The IPA-3400 has a Patented, dual syringe stepper motor driven system that offers continuous monitoring of the fluid flow, providing a more realistic flow path for the infusion device under test and more accurate readings.

The independent stepper motor control of the custom designed, ceramic valving allows the system to run quietly and smoothly, with a bidirectional powered fluid flow for use in the built in cleaning cycle.

The Next Generation in Infusion Pump Analyzers is here!          

Large 7” Color Touch Screen 1,2,3 and 4 Channel Models available (Field Upgradeable) User Swappable, Fully Self Contained Flow Modules Calibration in Flow Modules No need to be down for calibration or service!

Smooth Dual Syringe System Eliminates Drain Cycle Inconsistencies Whisper Quiet Operation Auto Start Built-in Auto Test Sequences Built-in Data Collection Built-in Reports

Screenshots from the IPA-3400

Easy access to modules for expansion and calibration.

Each module is calibrated with up to four channels in each IPA-3400. Stagger the calibration time for modules to prevent downtime.

Users can also run specific test routines specified by various manufacturers using built in autosequences. Advanced features in the autosequences even allows the inclusion of pictures to aid with the setup and configuration of each step.

IPA-3400 with Swappable Modules

Phone: 1-888-223-6763 Email: sales@bcgroupintl.com Website: www.bcgroupintl.com ISO 9001 & 13485 Certified ISO 17025 Accredited