TechNation Magazine November 2020

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ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

NOVEMBER 2020

TEAMWORK CONCEPT:

BRIDGE COMMUNICATION GAPS BETWEEN HOSPITAL DEPARTMENTS PAGE 50

12 Department of the Month

UCI Medical Center

Biomedical Engineering Department

18 Association of the Month

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Vol. 11

The Heartland Biomedical Association (HBA)

44 Roundtable

Radiography

73 Roman Review

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CONTENTS

FEATURED

44

HE ROUNDTABLE: T RADIOGRAPHY We reached out to several radiography experts seeking information regarding the latest features in radiography equipment, how to overcome budget challenges and more.

Next month’s Roundtable article: Test Equipment

50

TEAMWORK CONCEPT: BRIDGE COMMUNICATION GAPS BETWEEN HOSPITAL DEPARTMENTS HTM professionals must know their customers, be good listeners, show empathy and more to be among the best of the best. An understanding of each department’s needs and the best practices for resolving their concerns also go a long way toward outstanding inter-departmental relationships.

Next month’s Feature article: Holiday Wish List

TechNation (Vol. 11, Issue #11) November 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

NOVEMBER 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 Department of the Month: UCI Medical Center Biomedical Engineering Department p.14 Professional of the Month: Tri Q. Dang p.18 Association of the Month: The Heartland Biomedical Association (HBA) P.20 INDUSTRY UPDATES p.20 News and Notes: Updates

from the HTM Industry p.28 Ribbon Cutting: Lexicon MedParts p.30 AAMI Update p.32 ECRI Update P.34 p.34 p.37 p.38 p.40

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

P.56 EXPERT ADVICE p.56 Career Center p.58 How to Find the Right Refurbished Diagnostic Imaging & Oncology Equipment Provider, sponsored by Avante p.61 Cybersecurity p.62 The Future p.64 20/20 Imaging Insights, sponsored by Innovatus Imaging p.66 View on Value p.69 The Other Side p.70 Fast Remediation for Medical Device Cyber security,sponsored by Nuvolo p.73 Roman Review P.76 BREAKROOM p.76 Did You Know? p.78 The Vault p.80 MedWrench Bulletin Board p.86 Recap: HTM Mixer Wisconsin p.88 Scrapbook: HTM Mixer Wisconsin p.94 Flashback p.90 Service Index p.93 Alphabetical Index

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SPOTLIGHT UCI Medical Center Biomedical Engineering Department members include (back row, left to right) Warren Maralit, Ben Kong, Paul Poplaski, Charles Adams, Gary Moreno, Jesse Lopez, (front row, left to right) Chris Khodaverdy, Michael Villanzuela, Kris Abejo, Jinal Patel, Liz Sia, Jon Correa and Raul Jimenez. Not pictured is Kylie Foster.

DEPARTMENT OF THE MONTH

UCI Medical Center Biomedical Engineering Department

BY K. RICHARD DOUGLAS

I

n Orange County, California, innovation and cutting-edge technology in medicine is not only practiced; it’s taught. The University of California Medical Center in Irvine is a world-class academic and high-tech center for healing and research.

The center’s biomedical engineering department is comprised of 14 members.

Members of the department include Director Charles Adams, MBA; Operations Manager Jesse Lopez, Administrative Assistant Liz Sia and Business Analyst Kris Abejo, MHA. The team’s technicians include Raul Jimenez, Warren Maralit, Jon Correa, CBET; Wilson Tan, Ben Kong, Jinal Patel, MCE; Chris Khodaverdy, Gary Moreno, Joseph Rodriguez and Kylie Foster.

The group is responsible for managing the medical equipment at a 440-bed facility with a second medical center planned on the academic campus.

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“Today, the number of clinics sits at 15, but tomorrow, it increases. Our model is in a growth mode so it feels like we add clinics on a daily basis,” Adams says.

He says that the University of California’s mission is to “Discover – Teach – Heal.”

“UCI biomed gets involved in every aspect of that mission. Currently, we are supporting equipment (under Institutional Review Board guidelines) that isn’t installed anywhere else in the world. We work directly with the OEM in every aspect of install, operationalizing and maintaining this new technology. We live the ‘Teach’ portion of our mission every day in those quick one-on-one in-services on the nursing floors. We further focus on ‘Teach’ by working with local academic centers for intern placement.

We currently have two interns working on our team. They typically spend six months with us and then we help them apply and obtain career positions,” Adams says.

He says that “Heal” is the goal of

all medical professionals, and recently, the team was able to support a study and acquisition for new intensive care beds with surfaces that truly make a difference in the patient skin healing process.

“We are an academic center, which does typically draw those with like-type backgrounds to UCI. Almost all of our team members have a degree and three have advanced degrees. We currently are a staff of 14 and soon to be growing,” Adams says The question of service contracts is reviewed by the director and business analyst.

“The biomed director and biomed business analyst review and complete due diligence for all medical equipment service agreements. There is an internal focus inclusive of frontline equipment users and leadership along with clinical staff in the stakeholder departments,” Adams says.

He says that the internal focus is to obtain the desire of the stakeholders and to understand their satisfaction with previous services.

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SPOTLIGHT

“The external focus is with the preferred vendor to obtain service options. There is a significant amount of due diligence to be concluded with the vendor but highlights are; review the previous two-three years of service, is there an end-of-life and/or end-of-service date, contract options, vendor staffing levels and locations, parts availability and locations,” Adams adds.

The goal is to bring more of the service in-house.

“Health care as a whole has been dealing with one of the worst pandemics in history. The financial loss is unprecedented and requires all of us in health care to look for ways to save money. We have begun developing a Shared Risk and Reward Fund (SRRF) tool that allows us to right size our service agreements. We will be moving away from more of the full-service agreements to a more in-house model. Hiring skilled technical staff in various modalities to allow our hospitals to manage equipment service/risk in-house,” Adams says.

He adds that the HTM leaders from each UC Medical Center get together on a reoccurring basis.

“Part of our working together is service agreement normalization and options; allows us to go to market as a group opposed to one-off medical centers,” he says.

FIRST TO SEE NEW TECHNOLOGY The team really is on the cutting-edge of new technologies and are some of the first to see these technologies up close. They are also involved in the capital purchase process.

“Because we are an academic center, and in California, it is normal for us to work with OEMs on new technology and beta testing. While there is a burden of time and effort put into this process, the reward for the staff is keeping up on cutting-edge technology in our field,” Adams says.

“Biomed’s responsibility with capital is to bring the facts; cost of maintaining existing fleet, standardization, compatibility and connectivity. Recently, we supported due-diligence with OR integration. Like most medical centers, we had most of the OR suites specialized. The goal of OR leadership was to have each OR suite usable by any specialty. This requires each room to be redundant and available for most any case,” Adams says.

He says that biomed took the role of visiting other medical centers and assessing various OEM offerings.

“After acquisition, we support the project management efforts in getting infrastructure installed. Today our surgical department has much greater flexibility given each room is agnos-

Pictured (from left to right) Jon Correa, Warren Maralit and Ben Kong conduct an in-service.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Operations Manager Jesse Lopez troubleshoots a patient monitor.

tic,” Adams says.

“Another acquisition biomed has played a key role in, is replacing our fleet of defibs. Biomed facilitated the process of; vendor reviews, stakeholder meetings, technology assessment, support supply chain processes. Once the acquisition has transpired, we will work with nursing, supporting the user training and roll-out into the various departments,” Adams adds.

The team has also been called into action to help manage the surge caused by the pandemic.

“COVID provided not only a need but a requirement for biomed departments to get creative supporting COVID surge needs. Over the last couple of years, we had made a conscious decision to not always trade in older medical equipment. We happen to have saved back 45 of the patient monitors when we upgraded our NICU. We were able to use those monitors, after a software update, in our COVID surge tents,” Adams says.

Away from work, many of the team members participate in local county chapters of CMIA and biomed leadership participates in national conferences.

In Orange County, patients have access to one of the country’s top medical facilities, and the HTM professionals who manage the medical equipment are on a par with the very best.

NOVEMBER 2020

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SPOTLIGHT

PROFESSIONAL OF THE MONTH Tri Q. Dang

BY K. RICHARD DOUGLAS

S

ometimes the road to a biomed career comes out of necessity. It can also come out of a commitment to doing something good.

That was the case with Tri Q. Dang, biomedical equipment tech III and team lead in the Clinical Engineering Department at Children’s Mercy Kansas City in Missouri.

“My journey began in Arlington, Texas at an Army recruitment center in a strip mall. Like many people, I did not realize that all medical equipment needed highly trained technicians to maintain it. At the time, a Master-Sergeant informed me that my aptitude made me a prime candidate 91A – medical equipment repair – which later was renamed to 68A,” Dang says.

“During my time of service, I was deployed to Iraq. On one mission, my buddy and I were tasked to fly into a small forward operating base, in the central southern region of Iraq, to maintain Polish combat hospital equipment. It was my first-time brush with casualties of war,” Dang says.

He says that the base had Polish Army doctors who were treating local nationalists.

“One day, we heard a young lady in agony and her screams echoed through the hospital. We asked the doctors why she was not sedated for her shoulder procedure.

They informed me their anesthesia unit had been broken for months, so my buddy and I got to work. We committed ourselves to repair, and we would not rest until the anesthesia device was going to be functional again. Late into evening, we got the unit 14

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NOVEMBER 2020

Tri Q. Dang says his success is a result of working with an excellent team.

operational again, and the next morning, there was a knee procedure in session. The patient was properly sedated and soundly asleep during his procedure, and I knew then that this career field was my calling,” Dang says.

Dang received his basic biomed training through the Department of Defense at Sheppard Air Force Base. He took the advanced course and then earned a bachelor’s degree in biomedical electronics from Thomas Edison State University.

“I am happy to share that I am the general floor team lead and it is a privilege to work for such a renowned institution like CMH. My team of 13 and I are responsible for every department in the main hospital and a smaller hospital in Kansas, but we do not service the outlying clinics, diagnostic imagining and labs equipment,” Dang says.

A WORKING AEM PLAN AND A ROAD TO ADVANCEMENT Projects to help his biomed team and his

facility have occupied much of Dang’s time in his current position.

“Since I have been with Children’s Mercy Hospital the last 14 months, I have spearheaded three major projects. With help from my team, we were able to develop an Alternative Equipment Maintenance (AEM) program, career progression training record and start up a depot of excellence,” he says.

“Our director wanted our shop to be the leading shop in the Kansas City area, so a year ago, before I started, he laid the foundation with our MEMP. Once I heard of his vision, I began my work with the AEM program. I convinced a group of BMET IIIs to attend an AEM workshop.

The goal for the AEM is to look at equipment maintenance procedures and challenge it,” Dang adds.

He says that he designed the AEM form, added details to the process and led the meetings.

“Our guiding motto was, ‘Is this really WWW.1TECHNATION.COM

SPOTLIGHT going to make the equipment safer to use or prolong the life of the equipment?’ We scrub through hundreds of different models to find a handful of models that would qualify for the program. Like most passionate technicians for their job, the debate got heated to argument; but I reminded the group of our collective goal,” Dang says.

“We reviewed thousands of work orders and have had countless debates to ensure that equipment remains safe and reliable when we change the procedure from the OEM standard,” he adds.

Dang says that the secondary reason to have the AEM program is to reduce wasted man-hours on pointless planned maintenance that does not add value to the organization.

“Our first model for the AEM program finalized October of 2019.

Now, we have 11 models on the program, seven models pending and five models being reviewed. Currently, our challenge is finding time to have a meeting and to vote on the models,” Dang says.

He explains that in this career, it is too often the case that technicians cannot get promoted until a position becomes available, and this fact sometimes drives technicians away.

“Over time, the shop would not be able to retain the talent that they have grown internally. I got to work on this issue. We wanted to celebrate individual achievement as well as reward dedication. Our director shared with me about his side project that has been off and on for the last three years. So, I redesigned the example that he handed me into a point system. We had several meetings to fine tune the process. My colleagues and I shaped the work into something we wanted and got the blessing of our leadership,” Dang says.

He says that the work encompasses a point system of training and projects for the individual members of the department.

“We set certain limits on modalities and award points based on the complexity of projects and/or equipment.

Those points will add up and, eventually, the individual can request a promotion. From BMET I to III, it can be adapted to any shop, thus solving our

retention problem. It was a collective work by the team leads and sponsored by our leadership,” Dang says.

He says that leadership saw this training record as a promise to the staff that growth and dedication will be rewarded.

“Secondly, it allows individuals to pinpoint achievement and recall it in the training record. Recently, I promoted two staff members using this model for a career progression. I am honored to be the stakeholder in a notable pursuit,” he says.

Dang says that his main challenge in most of the projects is staffing because at Children’s Mercy, they pride themselves on under selling and over delivering.

“Sometimes, my staff and I are stretched thin and during a pandemic resources quickly dry up. I have confidence in our leadership to navigate us out of these troublesome times and get us the resources we need to be successful,” Dang says.

Outside of work, Dang and his family like long hikes throughout the Missouri countryside. He says that he also enjoys eating out and trying new restaurants.

“The love of my life is my wife, Marina. Our daughter, Mai, keeps us quite busy like most four-year olds,” he says.

What should readers know about him?

“I am grateful for all the opportunities that were given to me, and it has been a privilege to lead great men and women in the biomedical field. My life has been more fulfilled since I stepped into this career field. I want to thank all the people who came before me, because their tireless support paved the way for techs like me to experience a wonderful biomedical field firsthand.

My success stems from the excellent staff in our department. Their hard work fuels my internal flame for our mission. As always, I want to thank them,” Dang says.

From seeking relief for a patient’s pain, to leading a biomed team, this HTM professional has achieved a lot.

Compassion started his career and it continues to be a driving force.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Tri Q. Dang and his wife, Marina, enjoy long hikes with their daughter, Mai.

FAVORITE BOOK:

“Adventures of Huckleberry Finn” by Mark Twain “Fahrenheit 451” by Ray Bradbury

FAVORITE MOVIE:

“We Were Soldiers”

FAVORITE FOOD:

Tonkotsu Ramen from Tiger Den in Houston, Texas

HIDDEN TALENT: BBQ and Grill

FAVORITE PART OF BEING A BIOMED:

“The people. I get to work with some of the most brilliant minds.

Knowing my effort makes a huge difference in people lives.”

WHAT’S ON MY BENCH? • • • • •

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NOVEMBER 2020

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SPOTLIGHT Members of the Heartland Biomedical Association are seen after the 2019 annual symposium.

ASSOCIATION OF THE MONTH The Heartland Biomedical Association (HBA)

BY K. RICHARD DOUGLAS

T

he Midwest is often referred to as the breadbasket of America because Midwestern farmers grow a lot of the wheat used to make bread.

This is the part of the country that includes the Great Plains. States in this region include Nebraska, Kansas, Iowa, the Dakotas, most of Oklahoma and portions of other states. Kansas is the nation’s leading wheat producing state.

Often referred to as “fly-over country,” this part of America is a source for canola, corn, soybeans and barley.

Once called the great American desert, the region is also a major source for livestock.

Such a large swath of the country requires a number of health care facilities and, by extension, HTM professionals. With the vast tracts of open land between cities and towns, those HTM professionals have to find a way to network and maintain relationships with their counterparts.

The Heartland Biomedical Associ-

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ation (HBA) helps these HTM professionals stay connected. It holds many of its events and activities in the Omaha, Nebraska area. The association has had members who have come from Iowa, Kansas, Missouri, Nebraska and South Dakota.

The group’s leadership includes President Scott Ostrand, Vice President T.J. McKillip and Secretary/ Treasurer Bill McSharry. Board members are Bill Doiel, Mike Mappes, Paul Straub, Sean Bowden and Keith Golda.

The association has been in existence for 26 years. It is officially an IRS section 501(c)(3) organization.

Ostrand says the first meeting was held in 1994 to begin work on its bylaws and elect the first officers.

Back at that time, Ostrand says Dale Rose and Paul Straub played key roles in starting the group.

“Dale Rose was the director of clinical engineering at Immanuel Medical Center in Omaha, Nebraska,

and Paul Straub was the director of clinical engineering at the University of Nebraska Medical Center also in Omaha, Nebraska. Paul is currently serving on our executive board. Both are CCEs and both are some of the smartest people I know,” he says.

Ostrand says that the HBA started with a handful of managers and techs in a reserved meeting room where they developed the bylaws and determined the meeting formats.

“Originally, we held meetings according to Robert’s Rules, but over time we felt a more casual meeting environment would be better attended. Some of the first official meetings were presentations of new equipment and their clinical uses. We relied on our relationships within the hospital and received education on clinical aspects of EEG, ophthalmic surgery and other local presenters,” Ostrand says.

Early on, the HBA recruited vendors to teach repair courses on-site for much lower tuition costs.

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SPOTLIGHT

(Above) Recent HBA award recipients (from left to right) are Scott Ostrand, TJ McKillip, Keith Golda, and Bill Doiel.

(Right) HBA President Scott Ostrand (holding selfie stick) and Board Member Sean Bowden are seen between educational presentations at a recent symposium.

Over the years, it brought in courses on ultrasound, radiology QA, ESU, injectors and more.

“Recently, we have had presenters for new test equipment; we were hosted by Agiliti to understand ISO certification requirements, and have scheduled a presentation on UV sterilization,” Ostrand adds.

The group offers an annual scholarship to local students to foster a relationship with new graduates and job opportunities. The first scholarship was offered in February of 2020.

SYMPOSIUM UPS AND DOWNS The year 2020 has been a challenging year for many organizations as meetings and events have had to be cancelled or postponed. The HBA was not spared. It has not been able to have scheduled meetings since March. It was forced to cancel its annual symposium because of the COVID-19 pandemic, but leadership is hopeful that it can host a November meeting.

“We have planned a UV sterilization presentation tentatively,” Ostrand says.

The 2019 symposium was a success and the group is looking forward to 2021.

“This last year, we had about 75 attendees over two days of education and vendor fair with another 60

participants in the Saturday golf outing,” Ostrand says.

“One thing we do is on Friday night, after the symposium, we host all of our vendors, presenters and attendees and have dinner at local favorite restaurants as a thank you to everyone’s hard work,” Ostrand says.

“Although this detracts from the overall fundraising efforts, we feel that we have met costs, still have a reserve fund and enough was generated for scholarships. Currently, we are exploring a joint symposium with HTMA-Midwest in Kansas City, Missouri and Gateway Biomedical Association in St. Louis, Missouri to be hosted in Kansas City as part of a HTM Mixer,” Ostrand adds.

Last year’s symposium included courses such as “BMET to Imaging Path,” “Automate, Optimize and Secure your Clinical Network” and “Implementing a Support Strategy for Diagnostic Ultrasound” to name a few.

The HBA holds regular meetings in January, March, May and November in a normal year, with the symposium scheduled for August.

Many biomed associations and societies cultivate relationships with local community and technical colleges to help out students and connect new biomeds with potential employers.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

The group was heading in that direction until the pandemic postponed plans.

“That is our next focus. We were invited to a job fair but it was cancelled due to the recent COVID pandemic. We don’t have any local biomedical technical schools, but we are focusing on electronics students who agree to take medical terminology and anatomy courses as electives. We are really trying to recruit and train local talent,” Ostrand says.

The group has also made an attempt to replace retiring baby-boom biomeds with the newest members of the profession.

“We are stepping up efforts at the local level. I’ve begun calling local colleges, asking about job fairs; reaching out. It’s very difficult to find replacement positions, but this is how we have to do it in ‘fly-over’ country.

Our new recruits are keeping membership steady,” Ostrand says.

In the heartland of the country, among the wheat fields and farms, there are Midwestern biomeds joined together to achieve great things for the HTM profession. With any luck, 2021 will be a year they return to all congregating once again.

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INDUSTRY UPDATES

NEWS & NOTES

Updates from the HTM Industry CENTRAK UNVEILS THE NEXT GENERATION OF ENTERPRISE LOCATION SERVICES CenTrak has announced its expansion into end-to-end locating, sensing and security services for the health care industry. CenTrak now offers an enterprise-ready platform consisting of its award-winning suite of hardware products and a growing list of software solutions, integrated through a series of strategic acquisitions since 2018.

By bringing hardware and software solutions under one roof, the company will create a more seamless implementation process, improve the user experience, enable the collection of real-time data to drive automated workflows and power evidence-based decision making to drive down operational costs.

“We’re excited to usher in a new era for CenTrak. Our goal is to offer a ‘one stop shop,’ to make it easier for customers to do business with us, while opening up new growth opportunities and laying the foundation for further innovation,” said David Minning, president and chief executive officer of

CenTrak. “As we look to the future, CenTrak’s evolution enables us to push beyond our previous capabilities and set a new standard for location services in health care.”

A market leader in location-based health care devices since 2007, CenTrak began offering asset management, patient flow and environmental monitoring software shortly after Halma PLC, CenTrak’s parent company, purchased Cetani in 2019.

The Cetani integration is part of a larger vision for the future of CenTrak, which also added indoor mapping capabilities with the acquisition of Spreo and security applications with the acquisition of Elpas Solutions Ltd. CenTrak will soon launch a variety of managed services to equip health care clients with the processes they need to ensure the success of their location investments; the company also plans to maintain an open platform to support customers who opt to work with third-party software providers. •

CYNERIO WINS GOLD AT 2020 IT WORLD AWARDS Network Products Guide has named Cynerio a Gold winner in the category of Best Technology: To Combat and Reduce the Impact of COVID-19 in the 15th Annual 2020 Network PG’s IT World Awards.

The IT World Awards are industry and peer recognitions from Network Products Guide honoring achievements of the world’s best in organizational performance, product and service innovations, hot technologies, executives and management teams, successful deployments, product management and engineering, customer satisfaction, and public relations in information technology and cybersecurity.

Judges from a broad spectrum of industry voices from around the world

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participated and their average scores determined the 2020 award winners.

Winners will be celebrated and presented with their awards during a virtual awards ceremony in November.

Cynerio’s platform leverages the power of AI and an in-house research team to help health care organizations navigate emergencies like COVID, streamline workflows, and save time and human resources. The platform grants hospitals the ability to protect patients while staying secure and compliant with a robust suite of healthcare IT solutions: Ongoing inventory and location tracking of every connected device (from Enterprise IoT and medical devices to OT systems), device utilization and capacity tracking,

risk assessments and anomaly detection, and risk mitigation tools designed to safeguard clinical services and prevent data theft.

“We are honored to be recognized as a Gold winner by IT World Awards for our efforts helping health care organizations combat the COVID-19 pandemic,” said Leon Lerman, Cynerio CEO and co-founder. “The logistical and technological challenges are unprecedented. Cynerio’s health care IoT security platform gives organizations a suite of solutions that keeps patients and data secure and enables quick and lasting wins in the dynamic and unpredictable clinical environment this pandemic has created.” •

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INDUSTRY UPDATES

INNOVATUS IMAGING OFFERS VIRTUAL TOUR With growing pressure on clinical engineering and imaging departments across all health care models to achieve higher operational efficiencies, and equipment ROI, Innovatus Imaging is opening up a virtual tour of its proprietary technology developed over nearly 40 years. By touring the company’s Centers of Excellence for Design, Engineering and Manufacturing, and Ultrasound Probe Repair, even virtually, healthcare technology management experts will be able to identify the processes and technology behind sustainable repairs that result in enhanced device life cycles, lower cost of ownership and higher ROI. “Many people don’t realize that Innovatus Imaging’s heritage lies with the industry’s most prolific pioneers,” said Matt Tomory, vice president of sales and marketing for Innovatus Imaging. “Our leaders developed the technology and the processes for holistic repairs and testing which today are still driving high efficiencies, best-in-class quality and performs as intended by the OEM.” The technology behind Innovatus Imaging’s industry-leading record for accurate, sustainable ultrasound probe repairs is showcased in an 8-minute virtual tour of the Centers of Excellence in Denver, Colorado, and Tulsa, Oklahoma. The video provides a glimpse of what to look for in repair processes that are proven to help save money from fewer repairs and device longevity.

The video tour, titled “Ultrasound Transducer Longevity, Performance and ROI Come Down to One Critical Difference: Technology,” can be found at www.innovatusimaging.com. •

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INDUSTRY UPDATES

NOVEL STANDARDS FOR UNREGULATED HEALTH SOFTWARE CONSIDER HUMAN FACTORS In this digital age, health software is becoming increasingly important for the delivery of health care. Unlike medical devices, unregulated software has not had the benefit of tried-and-true standards to help promote patient safety and health. Now, the Association for the Advancement of Medical Instrumentation (AAMI) has released the provisional standard HIT 1000-4, Application of Human Factors Engineering. It’s the latest in a suite of provisional standards designed not only for health software developers, but also for vendors, health care delivery organizations, end-users and everyone in-between.

“Standards for medical device software already exist, but these are focused on compliance with medical device regulations. Much of health software in the U.S. does not fall under those regulations and much of that software is modified by the users when it is incorporated into their larger health IT systems,” said Joe Lewelling, senior advisor on content and strategy at AAMI. “What makes this whole suite of provisional standards different is that we’re acknowledging that the end users, especially in a clinical setting, have an important role to play.”

“For medical devices, the standards tend to focus mostly on what manufacturers need to do to create a safe product. By comparison, software is more complicated,” added Neil Gardner, a health IT consultant who was instrumental in creating the suite.

“Because of the degree to which software is customizable and integrated into health IT systems at a local level, we really had to look at the full life cycle of health IT software and systems and address these new standards to all the various players that need to be involved to ensure the health IT solutions being implemented are safe and effective.”

The first of the suite, HIT 1000-1, Fundamental concepts, principles, and requirements, debuted as a provisional American national standard in 2018. It outlines the need for standardized quality systems, risk management and usability in the largely unguided wild west that is software development.

“As someone who works in information technologies for a hospital system, I can’t say ‘show me the IT safety standards.’ There aren’t any,” explained David Classen, MD, co-chair of the AAMI Health IT Committee. “For the most part, we are really creating these standards from the ground up.”

HIT 1000-3, which debuted in late 2019, focuses on risk management. The risks that come with improperly curated medical records are crucial for developers to understand; while those who implement, use and modify the software need to know the best

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routes for mitigating risk. The new HIT 1000-4 touches on a complimentary side of this ecosystem. It outlines how a software’s developers and the parties installing it should work closely with end users, such as clinicians, to ensure the products are easy to use and understand. This is important because risk management practices only work if a product is implemented and used correctly.

The authors emphasize that there is no “one size fits all” for health IT systems. Digital medical records help aggregate and organize patient history. Other programs may be used to network the constantly changing collection of medical devices in a hospital.

Trouble arises when the expectations of health professionals do not align with the know-how of developers or even the IT staff integrating the system. Additionally, when a program needs to be modified to meet new needs, developers are often involved only after a problem arises.

“Imagine if an airline decided to modify the programming of a Boeing 747, and never once worked with Boeing engineers to do so,” said Classen. “It’s inconceivable! And yet, for medical software, this happens all the time.”

HIT 1000-4 helps to remedy this by assigning responsibility throughout a program’s life cycle. During the development stage, business owners, users and implementers are expected to work together to outline expectations for the software. Similarly, when an acquired program is being added into a system, the professionals integrating it are expected to communicate with users and developers. Even during the end of an obsolete program’s life cycle, business owners, IT staff and users are expected to be equally aware of the hazards that come with decommissioning the software.

“Human factors – the way that clinicians and patients use and potentially misuse software – is an aspect of health information technology that U.S. authorities are particularly interested in,” added Lewelling.

He explained that the end-goal is for HIT 1000-4 and its sister documents to serve as foundations to build more comprehensive standards on an international stage. Gardner, who served for more than 25 years in a provincial Ministry of Health in Canada, is looking forward to this future.

“Just like medical device providers, health IT systems providers are becoming international in scope,” Gardner said. “If we can move to more consistent standards across the world, we’ll all be able to more effectively learn from one another to make these products and their implementations as safe and effective as possible.” •

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INDUSTRY UPDATES

MULTIMEDICAL SYSTEMS JOINS MAGNET GROUP GPO MultiMedical Systems (MMS), a national Innovation Institute subsidiary that specializes in healthcare technology management (HTM), has joined Magnet Group. Magnet Group, one of the oldest and most experienced group purchasing organizations (GPO) in the country, serves approximately 9,000 members.

Founded in 1979, Magnet Group is a specialty GPO with a portfolio focused on capital and small medical equipment, facilities related products, select medical products, HR services, technology and

other services. Magnet Group is “Your Other GPO” for simple secondary sourcing of quality contracts.

Established in 1996, MMS provides comprehensive clinical engineering services and asset management programs to hospitals, surgery centers, imaging centers, clinic systems, physician’s offices, dental offices and physical therapy offices. MMS provides quality maintenance and repair for most general biomedical devices, as well as specialty devices including anesthesia, ventilators, sterilizers, diagnostic ultrasound and

radiology. MMS Surgical Services Division provides on-site surgical instrument sharpening and repair, as well as repair, maintenance and sales of endoscopy equipment. MMS’ expertise ensures that the facility and equipment stays safe for the patient and compliant for all regulatory agencies. MMS’ mission is to cultivate innovative solutions in collaboration with others, transforming health care by doing more-with less-for more people. • For more information, visit www.ii4change.com.

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INDUSTRY UPDATES

TENACORE LLC, OB HEALTHCARE ANNOUNCE PARTNERSHIP

SPBS ADDS CYBERSECURITY RISK MANAGEMENT SPBS Inc. has announced the expansion of its service lines with the inclusion of cybersecurity to round out its asset management solution for the health care industry.

SPBS has enlisted the support of the industry’s top cybersecurity technology specialists to develop a holistic view of a health care provider’s assets in real time delivering visibility and threat prevention, as well as asset tracking, for medical devices, IoT and clinical networks.

“Here at SPBS our goal is not only to keep our client’s facilities running in top shape, but to work in a proactive manner with our clients to mitigate risks and reduce downtime,” SPBS Vice President of Sales James Blandi said. “This new service line not only gives us insight into their equipment, it helps both us and our clients work cohesively to upgrade the quality of the asset lifecycle.”

Cybersecurity in the IoT of health care is not only about securing a network and assets from an attack but having the capability to proactively manage and mitigate risk. •

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Tenacore LLC and OB Healthcare have entered into a strategic partnership, combining Tenacore’s depot-based, comprehensive healthcare technology solutions with OB Healthcare’s field-based preventative maintenance and project management solutions.

Health systems, independent service organizations (ISOs) and original equipment manufacturers (OEMs) alike face occasional variability in biomedical engineering resource availability, especially in the event of large-scale medical equipment preventative maintenance (PM) projects. As a result, there is frequent demand for additional resources to manage these types of projects, which is where OB Healthcare excels. During project assessment, units that do not pass quality control and require further evaluation and/or repair will be sent directly to a Tenacore service depot, instead of working with a separate vendor or dispositioning these units. This partnership allows clients to work under one agreement.

“This seamless solution allows for our customers to focus on managing their many other priorities and to be assured that their equipment will be quickly returned to patient use in full working order,” said Jim Willett, CEO, Tenacore LLC. Through the Tenacore-OB Healthcare partnership, the organizations can deliver their On-Site Project Support, Service and Repair solution. This truly differentiated solution is a hybrid medical equipment service offering, allowing both companies to deliver a combination of on-site project management and depot-based service and repair.

Leveraging proprietary software technology developed by OB Healthcare, the organizations are able to execute against large scale projects with unparalleled speed and accuracy.

“This software is exclusively tailored for the technicians performing preventative maintenance,” said Austin Otto, president, OB Healthcare. “It was designed with accurate and live reporting, enabling real-time status updates and the electronic delivery of service reports and documentation to a customer’s existing computerized maintenance management system (CMMS).” •

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INDUSTRY UPDATES

TRUASSET AMPS UP FEATURE OFFERINGS TruAsset CMMS software is continually evolving to meet the ever-changing needs of its health care customers.

“We listen to our customers, and in a desire to offer an easier way for prospective clients to obtain the information that pertains to them, we have launched our new website with an updated listing of our features. The best part is that our current customers enjoy these features and upgrades at no additional charge,” according to a news release.

• New Website: TruAsset has a new website that provides information about its software to ISOs, Biomedical/HTM, Facilities/Plant Operations and EVS with features that benefit the objectives of each group. Visit www.truasset.com for more details. TruAsset will also be launching a blog soon to keep current and prospective clients apprised of new and upcoming changes to its program and additional valued information.

• Pronk Technologies: TruAsset and Pronk Technologies development teams worked together to make the life of HTM/biomedical professionals easier by integrating the Pronk Safe-T Sim to communicate directly with TruAsset. With the click of a button biomeds can wirelessly communicate with the Safe-T Sim to run the desired electrical safety test and automatically have the results transferred into a work order in TruAsset. A demonstration video is available on the new website.

• OneSource Docs: Thanks to the newly released API, TruAsset can now offer oneSOURCE Integration to customers of TruAsset and oneSOURCE. Biomeds can seamlessly select the oneSOURCE button in the view of an asset to search for any documentation through an oneSOURCEaccount.

• Service Requests: TruAsset already offered a fully customizable service request system with automatic notification options, but there are now added options to have service requests move through a customer’s custom set stages and they can even design a survey that can be sent once the service request is closed as a measure of satisfaction upon staff at their location(s). Customer satisfaction is crucial in health care at all levels, surveys allow continual performance improvement for all types of customers. • For more information, visit www.truasset.com.

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INDUSTRY UPDATES RLDATIX ACQUIRES ONESOURCE

Founded in 1987, International X-Ray Brokers has always been a family owned and operated business. The company strives to provide excellent service to customers but it goes beyond that goal with an emphasis on treating its employees well and giving back to the community.

According to the company’s website, International X-Ray Brokers’ mission statement is, “Do what you say when you say you’re going to do it and do it right the first time.” This commitment provides a partnership of integrity and professionalism.

International X-Ray Brokers President Bob Feldman said the company recently donated 900 blue sterile masks to local first responders and a local hospital. He said that 200 masks went to Signature Healthcare Brockton Hospital with another 200 going to the Brockton Police Department. The Brockton Fire Department, which also manages a local ambulance company, received 500 masks from International X-Ray Brokers.

This act of kindness did not go unnoticed.

“I want to extend my sincerest appreciation for your donation of face shield to my department during the recent pandemic,” Police Chief Emanuel Gomes wrote in a thank you letter.

“Kindness like yours emulates the true nature of the good in our communities.”

Bob Feldman explained that he wished he could do more for these important men and women who serve the community he has lived in for 40-plus years.

“I am very big, even before the COVID-19 pandemic, about supporting the local police and fire department. I am a strong supporter,” Bob Feldman said. •

RLDatix, a global provider of intelligent patient safety solutions, has acquired oneSOURCE, a health care medical equipment SaaS database that provides online access to continuously updated instructions for use (IFU) and preventative maintenance documentation.

This acquisition further enhances RLDatix’s Applied Safety Intelligence framework by helping health care delivery organizations comply with global accreditation standards while ensuring the safe and effective use of medical equipment a fundamental component of patient safety.

According to ECRI Institute, responding to and learning from device problems is one of the top 10 patient safety concerns of 2020, with incidents involving medical devices or equipment being a risk in any care setting where they are found. The same report identified lack of access to current manufacturer IFUs as a key barrier for sterile processing departments responsible for cleaning and disinfecting instruments and equipment. Unsafe sterilization leads to an increase in surgical site infections (SSIs) which have, according to the Centers for Disease Control and Prevention, a 3% mortality rate and an associated annual cost of 3.3 billion.

“Proper usage of medical equipment is a critical component of patient safety and compliance,” said Jeff Surges, CEO of RLDatix. “With oneSOURCE, we are further catalyzing Applied Safety Intelligence – the move away from reactive risk management toward proactive prevention – while deepening our enterprise compliance capabilities that help our customers more effectively align with The Joint Commission and other global accreditors. This acquisition represents the latest chapter in our growth and further cements our position as the global leader in patient safety.”

With oneSOURCE, health care delivery organizations can access IFUs and other maintenance documents and retrieve the latest, most up-to-date manufacturer information available, including critical recalls. These databases are the most comprehensive in the industry, with more than 80% of U.S. hospitals utilizing them for surgical instruments and equipment; tissues and implants; dental; and facilities maintenance. At the end of August, a new user platform providing better access to more than 250,000 manufacturers’ IFUs and services manuals was released to the market.

Health care delivery organizations that utilize oneSOURCE alongside RLDatix’s core enterprise safety and risk management solutions will benefit from critical data-driven insights to help prevent safety events from occurring. •

For more information, visit internationalxraybrokers.com.

For more information, visit rldatix.com/onesource.

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INDUSTRY UPDATES TKA, HTG FORM ASSET MANAGEMENT BUSINESS The formation of an asset management firm, Healthcare Technology Group (HTG), was announced by The Innovation Institute and Tech Knowledge Associates (TKA), its subsidiary specializing in full-risk health care technology management. Drawing from decades of service and experience, HTG aims to reinvent and simplify the concept of medical equipment management.

HTG will be led by Steve Cannon as president and CEO. Cannon has a long and distinguished career in health care, as well as in the health care technology and the asset management industry. He has held executive leadership positions at Sun Health and Premier. He served as the inaugural president at AllParts Medical, and has held executive leadership roles at Aramark, Philips Healthcare, Sodexo and Althea U.S. Cannon says that he intends for HTG to be the partner of choice for asset management in the U.S. health care market, and provider of health care technology consulting and other services for both the health care and commercial market segments nationwide.

Under The Innovation Institute, and with the Healthcare Technology Group business model and brand, Cannon added that the company expects to bring its technology and service standard to a broad number of health care providers. Speaking about HTG’s vision, Cannon explained that, “At a strategic level, HTG plans to offer unprecedented partnership structures to in-house

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

programs for both health systems and rural hospitals – programs that have historically only been offered to large hospitals and health systems.”

Cannon also emphasized that “HTG will be able to deliver a comprehensive and differentiated clinical asset management program in an ever-changing environment.” He says the company intends to create value and be transformative by providing one of the most comprehensive service offerings in the industry. HTG’s programs are designed to reduce their clients’ cost of maintaining their equipment portfolio, while also delivering improved equipment performance, reduced equipment downtime, enhanced customer satisfaction and optimized patient outcomes. • For more information, visit https://htg-us.com.

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INDUSTRY UPDATES

RIBBON CUTTING Lexicon MedParts

BY ERIN REGISTER

S

cott Kinkade, CEO and president of Lexicon MedParts, started in the medical imaging parts industry in April of 2003 with former company ReMedPar, under Ed Sloan. Located in Nashville, Tennessee, Kinkade started Lexicon MedParts in July of 2020.

“Due to COVID-19, I knew hospitals and other imaging facilities had exhausted their budgets early in 2020,” stated Kinkade. “They needed an avenue to help save money on their equipment parts spend and downtime, so that is one of the reasons I started Lexicon MedParts.”

TechNation learned more about Lexicon MedParts in a question-and-answer interview with Kinkade.

Q: WHAT IS THE MAIN FOCUS OF LEXICON MEDPARTS? A: Lexicon MedParts offers a solution for dirty power. Our medical power filter (MPF) utilizes a hybrid approach with proprietary and patent technology to mitigate the damaging effects of dirty power. The results reduce electrical stress and provide proven improvements and reliability to imaging equipment which translate to savings on a facility’s bottom line.

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downtime. Our medical power filter can help solve a large percentage of these problems.

Scott Kinkade, CEO/President Lexicon MedParts

Q: WHAT ARE SOME OF THE SERVICES LEXICON MEDPARTS OFFERS? A: I ask potential customers two simple questions: 1. Do you have dirty power?

2. Is your imaging equipment down again? If they say yes to one or both, in most cases both, I begin to explain how thousands of undetected surges occur in a busy medical facility every hour during normal operations. These surges cause excessive wear and tear on equipment leading to costly repairs, intermittent performance issues, premature board failures and equipment

Q: HOW DOES LEXICON MEDPARTS STAND OUT IN THE MEDICAL EQUIPMENT FIELD? A: Dirty power in the last few years has become a large topic of conversation in medical facilities. Hospitals and imaging centers now know what dirty power is doing to their equipment. They are looking for solutions to fix this expensive problem. That’s when Lexicon MedParts can step in with an economical solution to their problem/ issue.

Q: DO YOU HAVE ANY SPECIFIC GOALS THAT YOU WANT YOUR COMPANY TO ACHIEVE IN THE NEAR FUTURE? A: My goal is to get the word out that Lexicon MedParts has a practical and affordable solution for preventing damage to medical equipment caused by dirty power. Most importantly, I want to be a beneficial solution provider offering reliable resources while, at the same time, developing trusted relationships.

For more information, visit www.lexiconmedparts.com.

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AAMI UPDATE

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AMI is now accepting nominations for its annual “Bright Ideas” program, which recognizes innovative healthcare technology management (HTM) departments that are implementing creative solutions to challenges.

AAMI’s Technology Management Council (TMC) is seeking specific examples of HTM initiatives that have enhanced patient safety, reduced costs and/or improved hospital processes. The TMC will choose six departments to be profiled in AAMI’s publications throughout 2021.

Each article focuses on the actions or processes HTM departments have implemented to tackle a specific problem or improve patient care.

One of the six profiled departments will be selected to receive an excellence award at the AAMI Exchange 2022, June 3-6, in San Antonio, Texas, as well as a $1,000 check and an engraved award.

This year’s Bright Ideas award went to a team led by Donna Marie Dyer, senior director of GE Healthcare’s Healthcare Technology Management Program. The idea, “Taking a ‘Lean’ Approach to Healthcare Technology Management,” introduced a new organizational system that helped declutter HTM workplaces while streamlining repair and servicing processes.

“It makes so much sense that no one has said they want to go back to how things were,” Dyer said. “Clinical staff have more confidence that the devices that they’re using are being handled in a systematic, high-quality manner – that when they take a piece of equipment to the HTM department, there’s a process that happens there; it’s not a black hole.”

To submit your nomination, visit www.aami.org/BrightIdeas.

JUST PUBLISHED! AAMI HTM SUCCESSION PLANNING GUIDE For healthcare technology management (HTM) leaders who direct or manage programs and people, sudden employee resignations and even planned retirements can disrupt operations.

It doesn’t have to be this way. AAMI’s new HTM Succession Planning Guide is designed to help HTM leaders develop a succession plan for staffing at every HTM career level. AAMI’s Healthcare Technology Leadership Committee (HTLC) was instrumental in

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developing this guide.

“No manager should be scrambling to fill a position when someone suddenly leaves or retires,” said Danielle McGeary, AAMI’s vice president of HTM. “A succession plan allows HTM managers and directors to evaluate who on their staff is ready for promotion and how soon – and, for employees who are not ready, to determine the skill sets and development they need to be ready for a promotion.”

The guide provides a comprehensive tool for leaders to assess their team and identify opportunities to support growth, as well as to fairly and clearly explain a pathway forward to their staff. It includes a succession planning template to track the current and potential next roles, competencies, training needs and aspirations of an entire HTM team.

Get the guide at https://bit.ly/2Ebl2tD

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INDUSTRY UPDATES

AAMI CONSENSUS REPORTS GUIDE ‘BUBBLE HELMET’ DEVELOPMENT AS COVID-19 RESPONSE As the COVID-19 pandemic continues to afflict the world, innovative medical device designs are receiving emergency use authorizations from the Food and Drug Administration (FDA), including for production of ventilatory assistance helmets (VAHs).

Now, AAMI has released two consensus reports (CRs) to guide manufacturers in making safe and reliable VAHs. The consensus reports AAMI CR508:2020, Emergency use Ventilatory Assistance Helmet (VAH) Design Guidance, and AAMI CR509:2020, End user Disclosures for Emergency use Ventilatory Assistance Helmet (VAH), are available on the AAMI COVID-19 Emergency Guidance web page alongside seven other consensus reports developed in response to COVID-19.

COME GROW WITH US

Visit www.aami.org/COVID_CR for more information.

AAMI FOUNDATION CELEBRATES 10 YEARS OF SCHOLARSHIPS The AAMI Foundation has honored 46 students over the last decade with a Michael J. Miller Scholarship. The program celebrates its 10th anniversary this year. Altogether, the scholarship program has awarded $132,000 to students pursuing careers as clinical engineers and biomedical equipment technicians – investments that clearly have paid off over their careers.

“They are an impressive group of up-and-comers in the field – engineers and technicians who are making a significant difference at their facilities and in their communities,” said Steve Campbell, executive director of the AAMI Foundation.

Today, the AAMI Foundation awards 10 scholarships each year: nine to students studying to become biomedical equipment technicians or health technology specific engineering (including clinical engineering) and one to an individual studying to become a health systems engineer.

Each of the scholarships are worth $3,000, awarded in a one-time, lump sum check to each scholarship winner at the AAMI Exchange.

The AAMI Foundation tracked down many scholarship recipients who are now playing vital roles in their communities. Read more about them, and the scholarship program, at https://bit.ly/2ROTr4V

Build Your Career at Crothall Healthcare Technology Solutions Career opportunities abound when you are part of a growing Team. Crothall Healthcare Technology Solutions (HTS) has grown 373% in just the last 5 years and an amazing 20 times over in the last 10 years. With growth comes new jobs and new opportunities.

Come see why Crothall has earned Modern Healthcare’s Best Places to Work six years in a row.

ISN’T IT TIME FOR YOU TO FIND OUT MORE? Come grow with us. Please contact: Glenn Garrett Talent Acquisition Recruiter Glenn.garrett@compass-usa.com

Visit www.aami.org/careercenter for more information.

CROTHALL.COM

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

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INDUSTRY UPDATES

ECRI UPDATE

An N95 by Any Other Name – Alternative Products May Offer Insufficient Protection

O

f all the supply chain challenges brought on the by the COVID-19 pandemic, the procurement of high-quality respiratory protection – most notably N95 respirators, sometimes called “masks” – has been one of the most vexing. Not every health care worker requires the level of protection afforded by an N95. But for individuals at high risk of being exposed to droplets and aerosols from COVID-19 patients, personal protective equipment (PPE) that provides reliable, N95-level respiratory protection is essential.

Procuring N95 (or equivalent) respirators during the pandemic has required an unnerving amount of energy, inventiveness, money … and luck. With increased global demand depleting the inventories of traditional N95 suppliers, hospitals have had to scramble to identify alternate sources for these mission-critical, PPE items.

Unfortunately, working with non-traditional suppliers can be fraught with risk. Some shipments may never arrive; and some may include products that do not offer the level of protection advertised.

THE ISSUE IN BRIEF N95s are a type of filtering facepiece respirator. They fit over the wearer’s mouth and nose like a mask. But unlike surgical masks and some other types of face coverings, N95 respirators (1) are intended to form a tight seal against the wearer’s face, and (2) are made of materials that offer a high level of filtration. When fitted properly – so that a tight seal is formed – an N95 respirator allows air to pass, but blocks at least 95% of airborne particles under specified test conditions.

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N95s are designed to be worn once and then discarded; but shortages experienced during the pandemic have prompted extreme measures. N95s are being reused, or their “single use” is being extended. In addition, health care facilities are engaging with non-traditional suppliers, often to procure N95 alternatives – products promoted as offering the same level of performance as N95 respirators, but that have not been certified to meet that standard. KN95 respirators from China are one example.

All these options pose risks. The danger for health care workers and health systems alike is that wearers may not be getting the level of protection they expect. If a poor quality respirator is used while conducting an aerosol-generating procedure on a COVID-19 patient, the wearer is at heightened risk for exposure to the virus.

WHEN NON-TRADITIONAL BECOMES THE NORM “During the pandemic, we’re finding that most hospitals are turning to non-traditional suppliers out of necessity,” explains Kristina Cybularz, manager of comparative analytics for ECRI’s Supply Guide service. “Their traditional suppliers simply do not have enough supply to meet demand.”

ECRI’s data illustrates the changes, particularly for N95-like products. With the caveat that the incoming data has been a little messy – an expected consequence of health care organizations scrambling to meet the challenges brought on by the pandemic – Cybularz notes increases of approximately 200% in terms of the number of vendors being engaged and the number of distinct items. Further, she adds that “the increase in total spend has been even more dramatic: over 1,500%.”

During an August 2020 webcast on the topic of N95 respirators, ECRI polled viewers to gauge the prevalence of using non-traditional suppliers. Nearly two-thirds of the 60 organizations that responded specified that they are obtaining at least some PPE from non-traditional suppliers.

That’s not to say that there aren’t concerns, specifically about product quality. During that same ECRI webcast, nearly two-thirds of the respondents specified that they had at least some concerns about the quality of the N95s they were purchasing.

Too often, those concerns are well-founded.

THE IMPORTANCE OF TESTING N95 respirators, as certified by the U.S. National Institute for Occupational Safety and Health (NIOSH), will block at least 95% of airborne particles under specified test conditions. Products promoted as being equivalent to N95s need to offer that same level of protection. What we’re seeing during the COVID-19 pandemic, however, is that alternative respirators in some cases fall short of that goal.

ECRI’s Chris Lavanchy, engineering director for the organization’s device evaluation group, explains that anticipated increases in global demand have prompted a surge of new or repurposed overseas companies to start making respirators, which in turn has led to concerns about deficient quality control processes. Lavanchy notes that the KN95 respirators from China have attracted particular scrutiny, and with good reason: “NIOSH started examining these models and found that about half of the products tested did not offer the level of protection required.”

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INDUSTRY UPDATES

Testing conducted by ECRI confirmed what NIOSH was seeing: many of these products simply did not function as well as an N95. “Our member hospitals expressed concerns about the quality of alternatives like the KN95 respirators from China, so we added capabilities to test those products for them,” explains Lavanchy. ECRI examines models for filtration efficiency, inhalation resistance and exhalation resistance. Some of the models it has tested perform 1acceptably, MED-Ad-cables.pdf 25/08/2020

while others fail to meet the criteria.

“Most often there’s no easy way to tell just from looking at a product whether it will perform as expected.”

For hospitals and health care workers, that’s troubling.

ECRI’s N95 test findings are described in its publicly accessible alert: “Use of Imported N95-Style Masks, without NIOSH Certification or Independent Lab Validation, May Put Healthcare Workers and Patients at Risk during the COVID-19 18:30

Pandemic.” Additional resources on this topic are available to members of ECRI programs through their membership web pages.

To learn more about ECRI’s technology decision support solutions, including its Supply Guide service for optimizing the supply chain through pricing expertise and product testing, visit https:// www.ecri.org/solutions/technology-decisionsupport, or contact ECRI at (610) 825-6000, ext.

5891, or by e-mail at clientservices@ecri.org.

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THE BENCH

BIOMED 101

Focus on Preventive Maintenance in an Era of a Growing Population

BY JOSEPH SAM

A

ccording to the United States Census Bureau, by 2030, seniors are projected to outnumber children for the first time in U.S. history. As people live longer, more of them will likely need MRI or medical imaging scans to diagnose illness or disease during their lifetime. Journal of the American College of Radiology studies also show that MRI usage in emergency rooms, for issues like urinary calculus and headaches, has been on a steady rise since 1996.

The good news is that increased use of MRI means hospitals will get more return on their investment in this technology.

However, considering the increase in demand, hospitals will want to avoid downtime due to MRI issues or failure by making sure they increase the frequency of preventive maintenance (PM) on their equipment.

MORE PM MEANS PEACE OF MIND While OEMs suggest conducting PM on MRI equipment every six months, to maintain undisrupted workflow during this era of increased use, PM schedules should be updated to a quarterly routine to help ensure that machines are functioning properly.

Some hospitals might have additional MRI equipment that doesn’t get used as frequently. The assumption might be that less use of equipment means less need for PM, but that is not the case. In fact, machines that sit dormant for an extended time might be more susceptible to unknown issues because they don’t have frequent visual monitoring through regular use. Conducting PM on a

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quarterly schedule on all machines will help ensure equipment is working properly and will continue running smoothly.

PREPARE FOR PM During regular MRI use, engineers and technicians should watch for any signs or imaging artifacts that aren’t prohibitive to use, but warrant further review during PM. If an image can’t be read, don’t wait for the PM to see what might be causing the issue. Troubleshoot the issue immediately as this may be a sign of something serious.

Full PM instructions for specific MRI machines can be found in training materials that accompany imaging equipment, but there are some general yet important guidelines to keep in mind.

FOCUS ON MAGNET HEALTH The most critical component of an MRI system is the magnet helium systems vessel and should always be thoroughly reviewed during PM. A subzero temperature must be maintained, or the magnet will quench, which can cause substantial damage, loss and expense. Make sure to evaluate the top and surrounding areas of the vessel for ice and condensation, which is a major indication that there is a leak in the helium system and will require additional troubleshooting to determine the source of the issue.

To achieve efficient and reliable performance from the magnet system, the adsorber must be replaced according to the scheduled interval required by the model of the compressor in use.

Follow the appropriate replacement procedure for each particular machine to

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prevent contamination of the helium flex lines and cold head.

At every PM interval, check the magnet pressure and confirm it is within the system’s specifications. The magnet pressure gauge should read 1.3 psi(g). The magnet pressure can also be read from the service software (SeSo), where the “Magnet & Cooling” status should read 15.3 psi(a). The SeSo also contains a variety of detailed magnet system information.

The patient fan filter within the magnet bore should also be checked during PM and the air filter should be cleaned and replaced as needed.

KEEP THINGS COOL FOR BEST PERFORMANCE The cooling system operation is also vital to the MRI and keeps the components that require water cooling working efficiently. While performing system connections and hose checks, also check the TAS for leaks, which is mounted overhead at the filter panel. The primary and secondary strainer/filter should also be cleaned or replaced as necessary during PM. Checking the gradient system can prevent unnecessary service and possible image quality problems. It’s important to check all fans per axis at the gradient filters and verify their operability during every PM interval. If one or two fans on an axis are defective, the fans should be replaced. If all three fans on an axis are defective, the corresponding gradient filter

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THE BENCH TRIM 3.25”

is considered damaged due to overheating and should be replaced along with the fan assembly.

Lastly, the fan box in the GPA, which helps eliminate heat generated by power stages and output chokes, contains five fans which need to be checked for operability to make sure they’re working properly.

THE LEADER

IN NUCLEAR MEDICINE PARTS

AVOID DOWNTIME AND INCREASE REVENUE While each system has its own PM specifications, ultimately, protecting the magnet system, keeping components cool, checking for leaks and cleaning or replacing components are the critical steps that need to be accomplished during PM. Conducting PM on a quarterly schedule might seem like a lot of work to add to an already busy schedule, but it can save the burden and costs of downtime.

Downtime affects patients, who will need to find another facility.

It raises operating costs as it affects the facility, physician and radiology personnel’s work schedules. Physicians and other staff might transfer to different locations because too much downtime impacts their schedules. If medical imagining equipment is getting more use, now is the time to put more attention toward taking care of it.

As the growing population continues to live longer, health care facilities will continue to use MRI more frequently. By increasing the PM on MRI equipment to a quarterly schedule, hospitals will be able to confidently serve the growing population in the years to come.

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THE BENCH

WEBINAR WEDNESDAY

Sessions Cover Hot Topics STAFF REPORT

T

echNation’s Webinar Wednesday Series continues to deliver valuable insights and continuing education opportunities to healthcare technology management (HTM) professionals in the United states and around the world.

Approximately 6,000 attendees have viewed a live presentation through September with may more viewing this year’s webinars on-demand.

‘VERY INFORMATIVE WEBINAR’ The Webinar Wednesday presentation “Discover How Asante Health Security and Biomed Executives Built a Common Data Foundation” was sponsored by Medigate.

Thomas Finn, director of business development for Medigate moderated the webinar that featured Asante experts Karen McMillen, security analyst, and Rosalind Rucker, biomedical cybersecurity specialist.

Health care’s senior leadership rarely has an adequate grasp of the connected asset management and security challenges being faced by information security, biomedical and clinical engineering professionals.

Although workflows are converging, reporting structures aren’t likely in sync, the cross-functional tools of the trade remain different and the underlying data are not being shared effectively. The presenters shared their experiences using a common data foundation to drive non-traditional

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collaborations and educate senior leadership to ensure their engagement and ongoing support.

Attendees provided feedback via a post-webinar survey. One of the questions they were asked was, “What did you like most about today’s webinar?”

“Because I haven’t been out in the field for a while, it’s always nice to attend a very informative webinar like this to keep up with HTM current events,” BMET Instructor J. Seriosa said.

“I appreciate learning about cybersecurity and medical devices,” said C. Heaton, CBET. “The interaction of the presenters gave multiple viewpoints,” Clinical Engineering Manager J. Higgins said.

CYBERSECURITY DIFFICULTIES The presentation “Why Cybersecurity is Difficult to Achieve for Healthcare Organizations” was sponsored by Armis and eligible for 1 credit from the ACI. This 60-minute webinar featured experts Curtis Simpson, CISO, and Tom Mayblum, senior product manager, as they answered pressing cybersecurity questions that all health care organizations need to answer to protect themselves and their patients.

As health care institutions have been grappling with the overwhelming impact of COVID-19, many have also been fighting a second battle against hackers. Malicious hackers know that

health care organizations continue to be hyper-focused on addressing the pandemic, making them prime targets for ransomware. At the same time, they continue to deploy connected medical devices to help doctors, nurses and clinicians deliver faster, higher-quality care. But these devices also create an attack surface that most health care delivery organizations have difficulty seeing and securing.

And when it comes to connected medical devices, poor cybersecurity poses risks to patient safety and puts millions at risk.

Attendees enjoyed the valuable insights. In a post-webianr survey they were asked, “What did you like most about today’s webinar?”

“Specific examples of ransomware and specific examples of how segregated networks like GEs are not invulnerable,” said Biomedical Technologist O. Stephen.

“Information was excellent,” CE Manager V. Vaglivielo said.

“Very informative and well presented,” Clinical System Support Lead B. Haws said.

FUNDAMENTALS OF CONTRAST INJECTORS The presentation “Fundamentals of Contrast Injectors” sponsored by Althea provided insights to 154 HTM professionals from around the world.

It was presented by Michael Gossman, biomedical and diagnostic imaging specialist at Althea US Inc., and eligible for 1 credit from the ACI.

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THE BENCH

Gossman covered a general understanding of contrast injectors, examined the question “Why bring injectors in-house?” as well as the who, what, when and where of training at Althea US Inc. In addition, the presentation included contrast injector theory, basic operations of all injectors, a troubleshooting overview, a preventative maintenance overview, how to bring injector service in-house and a brief introduction to Althea and classes offered.

Attendees provided feedback via a post-webinar survey and were asked, “What did you like most about today’s webinar?”

“I liked the format and how he had equipment in the video and I could see him rather than just a power point.

Very well done. I could relate to that better. This was one of my more favorite Webinar Wednesdays just because of the format,” said D. Scott, senior biomedical technician.

“The live fundamental presentation was excellent and very informative.

Covered the basics very well,” said B. Hayes, CBET. “De-mystified injectors. It was a great overall covering of the device.

Learned a lot,” shared C. Heaton, CBET.

criteria by grouping them into three main categories for discussion. The categories were: • PEOPLE: Cross-Organization Collaboration and Coordination • PROCESSES: Flexible Customization, Workflow and Process Automation • I NTEGRATION: Synchronization and Data Sharing with Other Systems The webinar was well attended and received positive feedback in a post-webinar survey. Attendees were asked, “What did you like most about today’s webinar?”

“They did a great job of tackling all the ins and outs of purchasing a new CMMS,” Senior BMET S. Richardson said.

“It was informative and applicable to what I do on a daily basis,” said Biomedical Equipment Tech J. Hoeing.

“Covered a lot of information, really understood the scope of biomed,” said C. Heaton, CBET. For more information about the Webinar Wednesday series, including a calendar of upcoming presentations and an archive of on-demand sessions, visit WebinarWednesday.Live.

Thank you to our sponsors:

MODERNIZING YOUR CMMS Webinar Wednesday shared the presentation “Modernizing Your CMMS Solution – Key Considerations” by Nuvolo Advisory Solution Consultant Kyle Holetz and Senior Solution Consultant Dustin Smith. It was sponsored by Nuvolo and eligible for 1 credit from the ACI Holetz and Smith provided solutions to assist organizations in the process of transitioning away from legacy CMMS solutions and toward a new target platform. From interviews with multiple hospitals in different regions across North America, they have generated a set of key considerations that were included in their business requirements. During the webinar, they reviewed these decision

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THE BENCH

SHOP TALK POWERED BY

GE HEALTHCARE VOLUSON E6

Q:

Why do the still ultrasound images increase in number when being sent from the ultrasound machine to the PACS? Five images are taken during an exam and 50 end up on the PACS. Only five should be on the PACS.

A:

Is this happening in the PACS side?

Reply: Yes, the increased images show up on the PACS. The PACS is Artworks/Integramed. I have no way to access the logs.

A:

Consider the possible cause for this issue to be the User Interface, the print/send button may have malfunctioned and is sending multiple images to the PACS viewing station.

Reply: Hello, turns out there were five of the 20-amp fuses blown on the anode and cathode power units. Replaced them and the board on the cathode supply blew out. We then replaced the cathode supply and performed all necessary calibrations, problem solved.

A:

Oh wow, that’s big and expensive work. OK, at least it’s fixed. I’m glad it is solved. We had both our anode and cathode power modules replaced years ago, they were damaged from constant power fluctuations. We installed a large UPS system right after the replacement and it has since saved our CT scan from power anomalies.

CYNOSURE ICON

Q:

PHILIPS BRILLIANCE 16

Is it necessary that I detach the foot pedal line from the device to enable handpiece trigger function? The foot pedal function is working fine, but nothing happens when the handpiece trigger is pressed. I’m guessing I need to detach foot pedal, but forgot to check. Can someone confirm or advise?

Q:

A:

The gantry is shutting off a few seconds after key is turned on upon bootup. Sounds like a contactor turns off. Any ideas?

A:

When the gantry suddenly shuts down, do you see any error on the user screen? Normally, the gantry rotates, and then does other checks to the system, if something is off, then the gantry shuts down. What I’ve seen, even the console can cause the gantry to suddenly shut down if something is faulty there. We had our contactor changed one time, but I wasn’t here at the time to know the symptoms of a bad contactor.

With the Icon, there are two firing modes: trigger and trigger bypass. In the upper right corner of the screen is a yellow oval which is the mode indicator.

Yellow oval: trigger Yellow oval with a slash: trigger bypass The wording is a bit misleading, though. The bypass mode allows the user to fire with just the foot switch, but in the trigger mode the user must hold down the foot switch, which enables the trigger, and then the trigger can be used. So, the trigger mode requires both the foot switch and the trigger to be engaged.

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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ROUNDTABLE

ROUNDTABLE Radiography

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echNation reached out to several radiography experts seeking their participation in this roundtable article on radiography. The article addresses the latest features in radiography equipment, how to overcome budget challenges and more.

Participating in the article and sharing their insights are MXR Imaging Director Strategic Accounts David Chandre; Tri-Imaging Solutions Siemens Lead Engineer/Instructor Kenneth Hable, MD, BSRT; GE Healthcare Vice President of X-ray for U.S. and Canada Brian Murphy; Carestream Health Worldwide Product Line Manager for Radiology Systems Steve Romocki; and Konica Minolta Healthcare Americas Inc. Director of Marketing for DR Guillermo Sander.

Q: WHAT ARE SOME OF THE NEWEST FEATURES IN RADIOGRAPHY EQUIPMENT THAT FACILITIES SHOULD CONSIDER WHEN BUYING NEW? CHANDRE: It is an exciting time in medical imaging. This ever-changing area of health care never disappoints those interested in new technologies. Within the general imaging equipment category, we see advances in several areas that include the equipment as well as the tools used for image interpretation and distribution. Some of these include dynamic digital imaging, dual energy technology, dose tracking software, advanced auto-stitching, low-dose techniques and feature sets, the use of AI technology aiding in workflow and image interpretation, advances in the use of the FHIR interface platform as well as physician and patient portal access to image

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Kenneth Hable, MD BSRT Tri-Imaging Solutions Siemens and report information.

HABLE: Many of the newest and most exciting features entering the field of radiology equipment fall in the categories of machine learning and artificial intelligence (AI). Both are being integrated to improve a wide range of operational features and address all aspects of the system or equipment. This includes many different features of applied technology including the introduction of 3D cameras, enhanced automatic and virtual collimation, and exam workflow integration and management options. On the diagnostic side, AI is also making a significant impact within the field through the addition of deep learning techniques used to compare and aide in the reading of radiographic exams.

MURPHY: The introduction of artificial intelligence and the trend of lower radiation dose paired with higher image quality expectations across a fleet represent the new

complexity in buying decisions. New features in radiography equipment that can improve clinical outcomes for a facility spans from digitally enhanced image quality, cybersecurity packages, on-device artificial intelligence and software applications that can provide greater insights than what traditional 2D X-rays provided in the past. An example is GE Healthcare’s Critical Care Suite, the industry’s first on-device AI algorithm to prioritize critical chest X-ray review. There is not any one-size-fits-all answer, so it’s essential the vendor works closely with the buying committees to determine precisely what features and outcomes are most important to determine the best investment for their organization.

ROMOCKI: Medical imaging equipment has evolved over the years becoming more flexible and intuitive. Budget constraints, workflow issues and space challenges are now easily overcome with smarter technologies. When buying new equipment, facilities should consider their specific needs. These may include augmenting workflow and productivity or deploying specialty practice applications such as orthopedics, women’s health care, pediatrics and otolaryngology.

Choosing intelligent products that incorporate the latest technology such as artificial intelligence, while delivering quantifiable benefits, should be central to any equipment purchase today.

SANDER: First you have to be fully digital; not just the detector but the entire system including the software. Also look to how the platform can be upgraded to future technologies, such as new image processing, stitching capabilities and capabilities such as WWW.1TECHNATION.COM

ROUNDTABLE Dynamic Digital Radiology, which enables physicians to observe movement by capturing up to 15 sequential radiographs per second. Look beyond system operation to how the equipment and manufacturer enable proactive service, such as Blue Moon Lifecycle Solutions, to maximize uptime and minimize in-person intervention.

Finally, in an era of coronavirus, how efficiently can the system be cleaned between patients to maximize both safety and productivity.

Q: HOW CAN FACILITIES OVERCOME BUDGET CONSTRAINTS WHEN IT COMES TO ACQUIRING RADIOGRAPHY DEVICES? CHANDRE: This business dynamic is more important than ever before. The need to explore beyond the traditional capital equipment budget paradigm is now an essential component for all health care providers. With our nationwide coverage for sales and service support, we see many approaches to this topic. Some include a restructuring of the budgeting process to encompass a decentralized approach. In this model, capital expenses are mapped to full revenue streams and patient encounters.

Others pertain to the standardization of equipment purchases that leverage buying power and reduce the cost of implementation due to a common and repeatable construction and logistic process. And, of course, the utilization of varied acquisition models ranging from purchase, lease, subscription and more. Additionally, it is not uncommon to notice several similarities in equipment from OEM to OEM. This occurs often in the areas of general imaging and portable units. Many OEMs use similar or the same base structural components while developing their finished products. We recommend you explore the details of the system and its sub-components to confirm that any perceived value-adds reach beyond the OEM’s name. Often, the feature and functional needs you have, can be satisfied by multiple products with widely varied price points.

HABLE: Facilities should consider additional consideration during their budgeting plans around these key areas; 1) Identify the potential and expected life cycle of the equipment from the organizational point of view. This includes decisions such as; usage

tools such as AeroRemote Insights can provide the information facilities need to fully utilize imaging assets and plan for the future. Think through the use of the equipment in the next three years and examine the mix of studies you perform today and how that will expand in the future based on referral patterns. Some sites will purchase too many features and others don’t purchase enough, so again it goes back to what you need today and what you project for tomorrow.

Guillermo Sander Konica Minolta Healthcare Americas Inc. volume, usable life expectancy and future planned replacement schedules. 2) Identify and plan for the proper maintenance processes required to meet the desired equipment life cycle expectations. This means considering moving the routine preventative maintenance (PM) processes in-house as well as serious consideration of shared (first look) or complete in-house support of the equipment through utilization of existing biomedical and clinical engineering departments and staff.

MURPHY: We are always happy to work with facilities to find a solution that meets their needs.

ROMOCKI: Radiography devices have become far more flexible than before. Carestream encourages customers to engage in smart planning – understand needs, select solutions that fit radiology workflows, integrate systems and capitalize on the possibilities of digital imaging. Accordingly, facilities will be able to assess their budgets and make the right decisions. For example, upgrading for higher performance by choosing add-on features or using imaging software and detectors that works seamlessly across devices and reduces technologist training, are a few ways to overcome budgetary challenges.

SANDER: Consider different system architectures and whether a straight arm or U-arm, often used without a table, can meet your clinical needs. For example, the KDR Advanced U-arm is a highly versatile DR system that can perform exams with or without a table as well as standing, weight-bearing and chair/wheelchair studies. Analytics and business intelligence

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Q: WHAT SHOULD ONE LOOK FOR IN AN X-RAY/ RADIOLOGY SERVICE PROVIDER? CHANDRE: When selecting a service provider, we believe meaningful differentiators are, but not limited to, the following: • The education and evaluation of competence levels the provider structures for its service personnel; • The provider’s coverage capabilities – local, regional or nationwide; • Is it a single-source provider for your multi-modalities/multi-OEM imaging needs; • Ease in contacting, dispatching and showing measured results; • Industry ISO certifications; and • Knowledge of, and ability to, comply with FDA and local compliancy requirements.

HABLE: My recommendation is to consider any provider’s ability to offer a true provider/vendor partnership. This would include their ability to offer comprehensive, personalized service offerings. Examples would be troubleshooting technical support, part supply and support, as well as options for full, on-demand or flex service personnel offerings. Additional considerations should be given to a service provider’s ability to supply the necessary training for your in-house engineering and support staff.

System or platform specific training for your imaging, biomedical or clinical engineering staff allows you to utilize existing staff resources for maintenance that reduce system downtime and increase internal customer service.

MURPHY: Every hospital is under pressure to optimize the total cost of ownership.

Needing to do more with less is the norm and health care providers must use innovative technology to compete. Digital service solutions use technology like

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ROUNDTABLE preventive, predictive and prescriptive analytics to drive actionable insights. We would encourage radiology departments to look for service providers with extensive experience in health care combined with the ability to use machine data and analytics to provide insights for healthcare technology management improvements, including sustainable cost savings, while enhancing quality and efficiency. These are typically capabilities that are well suited for OEM service providers.

David Chandre MXR

ROMOCKI: Your health care facility is unique.

Find a provider that will work with you to leverage your image capture devices for higher image quality, productivity and speed. They should be able to develop a custom mix of tools so that you are paying for things you need and use, as opposed to buying things you might not need right away. Most of all, your service provider should serve as a guide, offering suitable solutions and training with access to a network of technology consultants, field service engineers and technicians. Ideally, relationships with a radiology service provider should grow as your imaging needs grow.

SANDER: Definitely look beyond break/fix and reactive maintenance. The business climate today doesn’t allow sites to have a system on standby. Ask about the tools and services available to manage the system when everything is going well. Does the provider or system capture data on productivity, rejects and retakes, usage, type

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of exams, etc., to proactively optimize use?

Is remote monitoring available to help identify an issue before it leads to downtime to help the facility maximize ROI? Q: WHAT STEPS CAN BE TAKEN TO FACILITATE FUTURE UPGRADES? CHANDRE: We recommend working with equipment providers that offer a clear and flexible life cycle support path for the equipment under consideration. This should include the ability to receive upgrades, and service support, from the OEM and qualified third-party providers. An inability to step outside of OEM coverage can limit health care providers in many areas, including equipment upgrades. Consideration should also be given to the ability to receive software upgrades via remote access to the systems. This valuable method is often lost in the larger discussion of HIT security. We encourage our customers to thoroughly review this method and weigh the risk/benefits of this item with their HIT/ HTM teams.

HABLE: I strongly recommend a clearly defined SOW and/or SLA prior to purchasing decision. Considerations for the SOW/ SLA should focus on compatibility with the current and desired facility workflow. This helps ensure future upgrades integrate as seamlessly as possible within the departments existing workflow while meeting the new goals set forth for the new addition.

Work with related departments such as HTM/IT staff so features such as security and interoperability can be accounted for in advance. Lastly, consult with your favored third-party service provider to consider after warranty support, part availability and staff training.

MURPHY: Technology obsolescence management programs offered by OEM service providers can help ensure your investments remain current over the life cycle of the product. These offerings enable refreshes of your radiology equipment by leveraging computing system hardware and system software upgrade options, along with cybersecurity and O/S vitality solutions.

Often OEM service providers can structure these offerings as part of a recurring subscription that can meet your operating budget needs.

ROMOCKI: With careful planning, worthwhile upgrades are within reach. Identify your requirements and consider benefits to technologists, clinicians and patients. Does your site need a software or hardware upgrade? Would an add-on feature bridge the gap? Could a portable imaging system fill a need? These are a few important questions to answer as your facility mulls an upgrade. Depending on the solutions in use, it is possible to scale and extend the life of imaging devices. Work with your radiology service provider to examine solutions available to you.

SANDER: First and foremost, ask the questions so you understand what you are buying. Can I add a second detector? Can I add more features? How will the manufacturer continue to invest in the platform?

Systems may have a digital detector, but was the software also designed to operate the equipment, control the column and arm movement or provide direct a connection to the generator.

Q: WHAT ADVICE WOULD YOU GIVE A BIOMED INVOLVED IN THE PURCHASING OF A FACILITY’S RADIOGRAPHY DEVICES? CHANDRE: We believe the involvement of biomedical personnel is critical for a sound decision when purchasing imaging equipment. They serve as subject matter experts (SME) to the decision team. They aid in the evaluation of the system’s technical parameters, such as, research regarding any known system up-time issues, serviceability, service options, biomed training considerations, PM requirements and connectivity to facility systems as well as adding to discussions pertaining to equipment life cycle and/or total cost of ownership projections.

HABLE: Really pay attention to maintenance costs as this is their area to provide significant impact to the bottom-line.

Consider OEM warranty costs as well as shared and third-party provided options.

Work with a provider to consider all the costs and availability/feasibility of obtaining the necessary training, tools and other special equipment needed to properly support the equipment. Additional considerations should be given to the ability to integrate the support of any new equipment into their existing workflow and

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ROUNDTABLE Does the system or manufacturer give them the tools to proactively provide maintenance, troubleshoot and solve problems to maintain uptime? If something goes wrong, how quickly can it be addressed and how does the manufacturer support them?

Q: WHAT ELSE DO YOU THINK TECHNATION READERS NEED TO KNOW ABOUT RADIOGRAPHY EQUIPMENT?

Brian Murphy GE Healthcare volume, what the OEM recommended PM and service intervals are and how the addition of this equipment will fit into their current system to monitor and manage it.

MURPHY: Biomed team members should focus on promoting products and services that promote a lower the total cost of ownership. These can include elements of the following service enablers: • Real-time monitoring and remote repairs that can help reduce disruptions and system downtime; • Offerings that ensure your health care technologies are current to enhance clinical capabilities; • Solutions that increase asset optimization and staff productivity; and • Service provider capabilities that can save time and money when ordering parts or scheduling device repairs.

ROMOCKI: Thoughtful planning lies at the core of every purchase. Radiography devices perform critical functions, whether at a hospital or an imaging center. Clinicians require high-quality images to make accurate diagnoses for treatment. Enhanced productivity and improved workflow features enable facilities to function at their best while offering optimal patient care with low-dose radiation and shorter wait times.

Collaborate with an innovator and make sure that the solution you pick meets your needs today and considers changing needs into the future.

SANDER: Biomeds should be an integral part of the decision-making process for new equipment. They should consider how they can help the facility be more productive.

CHANDRE: The acquisition of medical imaging equipment reaches well beyond its’ final intended purpose of providing highly diagnostic medical images. Its’ purchase impacts many diverse areas and decision points. These include facility services and construction, ease of installation, the technologist’s use of the equipment and the system’s associated workflows, HTM support needs, the efficient flow of information into and out of the system via HIT elements such as RIS/PACS, and the needs of those performing the final interpretation of the patient’s images. The needs of all of these constituents need to be considered when acquiring medical imaging equipment. Having an industry partner experienced, knowledgeable and consultative is critical when purchasing medical imaging equipment of all types.

HABLE: OEMs have a responsibility to provide the necessary access and documentation for in-house engineers and third-party service providers to ensure system compliance following the servicing of imaging systems. Request and ensure you’ve received all documentation for service and support of the equipment as well as any necessary accessories or required tools prior to acceptance. Have a clear process for service and support requests with the OEM to address warranty issues as well as with your in-house and/or third-party service provider as the OEM warranty period comes to an end. This will help ensure the necessary levels of support, part availability and training are available to you and your staff for proper support after the warranty period.

MURPHY: With more than 2 billion X-ray exams done annually, X-ray is often the hospital’s first impression of a patient. Just like first impressions with people, the first image taken helps set the path going forward. At GE Healthcare, X-ray is reinventing itself to be the most intuitive and

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

technologically powerful imaging tool that helps health care providers deliver great diagnostic confidence. The future of X-ray is providing images that reveal insights and improve outcomes in real time.

ROMOCKI: Digital radiography has made great strides in the last five to 10 years.

Radiography equipment takes image acquisition and processing to a higher level, with tools like shareable detectors that are not tied to a single device, for instance.

Image capture software can process images with greater sensitivity and intelligent imaging options for better results. Today’s portable systems take many radiology services directly to the patient at the bedside, in the operating room or intensive care unit. As the population ages, the need for sensible, flexible solutions will accelerate.

With continuous innovation and a focus on customer needs, radiography equipment will continue to play a significant role in the medical setting.

Steve Romocki Carestream Health Worldwide

SANDER: It is important to consider the equipment provider. Look at companies that understand service is as important as the system itself. At Konica Minolta, we provide remote monitoring to proactively send parts before the system goes down.

Our service solutions troubleshoot issues remotely and we provide a support services portal 24/7. It’s those little extras beyond maintenance and repair that can impact the facility’s bottom line through enhanced productivity and efficiency.

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COVER STORY

“

Communication is always the key.

It’s important to make sure that each department knows that we are all on the same team with the same objective; patient care.

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TEAMWORK CONCEPT:

BRIDGE COMMUNICATION GAPS BETWEEN HOSPITAL DEPARTMENTS

BY K. RICHARD DOUGLAS

I

n financial services, there is a standard called “know your customer.” It is the requirement that a financial advisor must be well-aware of each client’s risk tolerance, investment knowledge and current financial positions before rendering advice. In that way, they are not making unsuitable recommendations and the client will be helped in the most relevant way possible.

In order to know their clients, a financial advisor needs to spend time with them, ask questions, assess their overall situation and make reasonable and appropriate recommendations.

Listening is key. Professional salespeople learn this lesson, successful business people know this rule and those who provide service to customers find that the rule goes a long way in promoting effective communication.

Empathy is also a good habit to practice. Understanding what a customer is going through, what their needs are and what steps will meet those needs will result in satisfied customers. An awareness of the customer’s business requirements, protocols and demands helps with providing the best level of service possible.

The role of the financial advisor is not that far removed from that of the HTM professional. An understanding of each department’s needs and the best practices for resolving their concerns go a long way toward winning positive feedback and great inter-departmental relationships.

“Communication is always the key. It’s important to make sure that each department knows that we are all on the same

team with the same objective; patient care,” says Matthew Kenney, CHTM, director of HTM/biomed at Aiken Regional Medical Centers in Aiken, South Carolina.

Kenney says that in the midst of the COVID-19 pandemic, realizing the extra strain on nursing allows his biomeds to show empathy to their clinical colleagues.

“For my department, we understand that nursing has a lot on their plates; especially now. So, we want to help them in any way. If they need extra IV pumps, they call us and we go find them for them.

Need extra beds? We will bring them to you. We want to leave them to doing what they do best. At the same time, when we are on the search for equipment and we have a nurse or a tech help us in locating said equipment, we always reward them.

We hand out meal tickets so they can treat themselves to a free lunch or breakfast,” Kenney says.

He says that this also works when they have unlocatable equipment.

“We also incorporate housekeeping in helping to find missing equipment. They go into every room to clean, so if we can get them a picture of what we are looking for and a tag number, they are usually our best bet in finding that lost equipment,” Kenney adds.

MORE THAN THE FIX-IT PEOPLE Framing HTM’s role in the health care ecosystem is part of the challenge when dealing with clinical staff. Biomeds are much more than a repair person. They have a broad skill set to manage medical

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

equipment throughout its lifecycle. Addressing the full breadth of the HTM department’s abilities is an important component in establishing a mutually respected relationship.

“When I first stepped into leadership, during the meet and greet, the CMO of one of the hospitals laughingly summarized biomed as the ‘fix it people; make sure the equipment turns on and make sure it works.’ I understood his view, which is common, but desperately wanted to make it known that our duties and goals stretched far beyond just fixing equipment.

At that moment, I made it a goal to redefine the image of biomed and to promote our position within the health care system,” says Douglas Redwine, operations manager of the Healthcare Technology Management (HTM) Department for the Central Region of Texas Health.

Redwine says that he began exploring how his department operated and how others viewed them.

“I determined that our biggest room for improving was by becoming more personable as a department. We had the business side of things correct; dashboards, real-time reports and etcetera. But we were missing the emphasis on the major factor of our duties, which is the customer service aspect,” he says.

He found a few things to successfully promote HTM and, as a result, bridge the communication gap with other departments.

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COVER STORY “Right after the aforementioned meeting, I began asking my staff how they described what they did for a living to other people. To my surprise, I discovered they basically viewed themselves as the ‘fix-it people’ as well, which was an eye opener and explained why others viewed us as such. As a result, I created a department mission and vision statement to clearly define who we are, what we do and how we do it,” Redwine says.

He says that he highlighted the fact that the HTM team was in the business of customer service and its first goal is to deliver excellent service to its valued customers.

“I also included in our vision that we strove to be an integral and visible part of the health care environment. I worked with my team and made the mission our mode of operation. I began sharing our mission statement with leads of other departments in our meetings and whenever I submitted any documentation, I made sure to include it. It was very effective in communicating to other departments our desire to serve and work alongside them as we did our job,” Redwine says.

He says that next, they focused on making an extra effort to check-in with other departments outside of scheduled meetings or when they were summoned to address an issue.

“Usually biomed attends environment of care (EOC) meetings, shares the pertinent data concerning work orders and

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PM completion, but often there wasn’t much staff interaction other than techs retrieving and returning patient equipment,” Redwine says.

“I sought to eliminate the strictly business mentality and encouraged my team to increase rounding of departments (I count it as productivity) to be more visible and to proactively engage staff. This has gone a long way to foster a sense of community and helped build better working relationships with other departments,” he adds.

Redwine says that in the past, he had observed that some departments – especially facilities and IT – had a “pass the buck” attitude toward biomed.

“If there was an issue that related to patient equipment and wasn’t clearly defined it would often get discarded as; ‘that’s a biomed issue,’ and their willingness to partner up or investigate further was not forthcoming,” he says.

“But, through the building of good working relationships, we have overcome that mentality and work on projects and incidentals as well with great cooperation. For my part, I not only attend pertinent meetings, but I make sure to lead by example and join in on visiting sites and rounding as much as possible,” Redwine adds.

EVERYONE ON THE SAME PAGE As stated earlier, communication is key to keeping customers satisfied and addressing their needs. There are ways to avoid a gap in these communications and keeping everyone on the same page.

“When I think of communication gaps, I think of the areas that

operate through some form of ‘tribal knowledge;’ the support areas usually report to different leaders therefore there isn’t a clear understanding of who does what. There is nothing in writing of who does what that everyone has agreed on and typically these communication problems surface when issues don’t get resolved that require collaboration from multiple departments,” says Matt Royal, MS, CTM, CHSP, CHFSP, CHEP, CHTM, CLSO-M, CHC, CHFM, CBET, director of biomedical engineering at Eskenazi Health in Indianapolis, Indiana.

He says that an HTM department can be a catalyst for starting and facilitating the tribal knowledge and getting it into a document that can be shared.

“As a starting foundation, my process is to bring together the department leaders and have a brainstorming session on all the areas of support; whether that is service, education, operations, patient experience or performance improvement. For example, a hospital’s bed management process typically has multiple departments involved; HTM for service, nursing as the users, EVS as the group that cleans the beds. There may be requirements for rental beds or bed movement by a transportation department,” Royal says.

He says that getting a support document that everyone agrees on closes the communication gap and can ultimately help establish ownership and understanding of who does what, but can also lead to performance improvement initiatives and shared goals.

Royal says that another goal of closing the communication gap is developing a plan, with other department’s contingency plans, for back up equipment; this has multiple benefits.

“The benefit for the clinical team is they don’t have to cancel or reschedule appointments; the benefit for HTM, it

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Douglas Redwine

Matthew Kenney

Healthcare Technology Management (HTM) Department for the Central Region of Texas Health

Aiken Regional Medical Centers

can offer some cost savings on a repair where emergency service or overnight shipping costs might be avoided. When there is poor contingency planning, the communication is often bad and everyone suffers,” he says.

He says that any support documentation or contingency documentation should also include a communication plan.

“This plan should include who to notify and when they are notified. The ‘who to notify’ can be considered an escalation notification depending on the issue and the group that needs to be informed. The ‘when they are notified’ can be considered for how often an update is communicated.

Formalizing these communication plans can close communication gaps, take communication out of tribal knowledge and build a culture of reliable communication and operations,” Royal adds.

The other approach to building a unified team among departments is to actively pursue involvement in multi-department activities.

“My remedy to improve communication was to encourage my team to be more active in the life of the hospital. I found that there were plenty of things going on but biomed seldom participated. I begin joining in on various events and encouraging my team to take some time to join in on the fun and community events,” Redwine says.

He says that whenever possible, they make sure biomed volunteers in charity runs, serving meals, clothes drive, staff softball games, dress up day and other events.

“I’ve seen evidence of boosted morale and camaraderie by my team members after participating in the extracurricular

activities,” he says.

“It’s pretty simplistic, but the adjustment to becoming customer service-focused has greatly improved our presence and perceived value within the hospital environment. Of course, we definitely are still the ‘fix it people,’ but now we are recognized as part of the team. This year, I was overwhelmed by the many acknowledgements and accolades from staff during HTM Week. I’ve been in the business for a long time and had never witnessed that type of recognition for HTM. It was a pretty awesome change,” Redwine says.

A MEETING OF MINDS Part of keeping communication flowing between biomed and other departments is through participation in forums that bring together various department representatives.

Kenney provides one example of how this can work.

“I also have joined in on the Patient Safety Council. This council is made up of all the players that are scored through HCAPS; nursing, housekeeping, radiology, registration and others,” he says.

“I am the only director in the group that does not have a direct impact on HCAP scores. What I bring to the meeting is an outside set of eyes and a vocal opinion on how we can improve as a team. I also run the hospital safety huddle every day. This huddle is for all directors to go over safety issues and report-outs of the previous 24 hours. This puts HTM directly in the spotlight as a strong voice in the hospital through leadership. It also allows me to bring up any issues that may be causing equipment failures or other pertinent information as it pertains to HTM,” Kenney says.

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Matt Royal Eskenazi Health

He adds that the HTM department utilizes an online work order system that nursing can use, but they prefer the one-on-one interaction to give staff the feeling that HTM genuinely cares about their needs.

“We don’t want them to get the idea that their work orders are just put on top of a stack of others. We pride ourselves on direct contact and immediate results. We have a slogan that I believe has been adopted in many places and that is, ‘We are in this together.’ We truly live that every day. We don’t ever say ‘No.’ We don’t ever say ‘That’s not my job.’ Instead, we say ‘Let me take a look at that for you’ and if it’s something that isn’t us, we take it upon ourselves to make the secondary contact for the nursing units,” Kenney adds.

He says that all this work could not be possible without his great HTM team members.

“They bought into my philosophy right away and it’s now second nature. I couldn’t ask for a better team. We also have buy-in from administration. They lean on our expertise and value what it brings to the table. We are not just a department in the basement to be forgotten (we are actually on the top floor of the hospital),” Kenney says.

“In the end, we lead by example and can always be counted on when called upon,” he adds.

The ability for an HTM department to build relationships with customers, administration and vendors shows a willingness to be a beneficial partner.

Listening and active participation within the larger health care team reminds everyone of HTM’s value and importance.

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EXPERT ADVICE

CAREER CENTER What is ‘company culture’ really about?

BY KATHLEEN FURORE

I

’ve been hearing about “company culture” quite a bit these days, and about how important it is, especially within today’s challenging work environment. I’ve never been quite sure what the term really means – and I’ve been even less certain about how any company can build and maintain a company culture with so many employees working off-site.

gaming rooms, or nap rooms. These are all perks. Culture is the intangible feelings created by tangible actions.

Culture is leadership building relationships with staff who are layers below; it’s providing training and career growth opportunities to staff, and it’s investing time to do these things.

Culture will look different for each organization and even as a company grows, its culture will shift as well.

I asked Tom Gimbel, CEO and founder of Chicago-based LaSalle Network, a national staffing, recruiting and culture consultancy firm, for a quick lesson in company culture. It’s something Gimbel has been focusing on since he started the company in 1998 – far before “company culture” became the buzzword it is today. Here’s what he told me:

Q: WHY IS IT SO IMPORTANT TO HAVE EVERYONE ON THE SAME PAGE WHERE CULTURE IS CONCERNED? A: If you care to retain talent, then you should be concerned that your culture is aligned across the organization. The main reason talent leaves a company is because of their manager. Company leaders need to spend time developing their middle managers because that’s where a big disconnect exists.

Leadership may want the organization’s culture to be one thing, but it’s not being trickled down to staff from middle managers correctly. One way to prevent this from happening is what I’ve called “corporate grandparenting,” where a leader will spend time building a relationship with an employee who is two layers below.

For instance, a CEO building a relationship with the CFO’s direct

Q: HOW WOULD YOU DESCRIBE COMPANY CULTURE? AND IS IT SOMETHING BIG CORPORATIONS AS WELL AS SMALL INDEPENDENT ENTERPRISES MUST CULTIVATE? A: As company culture became a buzzword over the last 10-plus years, many companies have made the mistake of confusing it with “perks.” They believe great cultures are those that give employees farm-to-table catered lunches, have Ping-Pong tables and

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Kathleen Furore report and so on. Beyond effectively training your middle managers, this is another way to ensure the values of your organization aren’t being forgotten or misrepresented as new hires join the organization.

Q: HOW CAN A COMPANY BUILD AND MAINTAIN THE KIND OF CULTURE THEY STRIVE FOR WHEN NOT EVERYONE IS WORKING IN THE OFFICE NOW? AND WHAT ROLE DO THE EMPLOYEES HAVE TO PLAY? A: The organizations that focused on flashy perks as culture are having difficulty in a remote world. Kegs, catered lunches, bringing your dog to work, unlimited PTO – those things may not matter as much anymore. No one is in the office to enjoy the keg or lunch, everyone is with their pets at home, and most Americans aren’t traveling too much so unlimited PTO doesn’t seem like that much of a perk.

The organizations that knew culture is at its best when it affects how people feel are thriving right now.

To maintain culture virtually, it takes an investment of time from leadership, but, with so much technology to assist, it’s easier for leaders to

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EXPERT ADVICE

“spend time” with staff. I’ve called at least five staff-level employees daily on video since the start of quarantine in mid-March, as has our C-suite, just to check in and ask employees how they are doing. It’s something easy that all leaders can do.

Now, more than ever, employees want to know they are cared about, listened to and heard. They want to know you are on the same team, working toward the same goal.

They need transparent communication, they need to have some wins, and they need to be recognized for their contributions. These things were important in the office, and they are equally important with staff working remote.

However, culture isn’t just leadership’s responsibility – it’s a shared responsibility across the entire organization.

Working virtually, its important leaders reiterate to staff that the culture, and perpetuating it, is shared. It will require work from all parties – and it starts with how you show up for your co-workers each day.

KATHLEEN FURORE is a Chicago-based writer and editor who has covered personal finance and other business-related topics for a variety of trade and consumer publications. You can email her your career questions at kfurore@yahoo.com.

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SPONSORED CONTENT

HOW TO FIND THE RIGHT REFURBISHED DIAGNOSTIC IMAGING & ONCOLOGY EQUIPMENT PROVIDER

BY JIM SHARKEY

T

he purchase of larger refurbished systems for diagnostic imaging and oncology such as linear accelerators, CT, cath labs and MRI can cost between $200,000 and upwards of $1 million. While these costs are a sizeable capital expenditure, the purchase of quality refurbished systems can present a great cost savings when compared to cost of the same new equipment.

Opting for refurbished equipment is particularly attractive if you match it with similar models that are already in use at your facility. This allows you to leverage the knowledge base and training of your treatment team while reducing the adoption time for a new technology. Refurbished equipment can offer the same performance and reliability as a new model, at a fraction of the price.

But with so many resellers of medical equipment out there, how can you be sure the benefits of purchasing a refurbished system do not end up as a loss in revenue and quality patient care?

When choosing an equipment provider, you need to ask yourself the following questions: 1. How do I know I am dealing with a reputable company?

2. How can I be confident I will get quality systems in the configurations I need?

3. Will I have a partner for cost-effective ongoing maintenance and parts?

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Jim Sharkey Avante Health Solutions

To answer these questions, you should learn everything you can about your equipment provider. To start, ask the company to provide references of facilities that purchased the equipment you’re looking for, including recent sales and sales of at least the past five years. This will give you a better idea of how the equipment has functioned over time and how good the ongoing support has been.

Visit and tour the company’s facility and bring both administrative and technical personal from your organization. The company should make the same available. This visit will give clear indication of quality of work and capabilities of the organization.

They should have plenty of inventory, the ability to fully test systems and a large inventory of parts to support ongoing maintenance. Have them show

you their processes for refurbishment, delivery and installation. Be sure to ask if the company has certified quality management systems. Medical device companies whose processes have achieved ISO 9001:2015 or ISO 13485:2016 have demonstrated the ability to provide products and related services that consistently meet applicable regulatory requirements.

Perhaps the most important thing to keep in mind during the vetting and installation process is the company’s service and maintenance capabilities.

Once the system is installed successfully, you want the cost savings to continue throughout the ongoing maintenance and service process. Choosing the right provider can offer your facility cost-effective service while ensuring you have the quality, performance and uptime you need.

CHOOSING THE RIGHT REFURBISHED EQUIPMENT PROVIDER HAS LASTING BENEFITS In addition to cost, you also want to make sure your equipment provider has the ability to perform service and maintenance for the multiple brands that are typically found in a medical facility. By taking advantage of your provider’s wide range of experience, you have the benefit of a single source for support and billing while still having skilled technicians work on your systems.

The availability and pricing for parts is another important consider-

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EXPERT ADVICE ation when making your selection. While it’s expected that a manufacturer will have parts readily available, this may not always be the case. It’s also important to determine how many parts they actually have in stock, rather than “available.”

Having easy access to parts is critical for fast turnaround on repairs.

Choosing the right equipment provider will not only result in cost savings, but it will also ensure a seamless transition from purchasing, to installation, to ongoing service.

Avante Health Solutions is the largest independent provider of equipment, service and parts for all diagnostic imaging and oncology devices worldwide.

Avante’s quality management processes have been ISO 13485:2016 certified. Avante is committed to lessening the financial burden of equipment acquisition and continuing equipment maintenance so that you can maintain the quality of care for your patients.

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JIM SHARKEY is vice president of oncology operations for the Avante Health Solutions Center of Excellence in Charlotte, North Carolina.

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For more information on diagnostic imaging and oncology equipment solutions from Avante, visit avantehs.com. vc_TechNation_Clr Ad_7x4.5_20Oct21.pdf

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CYBERSECURITY

Cybersecurity Essentials – Defense in Depth

BY CONNOR WALSH, CISSP

O

ver the last several years, we have seen a dramatic increase to not only the number of medical systems that are networked, but also how they are networked. From medical devices with applications residing in the cloud, to establishing external site-to-site connections for vendors to provide critical support, HTM professionals find themselves weighing the risk versus reward of introducing potential vulnerabilities into their networks.

To deal with this new threat landscape, we must deploy a Defense in Depth strategy to ensure these potential risks are mitigated as much as possible. This concept implies that an organization will deploy a combination of “security controls” or safeguards that are in place to minimize risk. These controls are typically categorized into three main categories: physical-, technicalor administrative-based, and all fulfill the common goal of maintaining the confidentiality, integrity and availability (CIA) of our data.

Physical security controls are used to mitigate physical threats. Common examples that HTM professionals may encounter are physical walls/ barriers for restricting access to sensitive areas, video surveillance, alarm systems, access control systems and security guards. For example, at your facility, how do you secure your medical system’s servers housing sensitive PHI/PII? For most, they would be housed in a centralized, locked room with card/badge swipe and key access as the only means of entry. If any unauthorized entity attempted to enter, alarms would trigger and security would be called.

This is likely to deter any potential

physical threat from accessing your medical servers.

Technical security controls are typically software based and are meant to prevent any unauthorized access to your medical systems.

Operating system patching, two-factor authentication, host and network-based intrusion prevention systems, at-rest and in-transit encryption, and network isolation/ segmentation (i.e. VLANs) are common technical security controls that could be implemented by HTM professionals. During equipment planning, make sure you are asking the vendor for and reviewing the manufacturer disclosure statement for medical device security (MDS 2) forms during technical evaluations. Cybersecurity should be considered in all proposals, and these forms will help you plan for the technical controls you can implement during installation.

The last main category of security controls is administrative based.

These are your organization’s policies, standards, procedures and guidelines as well as organizational training. Two of the most common administrative controls that an HTM professional may encounter revolve around environment of care (EOC) rounds. During the rounds, one of the first questions we may be asking clinicians is if they know what to do if a medical device stops working, and if they don’t know, briefly training them on our department’s policies. Additional policies and/or procedures that we may encounter are hard drive removal, removeable media scanning, OS and anti-virus patching, and disaster recovery.

The idea of Defense in Depth

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Connor Walsh, CISSP

comes into play when we combine security controls from each of the above three categories. Physical security controls should always be your first line of defense, but they alone are not enough. As HTM professionals, we need to perform due diligence when it comes to procuring new devices, reviewing vendor MDS 2 forms, and rolling them out with the approved and adequate technical controls in place. Finally, as we roll out these new systems, we need to ensure that as we manage them through their life cycle, that they continue to conform to our department policies. Applying a Defense in Depth approach to your new medical system deployments is of utmost importance as we continue to navigate this new threat landscape.

CONNOR WALSH, CISSP, is a biomedical engineer for the Department of Veterans Affairs.

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 FUTURE Returning to School Amid COVID-19 Pandemic

BY STEVEN J. YELTON, P.E.

I

wrote my last column discussing how we are dealing with the COVID-19 outbreak.

I had no idea that I would be writing my next column on COVID-19, except maybe to say how great it was to be past that now.

Well, that didn’t happen. I’ll provide a bit of an update on how things are going from my point of view.

I’m writing this column in September. It will appear in November. Things haven’t changed that much at my college as far as how we are doing business. My classes are totally virtual this semester as they became last spring. Our students are required to do cooperative education (co-op) and we have lots of laboratory content online, so we are counting on that helping our students get the laboratory experiences that they so greatly need.

Given where the state of Ohio was with the pandemic in September, our classes for the spring semester of 2021 will be largely virtual. There is a possibility to have face-to-face laboratories with special permission from administration.

My laboratory experiences, which normally occur at a local hospital, are not happening at this time.

I’m finding that my colleagues at the hospital, board colleagues, as well as students are getting accustomed to the “new normal” (which in my case is “virtual”) with respect to meetings, class meetings and collaborations. The idea of having meetings that last many hours are becoming commonplace. I have to admit

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that this isn’t my preference, but at least we are able to make progress under difficult conditions.

For many years, employers have asked that our graduates have experience with computer-based or remote learning. This could be virtual classes, a class that is presented via computer or even a remote class very similar to what we are doing now. Employers are always looking for a way to provide training for HTM staff in a cost-effective manner. They expressed to me that if a student becomes comfortable with remote learning while in school, they will be much more successful with on-the-job training that may be remote.

Most of the hospitals that I deal with provide their HTM staff with as much live training and service schools as possible with a travel and training budget.

Currently, my students are becoming very adept at virtual learning!

I mentioned in my previous column that another challenge that we have is placing co-op students in HTM-related positions. Some employers were able to retain all of their co-op students, but others were required to eliminate those positions for (hopefully) the short term.

Some good news is that we are experiencing an upswing in the hiring of our cooperative education students. The hospitals are largely able to rehire co-op students that were on furlough throughout the summer and some were able to reopen eliminated positions. I have noticed that the employers who were able to retain co-op students are much better

Steven J. Yelton P.E.

off than ones that didn’t for many obvious reasons.

I was and am still extremely impressed by how the HTM community has banded together to help everyone get through this troubling time. The AAMI online communities remain active with help and suggestions for dealing with every kind of situation that you could imagine. I wanted to mention this again and offer my thanks to all of my HTM colleagues.

Many of the HTM departments within hospitals are still experiencing partially remote operation, however they are moving back to the “local” arrangement. This was interesting to me from the standpoint of having to touch the equipment to fix it for the most part. This is obviously still true for the most part.

I’m seeing that even with the movement to the previous way of doing business in the hospitals, I would not be surprised if some of the changes stick. At my hospital, we have seen some improvements as a result of COVID-19 changes that were made and that is a good thing.

One thing that is more important now than ever is recruiting for our field. We have experienced a slight decline in our HTM program enrollment at the college this semester. I have heard this same thing from some of my colleagues at other

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colleges. I know that there were some students who put off college in the fall semester because of the COVID-19 pandemic. I understand this to some extent for students who are going away to school.

The vast majority of our students are local since we are a community college. I felt that for all practical purposes, our enrollment should have been significantly higher in the fall. Students could stay home and attend a community college and get some of their credits out of the way at a lower cost or maybe even try a technical program such as HTM. In our case, this really didn’t happen. As I mentioned, we also didn’t see an increase in the HTM program. As always, there are lots of good paying jobs available and it’s to all of our advantage to support our field.

Please, during these trying times, try to help recruit for our field.

STEVEN J. YELTON, P.E.; is a senior HTM engineer for a large health network in Cincinnati, Ohio and is a professor emeritus at Cincinnati State Technical and Community College where he teaches biomedical instrumentation (HTM) courses. He is the chair of AAMI’s board of directors, vicechair of the AAMI Foundation board of directors, previous chair of AAMI’s Technology Management Council (TMC), chair of AAMI’s HTAC Committee and is Delegate to the Accreditation Board for Engineering and Technology (ABET).

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20/20 IMAGING INSIGHTS What’s That Noise?

BY TED LUCIDI, CBET

T

oday, we’re surrounded by countless pieces of technology in our everyday lives. Almost every electronic device contains some type of oscillator circuit that has the potential to affect the electro-magnetic spectrum. Call it Electro-Magnetic Interference (EMI), Radio-Frequency Interference (RFI) or environmental/atmospheric noise. I recently read an article that classified this concept as electro-magnetic pollution.

Throughout my career in ultrasound, one of the most frequent and most challenging problems to solve has been related to noise artifacts. Typically, these present as axial bands of constant or flashing color in Color Doppler mode. Intense sources of noise can affect 2D imaging in the form of faint gray, semi-axial streaks and/or semi-circular swirls overlaid on the image.

Health care facilities are filled with massive amounts of RF pollution. At the macro-level, X-ray generators, electro-surgical generators, walkie-talkies and countless wireless devices quickly come to mind. I can confidently say that there are thousands more that never would. Microwave ovens, florescent light ballasts, surgical lights, gel warmers, motorized doors, elevator motors, treadmills and, yes, a landline phone are some of the more obscure sources that have, in-fact, been root causes of noise in 2D and color doppler

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modes. In the case of the elevator motor, troubleshooting took three-months.

Manufacturers design their scanners and probes using various technologies to limit susceptibility to internal and external sources of RF energy. The concept of shielding is not new by any means and is credited to Michael Faraday in 1836. The main purpose is to prevent RFI from impacting sensitive electronics. In concept, it’s achieved by using a metallic screen to absorb RFI in the vicinity of the device. The shield absorbs RFI signals and funnels them to a ground connection or a virtual ground plane. By absorbing RFI signals before they reach the sensitive circuitry, the protected signals are kept clean.

Most of today’s scanners and probes are designed for increased RFI suppression. Still, there is no scanner or probe that is totally impervious to strong sources of RF energy. The amount of suppression depends on the types of technology used, the amount (or volume) of shielding and material used.

Each affects the range of, the strength of, and the frequencies that can be absorbed by the shielding.

PROBE DESIGN As an FDA-registered manufacturer of ultrasound probes and ultrasound-related devices, Innovatus Imaging has a complete understanding of the technology and following are some common techniques for shielding used in probe

Ted Lucidi, CBET Innovatus Imaging

design. Not all probe models are fully shielded and there are varying degrees of shielding based on the intended design provided through the engineering process.

Starting at the scanhead, the array and scanhead electronics would be wrapped in a copper foil. Each wire within the wiring harness is a micro-coaxial cable, meaning that each individual wire is individually shielded, and the entire harness bundle would be housed within a wire braid. One end of the wire braid would be soldered to the foil, which surrounds the scanhead electronics and the other end would be secured to either 1) the metal connector housing or 2) a section of the connector electronics which comes in contact with a grounded area within the scanner, when connected. Ideally, the entire probe from array to connector electronics would be surrounded by a metal jacket at the same potential as the scanner ground.

SCANNER DESIGN Scanner technology ranges from full-size systems to handheld devices and the need for and level of shielding, again, varies based on the intended design. Most of today’s full-size scanners are modular designs, meaning that the power supplies, front-end

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you’re

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DECEMBER 9-10, 2020 NASHVILLE, TN processor (card cage), back-end processor (typically a PC) and all accessories are separate independent devices, merely assembled into a common frame. The quality of the physical connections, of all the interconnected components, to the chassis can influence the effectiveness of the shielding. Most, or all, of the external connections to the scanner (external video, network, USB, etc.) including the probe connections are tied to some type of ground plane which ultimately are tied to the system ground.

ITEMS OF CONCERN Items such as network cables, external video cables, USB cables, loosely connected or disconnected from the wall or other devices may serve as antennas.

Excessive dust within the card cage(s), power supplies and system as a whole may serve as a bridge for RFI to bypass shielding.

Oxidation on spring clips on card cage covers and surrounding probe connector ports may impact the

quality of shielding between devices and ground.

The power cord resistance, the quality of the scanner’s connection to the facility’s ground system (receptacle quality) and ultimate connection to earth ground may affect RFI suppression.

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SUMMARY For maximum RF suppression, there should be a solid, quality connection between all shielded components, accessories, probes and cables from end-to-end. Any compromise in the direct connection to the grounding system may cause the scanner and/or the transducers to become more susceptible to internal and/or external RFI. Next month, we’ll look at some strange, but true, scenarios and a strong framework for troubleshooting.

TED LUCIDI, CBET, Customer Experience and Clinical Insights, Centers of Excellence for Ultrasound and MRI Coil Repair, Radiography, Design and Manufacturing, Innovatus Imaging.

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VIEW ON VALUE Who Watches the Watchmen

BY PATRICK FLAHERTY AND JOSEPH HADUCH

L

ast month we discussed, at length, the power and impact that the trade lobbying group MITA has on the diagnostic imaging business and, more broadly, hospital operations inclusive of reimbursement. As we set the stage for this month’s discussion, let’s recall some of the most salient points regarding MITA’s incursions into acute care operations.

A few years back MITA successfully lobbied CMS to drastically reduce reimbursement for general X-ray and computed radiography based on the premise that digital X-ray was compellingly better for patients; please note that no contractual commitments tied to objective clinical outcome improvements were offered by MITA or its members for capital that was exponentially more expensive than viable clinical equipment in place. More recently, and continuing up to today, MITA still persists with the public stance that all “servicers” of equipment should register with the FDA and be required to adopt a Quality Management System along with other requirements; this expectation despite a paucity of data showing any objective national issue with service quality.

MITA further continues to make claims that any use on non-OEM parts are synonymous with cutting economic corners that place patient access and safety at risk … let’s explore these last claims from our immediate local experience.

In response to the continued barrage of MITA lobbying, we decided to put

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the claims to an objective test and asked the four largest diagnostic imaging manufacturers for data (not including price) which we believe is minimally required to support the public claims in front of government officials and agencies. We asked these four manufacturers for the following data: • OEM estimated PM times by major modality • OEM actual PM time by major modality based on each year of ownership of a particular modality (example MRI year 3, PM2) as well as the standard deviation for national service to determine a baseline for productivity and operational consistency for PMs which could be used as a comparison with non-OEM service providers • Part recalibration or replacement data tied to each PM to create a baseline functional performance level from a parts and productivity perspective to determine whether the frequency of the PM was correctly correlated to expected system issues and parts replacement • Expected functional life of a part (SKU level) as well as the actual manufacturer, the latter of which is critical given the prevalence of sub-contractors to objectively operationalize parts related data within a decision-support process All-in-all, we believed and continue to believe the information above is the minimally required information to support the claims MITA continues to

make; all four OEMs from which the data was requested refused to provide the information, two of whom stated the data was proprietary.

Despite the claims of proprietary data, no pricing information was requested but the suppliers claimed the actual performance of the parts, the productivity and need for the service was proprietary … in this scenario, what is a provider supposed to use for decision-support, the word of the manufacturer? Clearly, through last months and this month’s column, we are publicly standing-up and challenging you to as well but, lets take a look at another party who should be standing up but who currently prefers to sit on the sideline … the large group purchasing organizations (GPOs).

The GPOs currently offer a wide range of contract options for the acquisition of clinical capital with a heavy concentration on diagnostic imaging. GPOs emphasize the larger economic base of their many clients to negotiate lower purchasing costs. A pre-negotiated fee is then paid by the supplier to the GPO based on total customer spend. Though some may think this dances along a legal line, the government has granted GPOs “safe harbor” from the federal government’s anti-kickback statue based on strict reporting rules and full payment transparency required of the GPOs along with what the government sees as a benefit to providers that serves the greater good. However, the GPO’s government authorized group contracting often creates contractual obligations

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HTM done efficiently and correctly can mitigate the 60-plus percent margins commanded by OEMs but only by demanding the availability of transparent and objective data. from suppliers connecting their aggregated spend to most favored pricing.

This is critical as many suppliers choose to index their “best” price to a GPO contract which they then use as a compliance shield which operationally inhibits a local contract from going lower than the indexed price. This practice, where present, can permit a supplier to lower egregiously high margins applied to smaller GPO members in exchange for not having to negotiate rationale pricing on a costplus basis for more objective business-based providers; in these scenarios, both the supplier and the GPO win as the supplier protects an irrational price and the GPO, whose administrative fee is based on actual spend, makes more money based on the higher price.

Higher pricing benefits both the GPO and the supplier. When granting safe harbor, the government mitigated the possibility of both the GPO and the supplier negotiating higher pricing by claiming providers were free to negotiate on their own if they thought GPO pricing wasn’t in their best interest.

However, when suppliers index their best pricing to the GPO it is impossible for providers to improve upon this vendor benchmark, thus obligating hospitals to the pre-negotiated GPO pricing. Given this stage, would you expect GPOs, the ostensible supporters

of the provider, whose very business exists entirely on competitive exceptions granted by the government to sustainably lower provider costs, to stand-up in support of providers on the topic of OEM clinical service and parts relative to MITA’s claims? If you thought yes, you would be wrong. Given the GPO’s seated position, lets look a little closer at the GPO and ask some further questions related to clinical equipment and support.

The first important fact is there are not many large GPOs functioning in the U.S. … there are three that currently dominate the medical and surgical landscape … HPG, Premier and Vizient.

The second important fact is that large GPOs enjoy commercial-like operating margins. Premier historically delivers 50-plus percent margins. The third fact is that GPOs have built large amounts of surplus capital from the Safe Harbor exemptions which they have judiciously used to acquire and build non-GPO based businesses. The acquired businesses, many of which offer advance technical and analytical applications for providers and many of which, from traditional commercial providers, carry prohibitive prices, have not been priced appreciably differently than market. The point is that GPOs are more, not less, like suppliers to providers than they are not … large portions of their revenue

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streams are based on suppliers good-will and the GPO is very careful not to disrupt a profit-center. Based on the GPO aggregated buying power, why would a GPO not come out and require its contracted suppliers of diagnostic imaging to provide baseline useful parts life, actual service productivity and variance, and PM efficiency? If they did, it would certainly make it easier to force the supplier-backed efforts of MITA to rely on objective data rather than self-serving and specious claims. The collective silence of the GPOs on the topic screams volumes about their profit-based objectives.

Health care is complex and providers are in a precarious position. HTM done efficiently and correctly can mitigate the 60-plus percent margins commanded by OEMs but only by demanding the availability of transparent and objective data. For as long as GPOs continue to avoid their responsibility to represent their members beyond superficial price-tag management, the effort in this space is harder … harder while the GPOs continue to cash supplier checks based on inflated margins. In an age when the Department of Justice continues to question provider consolidation for anti-competitive reasons, think long and hard about 2-3 GPOs with consolidated power who refuse to act on objective supplier failures … who watches these self-appointed watchmen?

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 OTHER SIDE An Old Invoice Dilemma

BY JIM FEDELE, CBET

R

ecently I was surprised by an email I received from our accounting department. It seems that one of our OEM “partners” sent them $31,000 worth of invoices to be paid without any purchase orders or authorization. I immediately picked up the phone and called my hospital accounting representative for the details of the situation. After many hours of investigation, I am finding out that our OEM “partners” are charging us for every minute past our contract coverage time. It seems that due to the use of technology they have found a way to automatically bill for labor indiscriminately based on when the field service rep clocks in and out of our facility. To me, this feels a little dishonest, although “technically legal.”

It certainly is not the way to help health care facilities reduce costs.

This situation did catch me by surprise. I feel my team keeps my well informed of situations that costs us additional money.

So, imagine how I felt when I received an email from accounting asking me to approve 10 invoices for a total of $31,000.

The person from accounting was very nice in her request, she said “Hey Jim, I have been trying to get these invoices paid and have not had any luck, since you seem to know everyone can you help?” Of course, I said yes. I have always tried to maintain a good rapport with our accounting and finance people. Having them as allies helps solve a lot of potential problems. As I started my investigation, I found out early that most of the invoices did not involve my people at all. That fact made me feel a lot better about the situation, which meant I did not have a system problem or a breakdown in communication.

I needed to completely understand the reasons for the invoicing. I reached out to the service manager and asked for the associated service reports for the invoices.

After receiving the information, I was even

more confused. The dollar amounts did not match invoices. Also, the start and stop times did not makes sense. Eventually, after repeated requests and continued confusion, I built a spreadsheet and asked the service manager to populate the missing and confusing information. Finally, at this point, I was able to analyze what was going on.

I found that the majority of the invoicing occurred days after the equipment had been installed. After a discussion with the radiology supervisor, I found out that the equipment had ongoing problems after the install. Apparently, the installation company had serious issues installing the equipment but felt they “had all the bugs worked out.”

However, that was not accurate. The unit continued to have problems that resulted in several days of repairs by the field service team. The charges were for labor after our 9-5 coverage time.

With this new information in hand, I requested clarification about these issues from the service manager. Given that we spend about $1.5 million in service coverage with this company, I truly felt we were being nickeled and dimed to death. My requests had seemingly been ignored. It was at this point that I informed the CFO of the situation and he quickly escalated the request for me. When I spoke to the service manager, he really did not have any good answers about why we were being charged for the issues that occurred after the new equipment was installed. I waited weeks waiting for them to “look into it” for the invoices that contained after hours labor, he explained that their “system” automatically bills for every 30 minutes passed the contractual coverage time.

At this point, I quizzed the service manager about how the process should work moving forward. He agreed that in most situations we should not be billed for work that ended past coverage hours unless they are requested to continue. I told him it feels like the automatic billing occurs

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Jim Fedele, CBET UPMC and BioTronics

intentionally so we will just pay it without question. He denied that that was the intent, but did admit that all credit requests had to go through him before being issued.

I continued to explain to him that the process seems disjointed and that we would need to fill in the gaps so we are not continually billed for work given the amount we were already spending with them. He eventually did agree with me and promised to rectify the situation and has since written off the charges.

I have spent a significant amount of time trying to resolve this. I feel like I got the run around. My advice to readers is this – make sure that you are reviewing invoices for repairs on equipment under contract and warranty. Many field service reps are now using electronic devices to open and close work orders in real time. This creates an opportunity for the OEM to bill for every minute past a contracted coverage time. You also should be aware that most warranties only provide coverage from 9 a.m. to 5 p.m. unless negotiated otherwise.

JIM FEDELE, CBET, is the senior director of clinical engineering for UPMC. He manages 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.

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EXPERT ADVICE

SPONSORED CONTENT

FAST REMEDIATION FOR MEDICAL DEVICE CYBER SECURITY

BY TONY BAILEY

I

n some health care organizations, there are two departments who don’t always sit at the same table. The healthcare technology management (HTM) team who support the medical devices, and the IT security team who responds to security events. The technicians in the HTM team are responsible for device safety and the IT security analysts protect information.

When there’s insufficient collaboration between these teams, device disruption due to security events can take too long to remediate. Adverse patient outcomes or data loss can then occur.

It’s not that there’s no one monitoring for unusual device activity. Medical device discovery and security vulnerability tools do an excellent job. They monitor networks and identify devices with vulnerabilities and create security notifications. They’re also able to provide information about the devices’ network information like IP and MAC address and, in some cases, an assessment of the cyber security risk.

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Tony Bailey Nuvolo

But the HTM and security teams need to ensure there’s a coordinated, quick remediation process that scales to hundreds of devices. Without this, device safety and a health care organization’s reputation can be put at risk.

But this coordination can get bogged down when device information is stored across legacy software

applications, documents and spreadsheets. With no common data fields or standardized data across multiple device inventories, it can take way too long even to find a device owner’s name.

The first step to achieve fast remediation is a single source of truth of device inventory. You can’t protect a device without a full device lifecycle profile from purchasing through to retirement. This single trusted data store should contain not only device hardware and software profiles but also the latest device usage information, last known location and the device owner’s name. And every time a device undergoes routine planned maintenance, or a corrective maintenance work order, the device information in this single inventory gets updated.

With a single inventory, combined with discovery and monitoring tools data, the security and HTM teams can get a shared view of device profile data and security event data in an “intelligence hub.” When unusual activity is

WWW.1TECHNATION.COM

EXPERT ADVICE

observed for a device, the security team can see what the device is, the owner, location, last maintenance date and the latest software information.

And this is where the fast remediation comes in. It’s probably the most important part of device cyber security.

After all, getting alerts is one thing.

Acting on them quickly with full visibility to all concerned is another.

The intelligence hub is built on a platform that orchestrates and automatically initiates remediation workflows. This workflow automatically creates a work order to dispatch HTM resources to respond and correct the affected device before it can impact patient care.

As a result, a health care organization can operate devices that are less open to disruption, improving patient safety. With the intelligence hub, the HTM team and security teams have accurate visibility into detailed device information such as location, software and firmware upgrades or a manufacturer recall.

Nuvolo OT Cyber Security creates an intelligence hub consisting of a single trusted data store of device information integrated with security events from device monitoring solutions like Medigate, Ordr, Asimily, Cynerio, Palo Alto Networks, CyberMDX and many others. The device data store replaces the multiple inventories and device records with a single SaaS-based solution. Nuvolo OT Cyber Security helps optimize safety, accessibility and availability by providing context and correlation of security events across all devices.

When a security event occurs, the security team not only knows who to contact, but they can also prioritize the response based on threat risk and the number of devices affected.

Running on Nuvolo initiates a workflow to orchestrate an automated

response that includes work orders to dispatch an authorized HTM resource to respond and work on the affected devices. This response approach includes device tracking and ticketing so that the security team has a real-time status on the response progress.

Nuvolo OT Cyber Security enables this seamless approach of people, process and technology to accelerate remediation. This approach helps improve quality and safety when device cyber security events occur. Nuvolo OT Cyber Security capabilities achieve the steps needed to ensure a strong cyber security posture, including: • Single device inventory • OT device monitoring when deployed with supporting third-party monitoring services • Pre-integrated vulnerability data sources that leverage National Institute of Standards and Technology (NIST) Common Weakness Enumeration (CWE), Common Platform Enumeration (CPE) and Common Vulnerabilities and

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•

•

Exposures (CVE) vulnerability data import​s . And, matching of documented vulnerabilities from NIST/MITRE Corporation​ A rules-based identification algorithm that identifies the device or devices that are affected by the event or vulnerability. And, the security context and impact of the event including what patch, configuration change or mitigating controls are required to then determine the remediation priority Orchestration of the next steps, including kicking off remediation workflows to generate a work order

For more information about Nuvolo OT Cyber Security to enable your health care organization to have a single device inventory, device monitoring and orchestrated remediation for security events. Visit https://www.nuvolo.com/ solution/cyber-security/.

TONY BAILEY is the director of product marketing for Nuvolo OT Cyber Security.

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ROMAN REVIEW Old Greek Wisdom

BY MANNY ROMAN, CRES

L

ast month I explored the concept of amor fati, a philosophy in which fate is regarded with appreciation and even with love. To love our fate is total acceptance of what has happened in our lives. This concept may be based on ancient philosopher Epictetus who said, “Seek not for events to happen as you wish but rather wish for events to happen as they do and your life will go smoothly.”

I have since been intrigued by this old Greek guy and have perused his sayings looking for wisdom that I may internalize. It is somewhat disturbing to me that I am now seeking this wisdom. It was greatly needed when I was a young man in life and business. Now it serves to give me comfort and also something to write about. So that is what I will do in this column: provide you with worthy quotes.

Epictetus: “He is a wise man who does not grieve for the things which he has not, but rejoices for those which he has.”

Manny Roman: Therefore, I will not grieve for the wisdom I could have had when younger, I will be happy it is now arriving. I will also extend this philosophy to my life, since I am relatively content I will now change that to rejoicing.

Epictetus: “There is only one way to happiness and that is to cease worrying about things which are beyond the power or our will. ”“Any person capable of angering you becomes your master; he can anger you only when you permit yourself to be disturbed by him.”

“It’s not what happens to you, but how you react to it that matters.”

Manny Roman: You may recognize similarities with modern interpretation by recent gurus such as Stephen Covey’s

“Be Proactive” the first habit of “The 7 Habits of Highly Effective People.”

Epictetus: “To accuse others for one’s own misfortune is a sign of want of education. To accuse oneself shows that one’s education has begun. To accuse neither oneself nor others shows that one’s education is complete.”

Manny Roman: You have the ability to determine your own attitude as well as the ability to determine how you respond to life’s slings and arrows.

Understand that the first response will be emotional and take the time to allow the thinking, more rational brain to help with your response.

Roman Emperor Marcus Aurelius: “Say to yourself in the early morning: I shall meet today ungrateful, violent, treacherous, envious, uncharitable men.

All of the ignorance of real good and ill ... I can neither be harmed by any of them, for no man will involve me in wrong, nor can I be angry with my kinsman or hate him; for we have come into the world to work together.”

Manny Roman: Your attitude determines how you will view things.

What you see depends on where you choose to sit.

Epictetus: “First say to yourself what you would be; and then do what you have to do.” “It is impossible for a man to learn what he thinks he already knows.”

Modern guru Robin S. Sharma: “Everything is created twice, first in the mind and then in reality.”

Manny Roman: One must strive to have a clear picture and plan in the mind before taking action.

Epictetus: “Wealth consists not in having great possessions, but in having few wants.” “Circumstances don’t make the man, they only reveal him to himself.”

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Manny Roman, CRES AMSP Business Operation Manager Kurt Vonnegut and Joseph Heller were at a party on Shelter Island hosted by a billionaire. Vonnegut wrote, “I said, Joe, how does it make you feel to know that our host only yesterday may have made more money than your novel ‘Catch-22’ has earned in its entire history?” And Joe said, “I’ve got something he can never have.” And I said, “What on Earth could that be, Joe?” And Joe said, “The knowledge that I’ve got enough.”

Define your “enough” and you will be happy to have it.

Epictetus: “If anyone tells you that a certain person speaks ill of you, do not make excuses about what is said of you but answer, ‘He was ignorant of my other faults, else he would not have mentioned these alone.’ ” “He is a drunkard who takes more than three glasses though he be not drunk.”

Manny Roman: OK, I was bothered by this last quote until I realized that wine comes in glass bottles. However, three bottles at one sitting does seem excessive. Share a bottle with someone who does not speak ill of you, that would be me.

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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InSight robotic lander

Solar panels

Seismometer (same instrument used to study earthquakes on Earth) detects faint rumblings inside Mars

5.8 m (19 ft.)

touched down on Mars’ Elysium Plain, Nov. 2018 Mars has far fewer quakes than Earth; instrument listened for constant low-volume vibrations

First clear view deep inside Mars Seismologists (earthquake scientists) have made the first direct measurements of three layers within Mars reaching from the planet’s crust all the way to its core.

Transition zones CRUST MANTLE

Crust consists of iron, magnesium, aluminum, calcium and potassium minerals. Iron oxide (rust) gives Mars its red color.

Mars’s crust has no plate tectonics

so sliding sections of crust do not cover up its geological history

Mars’ internal layers

1 2 3

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Crust-mantle boundary 35 km (almost 22 mi.) below surface

CORE

Like Earth, Mars has a dense metal core wrapped by lighter outer layers Core is mostly molten iron and nickel, plus about 16% to 17% sulfur

2

Mineral transition zone 1,110 to 1,170 km (690 to 727 mi.) deep; magnesium-iron-silicon rock is transformed by heat and pressure into wadsleyite, a mineral

3

Mantle -core boundary 1,520-1,600 km (945 to 994 mi.) deep; rock gives way to iron-rich liquid core Radius to center of core 1,600–1,810 km (994 to 1,125 mi.)

Size comparison Earth, by contrast, has moving, colliding plates of crust, constantly reshaping surface; new crust forms at under-sea cracks

EARTH MARS

Source: Alan Levander and Sizhuang Deng of Rice University; Geophysical Research Letters; NASA images Graphic: Helen Lee McComas, Tribune News Service

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Each person who submits a correct answer will be entered to win a $25 Amazon gift card. To submit your answer, visit 1TechNation.com/vault-November-2020. Good luck!

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BREAKROOM

MANAGING OVERDUE SCHEDULED MAINTE

Follow Ben Calibrating!

NANCE

MedWrench Guru Tony Cody, Technology Mana gement Director at Banner Health, provides his recommendations on how to manage your scheduled maintenance (SM).

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

When managing your scheduled maintenance (SM), the HTM site leader will have to develop/follow policy and procedure to address unperformed maintenance. This can be addressed at a high level in your Medical Equipment Management Plan, refined in your Scheduled Maintenance Policy and detailed in a SOP. I recommend this approach as it will protect your compliance and the “red tape” to change the SOP is a lot easier than changing policies. I outlined some of what I recom mend...

Read more here: http://bit.ly/managingSM

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he second HTM Mixer of 2020 was a big success. The Wisconsin Biomedical Association (WBA) teamed up with TechNation magazine and parent company MD Publishing to deliver a safe and clean HTM conference amid the COVID-19 pandemic.

MD Publishing Vice President Kristin Leavoy was ecstatic about the turnout in Milwaukee.

“The second of our three HTM Mixers was a great success! The members of the Wisconsin Biomedical Association did an outstanding job of promoting the event to their members and the hard work paid off,” Leavoy said. “We were once again able to host a meeting in a safe-and-clean environment that gave everyone the opportunity to network with colleagues and get the education needed for their CE credits.”

Generous sponsors – USOC Bio-medical Services, Innovatus Imaging and Technical Prospects – made registration free for hospital employees, members of the military and students. Attendees benefitted

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“ I was really impressed with the two educational session that I have attended. I actually learned an incredible amount and so much more than I was anticipating.” SHERI SCUDIERI, IMAGING EQUIPMENT SPECIALIST

from world-class educational sessions, tremendous networking events and a unique exhibit hall experience where HTM professionals could learn more about some of the latest and most trusted industry solutions.

There were even door prizes and awards!

Sheri Scudieri, an imaging equipment specialist at Gundersen Health System and member of the WBA board of directors, said the HTM Mixer exceeded her expectations.

“I am really passionate about these (in-person events). I am passionate about the industry. I feel like it is a great opportunity for us to all to get together sharing knowledge, networking and really boost each other up as far as us (WBA) and the industry and biomeds, the vendors, you all (TechNation). I think it is just a great opportunity for everyone,” Scudieri said.

When asked if the one-day HTM Mixer was worth the time and effort to attend she said, “Yes, very much so.”

“I was really impressed with the two educational session that I have attended,” she added during a break before attending her third educational session. “I actually learned an incredible amount and so much more than I was anticipating.”

She said that she drove three hours to attend the HTM Mixer and that “it was really worth it.”

Accruent Vice President of Healthcare Strategy Al Gresch, who presenter and exhibited at the HTM Mixer, said he felt “very safe” attending the

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BREAKROOM

“ Drop what you are doing and clear your schedule so you can attend the next MD Expo! Guaranteed it will be well worth your time. The education and presenters are phenomenal! The networking opportunities and chance to meet with vendors, explore their new technology 1:1, it’s all done for you. Take the time to invest in your education and show your support for the HTM field!” MELISSA WILKE, CBET

HTM Mixer in Milwaukee, especially after a positive experience at the earlier HTM Mixer in Colorado.

“It was similar in Colorado – which is why I had no qualms about coming here to Milwaukee,” Gresch explained. “The vendor tables are spread much further apart than they normally would be. Even where you have water, you have placards there telling people how to safely get water.

In the sessions that we put on, the people are spread apart and people come in between sessions and wipe everything down. Everyone is masked up. So, yeah, I felt very safe.”

Tri-Imaging Solutions Regional Sales Director Chris O’Toole said he travelled north from Nashville, Tennessee to be able to interact with the HTM community.

“Especially the way the things have been going the past six to eight months, it’s important to get out any time you have an opportunity to touch back with the customers, it’s

also important that we be here for our vendor partners because we do a lot of business together,” O’Toole said. “I think anytime there is an opportunity to, especially now with what’s going on, to get out, to see people in a socially distanced way it’s really important to do so now because we do really need to keep all the things that we are trying to do to build the industry going – even during difficult times.”

Gundersen Health System Manager of Clinical Engineering Melissa Wilke, CBET, also described the HTM Mixer as a “success.”

“The Milwaukee 2020 HTM Mixer was a success! We had 125 attendees from Wisconsin all the way to Kentucky. There were 39 vendors that also attended. It was really great to see new vendors coming out to support us and the event,” Wilke, who is also a WBA officer, said. “The education tracks were incredible. I had the chance to

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

talk with some attendees who had not been to an event before and they were very impressed with the caliber of education presented. It has left them with excitement for more! TechNation brought a breath of fresh air to Milwaukee that has had rave reviews from everyone in attendance.”

“On behalf of the WBA, congratulations to TechNation for the success of the Milwaukee Mixer! You are all truly a team who is willing to bring it all and wow your audience. You left us with excitement to attend another event. Thank you for it all,” she added.

Wilke was quick to encourage attendance at the MD Expo in Tampa, Florida this November and the HTM Mixer set for Nashville, Tennessee this December.

“Drop what you are doing and clear your schedule so you can attend the next MD Expo! Guaranteed it will be well worth your time. The education and presenters are phenomenal! The networking opportunities and chance to meet with vendors, explore their new technology 1:1, it’s all done for you,” Wilke said. “Take the time to invest in your education and show your support for the HTM field!”

For more information about the MD Expo in Tampa, visit MDExpoShow.com.

FOR MORE INFORMATION about the HTM Mixer in Nashville, visit HTMMixer.com.

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BREAKROOM

SCRAPBOOK HTM MIXER WISCONSIN 1. The TechNation team was on hand to greet

attendees and vendors. HTM Mixer Wisconsin sponsors helped provide free attendance to health care employees, active military and students.

2. Accruent Vice President of Client Success Alan

Gresch led two well-attended classes during the Wisconsin HTM Mixer.

3. Exhibitors, like Avante Health Solutions,

presented attendees with the latest advancements in HTM technology, products and services during dedicated exhibit hall hours.

The 2020 HTM Mixer in Milwaukee, Wisconsin achieved great success. The HTM Mixer, a Wisconsin Biomedical Association (WBA) event hosted by TechNation and powered by MD Expo, provided a safe, clean venue for more than 200 healthcare technology management professionals and leading vendors to meet, network and advance their careers.

4. The Young Professionals of MD (YP of MD)

were represented at the Wisconsin HTM Mixer.

Pictured are a few YP members networking during the welcome reception. To learn more about the Young Professionals group visit 1technation.com/yp/.

5. The TechNation team was on hand to provide details regarding HTMJobs.com, the current issue of the magazine and special TechNation face masks.

6. Attendees and vendors enjoyed networking

during the Welcome Reception at Vue, the only rooftop venue in Milwaukee with 360-degree views of the city.

7. ProHealth Care Director Biomedical Engineering Rob Bundick wore a custom MedWrench #BenC mask.

8. MD Publishing President John Krieg, Vice

President Kristin Leavoy and team members were presented with a heartfelt letter of gratitude from the Wisconsin Biomedical Association board. Accompanying the framed letter was a superhero cape, thanking the TechNation and MD Expo teams for being a hero to state biomedical associations.

9. Much like the Colorado HTM Mixer, the

Wisconsin HTM Mixer followed new, safer guidelines that included face masks, hand sanitizer and a less-crowded and saferenvironment that still provided valuable continuing education, networking and vendor engagement opportunities.

1

2

3

5

6

8 88

TECHNATION

NOVEMBER 2020

4

7

9

WWW.1TECHNATION.COM

CHECK OUT OUR COMPLETE TRAINING SCHEDULE ONLINE AT WWW.TRIIMAGING.COM/TRAINING

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THE ENGINEER

TM

01

02

03

04

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Our in-depth program was

System sales, upgrades,

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VISIT WWW.TRIIMAGING.COM ISO 13485:2016 CERTIFIED

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SERVICE INDEX TRAINING

www.ambickford.com • 800-795-3062

Soma Technology, Inc www.somatechnology.com • 1-800-438-7662

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

77

P

57

P

7

P P

Asset Management

Rigel Medical, Seaward Group www.seaward-groupusa.com • 813-886-2775

82

www.assetservices.com • 913-383-2738

Medical Equipment Solutions

2

www.medequipsol.com • 409-832-0447

ZRG Medical

27

www.zrgmedical.com • 760-438-8835

Auction/Liquidation

Master Medical Equipment MMEMed.com • 866-468-9558

www.medequipsol.com • 409-832-0447

ZRG Medical www.zrgmedical.com • 760-438-8835

sebiomedical.com/ • 828-396-6010

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

Nuvolo nuvolo.com • 844-468-8656

Injector Support and Service

27

International X-Ray Brokers

41

www.partssource.com/shop • 877-497-6412

P

Biomedical

www.injectorsupport.com • 888-667-1062 internationalxraybrokers.com • 508-559-9441 www.rtigroup.com • 800-222-7537

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

ALCO Sales & Service Co.

25

www.alcosales.com • 800-323-4282

BC Group International, Inc

BC

www.BCGroupStore.com • 314-638-3800

Biomedical Repair & Consulting Services, Inc.

83

www.brcsrepair.com • 844-656-9418

Biomedical Support Systems www.biomedicalsupportsystems.com • 1-800-290-1345

www.shroudguard.com • (800) 261-9953

FilAMed www.FilAMedllc.com • 833-FILAMED

InterMed Group www.intermed1.com • 386-462-5220

Master Medical Equipment MMEMed.com • 866-468-9558

Medical Equipment Doctor, INC. www.medicalequipdoc.com • 800-285-9918

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

Total Scope, Inc www.totalscopeinc.com/ • (800) 471-2255

NOVEMBER 2020

82

P P

68

P P

CMMS

RTI Electronics

PartsSource

D.A. Surgical

P P

Cardiology

2

Batteries

www.crothall.com • (800) 447-4476

42

74

Computed Tomography

Medical Equipment Solutions

Crothall Healthcare Technology Solutions

3

Cardiac Monitoring

Southeastern Biomedical, Inc

Asset Services

TECHNATION

SERVICE

Calibration

A.M. Bickford

90

PARTS

Anesthesia

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

P P

TTG www.ttgimagingsolutions.com • 866-NUC-MED1

Injector Support and Service www.injectorsupport.com • 888-667-1062

Maull Biomedical Training www.maullbiomedicaltraining.com • 440-724-7511

P

31

P P

Biomedical Support Systems

60

P

FilAMed

P

Master Medical Equipment

www.biomedicalsupportsystems.com • 1-800-290-1345 www.FilAMedllc.com • 833-FILAMED MMEMed.com • 866-468-9558

72

P P P

42

P P

internationalxraybrokers.com • 508-559-9441

33, 60

P P

Biomedical Support Systems

21

P

P P

79 77 89

P P P

35

P P

85

P P

55

P

Defibrillator

Diagnostic Imaging

54

P

Contrast Media Injectors

54

6

85

International X-Ray Brokers

54

P

6

P

42

P P

79

Endoscopy www.biomedicalsupportsystems.com • 1-800-290-1345

Cadmet www.cadmet.com • 800-543-7282

Healthmark Industries hmark.com • 800-521-6224

54 63

P

P

36

WWW.1TECHNATION.COM

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

www.brcsrepair.com • 844-656-9418

www.usocmedical.com • 855-888-8762

54

P

Ozark Biomedical www.ozarkbiomedical.com • 800-457-7576

83

P P

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

International X-Ray Brokers

ALCO Sales & Service Co.

internationalxraybrokers.com • 508-559-9441

SalesMaker Carts salesmakercarts.com • 800-821-4140

25 39

Imaging ZRG Medical www.zrgmedical.com • 760-438-8835

hmark.com • 800-521-6224

aiv-inc.com • 888-656-0755

Biomedical Support Systems www.biomedicalsupportsystems.com • 1-800-290-1345

Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701

FilAMed www.FilAMedllc.com • 833-FILAMED

Infusion Pump Repair www.infusionpumprepair.com • 855-477-8866

Master Medical Equipment MMEMed.com • 866-468-9558

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

aiv-inc.com • 888-656-0755

Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6702

FOBI www.FOBI.us • 888-231-3624

Infusion Pump Repair www.infusionpumprepair.com • 855-477-8866

Select BioMedical www.selectpos.com • 866-559-3500

P P

79

P P

4

P P

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

29

P P

54 42

P

P P

6

P

75 42

P P

54

P

P P

42

P P

72

P P

75 23

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

P

57

4

P P

7

P P

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

PartsSource www.partssource.com/shop • 877-497-6412

8 41

P P P

35

P P

72

P P P

35

P P

Nuclear Medicine E.L. Parts nuclearmedimaging.com • 847-421-1656

InterMed Group www.intermed1.com • 386-462-5220

TTG www.ttgimagingsolutions.com • 866-NUC-MED1

Online Resource MedWrench www.MedWrench.com • 866-989-7057

29

P

Monitors/CRTs www.ampronix.com • 800-400-7972

36

79

23

www.selectpos.com • 866-559-3500

Ampronix, Inc.

Infusion Therapy AIV

Select BioMedical

www.somatechnology.com • 1-800-438-7662

27

Infusion Pumps AIV

7

Monitors

Soma Technology, Inc

Infection Control Healthmark Industries

P

Mammography

General www.alcosales.com • 800-323-4282

57

Labratory

Gas Monitors Biomedical Repair & Consulting Services, Inc.

USOC Bio-Medical Services

TRAINING

Fetal Monitoring

www.somatechnology.com • 1-800-438-7662

SERVICE

P P

Soma Technology, Inc

PARTS

21

Company Info

AD PAGE

www.totalscopeinc.com/ • (800) 471-2255

P

TRAINING

Total Scope, Inc

54

SERVICE

www.multimedicalsystems.com • 888-532-8056

PARTS

Multimedical Systems

AD PAGE

Company Info

Webinar Wednesday www.1technation.com/webinars • 800-906-3373

48

P

Oxygen Blender FOBI www.FOBI.us • 888-231-3624

72

P P

29

P P

4

P P

Patient Monitoring AIV aiv-inc.com • 888-656-0755

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

NOVEMBER 2020

TECHNATION

91

SERVICE INDEX Biomedical Support Systems

54 www.biomedicalsupportsystems.com • 1-800-290-1345 PartsSource www.partssource.com/shop • 877-497-6412

Southeastern Biomedical, Inc sebiomedical.com/ • 828-396-6010

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

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

P

FilAMed www.FilAMedllc.com • 833-FILAMED

www.interpower.com • 800-662-2290

FilAMed www.FilAMedllc.com • 833-FILAMED

FOBI

82

P P

Medigate

68

P P

Nuvolo

7

P P

Surgical

www.medigate.io • nuvolo.com • 844-468-8656

Healthmark Industries hmark.com • 800-521-6224

6

P

www.ampronix.com • 800-400-7972

Soma Technology, Inc www.somatechnology.com • 1-800-438-7662

Prescotts surgicalmicroscopes.com • 800-438-3937

P

AIV aiv-inc.com • 888-656-0755

4

P P

www.brcsrepair.com • 844-656-9418

57

P

elitebiomedicalsolutions.com • 855-291-6701

Elite Biomedical Solutions FilAMed www.FilAMedllc.com • 833-FILAMED

www.bmets-usa.com/ • 870-431-5485

57

Refurbish

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

Southwestern Biomedical Electronics, Inc.

AIV aiv-inc.com • 888-656-0755

29

Rental/Leasing

www.swbiomed.com/ • 800-880-7231

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

Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6703

42

P

Repair www.alcosales.com • 800-323-4282

Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701

25 42

P P

Replacement Parts Elite Biomedical Solutions elitebiomedicalsolutions.com • 855-291-6701

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

ZRG Medical www.zrgmedical.com • 760-438-8835

NOVEMBER 2020

6 72

P

P P

49 74

36 74

P P

29

P P

83

P P

42

P P

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

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

Radcal Corporation www.radcal.com • 800-423-7169

42

P P

Rigel Medical, Seaward Group

17

P

RTI Electronics

27

6

P

54

P

68

P P

7

P P

Test Equipment www.ambickford.com • 800-795-3062

ALCO Sales & Service Co.

P

Telemetry IBC

Recruiting Stephens International Recruiting Inc.

77

Software

Biomedical Repair & Consulting Services, Inc.

Ampronix, Inc.

TECHNATION

www.ambickford.com • 800-795-3062

P

Radiology

92

A.M. Bickford

www.FOBI.us • 888-231-3624

Power System Components Interpower

Respiratory

41

Patient Monitors

TRAINING

P P

SERVICE

83

PARTS

P P

Company Info

AD PAGE

www.brcsrepair.com • 844-656-9418

16

TRAINING

Biomedical Repair & Consulting Services, Inc.

SERVICE

www.betabiomed.com/ • 800-315-7551

PARTS

BETA Biomed Services

AD PAGE

Company Info

www.seaward-groupusa.com • 813-886-2775 www.rtigroup.com • 800-222-7537

Southeastern Biomedical, Inc sebiomedical.com/ • 828-396-6010

77 BC

P P

5 59 3 77 82

P P

WWW.1TECHNATION.COM

SERVICE INDEX ECRI Institute www.ecri.org • 1-610-825-6000.

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

11

P

Summit Imaging

84

P

X-Ray

89

P

Tubes/Bulbs Cadmet www.cadmet.com • 800-543-7282

PartsSource www.partssource.com/shop • 877-497-6412

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

www.ampronix.com • 800-400-7972

CIRS, Inc. www.cirsinc.com • admin@cirsinc.com

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

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

63

P

InterMed Group

41

P P P

International X-Ray Brokers

89

P P

RTI Electronics

www.intermed1.com • 386-462-5220 internationalxraybrokers.com • 508-559-9441

Tri-Imaging Solutions 4

www.triimaging.com • 855-401-4888

P P

25

8 43

P P P

17

P

8 72

P P P

79 77

www.rtigroup.com • 800-222-7537

Ultrasound Ampronix, Inc.

www.mysummitimaging.com • 866-586-3744

TRAINING

www.cbet.edu • 866-866-9027

www.innovatusimaging.com • 844-687-5100

SERVICE

College of Biomedical Equipment Technology

Innovatus Imaging

PARTS

Training

Company Info

AD PAGE

TRAINING

SERVICE

PARTS

AD PAGE

Company Info

89

P P P

P

ALPHABETICAL INDEX AIV…………………………………… 29 ALCO Sales & Service Co.…………… 25 AM Bickford………………………… 77 Ampronix, Inc.…………………………… 4 Asset Services………………………… 82 BC Group International, Inc………… BC BETA Biomed Services……………… 16 Biomedical Repair & Consulting Services, Inc.…………………………………… 83 Biomedical Support Systems………… 54 Cadmet……………………………… 63 CIRS, Inc.…………………………… 25 College of Biomedical Equipment Technology…………………………… 11 Crothall Healthcare Technology Solutions…31 D.A. Surgical………………………… 60 E.L. Parts……………………………… 35 ECRI Institute………………………… 84 Elite Biomedical Solutions…………… 42

Engineering Services, KCS Inc……… 17 FilAMed………………………………… 6 FOBI………………………………… 72 Healthmark Industries……………… 36 Infusion Pump Repair………………… 75 Injector Support and Service………… 85 Innovatus Imaging……………………… 8 InterMed Group……………………… 72 International X-Ray Brokers………… 79 Interpower…………………………… IBC Master Medical Equipment………… 42 Maull Biomedical Training…………… 55 Medical Equipment Doctor, INC.… 33, 60 Medical Equipment Solutions………… 2 Medigate……………………………… 49 Multimedical Systems……………… 54 Nuvolo………………………………… 74 Ozark Biomedical…………………… 79 PartsSource………………………… 41

EMPOWERING THE BIOMEDICAL/HTM PROFESSIONAL

Prescotts……………………………… 74 Pronk Technologies, Inc. ……………… 5 Radcal Corporation…………………… 59 Rigel Medical, Seaward Group………… 3 RTI Electronics……………………… 77 SalesMaker Carts…………………… 39 Select BioMedical…………………… 23 Soma Technology, Inc……………… 57 Southeastern Biomedical, Inc……… 82 Southwestern Biomedical Electronics, Inc.…………………………………… 68 Stephens International Recruiting Inc.… 57 Summit Imaging……………………… 43 Total Scope, Inc……………………… 21 Tri-Imaging Solutions………………… 89 TTG…………………………………… 35 USOC Bio-Medical Services…………… 7 Webinar Wednesday………………… 48 ZRG Medical………………………… 27

NOVEMBER 2020

TECHNATION

93

BREAKROOM

FLASHBACK MD Expo Spring 2015

MD Expo Nashville held in the spring of 2015 was a huge success with top-quality education, a packed exhibit hall, signature networking events, and new features including product demos, workshops, and the Music City Surprise Party.

Paci fi c

Medic al’s bo hit a s ot h w t he y g as a a ve a w sample ay f re s o f Ja e ck Da niel’s Te nn e ssee W hiske y .

y ri se Part it y S urp M u sic C sh e a C th r e to art de T he para ck s long. John C cl a ssic s for blo fathe r’s is h wa s fi ve f o y C a sh ed so m e e Johnn pe rform n ce at th a . d n le e il tt v a a sh those in tow n N in dow n m u se u M

M D Publishin

g Presid ent an d Foun de r Jo hn Krieg kick s of f the Welcom e Rec eption.

ks Surprise Part y was five bloc The para de to the Music City er’s fath his of e som ed orm long. John Car ter Cash perf eum nce at the John ny Cash Mus classics for those in atte nda in dow ntow n Nashville.

94

TECHNATION

NOVEMBER 2020

r sprint c a clud ed a in th o o b olution s ght (left).

Eric Wri m aging S resid e nt The Tri -I P h it w e re a s see n h

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