ICE Magazine December 2020

THEICECOMMUNITY.COM

DECEMBER 2020 | VOLUME 4 | ISSUE 12

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

All Together

PRODUCT FOCUS

C-ARMS PAGE 27

Medical Imaging as a Collaborative Discipline PAGE 30

Rising Star DANIEL LAPIC PAGE 10

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EMOTIONAL INTELLIGENCE

It is fairly obvious that anyone having direct contact with customers should be trained on how to express concern to others, and how to meet their needs, wants or desires.

IN FOCUS

12

Garnet Health Medical Center Director of Diagnostic Imaging Joyce Timko faces challenges on an almost daily basis … and she loves it!

27

PRODUCT FOCUS

The global fixed and mobile C-arms market size is projected to reach $1.746 billion by 2026.

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ICEMAGAZINE | DECEMBER 2020

DIRECTOR’S CUT

Author shares some of the important people and lessons from his life.

46 ADVANCING THE IMAGING PROFESSIONAL

DECEMBER 2020

COVER STORY

At a time when patients’ entire medical histories can be synchronized with high-resolution pictures of their physical tissue itself, imaging has emerged as “a critical partner in clinical care for just about any other specialty, with very few exceptions.”

30 IMAGING NEWS

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CONTENTS SPOTLIGHT 10

Daniel Lapic, UPMC Presbyterian in Pittsburgh

12

In Focus

John M. Krieg john@mdpublishing.com

Joyce Timko, Garnet Health Medical Center

Vice President

Publisher

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Editorial

John Wallace Erin Register

Art Department Jonathan Riley Karlee Gower Amanda Purser

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Circulation

Lisa Lisle Jennifer Godwin

Digital Department Cindy Galindo Kennedy Krieg

Accounting Diane Costea

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8

Rising Star

ICEMAGAZINE | DECEMBER 2020

15

Rad Idea A3 Format and Process Improvement Methodologies

16

Off the Clock

Mark Watts, Enterprise Imaging Director: Fountain Hills Medical Center

NEWS 18

Imaging News

A Look at What’s Changing in the Imaging Industry

24

Webinar Wednesday

Webinar Shares Effective Management Tips

PRODUCTS 26

27

Market Report

Research Indicates C-arm market growth Product Focus

C-arms

INSIGHTS 34

Coding/Billing

Coding Certifications

36

Banner Imaging Virtual Sales Visits: Meeting the Challenges of a Pandemic

38

Emotional Intelligence

Showing Respect is Good Customer Service

40

PACS/IT/AI Auscultation and Remote AI

42

Rad HR

Pause, Reflect and Grow

44

Department/Operational Issues Make Virtual Better

46

Director’s Cut

What I Wish I Knew Then

48 49

AMSP Member Directory

Radon Medical Imaging

50 54

AMSP Member Profile ICE Break Index ADVANCING THE IMAGING PROFESSIONAL

1 2 3 Register online to view our live webinars each month.

ARRT Category A CE credit is pending approval by the AHRA.

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SPOTLIGHT

RISING

STAR DANIEL LAPIC

FUN FACTS

Favorite hobby: I enjoy everything outdoors and am a fitness enthusiast.

Favorite vacation spot: I have been to a lot of places but right now, my top is Surf City, North Carolina.

Secret skill/talent: I am a long tenured musician who has recorded a lot of music over the years and had a few songs looked over by some folks in Nashville. Currently, I’m working on a full instrumental album. I am a trained pianist and taught people lessons for seven years.

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ICEMAGAZINE | DECEMBER 2020

BY ERIN REGISTER

O

riginally from Beaver, Pennsylvania, Daniel Lapic, 43, is the supervisor of CT imaging at UPMC Presbyterian in Pittsburgh. Lapic spent 17 years as a CT technologist, including four years as the lead technologist, and has been in his current position for about a year and a half.

Daniel was nominated by UPMC Presbyterian Shadyside Senior Director of Imaging Services Lydia Kleinshnitz. Kleinshnitz spoke very highly of Lapic, saying, “Dan was our lead in the department for many years and was recently promoted to the supervisor role about a year ago. He has really changed the culture and decreased turnover. He has engaged the team and is building a solid team.”

ICE learned more about this “Rising Star” in a question-and-answer interview with Lapic.

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: I entered this field because my mom said, “Daniel, you’re either going into the radiography program or the nursing program ... you choose!” Actually, that wasn’t the main reason, but she was a heck of an influencer. Previously, I had worked in a hospital setting, working several different positions which allowed me to get a solid glimpse of what so many others did in health care. I always appreciated nurses and what they did, and my mom being one of them made that all the more true. I was also intrigued by the radiology department and ADVANCING THE IMAGING PROFESSIONAL

the exams they performed but never thought my life path would ever take me there.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: What I enjoy most about my job is the people I work with day in and day out and the constant challenges of working in a University Level 1 Trauma center provides.

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: What interests me the most about the imaging field currently, and has since I began my career in CT imaging, is pathology.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: My greatest accomplishment hasn’t been singular in nature. When I answer this question at this moment in all truthfulness, my greatest accomplishment has been to learn from past mistakes and grow from them, to know it’s ok that I don’t always have all the answers and to invest in the people who work for you. This has been my greatest accomplishment thus far.

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT FIVE YEARS? A: My goals are to see my department develop leaders in CT imaging with strong backgrounds in educational development and broad technological skill sets. • Daniel Lapic is the supervisor of CT imaging at UPMC Presbyterian and a fitness enthusiast.

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SPOTLIGHT

IN FOCUS JOYCE TIMKO

Joyce Timko faces challenges often.

They are basically part of her job description and she enjoys finding solutions.

BY JOHN WALLACE

I

n Middletown, New York, Garnet Health Medical Center Director of Diagnostic Imaging Joyce Timko faces challenges on an almost daily basis … and she loves it! In fact, those challenges are one of the things she loves about her career choice.

“I love that every day brings a new challenge to

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ICEMAGAZINE | DECEMBER 2020

find a solution to. I love puzzles and I feel radiology is a key piece to help solve the puzzle when it comes to patient care,” Timko says. “We get to use cutting edge technology, produce amazing images of the body, help patients and doctors, and the interaction with patients and staff all while trying to answer the question what is wrong with the patient or how can we help the patient get better.

Even in administration, there are puzzles and challenges every day that need innovative ideas and solutions. We are working in unprecedented times allowing administrators and staff technologists to be innovative in their every day.”

Her ability to lead and troubleshoot and just a few of her talents.

MTMI Global President Ernesto A. Cerdena first met Timko almost two decades ago. He is not surprised by her success. Her work ethic and desire to help others are among the traits that stood out when she worked with Cerdena.

“I have known Joyce for the past 18 years. I hired her as a newly grad mammo technologist from Quinnipiac University in 2002, and mentored to take on additional responsibilities. She was eventually promoted to PACS administrator and radiology manager roles,” Cerdena wrote in an email. “She went back to school to complete her graduate degree and began working on her Ph.D. as well. She has held numerous imaging leadership positions, participated and presented with the AHRA.” So, how did it all start for Timko? Like many diagnostic imaging leaders she found her calling early in life.

ADVANCING THE IMAGING PROFESSIONAL

Away from work, Joyce Timko enjoys spending time with her husband, Bryan, and their two-yearold Siberian Husky, Bella.

“While in high school, I participated in an Allied Health program associated with our community college for credit. The program was an introduction to the health field and health science including shadowing at our local hospital,” Timko recalls. “When I started the program, I thought I wanted to go into physical therapy, however my rotation in radiology changed my mind. Seeing the work being done in radiology, the film/screen technique, the one-slice and four-slice CT scanners, and the images produced completely fascinated me. I knew in the 11th grade of high school this was the field I wanted to pursue.”

Once she made the decision, Timko worked hard to become the first in her family to attend college and earn a degree. She earned a bachelor’s degree in radiology and a Master of Business Administration. She is currently working on a doctorate in health care administration.

She no doubt leads by example, but when asked to describe her leadership style she says, “My approach to leadership is to always stay positive, be approachable/available, be willing to jump in when needed, truly understand my teams’ work by walking in their shoes and, of course, have fun and laugh.”

“I will not ask my team to do anything I am not willing to do myself or with them,” she adds. “If they need help moving a patient, talking to a patient, positioning a difficult patient or just someone to vent to – I am there for them (including having their favorite chocolate bars for when a pick me up is needed). My team knows they can call me any time. Being positive is extremely important to me, even on the worst days there is always a positive aspect to be found.”

In addition, Timko stays informed by monitoring the latest trends and reading up on hot topics.

“I am always learning and researching, looking for opportunities to improve our workflow, patient care, and work environment. It is through the continual learning process and staying positive, we will learn to accept change, even embrace change to bring our department and quality of care to the next level,” she says.

It is not a surprise that she lists Ernie Cerdena as her first mentor.

“He was my leader at my first job after graduation from Quinnipiac in 2002 when I was a multi-modality tech perWWW.THEICECOMMUNITY.COM

JOYCE TIMKO

Director, Diagnostic Imaging Garnet Health Medical Center, formerly Orange Regional Medical Center What is the last book you read? Or, what book are you reading currently?

“Cemetery Road” by Greg Iles was the most recent book. I prefer audio books as I can read (listen) while commuting, at the gym, or when working around our property and splitting wood.

Favorite movie?

“The Bird Cage” What is something most of your coworkers don’t know about you?

My all-time favorite vehicle is a VW Bus. Recently I sold my 1976 VW Bus and am currently keeping my eye out for the perfect VW Bus (preferably one from the later 1960s) Who is your mentor?

Ernie Cerdena was my first mentor and continues to provide support today.

Currently Gene Bernieri, the vice president over imaging, provides guidance and support.

What is one thing you do every morning to start your day?

My husky, Bella, and I go for a walk to get the day started.

positive changes until you have achieved your goal(s).

Who has had the biggest influence on your life?

My parents. They both worked extremely hard to make sure my brother and I knew we could do anything in life we wanted and when times get tough you still could have fun even if that means going for a Sunday drive, getting lost and finding a new restaurant for lunch. I learned from my parents that tomorrow will be better than today, and never give up on your dreams.

What are your hobbies?

Reading, going to the gym (pre-COVID), and recently I have taken up crocheting.

What is your perfect meal?

Enjoying a BBQ of hot dogs, hamburgers and corn on the cobb with family and friends

Best advice you ever received?

Focus on what you have control over and make

forming mammography, X-ray and CT scan. He saw something in me and helped to develop my leadership by including me in the budget process, providing me with extra responsibility, stressing the importance to be involved with the AHRA community and continued learning,” she recalls. “He supported my plans to peruse a master’s degree while we worked together. Ernie promoted me to PACS administrator and X-ray supervisor. Along the way he continued to provide guidance and be a sounding board. To this day, 18 years later, if I have a question or need advice Ernie is available. I truly value the friendship and mentorship Ernie provided then when I was new grad and today.”

Away from work, Timko and her husband, Bryan, live in Orange County, New York with their two-year-old Siberian Husky, Bella. • ICEMAGAZINE

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SPOTLIGHT

Rad idea A3 & Action Plan

Focus Area:

Owner:

Date Created:

Review Team:

Next Review:

Focus Area Notes: Background / Problem Statement

Improve / Implementation Plan

X

[most activities/actions should be detailed enough not to span more than 1 month] Step

Action / Improvement Activity

Owner

Assist

C

= Original Plan

Start Date

Jul

Aug

Sep

Timeline

I

= Complete Oct

Nov

Dec

Jan

Feb

Target Improvement = Incomplete Mar

Apr

May

Jun

FY TTI Impact

Annual TTI Impact

1 1a 2 2a

Current State

Analyze

Goal / Target(s) to Improve (TTI) [from x to y by date]

[1-2 metrics only]

Leading Indicator / Metric

July

Aug

Sept

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

Jun

YTD Metric 1 Target Metric 1 Actual Metric 2 Target Metric 2 Actual

A3 FORMAT AND PROCESS IMPROVEMENT METHODOLOGIES

BY KIMLYN N. QUEEN-WEIS

I

like to utilize the A3 Format and Process Improvement Methodologies in collaboration with humble inquiry and coaching to empower my associates to become problem solvers at the front lines. I am a firm believer that our front line team members know what the day-to-day challenges and opportunities are and how to solve problems and create new standard workflows that lead to sustainable process improvements. Empowering our teams to own problem solving and process WWW.THEICECOMMUNITY.COM

improvement, in their day-to-day work, helps create greater efficiencies, improves associate engagement, increases trust, creates ownership in the outcomes and a deeper sense of pride in the overall performance of the team and department. • KIMLYN N. QUEEN-WEIS, MBA, CRA, FAHRA, Director Operations, Patient Logistics Services (Transfer Center), Director Operations, Virtual Health/Telehealth Services Share your RAD IDEA via an email to editor@mdpublishing.com.

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SPOTLIGHT

Off Clock THE

MARK WATTS, ENTERPRISE IMAGING DIRECTOR: FOUNTAIN HILLS MEDICAL CENTER

BY MATT SKOUFALOS

W

hen Mark Watts, a native of Portland, Oregon, first moved to Arizona, he was struck by its natural beauty. Arizona has a rich history of commercial mining, and Watts was taken by the romantic notions of land claims laws related to its prospecting past.

Mark Watts enjoys treks in the Saguaro National Park where he looks for and finds “treasures.”

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ICEMAGAZINE | DECEMBER 2020

Since the 18th century, people from Spain, Mexico, and the United States all have delved deep into the state’s mineral deposits, both formally and informally, seeking precious metals like gold, silver, and copper, and maneuvering themselves into opportunities to acquire the land beneath which these treasures are buried.

“The mountain-building episodes that brought mineralization to Arizona occurred mainly during the Precambrian and the Mesozoic and Cenozoic eras,” wrote geologist Jan Rasmusson. “Volcanic eruptions and intrusion of granitic rocks and minerals in the associated veins rose from the eastward-dipping oceanic plate that was being subducted under the northwestward-advancing North American continent.”

All that tectonic and volcanic activity yielded a wealth of resources that people have been working to recover ever since.

According to TheDiggings.com, which tracks mining deposits across the world, there are 469,629 records of mining claims on Arizona public land managed by the U.S. Bureau of Land Management (BLM), and the United States Geological Survey (USGS) has records ADVANCING THE IMAGING PROFESSIONAL

Nature’s beauty is a great backdrop for Mark Watts’ hikes and provide a break from his professional life.

of 7,761 mines constructed there.

The state is also home to more than 48,000 patents on public land, according to The Land Patents, which inventories individual and corporate homesteading, mining, ranching and logging rights on public land. Mineral rights on public lands can be obtained through the BLM, allowing for further exploration; the process of getting those rights to public lands is complex, but petitioners can often acquire it if they find something valuable there.

“It piqued my interest to whether you could actually find valuable resources and actually do it,” Watts said.

Scottsdale, Arizona, where Watts moved several years ago to pursue a career in radiology, was once a ranching community. The city’s economic growth was fueled by the rich mineral deposits beneath its surface. Its copper mines fueled the American war effort during the 1940s, and the businesses that extracted the metals also profited heavily from their labors. In the decades that followed, as mining technology improved, future generations came to prospect those sites and further repurpose them.

On a much smaller scale, Watts has the opportunity of doing something comparable: on daily sojourns into the virgin desert of nearby Saguaro National Park, which lies just a 15-minute hike from his home, his eyes are always peeled for flashes of color against the brown and green of the landscape.

“Some people like to go to the casinos,” Watts said. “They drop a coin WWW.THEICECOMMUNITY.COM

in a machine, and hope for a return on their investment. I like to go for a walk. I hope for a return on my investment by keeping my eyes peeled and looking for something that most people wouldn’t look for and wouldn’t bring it back home.”

Watts’ “retirement account,” as he calls it, isn’t vaulted away in a bank, nor digitized on a server. It’s locked up in hundreds of pounds of what he believes to be raw turquoise suitable for cutting up into jewelry-quality gemstone. Turquoise can get its blue-green color from the copper deposits in the stones, and it’s almost exclusively available in Arizona. When Watts and his wife take their morning hikes into the hillside, they’re walking over paths trod by humans for generations. He always brings along water, a hammer, and a chisel, to see what treasure the desert holds that they might have overlooked. Sometimes it’s semiprecious stones in small amounts; other times, it’s petroglyphs – rock carvings that vary in age from several hundred years to several thousand.

“When you’re out walking, you can see that people have been out here walking a long time in these deserts, just like my wife and I were,” Watts said.

“I don’t know that they were miners, but they enjoyed their time in the desert, and left their mark on it too.”

“The university has carbon-dated the rocks in that hill at over a billion years old,” he said. “I find it fun to go up there and see if I can find something valuable that somebody else overlooked.”

“It’s about finding something beau-

tiful in its natural state, and bringing it back home,” Watts said. “We go out with water, and we come back with rocks in our backpacks.”

Some of Watts’ adventuring hasn’t always gone as smoothly as a simple excavation.

Once when he was out on a solo hike, he recalled discovering a rock as big as the palm of his hand, showing greenish blue. It began to rain, exposing more of the rock’s surface, and revealing it to be a much larger stone that he estimated at 50 to 60 pounds.

“I started to carry it back down the hill, and because it was raining, and because I was going downhill, I slipped, and the rock went up in the air,” Watts said. “I fell down onto my back; it came down and landed between my legs. I called my son, and said, ‘Can you come and help me? I can walk, but I really want you to bring this rock back home.’ ” The next day, his thighs were black and blue where the rock had struck them. Watts keeps the rock in his backyard as a conversation piece.

“I thought to myself, ‘What does this say about my personality that I called him not because I was hurt, but because I wanted him to help me carry it down the hill?’ ” he said.

Such are the hazards of the amateur geologist, but at least Watts comes by it honestly. In his day-to-day work, Watts is a data miner, combing through mountains of medical imaging reports that were initially produced for diagnostic purposes, but which may yield subsequent value if refined.

“We have hundreds of thousands of studies that we’ve collected, and what have we done with that information?”

Watts said. “We’re finding value stored.”

“I have been collecting rocks for a long time and not developing them into jewelry, and we’ve been collecting data and not turning it into something that’s valuable for imaging,” he said. “The realization of potential, that’s the thing.” • ICEMAGAZINE

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NEWS

Imaging News FDA CLEARS YSIO X.PREE INTELLIGENT A LOOK AT WHAT’S CHANGING INRADIOGRAPHY THE IMAGING INDUSTRY SYSTEM Siemens Healthineers has announced Food and Drug Administration (FDA) clearance of the YSIO X.pree, a ceiling-mounted radiography system with the MyExam Companion intelligent user interface.

“In addition to this easy-to-use interface that guides the radiologic technologist through the exam workflow, the YSIO X.pree has a new 3D camera for patient positioning and advanced collimation, as well as a new smart image processing engine,” according to a news release. “With these features, the YSIO X.pree improves the user and patient experience in addition to optimizing clinical operations to transform the delivery of care.“ The YSIO X.pree, the release adds, is the first radiography system to feature the MyExam Companion user interface, which provides proactive guidance to help technologists of any skill level navigate a radiography procedure.

MyExam Companion combines available patient data such as gender and age with other user or machine-observable, patient-specific information to identify optimal acquisition and reconstruction parameters for each patient and radiography procedure. These innovations increase the efficiency of the imaging process.

The system’s new MyExam 3D camera helps speed up the clinical workflow. Its Virtual Collimation feature permits technologists to precisely adjust the size and shape of the X-ray beam via the touchscreen monitor and reduce the volume of irradiated patient tissue. The camera-based Smart Virtual Ortho functionality enables shorter preparation times for orthopedic multi-image acquisitions. With Smart Virtual Ortho, the user can set the field of view and adjust exposure parameters on the touchscreen with the aid of a live camera image of the patient, making long-leg

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ICEMAGAZINE | DECEMBER 2020

and full-spine examinations faster and easier to perform.

The camera’s Auto Thorax Collimation feature used automated, AI-based body-part detection and collimation to accelerate thorax examination workflows by analyzing the patient’s body contour and adjusting the collimator blades in less than half a second.

The YSIO X.pree is also more ergonomically designed than predecessor systems. In addition to its adjustable touch display, it has an adjustable tube touchscreen monitor that is positioned lower than monitors on previous ceiling-mounted units.

The system’s new image processing database is designed to deliver image consistency. Technologists can use the intelligent dynamic range optimization to set preferred image contrasts. Intelligent noise elimination removes image noise and enables low-dose settings for all clinical tasks, and gridless acquisition for free exposures limits the need for additional patient radiation dose. AI-based cropping is designed to produce well-cropped images each time.

“The YSIO X.pree ceiling-mounted radiography system represents a dramatic leap forward in intelligent X-ray imaging, providing our customers with an unprecedented level of intuitive operation for consistent X-ray images and potentially faster workflow,” said Niral Patel, vice president of X-ray products at Siemens Healthineers North America.

In other news, Siemens Healthineers and WakeMed Health & Hospitals have established a 10-year, patient-focused, value partnership to innovate care delivery and improve patient outcomes through robotics initiatives, advanced imaging capabilities and artificial intelligence, along with provider and staff training. •

ADVANCING THE IMAGING PROFESSIONAL

IMAGING CONFERENCE AND EXPO RETURNS TO FLORIDA The 2021 Imaging Conference and Expo (ICE) is set for February 11 and 12 in sunny Fort Lauderdale, Florida.

“ICE is excited to make its way to Ft. Lauderdale, Florida in February 2021 for our annual Imaging Conference & Expo,” MD Publishing President John Krieg said. “The beautiful Westin Fort Lauderdale Beach Resort will be the hub for imaging professionals from across the country to gather for two days of networking, education and exhibit halls.

Get ready to soak up the sun with us in Ft. Lauderdale!”

ICE is the only conference dedicated to imaging directors, radiology administrators and imaging engineers from hospital imaging departments, freestanding imaging centers and group practices. ICE offers valuable CE credits from the ASRT and ACI (pending approval) and, keeping in line with previously successful conferences, offers comprehensive educational opportunities for attendees.

Whether it’s invaluable continuing education, productive networking or the exclusive exhibit hall, attendees will have the perfect opportunity to enhance their careers and spend time with

WWW.THEICECOMMUNITY.COM

colleagues. As an added incentive, ICE conference admission is complimentary for all hospital employees, imaging center staff, members of the U.S. Armed Forces and students.

Attendees shared positive feedback when asked to describe ICE. “A great opportunity to gain insight from industry peers and leaders from around the country,” Regional Director R. Walston said.

“What a wonderful opportunity to discuss hot topics with industry leaders from both biomed and imaging! Thank you,” Director of Imaging Services W. Stirnkorb said.

ICE continues to be the only conference to combine leaders in imaging management with imaging engineers, providing an exclusive and unique community of key decision makers and influential imaging professionals. ICE is the perfect resource to grow and prosper, personally and professionally.

Attendees can visit AttendICE.com to find out more and subscribe to an e’newsletter for updates.

Exhibitors can request a booth online at AttendICE. com/reserve-booth-request/. •

ICEMAGAZINE

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NEWS CANON MEDICAL ANNOUNCES NEW AQUILION EXCEED LB An estimated 1.8 million new cancer cases will be diagnosed in the U.S. this year alone, according to the American Cancer Society. With a disease so prevalent, treatments like radiation therapy are critical, and while planning, clinicians require accuracy, precision and speed. Giving clinicians the opportunity to see more during radiation therapy planning, Canon Medical Systems USA Inc. introduced the Aquilion Exceed LB CT system (pending 510(k) clearance) during this year’s virtual American Society for Radiation Oncology (ASTRO) Annual Meeting.

The Aquilion Exceed LB can help radiation oncologists with fast and efficient radiation oncology workflows without compromising on patient position, image quality or reproducibility.

Features include accuracy in even the most complex simulations through industry-leading capabilities, like the largest bore opening (90 cm), edge-to-edge extended Field-of-View (90 cm) reconstruction and widest detector coverage (4 cm).

It offers better contouring using Artificial Intelligence (AI) with sharp, clear and distinct images from Canon

Medical’s Advanced intelligent Clear-IQ Engine (AiCE) Deep Learning Reconstruction (DLR) technology.

It has expanded capabilities – because of the Aquilion Exceed LB’s suite of premium CT capabilities, the system is positioned for shared services to enable high-quality treatment follow-up and interventional procedures.

“Accurate simulation across even the most challenging treatment plans is imperative during radiation therapy planning,” said Erin Angel, managing director, CT Business Unit, Canon Medical Systems USA Inc. “At Canon Medical, we deliver solutions that meet providers’ needs but also push the boundaries of traditional simulation. With the Aquilion Exceed LB, we brought deep learning reconstruction to the CT simulation space. This will revolutionize care for cancer patients and give the radiation oncology team the confidence and precision they need for accurate planning across patients.” •

SCRIPTSENDER, KONICA MINOLTA HEALTHCARE PARTNER TO STREAMLINE RADIOLOGY WORKFLOWS ScriptSender announced that it is partnering with Konica Minolta Healthcare Americas Inc. to create a faster and stronger communication pathway between radiology practices and referring physicians.

ScriptSender is a leader in enabling secure, one-click communications between health care providers. Using ScriptSender technology, any document from any application and any medical group can be sent to an imaging practice with a single click. Imaging centers can also send any document directly into the referrer’s system. No downloads, installations or interface building is required.

Konica Minolta will offer ScriptSender as a value-add to its Exa RIS and PACS customers. The substantial time and money spent on creating complex integrations to referring providers is time that can now be directed to patient care. ScriptSender technology securely transmits live data – not a PDF or image file – so the back-and-forth voicemails, missing fax pages, illegible artifacts and delays or errors inherent in faxing no longer impede clinical workflow.

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Kevin Borden, vice president of product for healthcare IT at Konica Minolta, said, “With this partnership, we’re helping imaging providers be more efficient and strategic.

They can now offer a unique solution to their referring provider community that will enhance communication, seamlessly integrate information into the patient record, and provide a more collaborative clinical environment. Results are faster, clinical information is clearer and securely shared, and significant costs can be saved.”

“Konica Minolta’s Exa Platform is gaining substantial momentum in the imaging market, and we’re very pleased to add greater value for their customers through one-click referral integration,” said Jim Burchfield, senior vice president of sales and business development for ScriptSender. “Together, our technologies make it so simple for radiology groups and their referring physicians to eliminate the manual fax workflows and expensive HL7 Interfaces, resulting in complete integration to Exa and fully automated clinical documents, orders and results.” •

ADVANCING THE IMAGING PROFESSIONAL

DUNLEE’S LIQUID METAL BEARING CT REPLACEMENT TUBE RECEIVES FDA CLEARANCE Dunlee, a manufacturer of imaging solution components, announced its DA200P40+LMB CT replacement tube has received FDA clearance. U.S. and European deliveries will begin by the end of 2020. Featuring CoolGlide technology, the CT tube is an alternative to the original equipment manufacturer (OEM) liquid metal bearing (LMB) replacement CT tube for GE Revolution Evo and Optima 660 CT scanners.

LMB CT tubes are prized for their long life, made possible because the liquid metal bearing doesn’t create friction, so there is less wear. The DA200P40+LMB tube also features a quieter sound pattern for smooth operation and a pleasant patient experience.

“Liquid metal bearing technology has been a proprietary technology of the major medical equipment manufacturers for many years. With this new product release, we are offering a unique, cost-effective solution, based on the latest technology,” said Jan Laheij, commercial lead imaging components, Dunlee. “Imaging departments are under tremendous pressure to keep health care accessible and to reduce operating costs, and by providing long-lasting, high-quality alternative X-ray tubes we are supporting them in this journey.”

The LMB DA200P40+LMB tube with Dunlee CoolGlide technology is specifically designed for use as a replacement tube on the GE Revolution Evo and Optima 660 CT scanners. Each tube is built according the highest quality and regulatory standards, and extensive testing confirms that it equals OEM tube performance.

CoolGlide liquid metal bearing technology was developed and is manufactured in Germany. Final tube manufacturing and assembly takes place in Illinois. “This allows us to be close to a main market and its customers, in order to provide fast deliveries and services,” Laheij explains.

In addition to FDA clearance for the U.S. market, the LMB DA200P40+LMB tube with Dunlee CoolGlide technology will receive MDR certification soon, which allows distribution in Europe. Dunlee plans to finalize registration for Canada and the Middle East region by first half of 2021, followed by a product launch in China planned in the second half of 2021 that will include release for the Optima 670 and Optima 680. • For more information, visit www.dunlee.com.

VARIAN STOCKHOLDERS APPROVE COMBINATION WITH SIEMENS HEALTHINEERS Varian has announced that its stockholders have voted to approve the previously announced pending combination with Siemens Healthineers AG at a special meeting.

Varian stockholders voted overwhelmingly in favor of the transaction.

“The overwhelming support our stockholders have expressed for this combination reflects the compelling value and important opportunity to shape the future of health care we see with Siemens Healthineers,” said Dow Wilson, chief executive officer. “This vote brings us closer not only toward completing this transformative combination, but also toward realizing our vision of a world

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without fear of cancer. We look forward to securing the remaining regulatory approvals and closing the transaction.”

Varian continues to work toward completing the transaction and remains focused on supporting customers and their patients. The transaction is expected to close in the first half of calendar year 2021, subject to other regulatory approvals and customary closing conditions.

The final vote results will be filed in a Form 8-K with the U.S. Securities and Exchange Commission. •

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NEWS

PHILIPS, LeQUEST TO PROVIDE ONLINE INTERACTIVE ULTRASOUND TRAINING Royal Philips and LeQuest, a leading provider of online interactive simulation-based training for the use of medical devices, recently announced a partnership to provide online interactive training for the Philips Ultrasound Affiniti system. As a result, medical staff can train individually at their own convenience without the need for equipment, avoiding the resulting loss of operational time on the system, as well as supporting faster onboarding and increasing confidence through practice with realistic simulation scenarios. Health care providers benefit from improved workflow, operational efficiencies and better-trained staff.

The Affiniti system offers health care professionals a powerful combination of performance and workflow for quick and efficient diagnosis with low operating cost, providing exceptional image quality across applications such as radiology, obstetrics and gynecology, and cardiology. By providing a flexible training solution to health care providers, the partnership supports them to achieve key parts of the quadruple aim: an improved experience for staff and patients, better health out-

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comes and a lower cost of care.

“Partnering with LeQuest enables us to further expand our offering of solutions that aid in optimizing the healthcare ecosystem,” said Bich Le, senior vice president and general manager ultrasound at Philips.

“As the role of ultrasound continues to expand, new capabilities, such as remote clinical collaboration and virtual training, have been particularly valuable during the COVID-19 pandemic, enabling providers to reduce in-person contact and reduce infection risk.”

In other news, Royal Philips recently announced that SimonMed Imaging, one of the largest outpatient imaging providers in the U.S., will bring the most advanced 3T MRI Philips technology to its centers of excellence across the U.S. The first MR systems, placed in California, Arizona, Illinois and Colorado, will feature software and services to enhance diagnoses ranging from brain injuries, liver and cardiac disease, to orthopedic injuries. Philips and SimonMed are also collaborating to further enhance the patient experience and speed in diagnostic imaging. •

ADVANCING THE IMAGING PROFESSIONAL

GE HEALTHCARE INTRODUCES CONTRAST-ENHANCED GUIDED BIOPSY SOLUTION GE Healthcare has announced the availability of Serena Bright in the United States. Serena Bright is the industry’s first contrast-enhanced guided biopsy solution and will help empower clinicians and patients in their fight against breast cancer.

Receiving U.S. Food and Drug Administration 510(k) clearance in June, this technology allows clinicians to conduct breast biopsy exams with contrast guidance using the same mammography equipment, in the same room and with the same staff as the screening or diagnostic mammogram.

Typically, for lesions found with contrast-enhanced mammography and not seen on ultrasound, clinicians will use other imaging guidance, such as MRI, for biopsy procedures.

Following an abnormal mammogram, it can take several weeks to get an MRI biopsy. As the backlog of cancer screenings caused by COVID-19 persists, delays in diagnosis will likely lead to presentation at more advanced stages and poorer clinical outcomes, with one study pointing to a potential increase of 33,890 excessive cancer deaths in the U.S. alone.

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Serena Bright may help decrease these delays, allowing follow-up biopsy procedures to be done in a matter of days, rather than waiting several weeks for MRI biopsy. When compared to MRI-biopsy guided therapy, the potential benefits of Contrast Enhanced Spectral Mammography (CESM) biopsy include shortened procedure time and improved overall patient experience.

Key to this technology’s application is GE Healthcare’s SenoBright HD CESM, a diagnostic breast exam with iodine-based contrast that provides high sensitivity for more accurate breast cancer diagnosis. By highlighting areas of unusual blood flow to localize lesions that need to be biopsied, CESM biopsy – Serena Bright – provides excellent image quality to help improve clinical confidence.

Health systems worldwide are looking to implement the Serena Bright technology in their fight against breast cancer, with Jefferson Health in Philadelphia being the first health care system in the United States to offer this technology in late 2020.

GE Healthcare also recently

announced U.S. FDA 510k clearance for its Ultra Edition package on Vivid cardiovascular ultrasound systems, which includes new features based on artificial intelligence (AI) that enable clinicians to acquire faster, more repeatable exams consistently.

Also, GE Healthcare has announced its largest ever ultrasound deal in the United States. The deal is an $11 million order by St. Luke’s University Health Network to install GE Healthcare ultrasound technology and IT workflow solutions system-wide. GE Healthcare will continue upgrades over the next four years to maintain latest technology for the health system.

St. Luke’s is experiencing exponential growth following expansion and several acquisitions over the last few years, which has resulted in complexities and pressure on the system. To solve for this, the network looked to standardize care and create efficiencies, bringing advanced and consistent technology to its ultrasound users in the vascular, radiology and echocardiography departments across its 12 hospitals. •

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NEWS

ICE WEBINARS STAFF REPORT

WEBINAR SHARES EFFECTIVE MANAGEMENT TIPS

I

n a recent ICE webinar, Kelly Pray presented “Leading Through Change – Best Practices in Change Management Leadership.”

Pray has been supporting the strategy on the organization’s response and recovery planning. She is certified by Prosci as both a Change Practitioner and Train the Trainer.

The webinar series continues to be a popular source for continuing education.

Pray discussed best practices regarding Attendees provided feedback via a post-wehow to effectively manbinar survey that included the age change for yourself, request, “Finish this sentence: your projects and your ICE webinars are ...” teams. Change is hard. The “ … great opportunities to COVID-19 pandemic has learn about what our peers only increased the difficulare doing so that we are not ty to successfully navigate flapping out there on our change. As organizations own,” said J. Beall, Army evolve their practices to Retired. meet the demands of this “ … a nice addition to the new normal, leaders must continuing education combe equipped with the tools munity,” Radiology Manager and resiliency to help their S. Gauntt said. teams. The good news? “ … interesting and filled – S. Gauntt, You don’t have to reinvent with information pertinent to Radiology the wheel to make this my everyday job role,” RadiolManager happen. Pray shared best ogy Department Supervisor practice approaches to M. Pawelkowski said. • managing change.

Pray is currently leading the enterprise FOR MORE INFORMATION about the ICE Webinar change management strategy at Children’s Series, visit ICEwebinars.live.

Hospital of Los Angeles. She is responsible for building out change management as an FOR INFORMATION ABOUT organizational competency in order to enthe 2021 ICE conference in Fort Lauderdale, sure adoption and usage across enterprise Florida, visit AttendICE.com. initiatives. Amidst the COVID-19 pandemic,

“ … a nice addition to the continuing education community.”

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ICEMAGAZINE | DECEMBER 2020

ADVANCING THE IMAGING PROFESSIONAL

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PRODUCTS

Market Report Research Indicates C-arm market growth STAFF REPORT

A

press release from Market Watch reports that the global fixed and mobile C-arms market size is projected to reach $1.746 billion by 2026, from $1.557 billion in 2020. This indicates a predicted compound annual growth rate (CAGR) of 1.9% during 2021-2026.

C-arms have radiographic capabilities, though they are used primarily for fluoroscopic imaging during surgical, orthopedic, critical care and emergency care procedures. Mobile C-arms are expected to witness the fastest growth over the forecast period because of tailored imaging solutions for a diverse range of clinical applications and greater flexibility in selection of navigation system. In addition, mobile C-arms have better maneuverability and precision and provide immediate hard copies of images, if need be, which expedites growth of the overall C-arms market.

A Grand View Research report on the global C-arm market focuses on the 2018-2025 forecast period and states, “The global fixed and mobile C-arms market size was valued at $1.68 billion in 2016 and is expected to grow at a CAGR of 3.4% over the forecast period.”

Mordor Intelligence reports that the 2020 to 2025 forecast period will experience market growth.

“The C-arm market is expected to register a CAGR of nearly 3.62% during the forecast period. The major factors driving the growth of the market include the rising geriatric population and 26

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the increasing incidence of chronic diseases, advancements in maneuverability and imaging capabilities, and increasing demand in emerging economies,” Mordor intelligence states.

“Imaging systems are becoming an essential technology and are present in nearly all well-equipped hospitals.

Specialists in fields, such as surgery, orthopedics, traumatology, vascular surgery, and cardiology use C-arms for intraoperative imaging,” the firm adds. “The devices provide high-resolution X-ray images in real-time, which helps physicians to monitor progress at any point during the operation and immediately make necessary corrections. As a result, treatment results are better and the patient’s recovery is also faster. C-arms are currently being used in several areas of medicine and their applications are expected to increase over time. These factors, along with the increasing demand for health care infrastructure in developing countries, are driving the C-arms market.”

Mordor Intelligence also predicts growth in the mini C-arm market in coming years.

“With an increasing focus on the portability of C-arms, there is a significant market opportunity for companies producing mini C-arms. Several mini C-arms are designed explicitly for extremity imaging and have a smaller footprint, along with increased mobility compared to the full-size c-arms,” according to Mordor Intelligence.

“Currently available systems in the mini C-arm category vary significantly in size and cost depending upon the functionality offered for the procedures.

Manufacturers are differentiating their products on the basis of mobility, the field of view and by including alternate imaging technologies. For instance, OrthoScan Inc.’s FD Pulse is the world’s first mini C-Arm equipped with pulsed fluoroscopy. The mini C-arms segment is expected to register several product launches during the forecast period, as companies are upgrading their product offerings at a fast pace by launching new products in this segment. Hence, owing to aforementioned factors, along with rising geriatric population and increasing incidence of chronic disease, the market is expected to witness significant growth over the forecast period.”

The research form goes on to predict the importance of the United States in this imaging market.

“The United States is expected to hold largest market share over the forecast period owing to the high standards of health care infrastructure in the United States. Due to the strict regulatory oversight in the United States, all the C-arms are replaced as per the replacement schedule stipulated by the health care regulatory authorities, which ensures that the new sales of C-arms in the United States are pretty consistent,” according to Mordor Intelligence. “The United States is currently the largest market in the world for C-arms and that can be credited to their huge installed base which ensures a large number of replacements each year. Furthermore, the high frequency of diagnostic examination, rising geriatric population and increasing prevalence of chronic diseases are also supplementing the C-arm market in the United States.” • ADVANCING THE IMAGING PROFESSIONAL

Product Focus C-arms

CANON MEDICAL Alphenix 4D CT

1

Canon Medical Systems USA Inc. has introduced an angiography configuration featuring its Alphenix Sky+ C-arm and Hybrid Catheterization Tilt/Cradle Table for interventional procedures with its Aquilion ONE/GENESIS Edition CT system. The new pairing, called the Alphenix 4D CT, allows clinicians to efficiently plan, treat and verify in a single clinical setting. The flexible hybrid system enables flexibility with innovative C-arm flip, right or left lateral flexibility, speed and full body 3D imaging capability. The Alphenix Sky+ offers revolutionary ImagingRite technology to generate a 3D image anytime, anywhere. •

*Disclaimer: Products are listed in no particular order.

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PRODUCTS

FUJIFILM

Persona C Mobile Fluoroscopy System Persona C Mobile Fluoroscopy System is an advanced C-arm solution engineered for fast, precise positioning and advanced image quality. This new C-arm system will be available with 21x21 cm or 30x30 cm amorphous Silicon (aSi) flat panel detector options for ultra-low dose fluoroscopy and vascular imaging. Featuring 81 cm of free space, a removable grid and dedicated “radiography mode” for high-quality still imaging, Persona C is designed for easy, precise navigation and imaging across a broad range of diagnostic imaging and minimally invasive surgical procedures. •

GE HEALTHCARE OEC Elite CFD

3

The OEC Elite CFD offers stunning image clarity and detail at low dose with enhancements for an easy and efficient experience. This system is designed to improve the C-arm experience enabling clinicians to see more anatomy with exceptional detail at low dose, experience clinical versatility for complex patients and case mix, and enable surgical workflow with ergonomics and efficiency. With advanced technology, intelligent workflow, and dose control, the OEC Elite CFD is ideally suited for a range of surgical needs including vascular, cardiac, orthopedics, gastrointestinal, endoscopic, urologic, critical care, pain management and emergency procedures. •

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ADVANCING THE IMAGING PROFESSIONAL

4 5

HOLOGIC InSight FD

The Hologic Fluoroscan InSight FD mini C-arm provides diversified imaging options, an enhanced interface and a 24-inch HD touchscreen interface for extremities imaging. The system incorporates a rotating flat detector.

This enables imaging of long bones and is designed to help minimize radiation by preventing patient and surgeon exposure to the unused area of the detector. •

SIEMENS HEALTHINEERS Artis icono floor

The ARTIS icono floor from Siemens Healthineers is a floor-mounted, single-plane angiography system for vascular, interventional cardiology, surgical and oncology procedures. The system’s OPTIQ image chain redesigns image processing for 2D imaging, increasing image quality across a wide range of C-arm angles and patient weights, regulating acquisition parameters to automatically achieve optimal image contrast at patient radiation doses that conform to the ALARA radiation safety principle. The improved roadmap function creates subtracted angiography images for easier navigation of the patient’s vascular system during fluoroscopy. Case Flows provide personalized workflow plans to optimize imaging parameters and system positions, in addition to displaying layouts for the entire procedure. With ceiling-like flexibility and a footprint of 269 square feet, the ARTIS icono floor provides coverage for patients of up to 6 feet 8 inches without repositioning, as well as lateral coverage of 6.23 feet. With its additional axis, the system can achieve virtually the same angles as a ceiling-mounted system and free space for anesthesia carts, echocardiography systems and patient monitors. •

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COVER STORY

All Together Medical Imaging as a Collaborative Discipline

By Matt Skoufalos

I

n addition to holding the distinction of being the first true digital specialty in medicine, the utility of medical imaging in generating objective information about the body, its disease states, chemical processes and essential anatomical construction makes the discipline an inherently

collaborative one. At a time when patients’ entire medical histories can be synchronized with high-resolution pictures of their physical tissue itself, imaging has emerged as “a critical partner in clinical care for just about any other specialty, with very few exceptions,” said Dr. Christopher Wald.

COVER STORY

A radiologist of 22 years and the current chair of the American College of Radiology (ACR) informatics commission, Wald has seen the imaging field become both narrower at its highest levels and broader at its base, the ultra-precise data it collects helping to advance specialties throughout the world of medicine. In the age of personalized medicine, medical imaging is the connective tissue that supports professionals in every phase of the patient care continuum, from orthopedics to oncology to the emergency room. And the power of imaging to detect diseases before they are known to the patient – and while they are still curable – has saved countless lives in breast and lung cancer screening programs, which are typically run by imaging departments.

Because the quantitative data it yields help inform decisions around clinical interventions, medical imaging is front and center in cross-disciplinary conversations around diagnosis, treatment planning, post-acute care and research, Wald said. The same data produced by imaging devices enables computer-assisted quality assurance that even allows imaging systems to improve themselves, compensating better for artifacts, monitoring and reducing radiation doses, and helping department leaders “make data-driven decisions on the useful life of equipment based on its actual observed utilization,” he said.

Aside from any of those applications, however, medical imaging is fundamentally a referral-based specialty, Wald said; by that token as well, it is an inherently collaborative

discipline, distinct from other specialties. Radiologists must maintain good relationships with referrers to continue getting their business; more importantly, they must also keep up with research across a variety of disciplines in order to provide relevant analysis and reporting on the imaging studies they perform.

“We have to be engaged with clinicians,” Wald said; “unless we know what they’re looking for, we cannot provide that. The days of a radiologist simply describing what they see; that doesn’t cut it anymore. Today, you want a radiology report that is actionable, and stated in agreed-upon terms; a report that synthesizes the imaging information with the clinical information from the patient’s chart, and clearly states, ‘Here’s what I think this is, and, if necessary, here is what other imaging test might be helpful to clarify or follow a diagnosis.’ ” Increasingly, imaging departments are developing programs to assist in following such recommendations over time to ensure they are followed.

By those measures, he said, “If I want to be effective, I have to collaborate.”

From a patient perspective, Wald said it’s “absolutely desirable” for clinical colleagues to collaborate with one another as well. He sees these opportunities as occurring “upstream from imaging,” i.e., clinical decision support in identifying the correct exam prior to performing it; and “downstream,” in clear reporting that follows to the referring physician. Wald also advocates for radiologists to make themselves available to their referring colleagues and patients to discuss and clarify their findings.

“On occasion, the radiologist’s opinion may differ greatly from the referring provider’s, and the recipient

of the report will call you back and say, ‘let’s look at this together,’ ” he said.

“Other times, the radiologist will completely redirect the clinical thinking and action with an unsuspected imaging diagnosis. Mutual trust and good working relationships contribute directly to safer patient care.”

One of the contingencies of being a digital specialty, however, is that medical imaging is entirely dependent upon informatics support, and in Wald’s estimation, that can either accelerate or impede its success. There are myriad technologies that support medical imaging in its totality, but the fundamental three – electronic health records (EHR), natural language transcription systems and PACS – “may have all evolved in silos at many facilities,” Wald said, and lack optimal front-end interoperability from the user’s perspective.

“While some imaging departments are fortunate enough to be working with a dedicated radiology informatics team that reports to them and maintains special knowledge about imaging IT over time, others may have to deal with enterprise informatics teams made up of general IT support specialists, who may not have the opportunity over time to develop the specific imaging informatics knowledge to be completely effective,” he said.

“In addition, there are multiple custom interfaces that have been built in imaging departments to facilitate the flow of data, all of which are slightly different from each other,” Wald said.

“Therefore, maintaining a well-functioning and optimized workflow for radiology departments and individual radiology tasks is no small feat.”

IT systems can offer better native interoperability by way of a single sign-on across platforms. Workflow ICEMAGAZINE

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COVER STORY

language can be ambiguous.

Whether it’s a paper chart or an EHR, the inherent ambiguity of unstructured language may limit our ability – or the computer’s – to properly utilize information that was created by a clinician, and to put that knowledge to work figuring out what diseases or symptoms may be present. Radiologists themselves have been known to dictate detailed descriptions of an imaging study in their very own personal style. I call this ‘radiopoetry,’ tongue in cheek, but unfortunately, this can sometimes make it hard for others to understand or act on their findings.”

“In philosophy and poetry, you can create a beautiful tension by using language in a nonstandard way,” he said, “but when it comes to the transmission for information in health records and medical reports, you really don’t want that.”

As the current chair of the ACR Informatics Commission, Wald also supports work to resolve some of those natural language concerns.

He cites the ACR-developed (Breast Imaging-Reporting and Data System) BI-RADS as a poster child of how “we’ve standardized” the lexicon and reporting measures to help ensure that “the downstream people know exactly what the radiologist diagnosed on the mammograms.”

Through committees of radiologists and referring physician consultants, ACR is also supporting the development of RADS that are applicable to other imaging subspecialties. Radiologist volunteers and ACR staff also are building out ACR Assist modules that encode these RADS systems, giving

“ We have to be engaged with clinicians, unless we know what they’re looking for, we cannot provide that. The days of a radiologist simply describing what they see; that doesn’t cut it anymore.”

Dr. Christopher Wald support software can help imaging departments create structured work lists that can be shared across locations, prioritized by clinical criteria, and which have access to patients’ clinical and imaging histories.

“If you want to achieve this level of integration and enhanced workflow, you really need help and investment to get such a workflow solution, and you need help from your imaging IT department to make that happen,” Wald said.

“New clinical knowledge in general, and information about individual patients specifically, is emerging so quickly as to outpace the ability of an individual human being to keep up,” he said. “In all but the biggest institutions, which have so many radiologists that they can be super sub-specialized, we’re at risk of falling behind in having all the information top-of-mind that we need to properly interpret the image.”

“We face a massive information management challenge,” Wald said, and addressing it will require technological solutions to interoperability challenges as well as shifts in thinking from practitioners. Developing a more precise, shared language in EHR and case reporting will enable IT-based systems to leverage their heft fully in support of radiologists’ interpretations.

“Medicine is practiced by humans,” he said; “humans use language, and 32

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the imaging industry an opportunity to include them inside the voice-recognition applications radiologists use in practice. With further advancement of a shared, standardized language, Wald expects that “the reports that we hand back to our clinical colleagues and patients can be as relevant, unambiguous and actionable as possible.”

Nicole M. Patterson, director of clinical engineering at UC West Chester Hospital in West Chester Township, Ohio, believes that “targeted communication” helps keep her staff familiar with the needs of the imaging department professionals with whom they interact. Her technicians make their rounds among imaging staff daily, building one-on-one relationships that establish a foundation for her own weekly contacts with them. Being proactive to their needs at a granular level helps to strengthen those interdepartmental relationships at a directorial level, where higher-level conversations about the 6,500 devices she oversees can occur.

“From director to director, we’re reviewing contracts, we’re reviewing any type of critical device trends; if there’s failures, what are we doing to mitigate those,” Patterson said.

Across UC Health System, the imaging and clinical engineering teams hold monthly enterprise imaging meetings that are also attended by nursing staff and other hospital leaders – “almost the same attendees that would attend our capital equipment discussions,” Patterson said. It’s a recent change that “is definitely beneficial,” because it offers the opportunity for all stakeholders to discuss their shared concerns ahead of capital purchases, she said.

“They’re a listening ear, and there’s a summary report that’s drafted, so when we’re at the capital equipment table, they’re not blindsided,” Patterson said. “Afterwards, people who aren’t usually as in the weeds [with individual ADVANCING THE IMAGING PROFESSIONAL

COVER STORY

devices] as the imaging department and we are do remember maintenance information on a certain device, or that there’s uptime issues in certain areas when it comes to capital equipment.”

Those roundtable meetings have led to a deepening of inter-departmental relationships during the normal course of their operations, as well as more frequent conversations about ways in which those involved in the talks can support one another, particularly during the novel coronavirus (COVID-19) pandemic.

“We’ll meet formally monthly and quarterly, but between that, as events occur, we’re on top of those,” Patterson said. “I’m definitely proud of where we’re moving, not only as a site, but as a system. We talk daily on an operational level, so if there’s any concerns there, we’re able to send a staff member. In this time as we’re fiscally strapped, communication has been very important.”

The high visibility of imaging equipment metrics available to both Patterson’s department and the UC West Chester imaging team also offers opportunities for each unit to derive performance improvements across the board.

“Data is so powerful that sometimes you get the question that you didn’t want to answer,” she said. “Sometimes it’s information overload. The beauty of providing visibility on how we operate is that my direct counterpart within imaging is aware of what’s going on, or can even question it. There’s times I can think something is mission-critical, but my director can say, ‘This can actually wait.’ ” “I really feel like being able to lay everything out on the table, being open to input or opinions, that’s happened here a lot,” Patterson said. “It’s definitely a collaborative space here.”

Daniel Gonzales has spent 30 years of his 35-year radiology career in leadWWW.THEICECOMMUNITY.COM

ership positions, and 20 of those as an issues that arise before any problem is imaging director. In those roles, Gonzaexacerbated. les, currently the director of diagnostic “Hospital staff can get in a rut,” imaging for Carlsbad Medical Center in Gonzales said. “I say, ‘If you have an isCarlsbad, New Mexico and vice-presisue with the department, please come dent of the American Society of Radioto me. I can get this settled, I can work logic Technologists (ASRT), said he’s with the staff to know what the issue is, learned that the best way to improve and if we can’t get this solved, we’ll go inter-departmental collaboration is by to the next level.’ ” fostering one-on-one relationships with “I like to have a really good rapport staff throughout the facility. with physicians, radiologists and ad“What I’ve found out over the years ministration; through communication of being able to work with the nursing and collaboration, that’s how we’re staff and the medical staff – building going to get things done here,” he said. that relationship, and trying to realize Gonzales leans on those personthat we’re all in this for the same thing al relationships and the hierarchy of – is without imaging, you lose a lot,” departmental leadership to foster Gonzales said. “We’ve found out in the important conversations around coronavirus era that these departments issues like staffing, as well as clinical whose employees have been affected concerns and equipment upgrades, in by coronavirus have put a big stress on which numerous stakeholders share the facility.” interests in the outcome. Managing Throughout the pandemic, two inter-departmental chains of commuimaging technologists under his supernication for the long term offers vision have missed time from work because of the virus; the temporary loss of one, a sonographer, “put a big strain on our ultrasound unit,” Gonzales said, “because he’s the only one who does echocardiograms.”

Nicole M. Patterson “They realized that we’re in a situation where you have to work together significant benefits for everyone to have a solution,” he said. “Once we involved; failing to do so can invite just start losing staff, it’s going to be a realas many setbacks. ly tough place to work.”

“Keeping up with technology is one At Carlsbad Medical Center, colof the main goals as a director,” Gonlaboration is fostered through daily zales said. “I have to take it day by day, encounters among various staffers and month by month, through changes whose tasks lead them to interact with of administration, and work at upgradmembers of one another’s specialties. ing our system yearly.”

Director-level conversations hap“We have to build towards that,” pen almost daily, and Gonzales says he said. “I need collaboration among department leaders work to settle any physicians when I do this.” •

“ I really feel like being able to lay everything out on the table, being open to input or opinions, that’s happened here a lot. It’s definitely a collaborative space here.”

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INSIGHTS

CODING CERTIFICATIONS T CODING/BILLING

BY MELODY W. MULAIK

here is always a lot of discussion in the health care industry about the need for “certified” coders and the potential benefits to health care entities that employ individuals who are credentialed in various aspects of coding, billing and compliance. Many radiology departments and imaging organizations struggle with this issue because it is not always clear what the benefits or advantages of being, or having, a certified coder really are for the organization. If it is determined that a coding certification is desired, then the question arises as to whether a radiology specific or general certification should be obtained.

There are several questions that should be asked prior to supporting or obtaining a certification: What is the national recognition of the certification? Who recognizes or accepts the credential? How will the individual obtain continuing education units (CEUs)? Is the organization really a member focused nonfor-profit entity or is it a private for-profit company?

To meet the requirements for a nationally recognized certification, there are a number of criteria that must be met. First, the organization that will develop, oversee and administer the examination generally contracts with a company that specializes in the creation of certification programs. These organizations include individuals known as psychometricians, who specialize in scientific test development. This organization then determines the optimal number of test questions, the categories of items to be tested (e.g., for medical coding, number of diagnosis questions, CPT® questions, HCPCS questions, etc.) and initiates the gathering of test questions and scenarios.

Once this process has begun, the organization assembles a panel of subject matter

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experts (SMEs) from across the industry or specialty who review the questions, add detractors or distractors (the wrong answers in multiple choice questions) and verify the correct response with authoritative coding guidance (depending upon the question database used, this verification may include publication, page number, etc.). Any nationally recognized certification must be able to survive a legal challenge by documenting the authoritative source for the correct answer.

A major consideration for individuals who must pay for their certification and ongoing education credits is the availability of products and seminars that contribute to the acquisition of continuing education units (CEUs). It is important that the CEUs be readily available and affordable, and that the presentations or products that qualify be relevant and pertinent to the type of work performed by the certified individual.

The certification process is expensive, regardless of whether the examination fees, CEUs and other charges are paid by an employer or the certified individual. The result of such an investment should be a nationally recognized, genuine certification that is accepted in the medical community and contributes to the career goals of the certified professional.

There are only two (2) radiology specific certifications that meet the criteria outlined above and they are both offered by the Radiology Coding Certification Board (RCCB).

These certifications are the (Radiology Certified Coder) RCC and the (Radiology Certified Coder-Interventional Radiology) RCC-IR. There are other radiology specific certifications on the market; however, these exams did not follow the previously outlined steps nor are they managed by a separate and distinct not-for-profit examination board. • MELODY W. MULAIK, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA, is the president of Revenue Cycle and Coding Strategies Inc.

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INSIGHTS

SPONSORED CONTENT

VIRTUAL SALES VISITS: MEETING THE CHALLENGES OF A PANDEMIC

BY JODI SHAFFER WITH THE BANNER IMAGING BUSINESS DEVELOPMENT TEAM

A

t the beginning of the COVID-19 pandemic, the whole world seemed to change overnight. Although deemed an essential service, many medical offices transitioned to telemedicine or simply closed their doors temporarily, drastically affecting those who provide services for them. On the other side of the equation, many companies, like Banner Imaging, moved to protect sales employees as well as the community by pulling sales teams out of the field. No longer could sales reps physically visit offices to perform their communication and service responsibilities, which is the main way this has been accomplished historically. They had to find other ways to get the job done.

Our team, as well as many others throughout the U.S., pivoted quickly to virtual visits, which can be conducted by many different communication vehicles such as telephone calls, text messaging, instant messaging, fax, email or video conferencing. We found that many of the same techniques of physical visits still apply to virtual visits, although sometimes virtual visits require a slightly different approach.

From this experience, we have compiled a list of helpful tips and tricks for making virtual visits, which we have shared below.

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ICEMAGAZINE | DECEMBER 2020

Like physical visits, it is still helpful to plan your day. Write down the offices you want to reach out to and keep track of those contacts. If you do not finish reaching out to the entire list, roll over the offices you didn’t visit to the next day’s list. Planning helps you to not only ensure you are communicating with all offices regularly, but it also helps keep you accountable for what you accomplish. You will likely still have offices calling for service issues. Be sure to balance your touch points between incoming requests and outgoing service calls. Stay in front of the communication with your contacts so that your communication with them is not only for service issues. Since out-of-sight can become out-of-mind, remind your contacts that you are still easy to reach and available to send out information needed, even though you are working remotely. Be flexible to their needs and adapt to their schedule if necessary.

Try every line of communication. Find out what form works best for each contact or office and then individualize your communication method with each contact. Keep track of what works best for each person. If you send emails with attachments, send both an attachment and an in-line graphic as some people view emails differently than others, and in these days of email scams and phishing, they may be wary of opening attachments. If you are assisting with technology or an issue that requires you to physically show your contact how to perform a task, like accessing images in PACS, set up a videoconferencing meeting, even if you don’t use video. These types of meetings allow your contact to share his ADVANCING THE IMAGING PROFESSIONAL

or her computer screen so that you can more easily pinpoint where there might be an issue. Don’t be afraid to set up a Connect Meeting or a virtual coffee. Often people are more willing to set aside a specific time when they can better focus on your message.

Remember that sales is about relationships, whether that is in person or not. Be sure to keep in touch with your primary contacts, but don’t be afraid to forge new relationships in this virtual world. If you ask the right questions, you can often find out when new staff members have been hired since you can no longer simply see the new faces in the office. Get to know them virtually as well. People are often very willing to be helpful if you just ask. It’s also a good idea to make sure that you are communicating with multiple contacts from the same office if possible. Not everyone is skilled at relaying information to others; sometimes they forget, or they simply get busy. Contacting many people in an office ensures that your message is getting relayed to all the people who need it. Always try to use the names of the contacts that you reach. You never know when someone who answers the phone will become your primary contact.

Email blasts can also be a great communication tool, but don’t just leave it at the email. Be sure to follow up with another method of communication, like a phone call. If you have a conversaWWW.THEICECOMMUNITY.COM

tion with someone, send a recap email that states the information that you discussed and how to contact you if they have any questions. This also gives them something to refer to later if needed. If you send something by mail, call to follow up to ensure they received it.

Find reasons to make contact. Review your data and use it to thank them or question them on the differences you are seeing. Touch base with your leaders to find out if any provider offices need follow up, and don’t forget to ask what you can do to improve services for them. If you have a team, share your intelligence and work as a team on shared offices. This can help you to have a comprehensive strategy and help you to find reasons for contact.

Most of all, be persistent. Visiting offices in a virtual environment can be a challenge, but it doesn’t mean that you must provide anything less than excellent service, nor does it have to affect your sales relationships. Staying flexible and individualizing service can help you keep those relationships strong and keep your business top of mind, even in a pandemic. •

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INSIGHTS

EMOTIONAL INTELLIGENCE

BY DANIEL BOBINSKI

SHOWING RESPECT IS GOOD CUSTOMER SERVICE

C

ommerce is not just the buying and selling of goods and services. Our friends at Merriam-Webster tell us that commerce is also the “exchange of ideas, opinions or sentiments.”

Everything listed above is required in society, and whether we’re the provider or consumer of any of it, commerce is always better when it’s conducted with respect.

Imagine you’re in need of a service, and two businesses near you provide that service.

One has a reputation for showing respect to everyone who comes in, while the other is more matter of fact. It’s not that the second company is disrespectful, they just don’t create a welcoming atmosphere.

All other things being equal (price, quali-

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ty of result, etc.,) which business would you choose?

Statistics show that after only two negative incidents at any place of business, customers are likely to shop elsewhere. That’s not a lot of wiggle room. Think of it as “two strikes and you’re out.”

Do you ever wonder how many customers your business may have lost due to customer service blunders? In a survey of more than 2,000 consumers in the U.S and the U.K., nearly half of the respondents said that poor customer service led them to switch to a different service provider in the past year.

Worse yet, the people who switch rarely tell you why.

Consider the following examples of poor customer service: • A customer service rep on the tele-

ADVANCING THE IMAGING PROFESSIONAL

• •

phone saying, “I’m sorry, there is no supervisor for you to talk to.”

A company not responding to a letter outlining a bad experience.

An employee listening to a person’s concerns but acting like those concerns are not important.

Think about it. If these things happened to you, how long would it be before you stopped patronizing the business?

Results from another survey, this one polling 1,000 U.S. consumers about shopping experiences in a wide variety of industries, indicate that consumers are tired of receiving poor service.

• More than 75 percent said they would hang up after waiting on hold for longer than five minutes.

• More than 80 percent would rather visit the dentist, pay their taxes or sit in a traffic jam than deal with an unhelpful representative.

• 75 percent said that they tell friends and family about their negative experiences.

• 85 percent reported that negative customer service experiences drive them to switch providers.

With statistics like this, it’s fairly obvious that anyone having direct contact with customers should be trained on how to express concern to others, and how to meet their needs, wants or desires. Add bonus points for showing an attitude of gracious appreciation.

The current world environment is even more reason for going over and above in this arena. In fact, research appearing in the California Management Review indicates that treating customers “adequately” is not enough to keep them anymore. Amazingly, satisfied customers will return to do business with you 28 percent of the time, but delighted customers will return 85 percent of the time. That’s HUGE. With those statistics, it only makes sense to provide outstanding customer service.

But let’s not restrict this idea only to paying customers.

Let’s expand our application to different departments within a larger organization. It’s never healthy to think of different departments as “us vs. them.” Everyone in an organization is on the same team, and treating co-workers as customers has been shown to increase morale and make a positive impact on the bottom line.

HELPFUL HINTS What follows are five helpful hints that can be adapted by any organization to help improve customer service.

Hint #1: Whenever possible, learn the names of your customers and/or coworkers and use their names when talking with them. This holds true even across departments in large

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companies.

Hint #2: Be cheerful. If someone is conducting a standard transaction with you, be glad to see them and/or hear from them and thank them wholeheartedly for bringing you their business.

If someone is bringing you a complaint, indicate that you take the issue seriously and that you’ll strive to resolve the issue as quickly as possible. Be sure to apologize!

Hint #3: Be prompt in all matters. In today’s world, even microwave ovens and 5G smartphones can be considered slow. Amazingly, slow service or response is one of the biggest complaints in the customer service realm, and yet it’s one of the easiest problems to resolve. Therefore, get on every service opportunity as fast as possible.

Hint #4: Get specific by asking, “How can I help you?”

This helps the customer (or co-worker) pinpoint his/her need so you know exactly where to focus your service.

Remember that your customer may not know exactly what your action should be, but they know what results they want. It’s your job to ascertain what results they’re looking for and then determine which actions are required of you to create those results.

Hint #5: When possible, compensate for confusion and mistakes. One example of this is restaurants not charging for an error or offering special coupons for future visits. If a home improvement store messes up an order on an appliance, they might offer free delivery or free installation of the appliance as a way to say, “We’re sorry.” Service industries can discount the fee charged for a service.

With so many ratings and reviews available on the Internet, consumers can shop and compare more today than any other time in history. That means outstanding customer satisfaction is an absolute must just to keep customers coming back.

Granted, every organization will have hiccups from time to time, and customers won’t get the service they deserve.

And yes, those situations may result in lost business. But the more you emphasize the service part of customer service, the more likely it is that your customers will hang around and speak well about your organization.

In today’s economy, that can make all the difference. • DANIEL BOBINSKI, M.ED. is a best-selling author and a popular speaker at conferences and retreats. For more than 30 years he’s been working with teams and individuals (1:1 coaching) to help them achieve excellence. He was also teaching Emotional Intelligence since before it was a thing. Reach Daniel on his office phone, 208-375-7606, or through his website, www.MyWorkplaceExcellence.com.

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INSIGHTS

AUSCULTATION AND REMOTE AI D

r. Gil was reviewing a well-designed SMS (texting) communication system that allowed the response from the patient to be monitored by artificial intelligence triage software. He loved the idea and ability to launch a real time telehealth face-to-face consultation if needed within the application. “I really love this product, but can I measure something remotely to help me decide what advice to give?”

PACS/IT/AI

BY MARK WATTS

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In my previous article I spoke of how an automated external defibrillators (AED), could instruct a lay person to shock a patient if needed. The sudden heart attack, a life or death event allows us to create a system in the AED to aid in a cardiac event. What would it take to help with respiratory events?

What if Dr. Gil could get a stethoscope to listen to lung and heart sounds remotely?

Could he recommend to an asthmatic child’s parents what to do via telemedicine?

Auscultation is the action of listening to sounds from the heart, lungs and other organs – typically with a stethoscope. It takes quite a few listens before a practitioner can decide if the patient is healthy or not. It takes practice.

StethoMe aims to save you the time and practice needed to become a pro and interpret the data. You do not need the years and years of experience a pulmonologist must have to interpret the auscultation records.

StethoMe tells you all a parent really wants to know whether your child’s respiratory sounds are healthy or not. And after consulting a doctor, you will be sure about what to do next.

It is frustrating for parents to see a child battling an illness and not to know how to help or how serious it is. After all, we just

want to do everything we can for them. No wonder there are millions of unnecessary visits to the ER every year. So, an AI-powered stethoscope at one’s home could give a peace of mind to parents. In the long run it could also save time for doctors and money for hospitals.

A new and exciting idea in health technology for sure. So, how did they come up with it? And what lies ahead for this company?

“The idea comes from the co-founders of StethoMe – Dr. Honorata Hafke-Dys and Dr. Jędrzej Kociński. Both are scientists, but also parents who struggled with their children’s frequent respiratory tract infections. After going through this experience, Honorata and Jędrzej discussed the idea of a home stethoscope that could potentially change the lives of many families around the world,” explained Wojciech Radomski, CEO of StethoMe. The Poland-based company’s software and device have already received the European CE Mark and are waiting for FDA approvals to expand into the United States.

The smart stethoscope is aimed at parents with young children. When there is a sign of sickness, after a quick auscultation, the AI can help parents and doctors work as a team to decide on the next step.

But fear not, fellow adults, we do not have to feel left out. The company is working on algorithms for identifying respiratory sounds in adults and recognizing heart sounds as well.

The product comes with a quick start guide, the stethoscope and a charger cable.

The design of StethoMe is light, wireless and minimalistic with a bright display. It is made from plastic, yet it doesn’t feel or look cheap. There are no buttons on the device, just a jack socket, so you just shake it gently to wake it up. It will re-enter sleep mode automatically when not used. You can tap the ADVANCING THE IMAGING PROFESSIONAL

display to switch between auscultation modes or to turn it off.

The device works as a regular stethoscope without the app – you only need to plug in your headphones, and you are ready to go. To unlock its full potential, you will need to download the app (supports both iOS and Android).

With headphones on, it is quite loud and, unfortunately, you cannot adjust the volume.

A parent would need to create an account and accept user permissions for the exciting part to begin. For the app to pair with your stethoscope, you will need Internet access, Bluetooth connection and location services turned on. I am not a big fan of providing more than necessary data to anyone. It would be a better user experience if we could choose not to give location permission.

The most important features of the StethoMe stethoscope include lung and heart examination, keeping record of medical history, artificial intelligence-based analysis and “full flexibility in terms of integration and API for the doctor’s analytical panel.”

I believe AI plays an important role in the future of medicine, stethoscopes and other medical inventions using neural networks could be as common and a basic part of your medicine cabinet as thermometers today. Let us see what this device can do, to prove my point!

Auscultation is made easy. First, you will be asked to set the age of the patient and choose whether you wish to auscultate the heart or lungs. The

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device automatically connects to the app. The instructions are easy to follow and there is always a picture to help you with every step. That is why setting the age of the patient was important during the first step. To make our lives a bit easier, the app shows us a picture of a child around the set age, with the points of auscultation indicated.

You will need to follow the animation on the screen and place the device on the skin for it to start recording. You do not have to push any buttons; the process is fully automatic. Auscultation can stop when the background noise is too loud. This could be a problem, especially with children feeling impatient and irritated.

After the whole process the app will immediately inform you if the child has abnormal (red) sounds or normal (green) results. The results are automatically analyzed and sent to the platform for doctors and parents to see in more detail.

It does not provide you with a diagnosis, but you can share the results with a pediatrician, and in case of abnormal sounds, they could ask to see the child in their office, in the ER or to stay at home and look for changes in their condition.

In the more detailed desktop version for doctors, we can also see the diagrams of the recordings, play back the sounds and find more information on the quality of the abnormalities.

(StethoMe categorizes these sounds according to the European Respiratory Society’s guidelines as wheezes, fine or coarse crackles, and rhonchi.) On the diagram you will be able to see if these happen during inhalation or exhalation.

Changes and innovation do not seem to steer clear of pulmonology either. If a smart stethoscope goes mainstream, doctors will have more time to focus on patients who they really need to see in person. A universal standard in such a subjective examination format as auscultation might lead to patients receiving more precise care.

People do not like change. It is not any different in health care. It took

But when it comes to our comfort, fun or just a truly gamechanging idea, we find it easier to welcome new inventions into our lives. plenty of time until the stethoscope, the symbol of health care, was accepted by the medical community back in the 19th century. The instrument was invented by French physician René-Théophile-Hyacinthe Laënnec, who published its description in 1819, but it took several decades until doctors started using it.

But when it comes to our comfort, fun or just a truly game-changing idea, we find it easier to welcome new inventions into our lives. A home stethoscope backed with AI could give parents an ease of mind, save children from an unnecessary trip to the doctor and assist health care providers to make the right call (and medical students to learn a bit quicker).

The current situation with AI and neural networks, digital health gadgets and the steady mindset change about telemedicine are all significant stepping stones to a better future. So, let us hope for a quicker change this time!

I think about the asthmatic children in smog-filled cities or areas with wildfires. I believe that a product like a home stethoscope backed with A.I. could make Dr. Gil and parents feel better about their caring and compassionate health care decisions. • MARK WATTS is the enterprise imaging director at Fountain Hills Medical Center.

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INSIGHTS

PAUSE, REFLECT AND GROW A RAD HR

BY JANEL BYRNE

s the year 2020 is coming to a close I have many emotions. I’m ready to say goodbye to 2020 and I’m increasingly uncertain with what 2021 has up its sleeve. I also know 2020 brought dramatic change and turmoil, while presenting opportunities for unexpected resilience and growth. It’s been a huge year of learning and, as leaders, learning is life-long and vital to how we show up.

With the hopes of capitalizing on the important lessons of 2020, I contacted a talented leadership and communications coach, consultant and facilitator, Lynnette Ward. I have the privilege of learning from Lynnette for a few years now and she graciously shared her annual process for reflecting and setting personal and professional goals.

As Lynnette recalls, her process

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stemmed from when she started her path as a coach/consultant and thought back to the importance of sales meetings during her business development roles as a time to debrief the previous year and set new goals. Additionally, for her, it was about the importance of stepping away for clearer thinking. Her first “annual retreat,” as she calls it, was when she went to Australia for just over 3 months after leaving her former career of 12 years. This adventure is where she achieved the clarity she needed to change careers.

She’s since kept the annual retreat as part of her process. It takes place in January to kick off the New Year where she goes “off the grid” with out of office messages up and her phone tucked away. While on her own, she spends her time gaining clarity around next steps and setting SMART goals. These goals are Specific, Measurable, Achievable, Relevant And Time-bound and she has ADVANCING THE IMAGING PROFESSIONAL

a number of accountability buddies in her life who support her ability to maintain this process and achieve the goals she sets for herself. Plus, she sets quarterly checkins to track her own progress.

Critical to Lynnette’s ability to reflect and set goals are a series of personal and professional questions to uncover what she has learned and, subsequently, what she wants to achieve. These questions include: • What went well this year?

What did not?

• Where did I excel?

• Is there something I never want to do again?

• What skills/knowledge do I need/want to master?

• What partnerships will I choose to repeat?

• What partnerships will I choose not to repeat?

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•

What partnerships do I want to build?

• What will I give up to make time to add new skills/ knowledge/partnerships?

• What did I learn this year?

• What did I accomplish this year?

• Am I staying on mission?

• Based on these reflections, what goals do I want to set?

• How will I stay accountable to these goals?

2020 has presented some of the most rewarding and excruciating leadership moments for me. It’s essential I understand where my strengths flourished and identify strategies for continued growth. It’s through these lessons and personal work I am able to lead and contribute value to my organization.

As I think about my own annual

retreat, time is already protected on my calendar, away from distractions, to dive deep into the aforementioned questions. I also intend to ask a few people to be my accountability buddies to support my ability to take this time to reflect, set and achieve my 2021 goals, Lynnette being one of them.

Don’t let the leadership lessons of 2020 pass you by – pause, reflect and grow!

The annual retreat is one of many leadership tools added to my toolkit by Lynnette Ward. For additional information, tools or partnership, she’s readily available via: linkedin.com/in/lynnetteward or lynnettejward@hotmail. com and be sure to tell her you learned about her annual retreat from this article.•

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INSIGHTS

MAKE VIRTUAL MATTER W Many choose to attend a virtual conference while multitasking at their daily job.

e now live most people I’ve spoin a world ken with feel there is a of virtual significant decrease in events. Many of us value associated with who are used to participating through experiencing life in the virtual environment. person – whether it There are things we can be concerts, condo to improve our exferences or even perience, and ultimately family activities – the outcome, by reimagDEPARTMENT/ have had to adapt ining how we consume OPERATIONAL ISSUES the conference events to experiencing life

BY JEF WILLIAMS through electronic virtually. formats. This has affected the way we learn, the way EDUCATION we socialize and the way we work.

As with most conferences, RSNA is driven The impact this has had on our largely by its educational component. Raindustry is felt significantly in the diologists, other clinicians and even operway we are managing educational ational leadership find tremendous value events and conferences. Beginning not only in completing additional CEs, but with the HIMSS conference this in engaging topics and research in ways past March through RSNA which that expound their understanding of the is scheduled to begin in late Nofuture of radiology. Of all the components vember, every major conference in of an annual conference, education may the imaging space has been virtube the best served by a virtual experialized in 2020. This has been felt ence. While the challenges associated of by all of the various participant presenting material virtually can increase stakeholders I have interacted its difficulty in delivery, attendees can with, including educators, attendleverage the virtual platforms to expand ees and vendors. the educational experience. On-site If you have participated in any virtual conferences in the recent past you have likely experienced a software platform designed to replicate the conference experience in a 2-D format. Graphic designers have developed a “game-like” experience where your mouse and keyboard replace your feet and hands. While this may provide some level of engagement,

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ICEMAGAZINE | DECEMBER 2020

conferences force attendees to choose between competing topics yet most virtual conferences provide for on-demand sessions that eliminate the need to be in a specific place at a specific time. This allows attendees to consume education at a pace and at times that are most convenient based on schedules or agendas.

Additionally, there is less concern associated with entering late or leaving early ADVANCING THE IMAGING PROFESSIONAL

based on how well the session meets expectations.

TECHNOLOGY Virtual platforms are the cause of real frustration for many vendors I have spoken with. Conferences are a primary channel for exposing existing and potential customers to new technologies.

The annual RSNA show goes beyond simply demonstrating software solutions and technologies. It is the largest imaging modality conference in the U.S. annually. While there may be some opportunities to demonstrate software enhancements and user experiences via virtual platforms it is very difficult when it comes to advances in modalities and room design.

There are, however, some ways attendees can engage vendors in the process of aligning meetings with strategic goals and objectives. While the opportunity to roam the aisles within the exhibit hall are significantly reduced experientially with a virtual conference, attendees can take control of the time and energy spent by communicating with existing and potential vendors.

Starting a dialogue and planning for specific meetings by generating agenda topics can maximize the vendor session.

This exercise brings tremendous value WWW.THEICECOMMUNITY.COM

organizationally as it requires one to review and prioritize organizational goals.

It also creates a true focus to the time spent with technology and modalities.

Finally, it drives the requirement that each vendor has the right resources participating to answer technical, functional or organizational questions.

NETWORKING The social value of attending conferences is what I hear from people the most. There are the formal networking events that provide for introductions and celebrating the shared interests of attendees and event promoters. But the real value of networking at conferences is rekindling old friendships, and spending time with people who we do not see often otherwise. As with most industries, the imaging space within health care is a constant concern for most of us who work within it. As a result, we forge friendships and long-term relationships with people as we navigate through our careers. Conferences provide the opportunity to check on people and enjoy talking over a meal.

While there are no virtual platforms that can come close to replacing the on-site experience of running into people or scheduling a coffee, there are things we can do as we approach a virtual confer-

ence to reconnect in meaningful ways.

Many choose to attend a virtual conference while multitasking at their daily job. This results in missed opportunities and reduced value overall. Consider taking time away (PTO), much like we would if we were flying to Chicago as a good approach to maximizing value.

Not only does this allow for focusing the blocked time on education and exploring technology, it can become the impetus for reaching out and scheduling one-on-one Zoom sessions with people with whom we would like to reconnect. In this year of virtualization, most of us struggle to maintain our long-distance friendships. Consider using the next virtual conference as the opportunity to reach out and schedule phone calls or Zoom sessions to check in virtually over a real cup of coffee â&#x20AC;&#x201C; or virtually over a real happy hour.

We all hope that 2021 brings us back to in person events and faceto-face conversations. In the meantime, let us pursue the best of what we can virtually. â&#x20AC;˘ JEF WILLIAMS, MBA, PMP, CIIP, is a managing partner at Paragon Consulting Partners.

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INSIGHTS

WHAT I WISH I KNEW THEN DIRECTOR’S CUT

BY MARIO PISTILLI

W

e have all heard the saying, “If I only knew then what I know now.” This is certainly true of my journey in this amazing career and wonderful life. I am constantly learning and growing and evolving. I have been so blessed with wonderful mentors that took their time to teach a sometimes dumb and often stubborn person. It is on the shoulders of these great people that I have achieved anything in life and for that I will be forever grateful. I hope that I can in turn help in the growth and development of others.

I want to share with you some of the important people and lessons in my life that because I am a slow learner took a while to sink in.

You need people that have your back. In climbing there is a concept of belaying, or the action of holding the rope to catch the fall of your partner. It is an act of trust and your life is literally in each other’s hands. We all need these people in our lives to catch us when we fall. In my life my two sisters, Minette Andrews and Marina McLaughlin, have had me on belay my whole life only I did not always realize it. They were my first teachers, and taught me to read and write before I ever hit kindergarten. They were hard taskmasters, but that head start served me well in life. My entire life I could always rely on them to push me and to be proud of any accomplishment no matter how small. I am sure that you have those people in your life as well, so reach out to them often and tell them thank you for being there to catch you when you fall.

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ICEMAGAZINE | DECEMBER 2020

Speak less and listen more. There is an old native American proverb, “Listen or thy tongue shall make thee deaf.” I still struggle with this one, as my brain fires off thoughts and I want to blurt them out. I wish over the years that I had listened more to my staff, my friends and my family. Steven Covey, in his book “The 7 Habits of Highly Effective People,” said “people don’t listen to understand. They listen to reply.” One of my coaches, Foster Mobley, uses the phrase, “the best leaders are world class noticers.”

You cannot notice things or be seeking to understand if you are focused on speaking. I have also learned that being a good listener may mean pulling information out of people by asking questions.

We over me. It may sound counter-intuitive, but putting others and the team ahead of yourself actually pays huge dividends.

Turning your focus outwards is also much less stressful. Try approaching situations with the attitude of helping others be successful instead of yourself. The best leaders understand that helping others to shine makes the room that much brighter.

Slow Down. Ashish Buttan, executive director of neurosciences CHLA, phrased it perfectly, “Everything cannot be accomplished by speed and aggression.” Sometimes it is OK to let a problem marinate if a solution is not readily at hand. Too often I rush into solution mode right away and keep hammering the square peg into the round hole. Give yourself permission to accept that you may not have all the answers right when you need them. Take some time to pause and do more research or just set it aside for a bit.

You can’t ask tomato plants to give you pineapples. I credit this proverb to Dr. Jose ADVANCING THE IMAGING PROFESSIONAL

Pineda Soto, head of the division of critical care medicine at CHLA. You cannot expect things from people that they do not have the tools or abilities to give. Make sure if you are not getting the response or output that you need or expect, that you have the right people doing the right tasks and the tasks they are trained and equipped to do.

Practicing personal care does not make you selfish. Only very recently have I really started to believe this. I always thought that working hard and neglecting myself was a sign of my dedication and work ethic. Actually it is the sign of my lack of maturity and good sense. If you really want to be the best leaders for others then practice self-care and resilience so that you can be your best self with others. Find those things that provide joy and resilience for you and take time to do those things. Also promote this with your teams and even with your co-workers.

Free yourself from focusing on what other people think. This is another one that took me this long to finally start to get. I let fear of failure or looking stupid

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hold me back from trying new things.

Only now have I learned that those that really matter don’t care and those that care don’t really matter. I credit this evolution to a small group of colleagues that I met during an executive training class (Dr. Cynthia Herrington, Dr. Susan Wu, Dawn Wilcox and Jodi Ogden), each of which are world-class leaders in their fields, wickedly smart and all around great humans. My longtime friends would be shocked to see me front and center at yoga class with Bunok Kravitz, aka the Yoga Bunny, but you will find me there on Saturday mornings next to the Venice Pier. By the way, I am the most awkward and least flexible yoga practitioner on the planet, but I no longer care. I have also committed to take dancing lessons, which is definitely my kryptonite. I encourage you all to let yourselves go and free yourself from meaningless self-constraints and do something that you have always been afraid to put yourself out there and do.

This is just a small sampling of all of the lessons I have grown to appreciate.

We are all a work in progress, and I

have so much more to learn. This will be my last Director’s Cut article for ICE as the year comes to an end. I am pleased to yield this column to a fresh and different perspective and look forward to learning from a new voice.

I wish to thank my loving wife, Suzy, and amazing son, T.J., for the understanding and support. They know I put them first, but also understand that learning and contributing to the health care and lives of others is my oxygen.

You will still hear from me as I resume my LinkedIn Series, Lunchtime Walk Thoughts in January 2021. You will also see some future articles and speeches in the coming months with all new content for 2021. • MARIO PISTILLI, CRA, MBA, FACHE, FAHRA, is administrative director for imaging and imaging research at Children’s Hospital Los Angeles. He is an active member and volunteers time for ACHE and HFMA organizations. He is currently serving on the AHRA national Board of Directors. He can be contacted at mpistiili@chla.usc.edu.

ICEMAGAZINE

47

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ADVANCING THE IMAGING PROFESSIONAL

SPONSORED CONTENT

MEMBER PROFILE

RADON MEDICAL IMAGING

BY ERIN REGISTER

R

Radon in a recent interview with Doak.

adon Medical Imaging LLC, one of two Radon companies with common ownership and shared marketing and support, started as a film and chemistry company in the 1970s by two gentlemen named Ray and Don. Over the years, Radon has evolved its business with the newest technology in medical imaging. Radon provides customers with the latest medical imaging systems that provide superior imaging quality with a very competitive cost of ownership.

Q:

Brian Doak, president of Radon Medical, has an extensive background in the medical equipment technology field, including 15 years in clinical engineering, 9 years of asset management oversight and 12 years with Radon. He serves as a member of Radon’s executive team, supporting sales and service efforts for their customers.

Radon is a member of the Association Medical Service Providers (AMSP), the premier national association of independent service and products providers to the healthcare technology industry.

ICE magazine learned more about

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How does Radon stand out in the medical imaging field?

Brian Doak, President bdoak@radonmed.com 540-890-1135

Q:

What is on the horizon for Radon?

A: Radon is able to stand out in our industry because of our employees. Each employee is highly trained and skilled in their area of expertise. Radon’s employees take customer service to levels that far exceed other competitors, including the OEMs. Radon’s dedication to customer service has granted us the privilege to have long-term relationships with our customers.

A: Radon is actively expanding our customer base throughout our large sales and service coverage area, covering the following states: Virginia, West Virginia, North Carolina, South Carolina, Maryland, Ohio, Pennsylvania, Tennessee, Kentucky, Delaware and Washington D.C. Radon has also expanded our product line in the past couple of years to include special procedures, including 3-D mammo, MR and CT.

Q:

Q:

A: Some of Radon’s core products include Canon Medical Systems, as well as Del Medical. A couple of our new products are Canon and Del Medical’s long-length imaging systems, as well as Fuji 3D Mammo.

A: Radon’s equipment service offerings not only include servicing what we sell, but also multi-vendor and multi-modality service on all major brands and models. Radon’s asset management services offer comprehensive service solutions to many of our customers.

2020 has been a hard year for pretty much every American. At this point, Radon is very fortunate to have been able to work through the COVID-19 pandemic and keep all of our employees and actually expand in 2020. •

What are some of the services and products Radon offers?

Q:

What has been Radon’s biggest achievement?

A: Radon has been awarded Canon’s Top Dealer. Radon also has been in the top three in U.S. sales with Del Medical.

One of our biggest achievements is the retention of our employees and long term relationships with our customers.

Is there anything else you would like our readers to know?

For more information about Radon Medical Imaging, visit radonmedicalimaging.com.

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“Life isn’t about finding yourself.

Life is about creating yourself.”

- George Bernard Shaw

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Science Matters

DNA from battlefield skeletons revealed a few were able to drink milk

New evidence came from DNA of people killed in a battle in northern Germany’s Tollense valley 3,200 years ago

Milk-drinking spread fast long ago Lactose tolerance – the ability to digest the milk sugar lactose as an adult – spread through the people of Central Europe in a few thousand years, starting 3,000 years ago.

Lactose tolerance, a DNA variation Advantage of being able to drink milk As humans evolved, tolerating milk brought major advantages: • It is high in protein and energy (carbohydrate) • It is cleaner, less contaminated than most water supplies • Milk improved chances of surviving famines

The ability to tolerate milk as an adult (a trait) depends on a multi-gene DNA variation involving multiple spots on a person’s genome

TOLERANCE

INTOLERANCE

DNA molecule

New discovery: The DNA

variation for lactose tolerance spread fast after arising in Central Europe

Milk drinkers today Approximate percent of total population that is lactose-intolerant Ancient battlefield

• Cattle, sheep, goats and camels all provide fresh, safe sources • Cheese, a milk product, is stable and nutritious

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Source: Joachim Burger of Johannes Gutenberg University Mainz; Current Biology; Food Intolerance Network; TNS Photos Graphic: Helen Lee McComas, Tribune News Service

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Stay warm this winter while advancing your career at ICE 2021 FEBRUARY 11-12, 2021 | FT. LAUDERDALE, FL

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different parts of the United States and seeing what they’re doing and building relationships with them.”

D. Jaramillo, Manager, Imaging Services Director

ICE 2021 FEATURED EDUCATION Inspire, Encourage and Empower

approachable with your team. Being resilient is an attainable goal that we must achieve!

Kenneth Fazzino, CRA, PMP, Director, Envision Physician Services

By the end of this session, attendees should have an understanding of different leadership styles, characteristics, and actions that can impact teams. We will discuss the characteristics of a successful leader and how they translate within our world. Empowerment is critical but must be done properly, we will review what makes it work.

Verifying Image Quality How to use an Ultrasound Phantom

Developing Your In-House Service Capabilities: Executing a MultiYear Plan

Dustin Telford, CRES, CHTM, CBET, CLES, Clinical Engineering Manager, Children’s Hospital & Medical Center Omaha Developing and maintaining a capable workforce is only one area that in-house programs, and those hoping to bring some services in-house, are challenged to manage to build a successful service program. During this presentation, the presenter will discuss how to develop a plan that incorporates contract negotiations, customer relationship management, and the quality to manage either a fully in-house program or a hybrid solution with business partners.

Brenda DeBastiani, MBA, BA, CRA, RT(R), FAHRA, Director of Imaging, Mon Health Medical Center and Carrie Stiles, MBA, CRA, FAHRA, RT(R)(CT), Houston Methodist Hospital All of us are experiencing more stress than ever, but why is it that some leaders thrive while others struggle? This presentation will talk about some of the most stressful situations that leaders undergo and how to use those events to be stronger and more

This session will review basic MRI principles along with safety and discussion of the ACR recommendations for MR safety based on the 2020 ACR Manual on MR Safety

Nicole Dhanraj, Systems Director, Northern Arizona Healthcare

This session will show how to use a phantom to verify and troubleshoot difficult problems with respect to image quality and show attendees how to use their skills to complete accredited PMs to OEM specifications.

How to be Resilient During Stressful Times

Susan MacIntyre, ARRT (R), ARRT (MR), MRSO (MRSC), CRA, MRI Supervisor, UPMC

Leading with Cultural Sensitivity

James Rickner, Director of Technical Services, MXR Imaging

Content includes worksheets and project planning resources.

MRI Safety Standards and Recommendations

You Say Your Staff Is Not Actively Engaged... Are You?

John Beall, Administrative Officer, Madigan Army Medical Center In 2020, Gallup released that the percentage of “engaged” workers in the U.S. -- those who are highly involved in, enthusiastic about, and committed to their work and workplace -reached 35% which is the highest level since the organization started tracking the metric on 2000. On the flip side, the report identified that the percentage of workers who are “actively disengaged” -- those who have miserable work experiences and spread their unhappiness to their colleagues -- was at 13%.

This means that a little over 50% of our staff falls under the “not engaged” category -those who are psychologically unattached to their work and company and who put time, but not energy or passion, into their work.

This population will usually show up to work and contribute the minimum required while always on the lookout for better employment opportunities.

During this session, we will learn how to improve and model engagement so that you can inculcate your team members that fall in the “not engaged” category.

5 Simple Steps to Develop Better Action Planning - A medical imaging capital case study

Perry Kirwan, CCE, VP Technology Management and Jason Theadore, CRA, CEO, Banner Imaging Services

needed. A beginner organizes information in a more random and error-prone fashion. A thinking model, like a playbook for a game or recipe for a meal, helps the leader learn more quickly and efficiently. Five simple steps can help any leader develop the proper plan of action for both strategic and tactical considerations: Stop & Think, Identify Assumptions, Evaluate Information, Draw Conclusions, Develop the Plan for Action.

The Importance of Imaging’s Role in the Patient Experience

Jason Scott, FAHRA, CRA, CPXP, Chief Patient Experience Officer, Witham Health Services Scanxiety is a relatively new term in medical imaging, but one that plays a huge role in a patient’s experience. Scanxiety is anxiety and worry that accompanies a period of time before undergoing or receiving the results of a radiology examination. The time period of when the referring provider orders an imaging test to the time the results are given can be very worrisome for the patient, as the patient experiences a high level of uneasiness of what the results might indicate.

It is up to us, as imaging professionals, to decrease the scanxiety level of our patients.

There are many behaviors that technologists can display to help minimize the fears that are felt by our patients. It is important to be empathetic towards our patient’s needs in order for them to have a more positive experience. Many times it is the “little things” like smiling, providing a gentle touch, or sitting with a patient, that makes the biggest impression upon our patients. However, it is up to leaders to portray a culture based upon delivering positive patient experiences.

The Magic 7 Triggers to Yes Manny Roman

We are not thinking machines, we are feeling machines that think. Modern real-time brain imaging techniques demonstrate what parts of the brain are activated under varying conditions. These imaging techniques prove that the part of our brains that control emotions is first to react to all input. It will make decisions based on emotions before presenting the information to the logical thinking part of the brain. We will explore 7 triggers that influence others to a “Yes” decision.

An expert, in any field, learns to group information around various principles. This allows the expert to quickly draw information when

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Diagnostic Solutions p. 37 SOLUTIONS

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ICE Webinar p. 9

W7 Global LLC p. 25

PartsSource, Inc. p. BC

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