ICE Magazine April 2021

THEICECOMMUNITY.COM

APRIL 2021 | VOLUME 5 | ISSUE 4

ADVANCING MAGAZINE

IMAGING PROFESSIONALS

Improving

the Patient Experience PAGE 36

and Your Bottom Line

CORPORATE PROFILE: PAGE 18

PRODUCT FOCUS

MRI PAGE 33

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FEATURES

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CORPORATE PROFILE

RISING STAR

Taylor Heron’s fast-paced imaging career includes future potential.

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The InterMed Group began as an X-ray service company in 1992, but it quickly expanded its service offerings to encompass ultrasound, nuclear medicine and X-ray.

COVER STORY

A focus on the patient experience can improve care, revenue and more. Imaging professionals share examples of how this approach has worked for them and their facilities.

OFF THE CLOCK

Banner Imaging Manager Laura Breuer shares in a spirited business with family members when not providing diagnostic imaging care.

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ICEMAGAZINE | APRIL 2021

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ADVANCING THE IMAGING PROFESSIONAL

REGISTER NOW!

RAD HR

Hit the pause button and focus on long-term solutions over short-term fixes.

30 WWW.THEICECOMMUNITY.COM

APRIL 2021

50

COMPANY SHOWCASE

MTMI opened its new international headquarters in 2020 with three state-of-theart classrooms in Milwaukee’s Research Park, near the Milwaukee County Medical Complex.

ICEMAGAZINE

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CONTENTS MD Publishing 1015 Tyrone Rd. Ste. 120 Tyrone, GA 30290 Phone: 800-906-3373 Fax: 770-632-9090 Publisher

John M. Krieg john@mdpublishing.com

Vice President

Kristin Leavoy kristin@mdpublishing.com

Editorial

John Wallace Erin Register

Art Department Jonathan Riley Karlee Gower Amanda Purser

Webinars

Jennifer Godwin

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Rising Star Taylor Heron In Focus Ann Podrasky, Radiology Associates of South Florida (RASF) section chief of ultrasound Rad Idea Masks and MRIs Off the Clock Laura Breuer, Banner Imaging Manager Corporate Profile The InterMed Group

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NEWS 22

Imaging News A Look at What’s Changing in the Imaging Industry 29 Webinars

Expert Shares Strategic Technology Planning Tips 30 Comapny Showcase MTMI

Jayme McKelvey Megan Cabot

PRODUCTS

Editorial Board

Account Executives

Manny Roman Christopher Nowak Jef Williams Josh Laberee Jason Theadore Nicole Walton-Trujillo

Events

Lisa Lisle

Digital Department Cindy Galindo Kennedy Krieg

Accounting Diane Costea

ICE Magazine (Vol. 5, Issue #4) April 2021 is published by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290.

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

For subscription information visit www.theicecommunity.com.

The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2021

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SPOTLIGHT

ICEMAGAZINE | APRIL 2021

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Market Report Reports Forecast MRI Market Growth 33 Product Focus MRI

INSIGHTS 40

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56 57 58 62

Coding/Billing Orders in the Hospital Setting Emotional Intelligence Maintaining Standards in the ‘Face’ of Change Director’s Cut Improving the Patient Experience PACS/IT Algorithms and Biorhythms Sponsored: Banner Imaging Getting it Right. At the Right Time. Every Time.

Revenue Modernization During a Worldwide Pandemic Rad HR The Power of ‘Pause’ Department/Operational Issues Handhelds and Governance Roman Review The Magic Trigger AMSP Member Directory AMSP Member Profile: Interstate Imaging

ICE Break Index ADVANCING THE IMAGING PROFESSIONAL

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SPOTLIGHT

RISING

STAR TAYLOR HERON

FUN FACTS Favorite Hobby:

Favorite Food:

Shopping

Extra cheese stuffed crust pizza

Favorite Show:

One Thing on Your Bucket List:

“The Home Edit”

Stay in a cabin and have a white Christmas

BY ERIN REGISTER

O

riginally from Laurel, Delaware, Taylor Heron, RT(R)(CT)(MR) has been in the imaging field for about five years. She began working for an imaging company in scheduling, then moved up to insurance, then to a tech aide.

“I enjoyed being a tech aide, so I decided I would probably really enjoy being a tech,” said Heron. “I absolutely love my career and am so glad I decided to go that route.”

Heron was nominated by Advanced Imaging Administrator Josh Laberee.

“In the three years she has been with me, she has gone from being an RT doing only X-rays to being fully licensed in CT and MRI,” noted Laberee. “She was born to do what she 10

ICEMAGAZINE | APRIL 2021

is doing, taking care of every patient like family. Her constant positivity is infectious, while her attention to detail on her exams and image quality is superb.”

ICE learned more about this Rising Star in a question-and-answer interview.

Q: WHY DID YOU CHOOSE TO GET INTO THIS FIELD? A: I always wanted to do something in the medical field, and after being a tech aide and seeing what all the technicians did, I really wanted to become that person.

Q: WHAT DO YOU LIKE MOST ABOUT YOUR POSITION? A: I like meeting so many different people.

ADVANCING THE IMAGING PROFESSIONAL

Q: WHAT INTERESTS YOU THE MOST ABOUT THE IMAGING FIELD? A: I love how every modality is so different.

Q: WHAT HAS BEEN YOUR GREATEST ACCOMPLISHMENT IN YOUR FIELD THUS FAR? A: The MRI registry was a very hard exam, I am still proud of passing that!

Q: WHAT GOALS DO YOU HAVE FOR YOURSELF IN THE NEXT 5 YEARS? A: I’d like to continue to move up the ladder, so I’m looking into getting my bachelor’s degree now. Ultimately, I’d like to be in an administrative-type position. • Taylor Heron enjoys time with family when not at work.

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ICEMAGAZINE

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SPOTLIGHT

IN FOCUS ANN PODRASKY

STAFF REPORT

A

nn Podrasky, MD, FSRU, FAIUM, earned a medical degree and residency training in diagnostic radiology from the University of California in San Francisco. She served as a fellow at UCSF in ultrasound and computed tomography. She also completed a fellowship in magnetic resonance imaging at Huntington Hospital.

Podrasky has been Radiology Associates of South Florida (RASF) section chief of ultrasound for over 25 years, guiding the expansion of ultrasound in the practice.

The Society of Radiologists in Ultrasound has elected Podrasky as a Fellow, a prestigious group of 114 North American experts in ultrasound. She is also an associate professor of radiology at FIU and an adjunct

professor at Miami-Dade College Medical Campus. She is medical editor for a major textbook, “Diagnostic Ultrasound: Abdomen and Pelvis.” She is a journal reviewer for three journals, the Journal of Ultrasound in Medicine, Ultrasound Quarterly and Abdominal Radiology and has twice been recognized as Reviewer of the Year for the Journal of Ultrasound in Medicine. She has been active on multiple national committees in her specialty and additionally served as an oral board examiner in ultrasound for the American Board of Radiology. Podrasky has presented topics at national and local radiology conferences and has published several papers, including for the American College of Radiology Appropriateness Criteria for Women’s Imaging.

Podrasky developed the Thyroid Ultrasound Clinic at Baptist Outpatient Center to promote excellence in thyroid diagnosis

“I approach leadership by treating all persons in the section with respect, setting expectations and coaching to raise performance.”

– Ann Podrasky

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ICEMAGAZINE | APRIL 2021

ADVANCING THE IMAGING PROFESSIONAL

ANN PODRASKY

Section Chief of Ultrasound, Radiology Associates of South Florida (RASF)

and thyroid cancer follow-up. She also has a strong interest in gynecologic and abdominal ultrasound, including ultrasound for liver surveillance, diagnosis and elastography.

She has implemented the only contrast enhanced ultrasound program in South Florida.

Also, Podrasky leads a team of radiologists with expertise in fetal MRI. She is a busy individual.

Podrasky’s goal since childhood was to become a doctor and when she discovered radiology she knew what her specialty would be in the medical field.

“Since I was young, my goal was to become a doctor. In medical school, I developed an interest in radiology during an elective when I realized I had the skill set for it,” she said. “From early in my radiology residency, I found an interest in ultrasound from my mentors to learn to scan and interpret the imaging.”

Podrasky continues to enjoy imaging, especially working in ultrasound.

“There are many things I love about my job. Ultrasound is a collaborative field and great for mentoring,” she said. “My sonographers are the radiologist’s eyes and hands, so I am very rewarded to work with them to train and improve their skills and knowledge.

We are all learning something every day, just when you think you have seen it all.”

The future of diagnostic imaging is almost certain to include more artificial intelligence (AI). Podrasky also expects to see advances in software and hardware.

“Besides new efficiency tools and AI, we continue to see new software and hardware developments to keep ultrasound an advanced tool within radiology,” she said. “We have been using contrast and elastography WWW.THEICECOMMUNITY.COM

for several years, but we look to have new applications in different parts of the body with new software and as evidence develops.”

She enjoys helping others and teaching the next generation of imaging professionals, but her greatest achievement is a reflection of her work and the understanding of her specialty.

“My greatest accomplishment was rising to the top of my field, being elected as a Fellow in the Society of Radiologists in Ultrasound, and then later a Fellow in the American Institute of Ultrasound in Medicine,” Podrasky said.

However, her focus is often on others and helping those around her reach new heights.

“I approach leadership by treating all persons in the section with respect, setting expectations and coaching to raise performance. I apply both standardization and individualization to exam performance, to give the patient the best answer for their individual problem,” Podrasky said. “Close teamwork is vital, in particular with our clinical specialists in ultrasound at the various facilities, and we all work to accomplish the mission of consistency and excellence in the ultrasound section.”

“I had incredible mentors at UC-San Francisco in the ultrasound field: Drs. Roy Filly, Faye Laing and Brooke Jeffrey. They taught me not only the physical part – how to scan, but how to think about our cases.

I hope to teach others in the same way, to use logic, but also excite to their passion for ultrasound,” she added.

When not working or teaching, she enjoys spending time with her husband. They have two adult sons – one is a U.S. Naval Officer and the other is finishing college. •

What book are you reading currently?

I am actually reading and editing a book, “Diagnostic Ultrasound: Abdomen and Pelvis,” for a publisher.

Favorite movie?

My favorite movies are “Apollo 13” and “Hidden Figures.” I love movies about the human spirit overcoming odds.

What is something most of your coworkers don’t know about you?

I once worked at NASA. Who is your mentor?

I think we can always get better at what we do, so I look at how other section leaders in our group do things for inspiration.

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

Drink coffee!

Best advice you ever received?

From my brother in college …

“Don’t let yourself get behind by more than a day.” Of course, I don’t always follow that now, but it was good advice in college.

Who has had the biggest influence on your life?

My mother. I knew she believed in me since I was 6 years old.

What would your superpower be?

My superpower would be automatically knowing what settings on the machine to change for a sonographer to get an optimal image.

What are your hobbies?

Travel, photography and blogging about ultrasound.

What is your perfect meal?

Chilean sea bass, sides and any type of chocolate dessert.

ICEMAGAZINE

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SPOTLIGHT

Rad idea MASKS AND MRIs

T

he U.S. Food and Drug Administration (FDA) is informing patients and health care providers that patients may be injured if they wear face masks (such as surgical or non-surgical masks and respirators) with metal parts and coatings during a magnetic resonance imaging (MRI) exam. Metal parts, like nose pieces sometimes called nose clips or wires, nanoparticles (ultrafine particles), or antimicrobial coating that may contain metal (such as silver or copper), may become hot and burn the patient during an MRI. The FDA recommends patients wear face masks with no metal during MRIs. When it is appropriate for a patient to wear a face mask during an MRI exam, such as during the COVID-19 public health emergency, ensure the face mask contains no metal. Some face masks include flexible parts, nose pieces, headband staples, nanoparticles, or antimicrobial coating that may contain metal. If the absence of metal cannot be confirmed and it is determined to be appropriate for the patient to wear a face mask, an alternative face mask where the absence of metal can be confirmed should be used. Health care providers who perform MRI exams are encouraged to provide face masks without metal to patients who will undergo an MRI. Continue to screen all patients for MRI safety, including looking for metallic objects, prior to MRI examinations.

If a patient experiences an adverse event, such as a burn, while wearing a face mask during an MRI, you are encouraged to report the event to the FDA. Your report, along with data from other sources, can provide information that helps improve patient safety. • For more information, visit tinyurl.com/MRImasks.

Share your RAD IDEA via an email to editor@mdpublishing.com.

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ICEMAGAZINE | APRIL 2021

ADVANCING THE IMAGING PROFESSIONAL

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SPOTLIGHT

Off Clock THE

LAURA BREUER

BIG FAT PASTOR SPIRITS OF LOVELAND, COLORADO

BY MATT SKOUFALOS

B

anner Imaging Manager Laura Breuer traces her family history to a lineage of German ancestry with generational ties to the beverage industry. But the eight-year ultrasound specialist never really expected that the family would wind up in the spirits business together, brewers in name as well as avocation.

A cocktail classic - old fashioned.

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ICEMAGAZINE | APRIL 2021

When they moved from Ohio to Colorado in 1999, the Breuers arrived just in time to witness the microbrewery boom in their new home state. At

some point, her father, Hans, was gifted a homebrew kit, then wine-making equipment and, after a decade or so, a still. Hans’ interest was spurred on by the secondary, smaller surge in the micro-distillery business that followed the Colorado brewing boom of the 1990s, and the close-knit family was eager to join him in it.

“We just like making things,” Laura Breuer said. “We had always wanted to start a family business, but couldn’t figure out what. We thought, ‘Maybe this is something we could do together.’ ” The family became just the 38th group to be awarded a distiller’s license from the state, and in 2017, opened the doors of Big Fat Pastor’s Spirits in Loveland, Colorado. Hans Breuer Sr., ADVANCING THE IMAGING PROFESSIONAL

Laura Breuer smiles from behind the bar at Big Fat Pastor Spirits.

and his son-in-law, Daniel Preller, work as its master distillers; mom, Peggy, a graphic artist, designs the merchandise, apparel and labels. Laura is the chief financial officer (CFO), her sister, Lindsey Preller, handles marketing and public relations, and their brother, Hans Jr., fills in the gaps at their 1,000-square-foot distillery and tasting room.

The first products the family tackled were vodka and gin, before expanding into bourbon and whiskey. The production of distilled spirits can require a lengthier aging process than that of beer, particularly for darker liquors, but lighter spirits mature within a few months. Laura Breuer recalls how they uncovered a variety of flavor profiles while refining their gin recipe.

“Gin is a blast,” she said. “There’s always a big juniper base, but depending upon how you infuse it into the spirit, it can be more subtle. It’s so fun to taste them all and find all the nuances to make our recipes how we want them.

We also do a 90-day barrel-rested gin, which gets a little bit of those flavors, but doesn’t get overwhelmed with oakiness.”

For those who do prefer an oaky spirit, Big Fat Pastor’s Soul Searchin’ bourbon whiskey is prepared with a base of Colorado-grown corn and barley, and its Holy Smokes malt whiskey blends Colorado barley with Scottish-imported peat smoked barley, “because it has the best flavor profile,” Laura Breuer said.

Aside from those limited out-ofstate ingredients, Big Fat Pastor sources locally as many of its ingredients as possible. Labels are printed nearby, botanicals come from Old Town Spice Shop in Fort Collins, Colorado, and the corn and root shoot barley in its vodka is grown right in Loveland.

“We really believe in supporting our own economy,” Laura Breuer said. “It’s better to build your own city up. We want to focus on our community and saturate the area.”

That local focus involves enjoying WWW.THEICECOMMUNITY.COM

the mutual support of neighboring distilleries, like Spring44, as well as partnering with area charities, including Realities for Children, a family service center in Fort Collins that helps to care for abused, neglected and at-risk children. When the novel coronavirus (COVID-19) pandemic shuttered tasting rooms across the country, Big Fat Pastor joined hundreds of other distillers across the country in pivoting from making small-batch spirits to making hand sanitizer. The family produced 1,000 bottles of the stuff, donating them to local churches, first responders and community nonprofits at a time when cleaning protocols were as important as ever, and alcohol-based cleaners could be in short supply.

“We want people to know who we are and have a good association with the name,” Laura Breuer said.

Those good works extend beyond the walls of the distillery – Hans Breuer is a pastor at the non-denominational Clearwater Church in Fort Collins, Colorado – as well as informing the hospitality guests are shown in its tasting room.

“Pre-COVID, we’d have big parties the first Friday of every month, a live local band in the distillery, a food truck out front and we’d be making drinks for everyone,” Laura Breuer said.

“On Saturdays we’d do tours, which was always really fun,” she said.

“When we have the music and the food truck, it can get loud. We can get sometimes 40 people in there; it’s a

lot for a small space like that.”

Peggy Breuer and Lindsey Preller develop the cocktail recipes at Big Fat Pastor Spirits, and, because Colorado distillery laws prohibit them from serving any beverages not made onsite, the family also creates its own mixers from scratch. Recipes and specials change quarterly to match what’s in season. Depending upon the time of the year, guests might enjoy a martini crafted with homemade dry vermouth, or a house-made limon- or orangecello. The opportunity to be creative and passionate about the business also allows the family to enjoy the work there as a change of pace from their weekday occupations.

“My brother-in-law runs his family appliance repair business; I run a medical imaging facility; my dad is a pastor,” Laura Breuer said. “It’s hard to manage the time commitment.”

Aside from their commitment to growing small and smartly, the Breuers are creating an enterprise they can someday hand off to the next generation, and as CFO, Laura Breuer is tasked with keeping the finances steady so that dream can be realized.

“When we were starting up, my sister had a little one, and we said, ‘He’s the future master distiller,’ ” Laura Breuer said. “This has always been something we wanted to pass on to our kids in the future. The dream was to give something to our children.” •

A view of the Big Fat Pastor’s Spirits tasting room.

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CORPORATE PROFILE

SPECIAL ADVERTISING SECTION

CORPORATE PROFILE The InterMed Group

T

he InterMed Group began as an X-ray service company in Gainesville, Florida back in 1992, but it quickly expanded its service offerings throughout the nineties to encompass ultrasound, nuclear medicine and biomedical.

“Working closely with health care facilities, we were able to witness first-hand the struggles that many operations have with managing their investments – be it inventory, preventative maintenance schedules, device and equipment procurement, medical device cybersecurity and, of course, equipment repairs. This prompted us to expand our services offerings and reach, acquiring MIT, Horizon CSA and most recently, Sigma Imaging Technologies,” The InterMed Group CEO Rick Staab said.

“At InterMed, we aren’t out to win against our competitors, we’re out to win by making the business and health care industry better,” he added. “Our decades of industry experience and breadth of services enable us to create efficiencies that save our clients’ time and money, enhance their services, and position them for growth. We always look for innovative new ways to provide services that will make health care more accessible and financially attainable to customers so that, in return, their patients receive the best care. It is important 18

ICEMAGAZINE | APRIL 2021

that we learn from our competitors and constantly seek ways to raise the bar; we hope that other businesses like InterMed look laterally to each other for motivation to improve on what others are doing, ultimately making the health care industry better.”

Staab shared one way this type of work is possible “Take our JumpTeamsTM for example; we observed a gap in the industry when it came to finding experienced service engineers that can take on responsibilities like special project; we kept hearing the same pain points repeatedly from customers – not enough time, the budget isn’t there, they lack the physical resources, and personnel to manage the process,” Staab explained. “This prompted us to develop the InterMed Group JumpTeamsTM – we provide and deploy engineer and technician support solutions for health care systems and imaging centers across the country. Since introducing JumpTeamsTM to the industry, we’ve seen a huge boom in similar offerings by other companies as well. I hope the

bar continues to be raised.”

ICE recently interviewed Staab to find out more about The InterMed Group.

Q:

What are some advantages that your company has over the competition?

Staab: Innovation. We want to break the mold and have bigger impact rather than just the standard, cookie-cutter approach. The team here at InterMed is made up of some seasoned industry powerhouse professionals that have been in the field for 10, 20, even 30plus years. Our team has experienced the heath care industry’s evolution firsthand; we are constantly evaluating how to adapt and make healthcare technology management better. Our mission at InterMed is to always bring the best; we know that to bring the best to our customers, we have to be the best at what we do. Our drive is to be efficient and impact health care, to make it more accessible to everyone, and not just make profits. Our goal is to bring hope to health care.

“At InterMed, we aren’t out to win against our competitors, we’re out to win by making the business and health care industry better.”

– Rick Staab, The InterMed Group CEO

ADVANCING THE IMAGING PROFESSIONAL

ing the health of our community. It’s part of what we do every single day.

We have an official charity, Tyler’s Hope for a Dystonia Cure. Dystonia is a neurological movement disorder with over one-third of dystonia patients being children. InterMed and Tyler’s Hope are committed to finding a cure for dystonia and we won’t stop until a cure is found.

InterMed employees receive hands-on field training internally and with OEMs annually to stay current and continue to provide the best service to clients.

Q:

What are some challenges that your company faced last year?

Staab: I think our biggest challenge in 2020, like many, was to keep all our team safe and healthy. Healthy mentally as well as physically; I don’t think anyone could have predicted the mental toll that the COVID-19 pandemic would have on health care and frontline workers. Through all the unknowns and challenges that we faced we really found that a positive mindset is key to overcoming any obstacle. By banding together and working even closer, from a physical distance of course, with each other and our customers we were able to embrace the challenges we were faced with and turn them into opportunities to improve.

So much remains unknown about the future, but we are optimistic. The dedication to the safety and well-being of patients and peers that InterMed witnessed throughout 2020 continues to inspire us to bring the best every day in every way.

Q:

Can you explain your company’s core competencies?

Staab: Healthcare technology manWWW.THEICECOMMUNITY.COM

agement (HTM) is a broad summation of what we do here at the InterMed Group; to our team everything we do is a service, including selling equipment. We really look at our relationships with customers as partnerships in longevity – yes our solutions help immediate needs, but we feel that it’s equally as important to look ahead and start planning for their future needs. It is a strategic approach rather than a reactive response to immediate needs; we harness artifical intelligence (AI) to evaluate important data so that we can provide our customers with options and supporting evidence that allows them to make smart decisions for their current situation and for the future. We often like to attend board meetings or strategic planning meetings so that we can help play an active role in the development and success of our partners’ organizations.

What we do in philanthropy is another part of our core values here at InterMed that really makes us stand out. We have learned that in addition to the best products and service, customers also deserve to buy from a company that is dedicated to improv-

Q:

What is on the horizon for your company?

Staab: Our goal is to become the number one independent service organization in the market and in the industry for healthcare technology management services. We already consider ourselves to be in the top one percent of true HTM providers in the country; we have all the services and technical skill sets to provide each element of service needed, from infusion pumps to MRI. If 2020 has taught us anything, it’s that change is inevitable, and it can come on swift. Our team embraces change as an opportunity to push ourselves to be better and more efficient.

We are a small yet nimble organization which has proven successful time and time again. Looking into the future of InterMed we hope to further expand our company nationally so that we can have a greater impact on health care; our JumpTeamsTM have completed work in almost all 50 states already, but we hope to put down more roots in more states throughout the upcoming years. Over the past decade we have already grown so much, expanding from our headquarters in Florida, throughout the entirety of the East Coast and bordering states. Our plan now is to head west into the central and mid-western states while we conICEMAGAZINE

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CORPORATE PROFILE

tinue to develop in some of the industry’s key markets for hospitals – Florida, Texas and California for example.

We’re seeing a lot of doors opening to partner with larger health systems that will really catapult our reach and impact within the industry.

It is just as important to us that as we expand our partnerships, we continue to attract the best engineers and team members to InterMed – our internal philosophy of constant and never-ending improvement is really highlighted by our investment in training and educating all our employees to be the best at what they do. We want all our teammates to be confident in the work they produce and proud of the work they are doing here at the InterMed Group.

Q:

Please share some company success stories with our readers – one time that you “saved the day” for a customer.

Staab: Our standard of service is what defines us. It’s our purpose and our passion. We seize every opportunity to serve our clients and exceed expectations at every turn. With our clients, downtime is critical to the success of their operation – especially in the current environment – so when they need parts or a new device installed, we understand that time is of the essence.

Early on during the pandemic, our team converted our warehouse depot to a repair space for urgent repairs to devices needed desperately by hospitals across the state. We took in over 500 ventilators to repair and prep for distribution to hospitals. It’s not the first time we’ve uprooted our facilities to meet the needs of hospitals and it certainly won’t be the last; our clients are out there saving lives on the frontline and it’s our duty to make sure the equipment and technology they need to do their jobs are working properly.

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ICEMAGAZINE | APRIL 2021

SPECIAL ADVERTISING SECTION

Q:

Riley Tasker, Imaging Sales Specialist, de-cables a Philips 1.5T MRI while Field Service Imaging Enginerr, Bill Guarnera, assists during an on-site client deinstallation.

Q:

Can you describe the company’s facility for our readers?.

Staab: Our corporate campus is based in Alachua, Florida – just outside of Gainesville, right in the heart of north-central Florida. Our corporate campus is 50,000 square feet on 40 acres of land; our building houses administrative offices and a warehouse for repairs, reconditioning, storage and training. As of February 2020, we have a second location in Westampton, New Jersey; with over 38,000 square feet of warehouse and office space, it’s exciting to have resources close by as we continue our expansion into the Northeast market.

InterMed continuously works to ensure we foster safe and inclusive working environments for our employees; everyone adapted quite well to the adjustments made over the past year due to COVID. Our focus has been on keeping workspaces clean, sanitized regularly, providing proper PPE and creating socially distanced spaces.

Can you share recent changes to your company, inventory, services, etc.?

Staab: In February of 2020, the InterMed Group acquired the New Jersey-based Sigma Imaging Technologies. Sigma’s longstanding specialization in big iron medical equipment further enhances our abilities in MR, CT and PET CT. Acquiring Sigma has significantly expanded our reach in parts, service and equipment sales offerings to current and prospective customers.

There has been a massive increase in cyber and digital data storage and processing in health care over the past year, a trend that we do not see slowing down anytime soon.

The health care industry is the most targeted industry when it comes to cybercrime and cybersecurity crime.

The InterMed Group is an industry leader for cybersecurity profiling; we assess medical devices, cloud systems, equipment – really any place within a health care system that stores data digitally. Recognizing the need for better cybersecurity management for many of our current clients, we are excited to expand our current cybersecurity profiling services to encompass remediation following our diagnosis, which is very exciting for us.

We have also been focusing a lot of our resources in harnessing the analytics and AI we have developed to increase our forecasting abilities for our clients. We are able to analyze the information we gather from our clients to personalize their immediate and anticipatory needs which increases efficiencies and mitigates any potential for downtime.

Q:

What can you tell us about InterMed employees?

Staab: We attract people that want to ADVANCING THE IMAGING PROFESSIONAL

be the best at what they do, but that are also seeking a purpose or a cause to get behind. We employ incredibly well rounded, good people that are constantly going above and beyond.

In business you often observe a disregard for morals, but not here at The InterMed Group; morals come first for us and for the people that make up our team. Everyone has a critical role in supporting our clients and their patients. It was never more evident that we have a great team of dedicated professionals here at InterMed than when the going got tough in 2020.

It is an honor for me to be able to be a part of this team.

Q:

What is most important to you about the way you do business?

Staab: Our mission at The InterMed Group is to always bring the best as the exclusive, trusted provider of scalable healthcare technology management services, powered by innovation and guided by experience. We seek out opportunities for our clients to grow, provide a level of services that exceed that of our competition and the expectations of our clients.

We believe we must earn our clients’ business every day, in every way.

We communicate with the staff and patients in a courteous, friendly and professional manner always.

We value integrity and keeping agreements, which is why all our employees operate under The Sundown Rule – Simply put, we address every challenge or customer concern by sundown each day so that our clients know our response and when to expect a resolution. This establishes a level of trust that is very hard to duplicate and supports our focus on long-term, mutually beneficial relationships. The Sundown Rule is in the core of our company values.

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Q:

Is there anything else you want readers to know about your company?

Staab: At InterMed we understand that our solutions not only change our clients’ business, but they also impact lives – and that is not something we take lightly. It’s what drives our commitment to excellence, our thirst for learning and our dedication to innovation. Seeing our role in the big picture inspires us to bring our best every day so that our clients’ can be their best.

Throughout our history, our commitment to quality and our craft in the industry is evident by our involvement in organizations that support the future of the health care industry. A testimony to InterMed’s pursuit to bring the best is our Quality Management System was first certified ISO 9001:2015 for adhering to a quality standard globally recognized as superior; most recently we received ISO 13485 certification for

Medical Device and Quality Management Systems. This means that our quality management system meets the most current standards for the service and sale of medical devices as set forth by the International Organization for Standardization.

We are an active member in the Alliance for Medical Equipment Services, comprised of six leading independent medical device service organizations throughout the United States, serving as an independent voice and advocate for health care providers. I am also a voting member of the Medical Device Servicing Steering Committee that reports to the FDA. Here at The InterMed Group our company and team members go beyond turning wrenches because we all know the industry will never stop evolving, so we will never stop pushing to create solutions for tomorrow’s challenges. •

InterMed’s headquarters in Alachua, FL is home to a mix of administrative offices and a warehouse used to store inventory, make repairs, and train their team.

ICEMAGAZINE

21

NEWS

Imaging News A LOOK AT WHAT’S CHANGING IN THE IMAGING INDUSTRY

PROBEHUNTER EXPANDS PROBE ADAPTER LINE ProbeHunter has announced the release of an adapter for the Mindray DC8 series.

“This means that we now can test all leading OEMs’ ultrasound probes – GE, Philips, Siemens, Samsung, Mindray and more – independent from the system, on ProbeHunter.

With 50 different multi-brand adapters in the portfolio, we can offer hospitals and anyone dealing or servicing ultrasound probes the ultimate tool for patient safety,” said CEO Björn Segall.

ProbeHunter is a multi-brand real-time testing device with innovative technology designed to quality assure ultrasound probes. It is designed for patient safety. It allows the user to get a super quick “Go or No Go” before using a probe on a patient.

22

“It is now easier than ever to get a ProbeHunter system, the Swedish government supports export business and offers a capital credit guarantee during the pandemic. It means, in general, that it is possible to have a ProbeHunter system today and pay later. I would like to encourage hospitals and the ultrasound probe industry to make use of this unique possibility for patient safety,” Björn Segall said in a press release. • For more information, email info@probehunter.com

PROBO MEDICAL ACQUIRES IMAX MEDICAL

MITA ADDRESSES MASKS DURING MRI EXAMS

Probo Medical, a global provider of medical imaging equipment, parts, repair and service, has announced the acquisition of IMAX Medical. Terms of the transactions were not disclosed.

IMAX, founded by Patrick Roussel in 2012, is a Nantes, France-based company specializing in the purchasing, sales and logistics of pre-owned medical diagnostic imaging equipment. IMAX is led today by Simon Roussel and supported by a team of medical equipment professionals with deep experience in the French and European markets.

“This is a significant announcement for Probo as we continue to grow our business on a global scale,” said Michael Asmer, CEO of Probo Medical. “France is an important market in the diagnostic medical imaging equipment vertical and we looked hard for a partner that shared our vision for the future. IMAX was clearly that partner. We are delighted to welcome the IMAX team to the Probo family.”

Probo Medical is backed by Varsity Healthcare Partners, a lower middle-market private equity investment firm focused on partnering with founders, entrepreneurs and management teams to build leading health care services companies. •

The Medical Imaging & Technology Alliance (MITA) released a statement in response to a U.S. Food and Drug Administration-issued safety notification on mask wearing during MRI examinations.

“The COVID-19 pandemic impacts the way diagnostic imaging examinations are performed. Particularly, patients may need to wear masks during the examination, which may impose hazards in the MR environment,” the MITA statement reads. “The U.S. FDA issued a safety notification to remind patients and providers not to wear any metal during the MR examination. MITA fully supports this reminder and reinforces the instructions for use with MR systems: • Check clothing for the presence of metal pieces, strips woven micro fabric • Recommend use of hospital supplied gowns and masks (for which safety is established by the hospital) in all cases • Check with the mask manufacturer that no metallic nano particles or fabric is included in any of the layers of the mask.”

MITA is a Division of the National Electrical Manufacturers Association (NEMA). •

ICEMAGAZINE | APRIL 2021

ADVANCING THE IMAGING PROFESSIONAL

ECRI LISTS TOP HEALTH TECHNOLOGY HAZARDS Hundreds of medical products have been authorized for temporary use in the past year to meet the unprecedented need for life-saving equipment and supplies during the COVID-19 pandemic. ECRI cautions that meticulous management of these Emergency Use Authorization (EUA) products is crucial to protecting patients, health care workers and hospital operations.

ECRI, an independent nonprofit organization, listed the complexity of managing devices that have been authorized through the EUA process at the top of its 2021 Top 10 Health Technology Hazards report.

“Emergency Use Authorization is a lower standard than is used to assess safety and effectiveness through FDA’s normal clearance process, and it requires more work on the part of the hospital,” says Marcus Schabacker, MD, Ph.D., president and chief executive officer of ECRI. Through its EUA process, FDA can green-light previously unapproved products – or new indications for previously cleared products – as acceptable for use during an emergency. Hospitals need to watch for safety and performance issues, monitor the device’s authorization status daily and know what to do with the device when the EUA ends,

according to ECRI experts.

Now in its 14th year, ECRI’s Top 10 Health Technology Hazards identifies health technology concerns that warrant attention by health care leaders. ECRI’s team of biomedical engineers, clinicians and health care management experts follows a rigorous review process to select topics for the annual list, drawing insight from incident investigations, reporting databases and independent medical device testing.

ECRI’s full list of health technology hazards for 2021 includes: • EUA device management • Drug name auto-display • Telehealth adoption • Imported N95-style masks • Consumer-grade devices • UV disinfection • Software vulnerabilities • AI in diagnostic imaging • Remote operation risks • 3D printing quality • For more information, visit tinyurl.com/ECRI2021-list.

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NEWS

HOLOGIC EXPANDS ULTRASOUND PORTFOLIO Hologic Inc. has announced the expansion of its ultrasound portfolio with the launch of the new SuperSonic MACH 20 ultrasound system.

Hologic now offers three tiers of ultrasound technology, ensuring more facilities have access to customized ultrasound solutions to address their unique imaging needs. Each of the systems is designed to increase efficiency and diagnostic accuracy, features exceptional image quality and innovative imaging modes, and offers an intuitive user experience.

“As the leader in breast imaging, we strive daily to deliver superior health care solutions that meet the unique and ever-changing needs of our customers,” said Jennifer Meade, Hologic’s division president of breast and skeletal health solutions. “By continuing to heavily invest in our growing ultrasound portfolio, we’re delivering on that promise. In less than a year, we’ve brought two new ultrasound systems to market through accelerated innovation, providing our customers with an array of targeted solutions designed to optimize ultrasound imaging and enhance the patient experience.”

The latest addition to Hologic’s ultrasound portfolio, the SuperSonic MACH 20 ultrasound system, provides added clinical value for general and specialty ultrasound imaging, including of the breast, liver, muscles and tendons. It features excellent B-mode image quality and runs on the same UltraFast imaging technology that powers Hologic’s full line of SuperSonic ultrasound systems, allowing users to perform dynamic tissue stiffness evaluation with ShearWave PLUS elastography. Radiologists and sonographers also enjoy an intuitive, ergonomic user experience thanks to the SonicPad touchpad, which is designed to reduce examination time and operator fatigue and injury.

Hologic has been expanding its comprehensive portfolio of ultrasound solutions since its acquisition of SuperSonic Imagine, a pioneer in the field of ultrasound imaging. •

TKA, AMI ANNOUNCE PARTNERSHIP The formation of American Medical Imaging (AMI) from six medical imaging technology sales and service companies across the continental U.S. was announced

by The Innovation Institute and Tech Knowledge Associates (TKA), its subsidiary specializing in full-risk healthcare technology management (HTM). The new AMI partnership of experienced imaging technology firms was brought together to deliver the entire spectrum of sales, repair and maintenance solutions to health care facilities nationwide.

AMI is led by Steve Cannon as president and CEO. He played a pivotal role in bringing together the six foundational companies that formed the AMI partnership. Cannon has over 40 years of experience in the healthcare technology and asset management industry. He has held senior leadership roles with SunHealth and the national GPO Premier and served as the inaugural president at the new AllParts Medical in 2009.

Cannon has also held executive leadership positions at Aramark, Philips Healthcare and Sodexo. In late 2020, Cannon took the helm of the asset management firm, Healthcare Technology Group.

The AMI partnership was founded on the aggregation of medical imaging technology sales and service companies in varied geographies, with presence in 16 states. By building on The Innovation Institute’s business model, and with the immediate breadth of service from the six foundational companies, AMI will bring customized technology solutions to health care providers of all sizes and needs.

Speaking to AMI’s capabilities, Cannon noted, “With the experience and strength of our multi-regional presence, AMI is able to offer a spectrum of high-quality services – from equipment sales, to maintenance and repair, to installation and removal, to IT solutions such as PACS. And we can do so with greater efficiency and at a lower cost to the health care providers we serve.”

Cannon added that for AMI, the initial growth phase has not yet ended.

“We plan to expand to even greater national coverage in the coming months, with the addition of several new companies to the AMI partnership,” he explained.

“Our vision is that 2021 will be a banner year for us in the improvement of medical imaging technology service delivery, with reach across the majority of the United States.” • For more information, visit ami-ii.com.

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ICEMAGAZINE | APRIL 2021

ADVANCING THE IMAGING PROFESSIONAL

UNITED IMAGING ANNOUNCES AGREEMENT WITH VIZIENT United Imaging has announced an agreement to offer its suite of computed tomography technology to Vizient members at contracted pricing.

For maximum clinical flexibility, all of United Imaging’s CT scanners (uCT) are enabled to image a wide variety of patient and exam types, including large patients, patients with metal implants, angiography and cardiology exams. Advanced applications and advanced post-reconstruction analysis are included with every scanner for comprehensive care. In addition, the Z-Detector architecture enables high-resolution and low-noise imaging across the entire uCT portfolio, and the software platform is also standard across all systems. United Imaging’s CT scanners also benefit from an Easy-Logic Intelligent Prediction platform combined with intuitive and intelligent workflow to support a sizable daily patient throughput while maintaining high image quality.

Vizient is the largest member-driven performance improvement company in the country with a diverse

MRI & CT Services

membership base that includes academic medical centers, pediatric facilities, community hospitals, integrated health delivery networks and nonacute health care providers and represents more than $100 billion in annual purchasing volume.

“United Imaging is on a mission,” noted Jeffrey M. Bundy, Ph.D., CEO of United Imaging Healthcare Solutions, “one that is well aligned with Vizient’s. Ours is Equal Healthcare for All, and we’re very happy to be able to provide Vizient members with quality and true business value that can help them expand the care they provide.”

United Imaging first launched investment in the U.S. market in 2013 with research and development, and since then has established a significant American service, commercial and artificial intelligence presence. The company opened a regional headquarters and global showroom in Houston in 2020, along with a factory to assemble and ship U.S. products, and a training center. •

MRI & CT Parts

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MRI & CT Parts

MRI & CT Parts ICEMAGAZINE

25

NEWS

iRAD ANNOUNCES DISTRIBUTORSHIP AGREEMENT iRad, Innovative Radiology Equipment Sales and Services LLC has announced a distributorship agreement with FUJIFILM Medical Services. The agreement gives iRad the ability to provide hospitals, imaging centers and clinics with the FUJIFILM X-ray and digital reader line as well as the newly released FUJIFILM Persona C-Arm. “As a world-leading imaging and information company, Fujifilm is dedicated both to improving image quality and advancing dose lowering technologies and safe health care standards for patients, all while delivering exceptional images,” said Tony Orlando, president of sales. “The team at iRad is excited to introduce these products to our current customer base as well as expand the market share for Fujifilm. We believe these

products should be in all hospitals and imaging centers. The technology far exceeds many others on the market.”

The agreement includes the following items: • FUJIFILM FDR ES and EVO DR panels for both retrofit and new systems • FUJIFILM Go portable/mobile X-ray systems for bedside X-ray exams • FUJIFILM AQRO mobile X-ray systems for pediatric use with lowest dose useage • FUJIFILM Clinica table X-ray systems for dedicated X-ray rooms in the clinic or hospital setting • FUJIFILM Persona C-Arm – the newest flat panel detector C-Arm in the market that allows for ultra-low dose fluoroscopy and vascular imaging. •

CANON MEDICAL AI-BASED IMAGE RECONSTRUCTION TECHNOLOGY MORE ACCESSIBLE Canon Medical is bringing the power of accessible artificial intelligence (AI) for improved image quality to more patients with expanded clinical indications for 1.5T MR. Advanced intelligent Clear-IQ Engine (AiCE) Deep Learning Reconstruction (DLR) can now be used for 96 percent of all procedures using the Vantage Orian 1.5T MR system, expanding from previously FDA-cleared brain and knee indications to a vastly larger number of clinical indications, from prostate to shoulders, including all joints, cardiac, pelvis, abdomen and spine.

AiCE was trained using vast amounts of high-quality image data and features a deep learning neural network that can reduce noise and boost signal to quickly deliver sharp, clear and distinct images, allowing clinicians

26

ICEMAGAZINE | APRIL 2021

to boost image quality, performance, productivity and throughput on a whole new scale.

“As we continue to expand the availability of AiCE, Canon Medical is ensuring that the maximum number of patients can benefit from the advanced images, expanded clinical capabilities and seamless integration that this advanced AI technology provides,” said Jonathan Furuyama, managing director, MR business unit, Canon Medical Systems USA Inc. “In today’s environment, making images easy to read and acquire is more important than ever, and this is the latest demonstration of our commitment to offering accessible AI that clinicians can use to make the greatest impact on patient care.” •

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ICEWEBINARS.LIVE

NEWS

STAFF REPORT

EXPERT SHARES STRATEGIC TECHNOLOGY PLANNING TIPS T he recent ICE webinar “Beyond the Technical – Strategic Technology Planning for Medical Imaging” was presented

by Carol Davis-Smith, president of Carol Davis-Smith & Associates and the vice chair of clinical engineering for the AAMI Board of Directors.

Davis-Smith has 30 years of experience in academic and not-for-profit medical centers, group purchasing, consulting and executive leadership. She holds a master’s degree from the University of Arizona and a bachelor’s degree from the University of Dayton. She is a certified clinical engineer and a Fellow in the American College of Clinical Engineering (FACCE) and the Association for the Advancement of Medical Instrumentation (AAMI).

In this session, Davis-Smith moved beyond the technical service assessment and focused on the clinical and business assessments important to an optimal strategic technology plan. She reviewed the entire process and the supporting resources to ensure everyone understands how all the perspectives work together. Attendees left

the session with insights to initiate or enhance the strategic technology planning process within their organization.

The webinar was popular with almost 100 people Carol Davis-Smith registered for the session. Attendees provided feedback via a post-webinar survey that included the question, “Overall, how satisfied were you with today’s webinar?”

“Carol is a great presenter and did a fabulous job,” Imaging Services Manager D. Skillicorn said.

“Satisfied as satisfied can be,” replied Biomedical Equipment Specialist M. Walker.

“Good speaker and great information – very satisfied,” said J. LeRose, interim director, radiology.

“Great content, going through capital planning now so the content was relevant,” said E. Camargo, radiology manager. • For more information, including a schedule of upcoming webinars, visit ICEwebinars.live.

“Great content, going through capital planning now so the content was relevant.”

– E. Camargo, radiology manager

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ICEMAGAZINE

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COMPANY SHOWCASE

SPECIAL ADVERTISING SECTION

COMPANY SHOWCASE MTMI

M

edical Technology Management Institute (MTMI) began in 1989 when J. Ed Barnes, Ph.D., saw a need for continuing education for radiologic technologists.

The company began with basic X-ray continuing education but soon branched out by adding cross training for their customers. MTMI had the first mammography training course to be accepted by the FDA to meet the MQSA requirement.

Soon MRI and CT training followed along with training for other modalities. Expansion continued with the addition of continuing education programs for physicists and physicians.

“Our team is one of our greatest strengths. Our instructors are leaders in their field, clinically active and industry experts in the latest technologies and procedures,” MTMI President Jay Mazurowski, MS, CRA, FAHRA, said.

“In addition, our webinar managers are highly proficient at delivering the optimal online learning experience. MTMI is also unique in the industry because we offer programs in all modalities and offerings that cover the complete imaging team: technologists, sonographers, medical physicists, physicians and biomedical technicians.

ICE recently had the opportunity to 30

ICEMAGAZINE | APRIL 2021

Q:

Jay Mazurowski, MS, CRA, FAHRA MTMI President

interview Mazurowski to find out more about the organization and what it offers the diagnostic imaging community.

Q:

Can you describe MTMI’s facility?

Mazurowski: MTMI opened its new international headquarters in 2020.

Three state-of-the-art classrooms include high-end sound systems and multiple large screen monitors in bright modern surroundings. It is located in Milwaukee’s Research Park, near the Milwaukee County Medical Complex.

Located near Mitchell International Airport, our headquarters provide easy access to the medical community and our faculty and enables us to provide the most updated information for our programs.

What are some advantages that your company has over the competition?

Mazurowski: MTMI programs are taught by imaging professionals who are currently working in their field. They have hands-on experience and have a unique perspective that resonates with our students. MTMI is one of the only continuing education companies to offer programs in virtually every modality. In addition, MTMI programs address the needs of a vertical audience by including technologists, sonographers, medical physicist, physicians and biomedical technicians.

One final advantage of MTMI is that almost all of our programs are offered as live webinars and we were the first company to offer simulcast of cross training.

Q:

What are some challenges that your company faced last year? How were you able to overcome them?

Mazurowski: The COVID-19 pandemic created a challenge in that face-toface programs had to be canceled.

MTMI has provided education via webinar for a long time and the transition of the face-to-face programs to webinar was seamless. We were pushed to new milestones such as the industry’s first-ever PACS training course offered live online. Our handson technical programs challenged us ADVANCING THE IMAGING PROFESSIONAL

to find new technologies to deliver the hands-on experience virtually.

Q:

What product or service that MTMI offers are you most excited about right now?

Mazurowski: Cross training courses are gaining the most interest ever, especially mammography and PACS. Within the course we use a game-based review session to keep it fun, yet educational. We are also very excited about a new course offering to a new audience for us. For the first time, we are offering the four-day course “Fundamentals of Medical Instrumentation and Biomedical Equipment Technology.” This course is offered in the classroom and via online webinar. It is designed as an introduction to healthcare technology management and also as a prep course for the Certified Biomedical Equipment Technician (CBET) exam.

Q:

What are some other recent highlights?

Mazurowski: MTMI recently opened a regional office in Houston, Texas to support the vibrant Texas medical community. The office is the home of two MTMI employees and includes a modern classroom.

Q:

What is on the horizon for MTMI? How will it evolve in the coming years?

Mazurowski: MTMI is poised for accelerated growth. We are launching a number of new initiatives including, a Magnetic Resonance Safety Officer (MRSO) course, advanced leadership programs to complement our very popular Pathways to Leadership program, the CBET prep course, interventional radiology cross training and a Six Sigma yellow belt course.

Q:

Can you share a success stories with our readers?

Mazurowski: MTMI plays a critical role in patient safety and patient care. Our programs teach imaging

“MTMI is unique in the industry because we offer programs in all modalities and offerings that cover the complete imaging team: technologists, sonographers, medical physicists, physicians and biomedical technicians.”

professionals the skills required to create optimal images that result in improved patient care and outcomes.

Many of our customers come to us for mammography ACR re-accreditation.

This consulting service is customized, accredited and is delivered in person by expert instructors. It helps to improve the quality of care for women’s health.

Q:

Can you tell us more about the expert instructors and the people who make MTMI go?

Mazurowski: One of MTMI’s core strengths is its people. We have a strong mix of talented employees who are experts at their job. Communication is key to the success of the team.

Hosting over 300 webinars per year requires seamless communication to manage the unlimited details.

Q:

What is MTMI’s mission statement?

Mazurowski: MTMI is dedicated to providing world-class, comprehensive and innovative continuing education solutions to support the medical imaging and associated services community that result in improved patient care. MTMI prides itself on delivering high-quality programs and outstanding customer service. • For more information, visit MTMI.net.

–Jay Mazurowski, MTMI President

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ICEMAGAZINE

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PRODUCTS

Market Report Reports Forecast MRI Market Growth STAFF REPORT

G

rand View Research, a market research and consulting company, predicts continued growth in the magnetic resonance imaging (MRI) market.

The global MRI market size was valued at $5.3 billion in 2020 and is expected to expand at a compound annual growth rate (CAGR) of 6.0% from 2021 to 2028, according to Grand View Research.

Magnetic resonance imaging (MRI) is an efficient diagnostic machine for identifying diseases related to spine lesions, tumors and stroke impacting the area of blood vessels and brain. The increasing prevalence of these diseases is expected to play an important role in market growth. For instance, as per the American Cancer Society, in 2019, more than 1.7 million new cancer cases were recorded in the U.S. In addition to this, the growing demand for quick and effective diagnostic procedures is expected to contribute to the adoption of MRI machines. Various countries are installing these MRI machines.

For instance, as per Organisation for Economic Co-operation and Development (OECD), in 2017 the number of MRI units installed in the U.S. was 37.6 per million population.

Advancements in diagnostic techniques such as open MRI, visualization software and superconducting magnets are fueling the growth of the MRI market. The recent advances seen in MRI technology are mainly on the software. These software advancements help in enabling faster contrast scans and simplifies imaging workflow. Moreover, the development of cardiac pacemaker compatible MRI systems is also expected to propel market growth in the cardiology segment.

Furthermore, various paramagnetic contrast agents such as gadolinium-DTPA are used as an intravenous injection to provide sharp, precise and accurate images within a shorter time frame. These technological advancements in MRI are expect32

ICEMAGAZINE | APRIL 2021

ed to propel market growth during the forecast period.

COVID-19 is expected to have a negative impact on the MRI market. COVID-19 has impacted the outpatient imaging services segment. New York metropolitan health system reported an 87% reduction in outpatient imaging services and this is expected to impact the MRI market.

Various recent advancements such as diffusion and diffusion tensor imaging with tractography, neuroimaging including MR spectroscopy, perfusion imaging and functional imaging using the bold technique is expected to boost market growth during the forecast period. Also, the growing development of intraoperative MRI and usage of the same in various applications – such as neurosurgery – is expected to propel market growth during the forecast period. Moreover, diffusion-weighted MR imaging is mainly used to detect stroke within 30 minutes of its occurrence. Therefore, advancements in MRI machines to enhance its usage for various applications is expected to drive the market growth during the forecast period.

High magnetic frequency MRI systems are gaining pace; therefore, various universities are conducting research or studies on these systems. In February 2018, scientists at the University of Minnesota performed an MRI of the human body using 10.5T MRI machine. This machine is expected to open new avenues in diagnosis of a wide range of diseases such as Alzheimer’s, heart disease, diabetes and cancer.

MarketsandMarkets forecasts the MRI systems market will reach $7.09 billion by 2023 expanding at a CAGR of 3.9% during the forecast period. It reports that the key factors driving the growth of this market include a rising awareness about the benefits of early diagnosis, technological advancements leading to the replacement of low-field MRI systems with high-field MRI systems and the discovery of new helium deposits. On the other hand, the high cost of MRI systems and declining reimbursement rates for MRI procedures are likely to limit the growth of this market to a certain extent. • ADVANCING THE IMAGING PROFESSIONAL

Product Focus MRI

1

GE HEALTHCARE SIGNA Premier

GE Healthcare’s ultra-premium system, SIGNA Premier, features a 70-centimeter bore, a 3.0T short-bore superconductive magnet and the SuperG gradient coil – the most powerful gradient system GE has produced for a wide-bore, 3.0T system. SuperG is designed to provide the performance of a research-class 60-centimeter MR system in a 70-centimeter bore. SIGNA Premier features AIR Recon DL, the MR industry’s first U.S. FDA-cleared, deep learning-based image reconstruction technology that works across all anatomies. This pioneering technology, using a deep learning-based neural network, improves the patient experience through shorter scan times while also increasing diagnostic confidence with better image quality across all anatomies.

*Disclaimer: Products are listed in no particular order.

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PRODUCTS

2 SIEMENS HEALTHINEERS

CANON MEDICAL Vantage Galan 3T and Orian 1.5T

The Galan 3T and Orian 1.5T MRI platforms, both with Advanced intelligent Clear-IQ Engine (AiCE) Deep Learning Reconstruction (DLR) and Compressed SPEEDER, were featured at RSNA 2020. Canon Medical’s range of MR solutions are built with intelligent workflow and image-processing technologies to accelerate scans, improve diagnostic confidence and patient comfort, while delivering outstanding efficiencies for health care providers. AiCE DLR technology produces stunning MR images that are exceptionally detailed and with the low-noise properties expected of an inherently higher signal-to-noise ratio (SNR) source image. Canon Medical is a leader for clinically available Deep Learning Reconstruction on 3T and 1.5T MRI field strengths. Compressed SPEEDER can accelerate scan times across the whole body. This imaging approach enables high-speed imaging up to 2.5X times faster than current scan speeds while supporting diagnostic image performance. Faster exams can equate to increased productivity and/or being able to spend more time with patients.

MAGNETOM Lumina

The MAGNETOM Lumina 3 Tesla (3T) magnetic resonance imaging (MRI) scanner from Siemens Healthineers has a wide, 70-cm bore and cutting-edge technologies that include BioMatrix patient personalization technology with the Select&GO Interface, which eliminates the need for anatomical landmarking to permit faster patient positioning. Dot (Day Optimizing Throughput) technology automates the patient exam to support standardized, highly reproducible scan procedures. To accelerate routine examinations, Turbo Suite offers customized speed applications covering various areas of the body to reduce scan time by as much as 50 percent without compromising image quality.

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PRODUCTS

4 WWW.THEICECOMMUNITY.COM

UNITED IMAGING uMR OMEGA

uMR OMEGA is designed to provide greater access for your community with the world’s first 75-cm ultra-wide bore MRI. The uMR OMEGA has an industry-leading 680-pound table weight capacity, impeccable image quality provided by its world-class homogeneity, and a unique, calming in-bore lighting experience. Together, these factors enable uMR OMEGA to better accommodate bariatric patients and greatly improve the patient experience for all. With uCS 2.0 (Compressed Sensing), you can scan all body parts with up to 36x acceleration, enabling faster exams for your patients.

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Cover story

Improving

the Patient Experience and Your Bottom Line

BY MATT SKOUFALOS

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ADVANCING THE IMAGING PROFESSIONAL

“ Patient satisfaction is a big driver. In the Northeast, we have lots of competition, so the idea of patient retention, and attracting new patients, and keeping our patients satisfied is all very valuable.”

– Dr. Peter Curatolo

I

n the fall of 2015, the Beverly Hospital Lahey outpatient medical imaging center in Danvers, Massachusetts needed to replace one of its magnetic resonance imaging (MRI) scanners, and Peter Curatolo, MD, its MRI medical director, was tasked with leading the capital acquisition process.

At the outset of his exploration, Curatolo didn’t want to just upgrade necessary imaging equipment, he also wanted to seek out ways to expand and improve upon the array of services provided at the center, specifically in serving patients with claustrophobia and those scheduling breast imaging studies.

“Looking through our cancellations and no-show rate, I found that a disproportionate number of [those] patients were either claustrophobic or having breast imaging,” Curatolo said.

“We started doing due diligence, got all the vendors in, and at that time, a couple of them presented to us the idea of a patient-centered imaging suite. As we were building it, I started to appreciate that the design of the suite had a major impact on the physical and emotional well-being of the patient.”

The principle behind creating a suite designed to help patients remain calm during their imaging studies isn’t just to eliminate artifacts on scans and avoid re-takes, although those benefits certainly lend themselves to quality improvements for imaging technologists and the clinicians who review their work. By remediating the center’s deficits in reaching people who strugWWW.THEICECOMMUNITY.COM

gle with the anxiety around diagnostic imaging, and seeking to refine its approach to breast imaging, Lahey Outpatient Center Danvers is also elevating its profile among patients in its service area, and recapturing lost revenues.

The facility settled on Philips as its vendor, and began construction of an Ambient Experience MR In-Bore suite.

The suite is designed to give patients control over their sensory experiences within the room, allowing them to select from among any number of video and audio themes that relax them with soothing sensory experiences. Only the MR magnet and power injector are visible to patients, and the injector is strategically positioned so it’s not visible when patients enter the room. A wide-bore magnet is designed to appear more open to patients than other systems appear, which helps those battling claustrophobia to be calm during their studies.

A ceiling-mounted projector draws the patients’ focus, and once they’re positioned within the magnet, mirrored glasses allow them to view a second, 55-inch LED screen on the back wall of the suite, which displays the same video while they’re supine.

The room is lit by a large halo light and soft LED spotlights; its corners are gently curved, which lends a greater sense of depth to the space by creating the illusion of edgeless walls. Audio tracks can be set to coordinate with the video display, or patients can bring their own music to listen to during the study.

Those sensory modifiers all make the imaging suite about 10 percent more expensive than comparable rooms without them, which meant Curatolo needed to demonstrate the business case to leadership

for adding them.

“The hospital understood that there’s value in giving patients a good experience,” he said: “better exams, fewer no-shows and high patient satisfaction. That makes them think better of our institution, better of our imaging system, and there’s value in that; not just soft value, but real value.”

“Patients are more likely to come back to our institution if they have a good experience with MRI,” Curatolo said. “I think, in an ideal world, every imaging suite would be like this.”

When the installation was completed in the second quarter of 2016, it opened to positive feedback from patients and staff. As one of the first centers in the area to have installed the Ambient suite, Lahey Outpatient Center Danvers became a show site for Philips, and the magnet became the most-requested at the center, drawing in patients from as far away as Maine on the strength of word-ofmouth, positive reviews and media attention. Among staffers, the suite had also become the most popular worksite at the facility, “which is interesting because you’re getting the most difficult patients there from a technologist’s point of view,” Curatolo said.

“We did a lot of surveys, and a lot of direct interviews by technologists with patients, and easily demonstrated that the cost-benefit analysis worked out in our favor,” he said.

“Patient satisfaction is a big driver.

In the Northeast, we have lots of competition, so the idea of patient retention, and attracting new patients, and keeping our patients satisfied is all very valuable.”

Although the facility hasn’t quantiICEMAGAZINE

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Cover story

Improving the Patient Experience and Your Bottom Line

fied specifically how much recaptured revenue its patient-centric imaging suite has generated, Curatolo said the center has paid for the 10-percent premium by not only having fewer cancellations and no-shows, but also by halving the number of patients who reported feeling claustrophobic during their experience.

The suite also improved patient satisfaction among women undergoing breast MRI. Although those patients are treated in a prone position, and cannot see the video screens during

recently diagnosed with breast cancer and getting a study before they start their treatment, or they’re high-risk for breast cancer, or they’ve had a previous cancer,” he said. “All of these patients are different from the general screening population of women.”

That’s a sentiment shared by Christopher Austin, MD, MSc. Austin is the chief medical officer for Kheiron Medical Technologies of San Francisco, California. As device manufacturers focus on improving patients’ physical experiences and making them more calming, comprehending their state

“ This is really where there’s a great opportunity for radiology to think beyond the device and look very closely at what artificial intelligence (AI) can do to reduce patient anxiety.”

– Dr. Christopher Austin their exams, the suite still offers other calming elements, including soft, ambient lighting and customizable audio tracks to help calm them during the experience. Those sensory palliatives can help alleviate what might be an intensely intimidating experience for women who may be already apprehensive about undergoing breast imaging.

Breast MR may not come with the compression and physical discomfort of a mammogram, but it takes longer to complete, the patient’s breasts are exposed to the device while in a prone position, and those women who are undergoing the study “are, on the average, more apprehensive than a woman getting a routine screening breast study,” Curatolo said.

“Most of the patients we see fall into one of three categories: they’re 38

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of mind is equally important. Austin rightly points out that “what can cause the greatest anxiety are the unknowns” involved in the study.

“What is the machine actually seeing?” he said. “What if an abnormality is detected? Will the radiologist pick it up? How quickly will my scan be read and reported? How long will I have to wait to access the results?”

“This is really where there’s a great opportunity for radiology to think beyond the device and look very closely at what artificial intelligence (AI) can do to reduce patient anxiety,” Austin said.

“This may include accelerating image interpretation, providing added diagnostic confidence to the radiologist, getting the information back to the patient in a timely manner, and reducing

the probability of further unnecessary additional diagnostic procedures.”

From Austin’s perspective, efficiently delivering accurate study results is the most important part of breast screening for patients. AI mechanisms can provide “the added reassurance of a second pair of eyes,” he said, especially in the United States, where not every patient enjoys the benefit of two, independent radiologist reviews of their studies, as is done in Europe.

AI may act as a stand-in for the “gold-standard” of screening, improving cancer detection rates, and reducing the frequency of recall visits, “which for most women end up being normal … but may cause emotional trauma and anxiety, prolonging the uncertainty and the wait for results,” he said.

“In the United States, we have a single human radiologist who looks at every breast scan,” Austin said. “AI offers the possibility to shift from the single-reader paradigm to what is achievable in Europe. We are starting to show through our clinical trials that AI can bring double-reading quality to the single-reading screening world of the United States.”

To better strengthen patients’ understanding of these benefits requires better patient education on the role of technologies like AI-based algorithms, its benefits in decision support and the assurance that it is developed inclusive of a regulatory process.

“There’s still a pilot in the driver’s seat, and that is the doctor,” Austin said, “and the computer is helping them read the images.”

Austin also believes that AI-supported patient screening helps improve workflow by improving image quality.

That can have a direct impact on patient comfort by again reducing technical recall rates, which also limits the ADVANCING THE IMAGING PROFESSIONAL

risk of additional exposure to ionizing radiation in the case of mammography, and cuts back on “the mental anxiety of having to wait for the scan and the final report, which for some women could be a few additional weeks,” Austin said.

There’s also a business case for the implementation of AI-augmented diagnostic solutions; namely, that providers can lean on it “to differentiate their services and better compete for patients, especially in large, competitive markets,” Austin said.

“If a provider can confidently show that AI is giving patients improved confidence in the clinical service, and returning the results faster, this can influence patients who have choice in selecting their provider,” he said.

Failing to account for patient comfort, however, can negatively affect an imaging facility by providing a subpar patient experience, which “will always define where your patients go,” Austin said.

“Breast screening is one of the best examples, because women will talk about where they go for their screens, which modality was used and how friendly the technologist was,” he said. “Your bottom line is going to be impacted by their experience.”

Included within that calculus, he argues, is the importance of attracting and retaining qualified staff.

“Patients and staff want to see more transparency around those things that the organization is doing to try and really improve patient service,” Austin said, as well as innovating improvements based on understanding the patient experience.

“All great innovations in health care come through thinking about the patient journey,” Austin said. “Organizations are going to be blindsided if they haven’t prioritized this.”

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Focusing on the patient journey is one of the foremost precepts of the design philosophy at Marlborough, Massachusetts-based Hologic, said Jennifer Meade, president of its breast and skeletal health solutions division.

Meade cited the findings of the April 2017 “Ten Thousand Quantitative Findings Research Study” by Kadence International, in which a survey of 10,000 women revealed that the most-cited reason for avoiding a mammogram was fear of physical discomfort. Among the women surveyed, compression force, breast pinching and time under compression were the top three complaints made about undergoing a mammogram.

With that information in mind, Hologic’s SmartCurve breast stabilization system was designed to address the discomfort those women experienced. Switching out the flat paddles that historically have been used in mammogram acquisition for a curved shape that more closely mirrors the contours of the breast, Hologic was able to develop a device that reduced patient motion during the study, and also created a more uniform image.

Modifying the algorithms used in image processing also retained image quality, offering a more specific analysis of the images, improving diagnostic rates and reducing unnecessary recall studies.

“We really think about integrated solutions across the spectrum of patient care,” Meade said. “We consider how that path fits together, and the opportunity to drive more clinical certainty. We’re constantly thinking about how we drive detection, time under compression, and how to speed up workflow in that entire continuum, making sure the experience is seamless, with overall faster and better-quality outcomes for our patients.”

Better-quality patient experiences also can result in healthier patients and better disease detection rates. As patients who have the best experiences return to those settings in which they received a high standard of care, they improve their likelihood of achieving routine screenings and earlier detection of abnormalities.

“You want patients making their screening choices because of their positive experiences and we know we’ve made an impact there,” Meade said. “Think about the funnel of care: having a woman go get her mammogram is where it starts. Having the best technology, having the best experience, gets people in the door, and then we approach compliance on an annual basis. The more uncomfortable the experience, the more the risk that a patient will not be compliant next year.”

Meade said Hologic follows a few key tenets in guiding innovation of its products; these include image quality, cancer detection, workflow and improving patient experience. The takeaways from patient feedback are based not only on patient reports of their experiences, but also that of the technologists, whom she points out spend the most time with patients and can have the most impact on their experiences.

“When we think about things that we’re working on for the future, we do look at how do we arm that technologist with the very best workflow so we can spend time with the patients,” Meade said. “A really big environmental factor is the technologist. Having a passionate, skilled technologist who can spend time with the patient to make sure that the patient knows what to expect and guide them through that workflow – that has a really big impact on the patient.” • ICEMAGAZINE

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INSIGHTS

CODING/BILLING

BY MELODY W. MULAIK

ORDERS IN THE HOSPITAL SETTING T

he guidelines for the ordering of diagnostic tests in the non-hospital setting have been around for 20 years. This information is found in the Medicare Benefit Policy Manual, Chapter 15, Section 80.6: cms.hhs.gov/manuals/Downloads/bp102c15.pdf People sometimes incorrectly think there are no guidelines to follow for ordering services provided in a hospital setting which is not the case. The ordering of diagnostic tests in the hospital setting is governed by the Medicare Conditions of Participation (COP) for hospitals. These are found in the Code of Federal Regulations, 42 CFR §482.

The standard for medical record content [42 CFR §482.24(c)] states: “All orders, including verbal orders, must be dated, timed, and authenticated promptly by the ordering practitioner or by another practitioner who is responsible for the care of the patient only if such a practitioner is acting in accordance with state law, including scope-of-practice laws, hospital policies, and medical staff bylaws, rules and regulations.”

The standard also states that the hospital may use preprinted and electronic standing orders, order sets and protocols. However, these must be: Reviewed and approved by the medical staff and by the nursing 40

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and pharmacy leadership; consistent with nationally recognized and evidence-based guidelines; reviewed regularly by the medical staff and nursing and pharmacy leadership; and dated, timed and authenticated promptly by the ordering physician or practitioner in the patient’s medical record.

Alternatively, this may be performed by another practitioner who is responsible for the care of the patient, but only if he or she is acting in accordance with state law, hospital policy and medical staff bylaws, rules and regulations.

The radiologic services standard regarding patient and personnel safety [42 CFR §482.26(b)] states: “Radiologic services must be provided only on the order of practitioners with clinical privileges or, consistent with state law, of other practitioners authorized by the medical staff and the governing body to order the services.”

This means that all diagnostic tests must have an order documented and authenticated in the patient’s medical record, and the order must match the test that was performed. The ordering physician can be any physician who is authorized by the hospital’s medical staff to order diagnostic tests. All tests must be medically necessary, and the documentation supporting medical necessity must be in the patient’s hospital record.

The COP do not specify that the patient’s ADVANCING THE IMAGING PROFESSIONAL

treating physician must be the ordering physician, but some Medicare contractors have stated that an order from the patient’s treating physician is required to support medical necessity. Providers should review any guidance published by their local contractor. Keep in mind that published audit results from Medicare contractors and the Office of Inspector General (OIG) have frequently identified a high volume of errors due to lack of a physician order, an unsigned order or an order that does not match the test performed.

Hospitals should have a process in place to ensure that all diagnostic tests have orders that are signed by an authorized provider and match the study performed. If the hospital allows the radiologist to order diagnostic tests, then a process should also be developed to ensure that any changes made by the radiologist are documented and authenticated in the same manner that the original orders are documented and authenticated. Both radiologists and hospitals are potentially subject to refund obligations if there are not appropriate orders for performed services. • 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

EMOTIONAL INTELLIGENCE

BY DANIEL BOBINSKI

MAINTAINING STANDARDS IN THE ‘FACE’ OF CHANGE F

or too long, we’ve not seen enough faces. Several doctors I know are concerned about the impact of the Centers for Disease Control and Prevention (CDC) recommendations on interpersonal communications. So, I thought it would be appropriate to write about the need to maintain the standard of good interpersonal skills, even in the face of change.

Whenever I do team building workshops, one question I always ask is what people would like to see different at their workplace. Invariably, and I truly mean that, people always say they want better communications. But that answer is never good enough for me. Do they mean better or more frequent sharing of the corporate vision and the milestones being reached? Do they mean a better articulation of the objectives for the day or the week? Do they mean more frequent conversations with their supervisors and/or co-workers to get feedback on the quality of work being produced?

The word “communications” is a broad umbrella that covers many potential aspects of the workplace. I always press for more specifics. Today, I want to focus on the 42

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need to maintain good body language cues because lately we’ve been missing out on a lot of them.

Studies vary but when I teach about interpersonal communications, I refer to the following statistics: • Word choices = 7% of communication • Voice tone = 25% of communication • Body language = 68% of communication These numbers shed light on why I prefer talking on the phone rather than relying on text or email, and why I often prefer a video conference over talking on the phone.

With email and texting we can convey concepts, but the emotions and emphasis behind the words are missing. Emoticons help, but they don’t substitute for the intonation and inflections of voice.

Voices heard over a phone call help a lot, but even then our communications are only one third of what’s possible. The best and most effective communications occur face-to-face, but as you’ve probably noticed, we’ve been deprived of facial cues for a while now.

Many people with mild to moderate hearing loss have come to rely on facial cues to aid in understanding what someone’s saying.

And there are more of us than you may realize. On a personal note, I have 40% hearing ADVANCING THE IMAGING PROFESSIONAL

loss in one ear and 60% loss in the other. I’m not a fan of my hearing aid, and with the advent of facial coverings, I didn’t realize how much I’d come to rely on watching someone’s lips to aid in understanding what people are saying.

Over the past year, I’ve learned that many people have this same dilemma. The difficulty has been compounded with people wanting to maintain a safe distance from each other.

But beyond that, I and many others have observed that, overall, people aren’t as engaged with each other as they were 14 months ago. It seems that with the loss of facial cues, many people closed off a portion of their overall interactions with others. Since this tendency has an impact on our humanity, it is this issue that I want to address by offering a few suggestions.

The first, and likely most obvious, is to talk a little louder and work to articulate words. It’s amazing how much some of us “swallow” certain syllables or leave off the emphasis of certain consonants. I used to be super guilty of this, and I found out the hard way. I used to record myself when I was preparing to give professional presentations, and I was shocked to realize that some words that I thought I was saying clearly were hardly discernable. I’m not saying anyone needs to spend time recording and evaluating their speech; I refer to it only to point out how much we may think we’re being clear in our words when we’re not. If we’re wearing a face covering, articulating becomes even more important.

Second, let your hands do more talking. As the statistics above indicate, 68% of our communication is body language. If people can’t see our minor but ultimately important facial cues, we can augment by being more animated with our arm and hand movements. I realize this won’t always be possible, but when and where it is possible, more body language helps people understand what we’re trying to get across.

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Third, be sure to look people in the eye when talking with them. Together with this, strive to be a little more animated with your eye expressions. Muscles around our mouths give the best body language cues when talking face-to-face, but after that our eyes can help a lot.

At least three obstacles get in the way with this third suggestion. First, most of us are accustomed to relying on the muscles around our mouth. Being purposeful in animating our eyes requires a conscious choice. Second, a lot of people are accustomed to wearing sunglasses if outside. Face coverings plus eye coverings make it hard to convey any facial expression at all, so if you’re outside, it may be best to remove the eyeshades when talking with others, despite the sunshine. Third, in general, many people are not accustomed to a lot of eye contact and will be uncomfortable with it.

However, I firmly believe that making the effort will help a lot in keeping that valuable connection we have as human beings.

Finally, pay attention to the feedback you’re getting from the person or people with whom you are talking. With that, don’t be afraid to ask whether people can understand you if you think the communications aren’t what you think they should be.

Through this season of humanity, we cannot afford to hinder our communications. A little effort on our part can not only maintain a standard of good communication, but ultimately may improve it. And that can only be good for all of society. • 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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IMPROVING THE PATIENT EXPERIENCE M

any exams in medical imaging don’t take very long. Often, it takes longer to park the car outside the facility than to have your X-ray done.

This is not much time to make a good impression, but plenty of time to make a bad one.

DIRECTOR’S CUT

BY BETH A. ALLEN

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Customer service comes more easily to some people than others. We have all witnessed those team members deliver hospitality that just comes naturally. They can effortlessly ease a patient’s anxiety and deliver a patient experience that earns that tech rave reviews in the comment section of the patient survey. This kind of interaction can be too friendly for some patients.

Others may have a different personality type. While they are able to perform the exam with just as much expertise, if not more, the personal interaction does not come as easily. They are not rude or cranky, they just relate to patients with necessary information only.

There isn’t a right way for every patient. The important part of the interaction is to make sure that we are communicating all necessary information in a manner that is efficient, friendly and professional. Patients come to us in all different moods. We have no way to know what challenges they are dealing with today. We need to meet them where they are, assume good intent and be patient.

ADVANCING THE IMAGING PROFESSIONAL

AIDET is a method of communication that was developed by the Studor Group as an outline for health care professionals to follow. The acronym AIDET stands for Acknowledge, Introduce, Duration, Explanation and Thank You. A quick Google search for the term will produce quite a bit of detail about how institutions have used this format. Whether the personal side of the business of health care comes naturally or not, it serves as a checklist to make sure that we have communicated all pertinent information in an efficient, professional and cordial way. It also allows us to thank the patient for choosing us to participate in their imaging care.

When a technologist calls a patient into a room to perform an exam, it is important to remember that this space is like home to us. We come here every day. The equipment that we use day in and day out is often scary and intimidating to a patient. The information that we repeat over and over is new to the person we are speaking to. If we invite the patient into our space like we are inviting them into our living room; treat them with the respect and care that we would hope our family would receive by introducing ourselves and explaining what is going to happen; then thank them for spending time with us, it is a game changer.

The patient should be escorted out. No pointing to a sign that shows them where the exit is. Patients should not be wandering around the facility, which is a safety and HIPAA hazard.

Over the years, I have been a part of many different WWW.THEICECOMMUNITY.COM

patient experience initiatives. They all come down to respect and communication. I review the comments from our patient surveys each week. It really unlocks the code. I have identified the key to the course: be on time. Over and over, I see a comment about whether or not we met the expectations of how quickly the patient was called back for their exam.

Fortunately, most of the comments are positive but patients really let us know they do not like it if we are running behind.

A large percentage of people that leave a comment have something to say about whether we hit the mark here or not.

Due to many different scenarios, we are not always able to be on time. Equipment fails. We don’t have the information required when the patient arrives. Some patients just need more time than others to complete the exam. It is important that when that happens, we acknowledge the obvious. Communicate that we are behind and when the patient can expect to start the exam. This may not entirely fix the issue; people don’t like to wait. It will at least give them an expectation, so they do not just assume we forgot about them.

It really comes down to the basics.

Be on time, if at all possible. Communicate if we are not.

Be efficient, but don’t rush.

Listen.

Be nice and smile (even behind your mask).

Thank you for all you do. • ICEMAGAZINE

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INSIGHTS

ALGORITHMS AND BIORHYTHMS PACS/IT/AI

BY MARK WATTS

R

adiology administrators will understand this scenario: “Mark, we need to do a root cause analysis on an event.” This “event” was the misadministration of nutrients into the lungs of a patient.

An X-ray of the chest was acquired for nasogastric tube placement and processed.

Before the radiologist report could get back to the floor, the NG tube was used.

This is not the first time this has happened in health care. This is a rare “sentinel event.”

Could an artificial intelligence (AI) system have prevented this?

The Joint Commission, an organization committed to the continuous improvement of health care for the public, in collaboration with other stakeholders, designates events as sentinel because they require an immediate investigation and response. Ac-

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credited organizations are expected to respond to sentinel events with a “thorough and credible root cause analysis (RCA) and action plan.”

The most used form of comprehensive systematic analysis among Joint Commission-accredited organizations is root cause analysis, a process for identifying variation in performance, including the occurrence or possible occurrence.

Systems design and training occur.

They are documented in health care. Some examples are two forms of patient identification and the five rights for medication administration. The five rights are: • Right Patient • Right Drug • Right Dose • Right Route • Right Time Variation in performance of these best practices on a decision tree is the issue.

ADVANCING THE IMAGING PROFESSIONAL

PR

Medication reconciliation efforts have created guard rails to assist with the five rights. At this end, it is still a human who decides to administer the medication. A real person who gets tired, distracted by personal issues and who is human.

On March 10, 2019, a 737 Ethiopian Airlines jet crashed shortly after takeoff. A newly installed flight control system repeatedly pushed the nose of the plane down. This system could not be disengaged and overwhelmed the pilots’ attempts to control the plane. When the flight control system triggered the dive for the fourth and final time, the pilots fought back by pulling back on their controls columns with 180 pounds of force, but the nose of the plane sank even more, and the jet flew even faster.

This is a rare example of a system designed to improve safety that caused a sentinel event.

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Artificial Intelligence can help us recognize a blood clot in a pulmonary vessel, pulmonary emboli, but it will never care if a human has a pulmonary embolus.

I have developed, with a team of experts, a patented radiopaque non biological shaped marker paired with AI to recognize these markers to aid in the safe, correct placement of indwelling tubes and catheters.

My system would not have prevented the sentinel event referred to above. AI cannot stop a person from using the nasogastric tube before the radiologist reported that the tube was incorrectly placed.

To err is human, to practice medicine outside of your scope or override safety procedures is an error that even AI can’t overcome. • MARK WATTS is the enterprise imaging director at Fountain Hills Medical Center.

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INSIGHTS

SPONSORED CONTENT

GETTING IT RIGHT. AT THE RIGHT TIME. EVERY TIME.

Revenue Modernization During a Worldwide Pandemic

I BANNER IMAGING

BY TORI WASON

n health care, the only constant is change. Health care professionals strategically plan for technological advances, patients becoming consumers, governmental mandates, reimbursement cuts, and right when you think you have planned for everything; a pandemic happens. With all of this, how can patient access continue to increase revenue while creating a customer obsessed culture? Getting it right, at the right time, every time. Getting demographic and insurance information right the first time and prior to the patient’s arrival is key to reduce denials, touchpoints, collection efforts on the back end and bad debt.

In 2019, the Banner Imaging patient access team began evaluating tools and new processes to implement as a part of the larger Banner Revenue Modernization project. This started in 2019, with go-lives throughout 2020 and continued implementations and optimization will be coming our way this year.

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EXPERIAN Experian was the first software implemented for the Banner Imaging patient access team in 2020. This suite of products is a one-stop shop for eligibility verification, patient estimates and registration quality alerts and more. A real-time HL7 interface from the Fuji Radiology Information System (RIS) to Experian provides the team with instant eligibility results each time insurance information is updated in the RIS. Registration quality alerts (RQA) flag registration errors. These alerts come standard and can be customized allowing staff to correct these errors in real-time, which directly impacts the denials and multiple touches due to unnecessary re-work.

Banner Imaging also implemented a patient estimation tool in Experian, which allows the team to run cost estimates based on the patient’s benefits and our contracts.

Experian offers extensive reporting including, but not limited to, determine trends, training needs, staff development and missed collection opportunities. We will continue to add more Experian modules as we are looking at optimization. Medical necessity and an integrated payment plan ADVANCING THE IMAGING PROFESSIONAL

IES? B E E R LOVE FABOUT A HOW

E E R F TION P I R C S UB

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Subscribe to ICE Magazine option with Simplee by Flywire are among two of the modules on the horizon for future implementation.

CURAE Collecting payment before or on the patient’s date of service can be difficult in these times, but this practice is imperative to reducing the A/R, bad debt and back-end collection efforts. Banner Imaging offers patients flexible financing options through Curae to help increase those collections and ease the burden of stress for patients that may not have immediate funds to pay for their health care. Patients are presented with no interest and low monthly payment options and, once approved, they are able to use the funds at any Banner facility.

The application process takes less than a few minutes and an offer is presented in seconds. Banner Imaging receives the payment for services and the patient continues their payment agreement with Curae. Offering more options to patients for payment can help secure payment for services sooner.

SHOPPER ESTIMATES Price transparency is another focus in health care across the board.

Patients are consumers of health care and want to ensure they are getting quality care at a reasonable WWW.THEICECOMMUNITY.COM

price. Patients are empowered to make better decisions and advocate for their health care needs.

Banner Imaging has a pre-services department to provide patients with their benefits and out-ofpocket costs, but having online options available 24/7 makes it easier for a patient to shop or receive an estimate at any time. Banner Imaging went live in 2020 with a self-serve patient price estimator through Simplee by Flywire. This tool is available on our website and provides the patient an opportunity to verify an estimate for services without having to contact a representative. Banner Imaging plans to continue to add more procedure codes to this tool and expand options for patients.

Banner Imaging patient access will continue down the path of relentless improvement as we look to optimize the tools in place and add additional tools to enhance the patient experience while driving down denials and increasing revenue. Through the projects, opportunities, and challenges, we keep our motto at the forefront: Getting it Right. At the Right Time. Every Time. • TORI WASON, CHAM, is the director of PAS operations for Banner Imaging.

and stay up to date on industry trends, news, webinars and conferences!

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ICEMAGAZINE

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INSIGHTS

RAD HR

BY JANEL BYRNE

THE POWER OF ‘PAUSE’ M

y role at my current organization is two-fold. I’m responsible for envisioning and implementing the enterprise’s leadership development strategy and I am the direct leader of a team. I’ve been thinking a lot about how I “walk the talk” of the leadership behaviors my team and I are rolling out enterprise-wide. A leadership challenge that may sound familiar to you – I have competing priorities with limited resources, especially amidst this ongoing pandemic, and am trying to ensure my team has what they need to thrive, not just survive.

This type of pressure finds me in a constant tension of wanting to move fast to execute and knowing that initiatives, like defining effective leadership competencies and equipping 1,000-plus leaders to “walk the talk” of those competencies, requires significant assessment, collaboration, strategizing, resources, time and so on so they can truly become a part of the organization’s culture.

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Also, those I lead are humans first – they need their oxygen masks on before they can contribute effectively to the organization. And, in acknowledging that, I have to own that I also need to put my oxygen mask on to be an effective leader. So, what does that look like? As we make our way in 2021, I’ve been reflecting on the power of “pause.”

“I have to solve this problem right now!” is an easy trap for leaders to fall into. This statement automatically implies that this problem can be solved and that you, the leader, has to solve it now. Time and again, when I have moved quickly to an answer, especially on my own without tapping into the expertise of my team, I have spent a lot of brain power on a short-sighted fix to a situation versus a long-term, sustainable solution. Often, I have missed uncovering the actual problem (i.e., taking more time to ask questions to discover the root cause of the situation versus coming with solutions that only address the symptoms).

The result of this approach leaves with me ineffective, non-sustainable solutions for the organization and mentally exhausted without my oxygen mask on.

ADVANCING THE IMAGING PROFESSIONAL

Recognizing this, when I feel the pressure to have a solution now, instead of reacting, I prioritize the time to pause, put my oxygen mask on and ask myself some of the following questions: • What do I understand about this situation?

• What don’t I understand and need to be curious about (i.e., do I even know what the true problem is that we are trying to solve)?

• Is this a true priority to investigate further amidst my team’s priorities and available resources?

• If it is, what is the real timetable for determining a solution and what’s the “why” for that timetable?

• Who may have more subject matter expertise, let alone passion for this situation/realm to thought partner with?

• Can I appropriately empower this person/group to own figuring out the solution given their expertise, skill set/ strengths, work they find meaningful, expectations of their role, etc.

• What additional space do I need to give myself to think through this one?

I’m adding more questions as I play with pausing this year.

Qualitatively, I have experienced an increase in my own brain WWW.THEICECOMMUNITY.COM

power as multiple situations presented as “emergencies” for me to figure out are actually what I call, “cultural urgencies” – non-life or death situations that are rooted in internal politics that don’t require an immediate response and use of limited resources. Rather, they require thoughtful processing to determine how they do or do not contribute to sustaining strategies.

The pause is not easy – it takes a lot of time to unwind behavior you are used to, and I’m naturally wired to problem solve. That said, I put my oxygen mask on by physically taking three to five breaths to calm my immediate need to respond – and the racing thoughts in my head – so I can get myself to a grounded state where I can start thinking through the aforementioned questions. I’ve also asked my team to hold me accountable to pausing – and they continue to do so.

Sometimes the best answer is no answer at all – it’s prioritizing the space to think through the process to get you and your team to sustainable, instead of reactive, contributions to your organization. • JANEL BYRNE, MSW, SHRM-CP, is an organizational effectiveness manager at Children’s Hospital Los Angeles.

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INSIGHTS

HANDHELDS AND GOVERNANCE T

DEPARTMENT/ OPERATIONAL ISSUES

BY JEF WILLIAMS

he proliferation of handheld imaging devices continues to expand. These small medical imaging devices are most often used as bedside or point-of-care ultrasound (POCUS) in diagnosing or treating patients. They are affordable to the point that many clinicians have purchased them outside of the normal procurement process. And, while being an effective tool in aiding clinicians, they bring some unique challenges to organizations related to image management, integration and determining how they fit into the patient record. It is important that the governing body or committee that oversees the enterprise imaging strategy take steps to frame this disruptive technology within the parameters of its overarching goals.

These devices typically come with their own storage or archive platform in the cloud. As images are acquired, they are stored in the vendor’s hosted environment where users have access to

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image manipulation and viewing tools.

While this brings a level of simplicity in deployment, it creates challenges for organizations that want to integrate these images into the larger imaging archive model. If images are stored both in the cloud and locally, there needs to be robust integration to ensure that all copies of these images, wherever they reside, are kept in sync.

If the goal is ultimately having all imaging available via a single enterprise viewer, these images should also be available to that viewer. If the primary storage of these images remains in the cloud, one must ensure there are good image management policies and auditing capabilities in place.

The role these images play in the complete patient record will determine how to integrate these images to the EHR. The vendors provide strong integration points and many organizations have found a key stream of revenue by doing so. To store these images in context allows organizations to bill for the imaging done by these devices.

More importantly, having these images available to clinicians through the EHR simplifies their access at the point of care.

ADVANCING THE IMAGING PROFESSIONAL

Disruptive technology like this is good for our organizations. It challenges the status quo and tests our strategic planning. As is the case with handheld devices, some of these disruptions are entering our ecosystem outside of our prescribed processes and we must have the agility to respond. I began seeing these phone-driven ultrasound probes at the Consumer Electronics Show (CES) long before they made their appearance at the most popular health care conventions. It indicates that new technology is emerging as a consumer-driven solution and its introduction in the care environment will not follow standard procurement models.

WWW.THEICECOMMUNITY.COM

This is where governance is critical to an enterprise approach to imaging. The goal should not be to dissuade the adoption of disruptive technology but rather to enable it in a way to meet the objectives of a fully image-enabled patient record. There are ways to solve the challenges associated with new, affordable and widely adopted platforms and each organization must solve it uniquely based on its existing technology landscape.

But without strong governance, it will be entirely reactive and likely ineffective. • JEF WILLIAMS, MBA, PMP, CIIP, is a managing

“Having images available to clinicians through the EHR simplifies their access at the point of care.”

partner at Paragon Consulting Partners.

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INSIGHTS

THE MAGIC TRIGGER I

have conducted preprovide shortcuts to the resentations and writsponse. ten about the brain’s This may seem irrational, howdecision-making proever, imagine having to perform cess many times. I often a rational analysis of every single refer to Russell Grangincoming informational event. er’s “The 7 Triggers to We want to believe that we are Yes: The New Science rational beings with the ability to Behind Influencing scrutinize, examine and dissect People’s Decisions.” before making decisions. We can This book has transsometimes do this, however only ROMAN REVIEW formed how I endeavor after the amygdala steps away

BY MANNY ROMAN to engage and influence and allows it. others. The focal point The above mentioned “7 of the book is based on Triggers” are ways to access, the science that demonstrates that the gain attention, engage and activate the amygdala brain’s main decision-making process into providing the response we want to receive: is controlled by our prehistoric limbic Yes. These triggers provide the emotional system system’s amygdala. with the requisite shortcut to a decision without Studies have shown that this system controls feelings of motivation and reward, learning, memory fight-or-flight response and basic emotions. It is the amygdala that ensures that incoming information is screened for danger before the relatively newly developed prefrontal cortex gets an opportunity to analyze the situation. An emotional decision is made before the rational brain can access the information. The rational brain then usually only justifies the already made emotional decision. The first response is always emotional, and the amygdala will make a decision instantly.

Memory tags previously stored for similar events 54

ICEMAGAZINE | APRIL 2021

needing to forward the information for analysis.

This provides an effortless fast track that keeps the prefrontal cortex in its snooze default state.

Russell Granger’s namesake son has taken his father’s legacy to the Internet with a program that educates and trains in the application of the “7 Triggers” to real life. Russell has provided me the opportunity to explore the program at 7triggers. com. I am very impressed. The “7 Triggers” are beautifully presented in graphically interesting modules. I would recommend this program to anyone who wishes to improve the ability to influence others and enhance communication skills.

Now I want to discuss my favorite trigger: ADVANCING THE IMAGING PROFESSIONAL

Hope. Everyone seeks to improve their lives, status, health, happiness, etc. We hope that the decisions we make result in desired outcomes.

If we can frame our presentation to influence others toward their desires, we present the easy shortcut to their agreement. Hope is a hugely powerful trigger. We buy lottery tickets, drink the beer with the good-looking people in the commercials, we spend billions on cosmetics, and move to Vegas to play poker.

President Snow in the “Hunger Games” movie said, “Hope, it is the only thing stronger than fear. A little hope is effective, a lot of hope is dangerous. A spark is fine, as long as it’s contained.” Charles Revson, founder of Revlon said, “In the factory, we make cosmetics; in the store we sell hope.”

I will be conducting a presentation titled The Magic 7 Triggers to Yes at the 2021 Imaging Conference and Expo (ICE), May 11-12 in Fort Lauderdale, Florida. We will discuss all 7 triggers there, have some fun and be together again in the waning days of the pandemic. For more information, visit AttendICE.com. Hope to see you there. •

“Hope, it is the only thing stronger than fear.”

– President Snow, “Hunger Games”

MANNY ROMAN, CRES is the AMSP Business Operation Manager.

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AMSP

SPONSORED CONTENT

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Our large pool of modality specialists provide for lower costs and higher quality services for our customers throughout the U.S. Learn more at www.amsp.net.

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ICEMAGAZINE | APRIL 2021

ADVANCING THE IMAGING PROFESSIONAL

SPONSORED CONTENT

I M A G I N G

MEMBER PROFILE

INTERSTATE IMAGING

BY ERIN REGISTER

F

ormed in 1978 in Evansville, Indiana by Colonel Chuck Kinney, Interstate Medical Surgical was part of a vending, security and medical (surgical supply/X-ray) company. In 1989, the company was purchased by Stan Fishburn and he decided to solely focus on radiology equipment service and sales. As a result, the company was renamed Interstate Imaging.

Andrew Brinkman became president in 2021, with Shannon Allega as vice president and Adam Crawford as director of service. With its service and sales team, Interstate Imaging covers the Kentucky, Indiana, Illinois and Missouri regions.

Interstate Imaging 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 Interstate Imaging in a recent question-and-answer interview.

Q:

How does your company stand out in the medical imaging

field?

A: We provide value-based service for our clients. Simply, we provide financial savings for hospitals as they purchase service agreements from us without

WWW.THEICECOMMUNITY.COM

any reductions in the quality of service.

Additionally, our main tenet is to “take care of the customer.” If we say something, we stand by it. If the unit we sell has issues, we take care of it.

If an expert besides our team needs to be called in, we do it. Our clients trust us to do the right thing; we stand hand-in-hand with them.

We also partner with elite vendors, such as Carestream, Konica, Canon, Del Medical and Summit (AMRAD) to provide innovative imaging equipment solutions for our clients.

Q:

What are some of the services and products you offer? Is there a specific or new one you are excited about right now?

A: Our main focus is asset management for hospital facilities. It is a fully encompassing program where we service all radiology equipment throughout the hospital. We have been very successful reducing expenses for our asset management clients while providing better service and uptime on their imaging equipment.

We also sell and service all modalities of imaging equipment, such as X-ray, CT, MRI, cath labs, mammography, C-arm, ultrasound, etc. Over the past year, we have created an equipment rental program that has been successful. Among others, we offer digital X-ray portables, DR detectors and C-arms. Additionally, we purchase used equipment from our clients. Most of the time, we are able to provide a better offer than the OEM or equip-

ment brokers with less hassle, as well.

Q:

What has been your company’s biggest achievement?

A: We have been able to successfully transition to a service-based organization, as opposed to a new equipment sales-based company. We have really focused on increasing our service capabilities and client partnerships over the past few years.

We have built a large and strong team of field service engineers who are well-trained and knowledgeable about all modalities of imaging equipment.

Q:

What is on the horizon for your company? Do you have any goals you would like to achieve in the near future?

A: We plan on continuing to grow our asset management and service business throughout Kentucky, Indiana, Illinois and Missouri. We are also currently working to expand our direct footprint throughout the Midwest and South.

Q:

Is there anything else you would like our readers to

know?

A: If you need anything related to imaging, we have it or can source it. For example, we have a supply of various DR detectors available for sale or rent.

We also sell radiology accessories, such as lead aprons, sponges, stands, etc. • For more information, visit www.interstateimaging.com.

ICEMAGAZINE

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“Time is a created thing.

To say ‘I don’t have time,’ is like saying, ‘I don’t want to.’”

– Lao Tzu

[QUOTE OF THE MONTH]

ICE Break

N O I T P I R C S B E SU

OUT A B A W O ? HICE Community today to: Join IESthe E FREEB

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ADVANCING THE IMAGING PROFESSIONAL

Science Matters

Huge camera sees tiny black holes

A camera mounted on a telescope in Hawaii has spotted small, ancient black holes drifting through space, with clues to the mysterious dark matter and existence of other universes.

Subaru Hyper Camera’s Suprime-Cam first lens:

The big instrument

32 in. (82 cm) diameter

Telescope’s light-collecting mirror: 27 ft. (8.2 m) diameter

Subaru telescope

Light-detecting CCD array: 870 million pixels (megapixels)

On Mauna Kea, Hawaii

What it saw MILKY WAY GALAXY

1

Camera scanned many stars in Andromeda galaxy, found some that brightened, then dimmed

Earth

2

Black hole (mass less than the moon’s)

Star brightens ANDROMEDA GALAXY

Best explanation: A massive object passed between Earth and the star, and its gravity focused and intensified the light, a case of “gravitational lensing”

Distance: 2.5 million light years

Far-out implications

Mini-universes that broke from our universe shortly after the Big Bang appear as black holes

“Dark matter,” a mysterious, plentiful

material in the universe, could be wandering black holes as old as the earliest stars

These primordial black holes are small

universes dating back to the origin of our universe – and we live in a “multiverse”

Source: A. Kusenko and others in Physical Review Letters Graphic: Helen Lee McComas, © 2021 Tribune News Service

WWW.THEICECOMMUNITY.COM

Illustration: © Kavli IPMU

ICEMAGAZINE

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LAST CHANCE! new dates! soak up the sun

while advancing your career at ICE 2021

The Conference for Imaging Professionals WWW.ATTENDICE.COM

EVENT HIGHLIGHTS We know every part of the Imaging Expo is great, but make sure you don’t miss out on these big events: TUESDAY, MAY 11 • Exhibit Hall Grand Opening (4:30-6:30 pm)

WEDNESDAY, MAY 12 •K eynote Address: Panel Discussion (2:30-4 pm)

ICE 2021 is approved for 32 ARRT Category A CE credits by AHRA.

KEYNOTE ADDRESS

A Look Back at 2020 and the Lessons Learned This general session will provide viewpoints from a variety of esteemed representatives of the imaging profession on lessons learned from 2020. How they overcame the challenges faced and also highlighting the successes achieved.

DOOR PRIZE RAFFLE What’s better than free stuff? Nothing! You’ve done the work by visiting the vendors, now make sure you’re present on Wednesday, May 12 at 2:15 pm to win one of many great prizes including gift cards, electronic gadgets, and cold hard cash! But, you must be present to win, so don’t miss out!

FINALE PARTY The Finale Party is an event you don’t want to miss! We will wrap up the Imaging Conference and Expo with food and music.

ADDITIONAL INFORMATION HOTEL The Westin Fort Lauderdale Beach Resort 321 North Fort Lauderdale Beach Blvd Fort Lauderdale, FL 33304 PARKING On-site parking, fee: Discounted rate $14 daily Valet parking, fee: Discounted rate $25 overnight

AIRPORTs Fort Lauderdale-Hollywood International Airport (FLL) Hotel direction: 6.2 miles SW Approximately 15 minutes.

Miami International Airport (MIA) Hotel direction: 32 miles SW Approximately 50 minutes.

WWW.ATTENDICE.COM • FT. LAUDERDALE, FL • MAY 11-12, 2021 NAVIGATING THE FUTURE FOR IMAGING DIRECTORS AND SERVICE PROFESSIONALS

INDEX

ADVERTISER INDEX Innovatus Imaging p. 9 Association of Medical Service Providers (AMSP) p. 56

MTMI p. 30-31

The InterMed Group p. 18-21

SOLUTIONS

MW Imaging Corp. p. 5

TriImaging Solutions p. 3

PM Imaging Management p. 47

UMAC p. 2

Avante Health Solutions p. 4

International X-Ray p. 41 Banner Imaging p. 48

KEI Medical Imaging p. 25

Technical Prospects p. 11

Ray-Pac® Ray-Pac p. BC

W7 Global LLC p. 55

Diagnostic Solutions p. 41

MedWrench p. 15 Injector Support and Service p. 27

Richardson Electronics Healthcare p. 23

1 2 3

Webinar Wednesday p. 28 Register online to view our live webinars each month.

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

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Watch recorded webinars online.

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