COVID-19 DIGITAL SUPPLEMENT by MD Publishing

1technation.com

ADVANCING THE BIOMEDICAL / HTM PROFESSIONAL

DIGITAL SUPPLEMENT

COVID-19 DIGITAL SUPPLEMENT COVID-19 IMPACTS HTM INDUSTRY

AAMI RELEASES EMERGENCY CORONAVIRUS GUIDANCE PAGE 13

PAGE 6

HOSPITAL BMETS IGNORE COPYRIGHT LAW TO FIGHT PANDEMIC PAGE 19

ARMY MEDICAL MAINTENANCE TECHNICIANS RUSH VENTILATORS TO MILITARY HOSPITALS PAGE 37

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DIGITAL SUPPLEMENT TABLE OF CONTENTS P.6 P.9 P.12 P13 P.15

COVID-19 Impacts HTM Industry Organizations Provide COVID-19 Resources Philips to Increase Hospital Ventilator Production AAMI Releases Emergency Coronavirus Guidance Let CyberMDX Support Your Hospital’s COVID-19 Response Plan

P. 17 Reassessing Healthcare IoT Cybersecurity, Post COVID-19

P.19 Hospital BMETs Ignore Copyright Law to Fight Pandemic

P.21 Clinical Safety Begins with Equipment Cleanliness, Maintenance Program

P. 23 Mobile Rolling Barriers P. 25 Using Automated Healthcare Technologies to Stay

P. 33 Admittance and Software Solutions to Help With COVID-19 Needs

P. 35 ANSI Expands Standards Portal for COVID-19 Crisis to Include IEC Standards

P.37 Army Medical Maintenance Technicians Rush Ventilators To Military Hospitals

P. 38 COVID-19 Spotlights Right to Repair Issue P. 43 Modular X-Ray Shielding Rooms for Temporary Hospital Sites

P. 44 Siemens Foundation Provides $1.5m to Support COVID-19 Response Efforts

P. 46 Ford Expands Medical Equipment Production Efforts P. 50 Model: Nation Nears Peak of ‘Active’ COVID-19 Cases, Strain on Medical Resources

P. 51 Record-breaking Right to Repair Webinar P. 27 AMA, AHA Respond to Rise in Cyber Threats Exploiting P. 55 Stay Safe and Keep in Touch with Radcal the COVID-19 Pandemic P. 56 Survey: Supply and Resource Needs Increase Amid Pandemic P. 29 Health Technology Experts Are a Vital Resource for Coronavirus Response P. 57 Advertiser Index P. 31 PartsSource Opens Online Community to Encourage One Step Ahead of COVID-19

Sharing of Information Critical to Combating COVID-19

THANK YOU HTM HEROS! Advancing the Biomedical/HTM Professional

COVID-19 | DIGITAL SUPPLEMENT

COVID-19 IMPACTS HTM INDUSTRY BY ERIN REGISTER

OVID-19 has, without a doubt, taken the world by storm and impacted every industry in the country in various ways. The entire hospital system, including doctors, nurses, patients, equipment and more, has been affected tremendously by this disease. How has the healthcare technology management (HTM) industry been affected?

The Association for the Advancement of Medical Instrumentation (AAMI) hosted a COVID-19 Town Hall where HTM leaders, such as Danielle McGeary and Mike Busdicker, discussed what HTM professionals need to know. Additionally, the California Medical Instrumentation Association (CMIA) expanded its chapter meetings and held a virtual COVID-19 response panel discussion with BMETs and other HTM professionals from all over the country. TechNation has continued to discover the best information, advice and practices by interviewing more leaders of the HTM industry and how their departments have 6

DIGITAL SUPPLEMENT | COVID-19

been infected by COVID-19. When asked how COVID-19 has impacted his work, Dallas Sutton, clinical engineering manager at Wade Med, answered, “For us, while there have been some weekends for leadership and, very minimally, for technicians, we have just had a lot of additional initial inspections. We have also reprioritized how we work repairs – vents moved to the top of the list, then monitors and so forth. Our director, clinical engineer and a support technician have been working diligently to identify what rooms can be configured as non-traditional ICUs, which has resulted in additional work in monitor configuration, installation and getting cables pulled. Finally, we have actually gotten to do ‘fun’ stuff, like figuring out the ‘just in case’ capabilities of using a single vent on up to 4 patients and configuring an anesthesia unit to function as a vent. Based on the time invested above, PMs have suffered. We are mainly focusing on high risk and any low risk we can fit in. However, through all of this, we have still been able to support staff vacations,

which is something we credit to the efficiencies we have developed within the current team.” Jennifer DeFrancesco, system director at University of Cincinnati Health System, also told TechNation how her work has been impacted by the virus. “Our team has seen a big transition of our on-demand workload from areas that are closed, have a lower census or areas doing elective procedures to on-demand projects to expand ICU capacity on-site and offsite to support the hospital’s operations and the regional efforts,” said DeFrancesco. “HTM also has the added task of managing the ongoing regulatory requirements during this time, so overall our workload isn’t much decreased. A lot more of our daily work is going into innovations or tactical process improvements to improve delivery of patient treatment, reduce clinician exposure as well as PPE usage through better design of systems.” Sutton and others also noted the challenges they have faced and continue to face during this pandemic. www.1TechNation.com

“We have been challenged by the fact that some vendors have communicated their intent to defer PMs and other non-critical contracted work,” said Sutton. “Also, the most interesting problem was having a technician quit with no notice over COVID-19 concerns. We offered a leave of absence and a work-from-home option, which just made the rest of the team that much busier.” During the CMIA virtual panel, vendors refusing to come in for screenings was also a challenge that several HTM professionals noted. An HTM professional in the New York area was asked if he were to give himself advice six months ago what it would be. He just answered with three letters “PPE” and continued to explain how hospitals initially thought irrationally about them. Another challenge the panel discussed was the significant level of no shows. “People are scared to come in, so that leads to no technicians or managers to run the site,” said one member. Another member in Louisiana compared this deserter rate to his experience after Hurricane Katrina. When asked if other pieces of medical equipment (besides ventilators) may be a problem in the future, DeFrancesco said, “Physiological monitoring from an expansion standpoint has been one of the main focuses and has led to system updates, strengthening and expansion. Our system and neurons have also been a big piece of our expanded readiness plan to ensure that the “new” areas that go-live will have a way to get all endpoint data from physiological monitors, ventilators and other endpoints automatically charted in the EHR. Dialysis units and ECMO machines have also realized an anecdotal uptick in utilization with COVID patients as they progress through the disease. In high-surge areas, these may need to be reviewed by HTM as well as potential capacity-limiters. Oxygen delivery systems and capacity are likely the number one item to support ventilators and other oxygen delivery therapies. While this will likely fall to facilities or engineering in your organization, HTM needs to ensure that they are key collaborators working to assess and provide input for oxygen availability and delivery for these patients.” Advancing the Biomedical/HTM Professional

HTM professionals also provided the to COVID-19 but have put a special code precautionary measures they have taken in the pieces of equipment so they know to reduce contact between people, which ones to go back to. Another including each other, within the hospital. member encouraged everyone to make the Sutton stated, “The first thing I did effort to document everything and was count ceiling tiles between techniestablish a good vendor relationship. cians’ workbenches, which resulted in me “There have been no changes on the moving some technicians around. We actual equipment,” said a member. occupied the conference room and “I framed our improvements through an initiative with desks that our team called ‘Critical Systems Strengthening.’ This are not initiative boiled down to us brain dumping everything we normally used in order thought may be needed and working to strengthen our to allow for capacity to support them...” – Jennifer DeFrancesco as much distance between technicians. We ended up allowing about “That’s always been our preparation 90% of the imaging engineers to take point – to get the equipment fixed and advantage of the opportunity to work back on the floor. Know what to do and from home, which seems to be working know what needs to be done.” well. The most challenging thing was the “Just do what we do,” stated Sutton. shortage in Super Sani wipes, which we “HTM professionals are just that – prouse more often than other wipes. They fessionals. Many of us are former military actually kill COVID-19. We were asked and have functioned in ‘combat mode’ at to give up the stock we had and start different points in our careers, and that is using Oxycide. This was initially a how you handle situations like this. Be challenge, as we had to work through calm, prioritize and execute.” developing a proper mixture that would “Really take a look at your specific wet equipment long enough to be effective devices and organizational environment,” but not run into places it shouldn’t be. said DeFrancesco. “I framed our improveThings seem to be working well.” ments through an initiative with our team DeFrancesco said her team is using called ‘Critical Systems Strengthening.’ two shifts covering 19 hours onsite. This initiative boiled down to us brain Rather than the traditional 6 a.m-5 p.m. dumping everything we thought may be shift. needed and working to strengthen our “Our team instituted two shifts with capacity to support them or to expand onsite staff 6 a.m.-1 a.m. daily and on call and strengthen those systems physically covering the remaining hours,” she said. within our environment. Managing staff “This reduces potential exposure from morale is also something you need to be team member to team member. Essentialacutely aware of. I did a basic ‘Fight, ly, we now treat all equipment like it’s Flight and Freeze’ exercise with my staff dirty and are cleaning it prior to evaluaand I have Post-Its on my desk with each tion. This reduces potential for exposure team, the names of staff and where they and was an easy change since the are at. In case you’re wondering, I’ve most departments were already set up that often been in ‘fight’ mode, but I have my way.” moments of ‘freeze’ including falling into While HTMs everywhere are facing binge watching ‘Tiger King’ on the everyday challenges, these professionals weekends.” have a lot of knowledge, advice and tips to share with their peers. For more information and news updates on An important tip one of the CMIA COVID-19 and its impact on the HTM industry, panel members mentioned regarded their visit www.1technation.com. solution to open PMs. He said his hospital has kept PMs and service calls open due COVID-19 | DIGITAL SUPPLEMENT

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REASSESSING HEALTHCARE IoT CYBERSECURITY, POST COVID-19 BY JONATHAN LANGER

hile it’s difficult to think beyond the impact COVID-19 is having on our families and extended communities, our concerns for global health and the economic calamity currently playing out are also impossible to ignore. Yet another sobering reality is knowing that cyber criminals have been capitalizing on the crisis as well.

Although COVID-19 has surely succeeded in throwing the world off balance, it has also brought the need for clinical network visibility and security into sharper focus. Bottomline, when the dust settles on this crisis, the healthcare IoT cybersecurity solution space is going to get a hard look. In fact, most all industry analysts project a surge in demand. With that in mind, and because Medigate believes that product capabilities in our solution market will be scored differently after the crisis, please consider keeping the following tips top of mind, as the foundational tenets of healthcare IoT cybersecurity have not changed: Healthcare Focus: “Concepts don’t win here, ideas don’t win, it’s impact that wins,” said Bill Aulet, managing director of the Martin Trust Center for MIT Entrepreneurship. And that’s why healthcare providers should be focused on solutions solely dedicated to their own industry. No competing development and service agendas are a good thing. At best, cross-industry IoT cybersecurity solutions require health systems to abstract their benefits, whereas a solution specifically focused on improving and securing clinical workflows ensures the relevance of every platform enhancement. The evaluator’s job is to advance practice, not bring a potential vendor up to speed. Customer Experience: Investigate the company profile of the vendors that you’re evaluating. Are they engineering heavy or Advancing the Biomedical/HTM Professional

tilted toward SG&A? Because there is no such thing as “plug and play” IoT cybersecurity in healthcare, your expectations around the quality of the field engineering support should be high, especially at this stage of market maturity. They should be clinical network-specialized subject matter experts (SMEs). When they are, they will prove themselves to be highly valued, long term difference-makers. When they are not, you will find your team and your project quickly losing momentum and void of fresh ideas. Interview the vendor’s field engineers and back-office client-assigned resources. If they’re focused on product features instead of relevant use-cases and workflows, don’t just take a step back, take a detour. Data Quality: Visibility is foundational to effective IoT cybersecurity. As they say, you can’t manage what you can’t see. To put a finer point on this, asset discovery without detailed asset profiling is meaningless. For example, you can’t address an OS vulnerability if you don’t know the hosted version of the OS, and so on. In other words, visibility is about data quality, and varying levels of data quality distinguish all of the market’s solution providers. Not just what they capture, but how they do it. Be wary of vendors who shift the focus elsewhere or attempt to limit the functional groups to whom they pitch. The integrations that will bring these solutions to life are governed by data quality. And for security data to be properly operationalized, it must be relevant to cross functional, complementary workflows that are not limited to IT, but span IT, Security, HTM, procurement and finance. Integrations: Given how the cloud has eased traditional data integration problems, it is now easy for vendors to claim that they integrate “with everyone.” But meaningful integrations are not about “passing data” via APIs. Rather, they are defined by new, demonstrable use cases and enhanced

workflows. Evaluators should ask to see operationalized examples. For example, if you’re thinking about using asset visibility to drive a network segmentation project, ask for evidence that the vendor’s solution has been successfully applied for this purpose. If the claim is that captured utilization data can improve preventive maintenance scheduling and allow better Service Level Agreements (SLAs) to be enforced, ask for specific examples. For more information visit www.medigate.io

Although I’m not encouraging prospective solution evaluators to slow down their buying processes, it’s important to reinforce that company orientation and profile, customer experience, integration effectiveness and data quality are tips of the iceberg. Industry-relevant client footprint, referencability, retention, new release cadence, responsiveness, etc., should also carry significant weight, as they are far more meaningful attributes than a list of features that should update several times before the vendor is even selected. It’s said that a risk is simply the possibility of a loss, but a peril is a cause of loss. That said, the fearmongering typical of many vendors in these times of crisis is done at their own peril. Because if the cyber risks associated with patient-centered clinical networking aren’t yet self-evident, they should be. Perhaps when the COVID-19 crisis has passed, our conversations about healthcare cybersecurity can shift from long debated risks to working, real world informed solutions. And because solution maturity is not going to level the playing field, but increase differentiation, perhaps we can all work on improving the ways we learn, promote, evaluate and select emerging technologies. COVID-19 | DIGITAL SUPPLEMENT

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HOSPITAL BMETS IGNORE COPYRIGHT LAW TO FIGHT PANDEMIC BY PAUL DETRICK, REASON.COM

ressed in his blue medical mask and scrubs, Justin Barbour looks like a doctor on a break from treating COVID-19 patients. He’s actually a biomedical technician, or BMET – someone who fixes medical devices. He’s on staff at a Houston hospital that he asked that we keep anonymous.

Barbour’s job has suddenly become dangerous. “If one of us gets sick, then, obviously, multiple technicians in a room, somebody else is probably gonna get sick, and you could take down a whole hospital just by taking down your biomed staff,” he tells Reason. Barbour, who has been working as a BMET for over a decade, often uses service manuals when repairing equipment, but he lacks a lot of essential documentation. So he turns to online forums and relies on his intuition. During the COVID-19 pandemic, BMETs have turned especially often to this decentralized information-sharing network to repair essential hospital equipment. But they’ve been using it for years, trading information on Reddit, Facebook, and websites like MedWrench and DotMed. Medical device manufacturers have responded by imposing software locks, proprietary code, and requirements that users obtain special authorizations. They’ve also fought against DIY repair services in court. So biomedical technicians have had to think especially creatively—because in a pandemic, one broken machine could be the difference between life and death. Kyle Wiens, the CEO and founder of the third-party repair company iFixIt, says medical device companies have adopted certain tactics pioneered by Apple. “Well, we’ll sell it to you, but we’re not going to let you service it,” he says. “We want to be the ones to service it.” Manufacturers frequently claim that the information in manuals is their intellectual property—a result of broadly written copyright laws that date back to the 1990s. Advancing the Biomedical/HTM Professional

These were intended to protect the music and film industries from pirates, which were taking their work and sharing it first through physical bootlegs and then online. But in the 2000s, software began to get integrated into phones, household items, cars, farming equipment, and medical devices too. Manufacturers claimed that copyright laws established that they’re the only ones the law permits to repair consumer devices. “There [are] some manufacturers that won’t even sell us parts. It’s proprietary and we have no access to it,” says Barbour. BMETs around the world began to rely on Frankshospitalworkshop.com, a website started by a technician in Tanzania named Frank. Frank (who kept his last name private) was having trouble servicing medical devices that had been donated to hospitals in Africa, since he lacked the proprietary keys to make them useable. He figured other people might be in his same position, so he started a website where he posted manuals and wrote about how the equipment worked. Frank’s site was, “from my experience, the most comprehensive, most used resource for medical service information,” says Wiens. Then manufacturers started sending Frank takedown requests. Now, when

businesses forbid certain downloads of manuals, his site is limited to featuring the companies’ names. A right-to-repair movement has been fighting to change federal copyright law—or to pass state-level laws that let people fix their own devices. But medical device companies fought back with letters to lawmakers, saying right-to-repair laws could endanger the lives of patients if devices were fixed improperly by untrained personnel. The trade association AdvaMed, which represents medical device companies, has even lobbied the Food and Drug Administration to regulate third-party device repairs. But after the agency did an assessment in 2018, it concluded that third parties provide high-quality, safe, and effective servicing of medical devices. iFixit recently announced an initiative to begin collecting service manuals and information about medical devices on its website. They are looking for more info, as well as for people to help organize the information for BMETs. This article first appeared on Reason.com and can be viewed here: https://reason.com/ video/hospital-technicians-ignore-copyrightlaw-to-fight-covid-19/

COVID-19 | DIGITAL SUPPLEMENT

CLINICAL SAFETY BEGINS WITH EQUIPMENT CLEANLINESS, MAINTENANCE PROGRAM BY DAVE FRANCOEUR

Where is it? Is it being used? Is it broken? Is it clean? Every day, hospital clinical staff waste valuable time asking these questions about portable clinical devices – questions an established clinical equipment maintenance program would render moot, because staff would have what they need when they need it. Without a clinical equipment cleanliness and maintenance program in place that improves access to hygienic, operable portable clinical devices, staff can spend up to 15 minutes per device searching for missing equipment, room by room, floor by floor. Once they find what they’re looking for, staff then have to determine whether the device is working and whether it’s clean. If it’s not working, or if it’s not clean, staff either have to search for another device, or take the time to properly prepare the one they found for patient use. All the while, the patient is waiting. The result? Inefficient processes. Dissatisfied patients. And frustrated staff. Obviously clean equipment is essential to infection prevention in the medical environment as well. From wheelchairs and stretchers to infusion pumps and pulse oximeters, cleanliness is the number one priority. Clean equipment is a critical component of preventing healthcare-associated infections (HAIs), which are a significant risk to patient health and safety. HAIs, many of which are preventable, are responsible for tens of thousands of deaths and billions of dollars of medical expenses every year. In fact, the Centers for Disease Control and Prevention (CDC) estimates 1 in 31 patients daily in the U.S. has at least one HAI. THE BASICS Clinical equipment maintenance programs ensure at-the-ready access to clean, Advancing the Biomedical/HTM Professional

operable portable clinical devices using one of three methodologies: 1. Forward stocking: Staff access devices in a self-serve setup, based on established PAR levels; 2. Central stocking: Staff request delivery of devices from a central location, from which devices are dispatched as needed; 3. Hybrid stocking: Staff have self-serve access as well as the availability of a central location from which devices are dispatched. Clinical equipment maintenance programs feature a dedicated equipment maintenance team whose time and resources are exclusively focused on ensuring equipment function and availability, including inventory and storage as well as cleaning and repair. Additionally, all team members are highly trained on established protocols regarding the appropriate cleaning and handling of portable clinical equipment. Often, device repair can be addressed more quickly simply due to the fact that the devices are handled more frequently and by individuals trained to fix them. More touches and more training means more opportunities to find minor problems that can be corrected before they turn into major ones. Clinical equipment maintenance programs typically replace similar functions through environmental services or central sterile supply. Programs can be scaled to meet the needs of any hospital, based on the size of the facility, the size of the staff, patient volume, the equipment needed and each hospital’s own set of issues to solve – because every hospital has its own unique challenges and opportunities when it comes to device availability and maintenance. THE BENEFITS Clinical equipment maintenance programs can improve the efficiency and effectiveness of managing portable clinical devices. They’re better for

patients, better for staff and they’re better for hospitals’ bottom lines. Benefits of a clinical equipment maintenance program include: Safety • Reduces the risk of cross contamination • Reduces the risk of HAIs • Includes dedicated staff trained in established protocols for cleaning and handling devices Efficiency • Improves the availability of clean, operable portable equipment • Reduces the occurrence of lost and missing equipment • Reduces staff time spent searching for equipment Utilization • Improves equipment utilization • Increases device uptime Savings • Increases device lifetime • Decreases equipment rental and purchase expense • Improves inventory management and control Compliance • Drives consistent required compliance • Improves program reliability and consistency Satisfaction • Improves patient satisfaction • Improves staff satisfaction, which increases productivity and retention If you want to improve patient care, boost efficiencies, impact the satisfaction of both patients and your medical staff, and drive savings in bottom-line equipment-related costs, a clinical equipment maintenance program might be just what you’re looking for. — David Francoeur is the senior vice president of marketing and sales at Tech Knowledge Associates. COVID-19 | DIGITAL SUPPLEMENT

Thank You,

BMET Heroes. You have always been heroes to us for all you do to ensure that critical equipment is ready for patients. The extraordinary effort being made throughout the COVID-19 crisis is on display, and we are witness to the very best of you all. We thank every biomedical engineer, manager, director and support personnel for your courage and commitment.

Stay Safe, Stay Strong

www.pronktech.com |

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he COVID-19 crisis is putting hospitals everywhere under an unprecedented amount of pressure. Hospital teams today need to track inventory, support the set up of field hospitals and quarantine wards, and secure connected medical devices against cyber attacks. Needless to say, this all gets more complicated during crises like COVID-19.

Hospitals must now cope with diminished clinical and medical staff who have been infected or quarantined, and extreme demand on resources, including medical supplies, bed vacancies, and medical devices they need to treat patients. With staff shortages and even more demand for medical equipment, hospitals need to find innovative ways to speed up processes and keep their organizations running optimally with as few resources as possible. Luckily, automation technologies designed specifically to expedite processes in clinical environments and keep medical services running at peak capacity are available for hospitals everywhere. This tech is here to help hospitals keep operations running smoothly, ensure continuous medical services, and help comply with strict federal and state healthcare regulations. AUTOMATED HEALTHCARE TECHNOLOGIES TO THE RESCUE Automated healthcare technologies were developed to help Biomed/clinical engineering teams and their IT counterparts manage and adapt to evolving and unforeseen challenges, whether it’s business-as-usual or a pandemic crisis scenario: Advancing the Biomedical/HTM Professional

• Comprehensive device discovery — automatic and instant inventory of all connected devices, including their physical locations, and utilization patterns helps hospitals quickly make decisions about: » redistributing equipment and relocating patients between departments and sites, like field hospitals • Support for field hospitals and other emergency sites — asset location tracking follows devices across multiple sites • Visualized device communication patterns — provide instant insights into device communication patterns to help prevent device slow-down and clinical network downtime • MDS2 form integration — aggregated information from MDS2 forms, real-time monitoring of device communications, and live industry data help teams ensure device security standards comply with Federal and state regulations • Customized dashboards — help sync Biomed and IT teams with tailored team and personal views, including specialized dashboards for COVID-19 and other emergency scenarios; they also ensure the right people get the right information at the right time, which is crucial for coordination especially when handling the challenges of a remote workforce • Ongoing risk assessment for medical devices — real-time security risk alerts assign risk according to device criticality and medical impact, and allow for quick

prioritization and decision making in emergency situations • Robust segmentation policies — policies are built based on device criticality and medical impact, ensuring medical devices crucial to clinical workflow and patient care keep running optimally, at low risk of being infected For more information on how your hospital can leverage automated technologies through the COVID-19 pandemic, read the COVID-19 Response Toolkit for Healthcare IT & Biomed Professionals. To accommodate hospitals’ developing needs, Cynerio’s platform is being offered for free until the end of 2020. Contact us for more details. ABOUT CYNERIO Cynerio is the world’s premier medical-first IoT cybersecurity solution. We view cybersecurity as a standard part of patient care and provide healthcare delivery organizations with the insight and tools they need to secure clinical ecosystems and achieve long-term, scalable threat remediation without disrupting operations or the delivery of care. Learn more at www.cynerio.com COVID-19 | DIGITAL SUPPLEMENT

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AMA, AHA RESPOND TO RISE IN CYBER THREATS EXPLOITING THE COVID-19 PANDEMIC New joint cybersecurity resource helps physicians and hospitals keep pace with malicious cyber activity

esponding to a spike in cyber threats that exploit telework technologies during the COVID-19 pandemic, the American Medical Association (AMA) and the American Hospital Association (AHA) have teamed up to provide physicians and hospitals with guidance on protecting a remote work environment from cyber criminals.

The two leading associations have created a joint cybersecurity resource, Working from home during the COVID-19 pandemic, offering actions to strengthen home or hospital-based computers, networks and medical devices from the rise in COVID-19themed security threats and attacks. The resource includes checklists, sources, tips and advice on strengthening protections to keep pace with deceptive cyberattacks that could disrupt patient care or threaten medical Advancing the Biomedical/HTM Professional

records and other data. “Amid increased reports of malicious cyber activity, some physicians and care teams are working from their homes and relying on technologies to support physical distancing measures while ensuring availability of care to those who need it,” said AMA President Patrice A. Harris, M.D., M.A. “For physicians helping patients from their homes and using personal computers and mobile devices, the AMA and AHA have moved quickly to provide a resource with important steps to help keep a home office as resilient to viruses, malware and hackers as a medical practice or hospital.” On April 1, the Federal Bureau of Investigations (FBI) released a public advisory noting that more than 1,200 complaints related to COVID-19 scams were received at its Internet Crime Complaint Center. According to the FBI, “in recent weeks, cyber actors have

engaged in phishing campaigns against first responders, … deployed ransomware at medical facilities and created fake COVID-19 websites that quietly download malware to victim devices. Based on recent trends, the FBI assesses these same groups will target businesses and individuals working from home via telework software vulnerabilities, education technology platforms and new Business Email Compromise schemes.” The new cybersecurity guide joins a growing list of essential tools and resources as the AMA continues to supply all physicians with comprehensive guidance needed for patient care as the COVID-19 pandemic evolves. Stay informed and updated on clinical information, guides, advocacy and medical ethics by connecting with the AMA COVID-19 Resource Center.

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HEALTH TECHNOLOGY EXPERTS ARE A VITAL RESOURCE FOR CORONAVIRUS RESPONSE BY AAMI

ealth care organizations need to ensure that medical equipment is maintained by trained healthcare technology management (HTM) professionals, especially during this COVID-19 pandemic.

That’s the guidance from the nonprofit Association for the Advancement of Medical Instrumentation (AAMI) in the wake of news reports that individuals who are not trained in healthcare technology are recommissioning, repairing, or maintaining life-saving technologies like ventilators. “While AAMI is aware of well-intentioned work in response to the Coronavirus pandemic, it is imperative that patients are not put at risk,” said Rob Jensen, AAMI’s president and chief executive officer. “AAMI strongly encourages those new to this arena to seek out health technology management experts at the earliest opportunity to maximize the benefit of your efforts.” Recent news has cited efforts that include designing new equipment, recommissioning old or out-of-service devices, refurbishing devices, and adapting technologies to serve additional patients. “One of the most important ways to Advancing the Biomedical/HTM Professional

ensure a high standard of performance for these medical devices and systems is to utilize the dedicated experts who have been specifically trained to repair, maintain, and operate that equipment every day — healthcare technology management professionals, or HTM professionals,” said Danielle McGeary, vice president of HTM at AAMI. “As health technology experts, HTM professionals should be consulted when attempting to refurbish or fix medical equipment and technology — especially during crisis situations where expertise is vital.” Ensuring the use of proper testing procedures and test equipment to confirm that these medical devices are working properly represents a few examples of how health technology experts can assist, McGeary noted. “Ventilators are life support equipment, and if not repaired or maintained properly, patient lives could be severely put at risk,” she said. AAMI, a nonprofit, consensus-building organization, represents healthcare technology professionals around the world. AAMI also develops medical device standards, provides education and training opportunities, and advances the role of HTM professionals in health care.

HTM professionals can be found in every hospital in the United States and across the world. Many are employed in a hospital environment, with titles including biomedical equipment technicians, biomedical engineers, clinician engineers, and more. HTM professionals are subject matter experts for fixing, troubleshooting, and testing medical devices, and many have received specific training from ventilator manufacturers on the proper use and maintenance of these devices. Additionally, HTM professionals are a critical knowledge base for equipment planning, purchase, installation, maintenance, troubleshooting, and on-call technical support. “Even as health systems are strained by the Coronavirus pandemic, HTM departments must ensure that all equipment is functioning to the manufacturer’s specifications prior to be being placed on a patient. With medical equipment arriving at hospitals from so many different sources, now is not the time to skip any incoming inspections,” McGeary said. For help connecting with local HTM professionals, please contact your local HTM association or AAMI directly at www.aami.org/contact.

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PARTSSOURCE OPENS ONLINE COMMUNITY TO ENCOURAGE SHARING OF INFORMATION CRITICAL TO COMBATING COVID-19

artsSource, a technology-based healthcare services company that uses patented, evidence-based decision support to improve asset uptime, decrease long-tail expenses and streamline workflow, recently announced an initiative to encourage peer-to-peer sharing of insights, resources and tools needed to combat COVID-19.

The PartsSource Community is an online peer-to-peer collaboration platform designed to encourage innovation and knowledge-sharing among clinical engineering (CE) and supply chain teams in the company’s more than 3,500 hospital clients. Previously available only to PartsSource Pro enterprise clients, now the PartsSource Community is available free of charge to help all clients achieve high-performance healthcare technology management (HTM). Clients can use the PartsSource Community to access curated content, connect with industry colleagues, exchange best practices and obtain real-time insights. In response to the pandemic, the PartsSource Community now includes new resources and tools specific to coping with COVID-19. In particular, PartsSource has analyzed millions of data points from across its network of providers and suppliers to model the ideal supply chain for hotspot hospitals as well as those that have yet to face a surge in COVID-19 patients. “At this challenging moment in history, we believe all HTM and clinical engineering leaders should have access Advancing the Biomedical/HTM Professional

to real-time insights and best practices from their peers across the country to help tackle the COVID-19 challenge,” said Philip Settimi MSE, MD, President and CEO of PartsSource. “As we have worked to get mission-critical parts, equipment and rentals to hospitals across the country, we have gained deep actionable insights from the early phase of the pandemic. Expanding the PartsSource Community to share these insights with all our clients is the right thing to do as we strive together to improve clinical uptime and care for COVID-19 patients.” COVID-19 RESOURCES NOW AVAILABLE The new COVID-19 focus of the PartsSource Community includes a variety of resources designed to help HTM teams cope with exponential increases in demand for certain equipment and supplies. Some of the most critical resources within the PartsSource Community are: • COVID-19 Top Modalities Guide: This exclusive guide is based upon a predictive model built from analysis of millions of purchasing data points as well as insights from conversations with hundreds of customers about their COVID-19 needs. It leverages data science to help clients quickly identify which parts, and in what quantity, they will need to support uptime for COVID-19 mission-critical equipment, in particular ventilators and other respiratory equipment, patient monitoring equipment and infusion pumps. • Discussion Boards: To promote

real-time communication of best practices through peer-to-peer connections, the new COVID-19 PartsSource Community discussion board is open to all HTM leaders. • Library of Industry Resources: PartsSource has curated and centralized COVID-19 resources from across industry and government, including information from the Center for Medicare & Medicaid Services (CMS), the Centers for Disease Control (CDC), the Emergency Care Research Institute (ECRI Institute), and the Association for the Advancement of Medical Instrumentation (AAMI). The PartsSource Community also includes educational videos and proprietary tools that support strategic HTM initiatives, such as the industry’s first alternative equipment maintenance (AEM) database and a Capital planning toolkit. To demonstrate its commitment to serve the nation’s clinical engineering teams as a partner, PartsSource continues to add new members and exclusive content and will continuously expand the value of the community for HTM leaders. “True partnership is about mutual value and stepping up to help in times of adversity,” said Settimi. “At PartsSource, we’re committed to supporting our clients to overcome the unprecedented challenge of COVID-19. Working together, I’m confident we will get through this public health challenge and come out stronger on the other side.” For more information visit www.partssource.com COVID-19 | DIGITAL SUPPLEMENT

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ADMITTANCE AND SOFTWARE SOLUTIONS TO HELP WITH COVID-19 NEEDS

MT Datasouth products have been used in well over 500 hospitals, including many Army Medical Department (AMEDD) locations and on the hospital ships USNS Comfort and USNS Mercy.

INCREASED NUMBER OF ADMITTANCE/ INTAKE STATIONS AND NEW TESTING SITES Wristband and label printers available include hospital wristband printers, mobile wristband/label printers, and high volume label printers. The firmware in our printers accepts existing data streams without the need for the hospital IT staff to have to make a bunch of changes. Popular emulations like Zebra are included as well as our own proprietary firmware known as PAL® which enables us to quickly set up formatting specific to each healthcare location’s specific needs; we can also make changes to formats and layouts Advancing the Biomedical/HTM Professional

as they arise (all of this can be done remotely). Our printers are also ideal for printing durable asset tags that last for new equipment that comes in specifically to address the crisis.

capability for the healthcare user to quickly and easily create new formats and layouts for wristbands and labels on their own whenever they need to. They also can admit patients with the software as described below.

EASILY IDENTIFY STATUS OF PATIENTS AND CREATE NEW LAYOUTS OF WRISTBANDS AND LABELS ON-DEMAND If special layouts or formats are needed that make a patient’s current testing status for COVID-19 obvious: positive, negative, or tested but no results back or if new layouts are needed later as new designations become required in this dynamic situation, then there are two ways that we can help. The first is with our PAL® firmware as described above, where our support team makes these changes with minimal effort required from the hospital IT staff. The second way is with our AMT Process 24/7 software that provides the

WORKING OFFLINE If new offsite locations lack network capability or strong security, then software on mobile tablets and laptops that can admit patients and print labels and wristbands without that connection are beneficial. AMT Process 24/7 is software for both patient admittance and for creating wristband and label formats and layouts and it resides directly on the laptop, PC, or tablet rather than on the network. Patient admittance data can later be uploaded into the hospital’s system. For More Info call: 800-215-9192 or visit: www.amtdatasouth.com

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ANSI EXPANDS STANDARDS PORTAL FOR COVID-19 CRISIS TO INCLUDE IEC STANDARDS T

he American National Standards Institute (ANSI) has expanded its portal for international standards to help speed COVID-19 response efforts to include International Electrotechnical Commission (IEC) standards for medical electrical equipment. In addition to the International Organization for Standardization (ISO) standards already included in ANSI’s portal, the newly added IEC standards can further assist efforts to increase production of critical care ventilators as the number of patients who need them continue to rise.

The ANSI portal, Freely Available ISO and IEC Standards to Help Address COVID-19 Crisis, now includes 36 international standards covering medical equipment and devices – including ventilators and respiratory equipment; protective clothing used in health care settings; and business continuity management, security and resilience. Advancing the Biomedical/HTM Professional

ANSI is the coordinator of the U.S. voluntary consensus standardization system and the U.S. member body to ISO and the IEC. The standards are accessible in read-only format at no cost during the crisis; additional standards may be added in the future. To access the portal, users must accept the license agreement and register. Once registered, users can return to the portal via https://asc.ansi.org. “ANSI is committed to supporting rapid response efforts in the fight against the COVID-19 public health pandemic,” said ANSI president and CEO S. Joe Bhatia. “ANSI and the U.S. standardization community have always eagerly stepped up to address issues of national and global concern, and the challenge presented by COVID-19 is no different.” ANSI members and accredited standards developers – including AAMI, IEEE and ASTM – are providing free

access to standards and resources to help speed a rapid COVID-19 response: • AAMI standards for use in health care settings • IEEE standards to support research, infrastructure and communications • ASTM standards for the production and testing of personal protective equipment ANSI has also launched a COVID-19 Resource Webpage highlighting activities of the U.S. standardization community in the fight against the pandemic. Available at www.ansi.org/COVID-19, the resource page spotlights ANSI members’ activities supporting public health, safety, and infrastructure, and includes important ANSI announcements, distance learning opportunities, and other resources. To learn more about the ANSI Federation’s COVID-19 response efforts, visit www.ansi.org/COVID-19. COVID-19 | DIGITAL SUPPLEMENT

ENTECH has the technical staff to support your clinical and imaging equipment service needs during this critical time. Some of your facilities may have in-house service technicians who are not able to perform services due to illness or quarantine situations. As a result of limited resources, your facility may be in need of basic clinical/ biomedical engineering services. ENTECH can assist with your current, possibly heavy, workload due to any issues as a result of the COVID-19 pandemic. Regulatory compliance and project management may suffer as a result of staff having to support basic clinical engineering services. We can fill those gaps as well. Our 230+ Arizona- and Colorado-based biomedical, specialty, imaging technicians, physicists/QC techs, project managers and integrated clinical technology specialists are available to assist you in the short or long term for preventive/scheduled maintenance, repairs, projects and even cybersecurity needs. Out of state vendors have most likely restricted travel for field service technicians and your specialty and imaging equipment may not be serviced in a timely fashion. Because we are local, we can quickly respond to your needs. Have a problem or concern involving medical equipment not addressed above? ENTECH offers a full range of services to suit any need you have and to fill gaps during this crucial time. Just ask us â€“ weâ€™re here to help.

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ARMY MEDICAL MAINTENANCE TECHNICIANS RUSH VENTILATORS TO MILITARY HOSPITALS BY C.J. LOVELACE

n the fight against COVID-19, every ventilator the U.S. Army can get working is another life potentially saved.

That’s why Army biomedical equipment specialists around the globe are tirelessly turning their wrenches to repair and return ventilators to military hospitals and medical units, in support of the whole-of-government’s COVID-19 response. “We’re taking the vents, calibrating them, putting in needed parts, doing a thorough inspection and sending them back out with all the accessories and consumables so they are ready for use right out of the box,” said Tom Fortner, a technician assigned to the U.S. Army Medical Materiel Agency’s medical maintenance division at Tobyhanna Army Depot. USAMMA, a direct reporting unit of Army Medical Logistics Command, has three stateside depot-level maintenance facilities, each covering a geographical region. MMOD-Toby handles the East region, while MMOD-Hill, located at Hill Air Force Base in Utah, covers the Central region. MMOD-Tracy in California takes care of the West. Army medical maintenance teams at each location are prioritizing not only the calibration and repair of ventilators, but also oxygen generators, suction apparatus and patient monitors to support COVID-19 response efforts. Fortner said the teams have been turning these devices around in record time. He said some devices that only need minor fixes or checks are repaired

Advancing the Biomedical/HTM Professional

Chief Warrant Officer 3 Daniel Button is pictured handing off ventilators to the Georgia Air National Guard on April 3 following maintenance operations at Tobyhanna Army Depot. (U.S. Army photo by Tom Fortner) (Photo Credit: U.S. Army) and returned in just hours. Once ready to ship, the delivery process can go just as quickly. For example, a recent shipment of ventilators back to the Georgia Air National Guard went out on a Friday evening and were in use in the hospital by Sunday morning. The team has been handling the added workload with great efficiency, according to Fortner. “We have a pretty good little system

going,” Fortner said. “It’s definitely kudos to them.” “I’m proud to see the continued teamwork, sense of pride and urgency shown by our employees at the MMOD’s during this response to COVID-19,” said Jack Rosarius, director of USAMMA’s Medical Maintenance Management Directorate. “Their work continues to be appreciated and essential in the Army’s battle of this health crisis.”

COVID-19 | DIGITAL SUPPLEMENT

COVID-19 SPOTLIGHTS RIGHT TO REPAIR ISSUE

BY JOHN WALLACE

eports abound about the latest novel coronavirus outbreak. The World Health Organization (WHO) has declared COVID-19 to be a pandemic and the increasing number of patients support that decision.

News reports have questioned the availability of adequate medical devices to treat and care for patients. The accounts mention everything from hospital beds to ventilators. Along with the need to acquire medical devices is a need to be able to maintain and repair devices as the COVID-19 patient population continues to grow. Many manufacturers do not provide access to repair documentation, limiting who can repair the equipment, according to a news release from the U.S. PIRG Right to Repair campaign. That discourages third-party medical repair companies or in-house medical engineers from trying to fix things, the news release added. “In order to keep equipment that is critical to treating COVID-19 working with the least possible downtime, medical device manufacturers should immediately release 38

DIGITAL SUPPLEMENT | COVID-19

all repair documentation and software, schematics and manuals for that equipment, especially ventilators,” said U.S. PIRG Right to Repair campaign director Nathan Proctor. “The fastest repair service is when hospital technicians have what they need to do repairs in-house, or can hire qualified technicians at their discretion. Preventing repair is generally a bad idea. That is even more true in a crisis, when systems are under stress. It could mean the difference between life and death.” In addition to ventilators, other equipment needed to diagnose and treat COVID-19 will likely see increased use and require maintenance. Imaging equipment used to evaluate patients and determine pulmonary conditions is likely to see increased maintenance requests and also benefit from additional repair information. In a statement, GE Healthcare said, “GE is committed to the safe and compliant servicing of life-saving and sustaining regulated medical devices. GE will continue to provide all appropriate access to service this equipment by our own employees, customers and third-party service providers.”

Some manufacturers have previously claimed that independent repair is less safe or reliable than those performed by OEM staff. However, an in-depth study showed there are no safety issues with non-manufacturer repair. In 2018, the Food and Drug Administration investigated repair and maintenance issues and found that non-manufacturer repair was safe, saying that independent technicians, hospital technicians and manufacturers all “provide high-quality, safe, and effective servicing of medical devices.” “Whether or not they are employed by the manufacturer, a qualified technician with the right information and tools can fix the equipment. Obviously, this is an all-hands-on-deck moment, and we should remove barriers that prevent qualified technicians from servicing medical equipment,” said Gay Gordon-Byrne, executive director of Repair.org, a national coalition backing Right to Repair. “Manufacturer-only repair policies hamstring our medical systems. Repair information should never have been withheld,” added Proctor. “I urge manufacwww.1TechNation.com

turers to release the information hospitals need to keep treating COVID patients – and for government leaders to step in if they do not. In this time of crisis, we must put patients’ lives first.” When asked if he or his colleagues had experiences during this COVID-19 situation that is impacting patient care in a negative way, he pointed to preventative maintenance (PM) schedules and other concerns. Steven Kelley, regional director of biomedical engineering for Piedmont Healthcare in Atlanta, said he is experiencing issues in regard to a shortage of equipment, including ventilators (vents). “Yes, we are dealing with trying to get more vents. The issue we run into is the vents that are available are not our standard and how to get quick training on them,” Kelley explains. “Another issue is some vendors have said they are stopping PMs and any non-critical service events. We have contacted DNV and they say the PM is critical and the equipment is considered unsafe when it is past the recommended PM schedule time. They did say if we cannot get a vendor in then we should make sure to document everything. I have contacted the vendors and asked for a statement on their letterhead of how long a device can go without a PM and still be considered safe. I have told them that we will take that info and change all our PM schedules going forward,” Kelley writes in an email “Because if it is safe now it will be safe always. So far they have backed down and are providing any help we need.” The Right to Repair issue is also causing concerns as some OEMs have restricted travel for employees, including service personnel. Also, many health care facilities are not allowing non-hospital employees within facilities. Perry Kirwan, vice president technology management at Banner Health, shared his thoughts. “It is interesting to me to see that OEMs are not in complete alignment with regulatory agencies. Some OEMs are not Advancing the Biomedical/HTM Professional

considering scheduled/preventative maintenance as a critical activity however the regulatory agencies (for now) are slow to relax those requirements,” Kirwan said. “In the end – a lot of this is going to point to the value of in-house, third-party and OEM all working together in a coordinated way to make this work,” he added. David Francoeur, senior vice president marketing and sales at Tech Knowledge Associates LLC, is familiar with this issue. He has attended several meetings, FDA workshops and AAMI events regarding the servicing and remanufacturing of medical devices. “This all stems from the COVID-19 pandemic. In many situations, health care facilities are not allowing service representatives into their facilities to perform maintenance, or for any reason. In many cases the in-house HTM professional doesn’t always have the manufacturer’s support in terms of documentation, technical support and/or parts to name a few. Within each health care facility, there are typically hospital employees or independent service organizations performing the necessary management of medical devices for the individual facilities which are allowed and required to be on site to support the maintenance of all medical devices,” Francoeur explained. “From where I sit, this is a perfect storm scenario. Non-hospital employees are not being allowed to go into health care facilities for concern they may be carrying the virus,” he added. “This is creating the perfect occasion where the original equipment manufacturers (OEM), and the non-manufacturer independent service organizations (ISO) as well as in-house healthcare delivery organizations’ (HDO) HTM professionals can and should be working together to support the patient. By having ISO/HDO HTM professionals on site, they can be the eyes and arms of the manufacturer, and ensure through proper support to include, but not limited to,

documentation, communication, technical support, parts procurement, key metrics demonstrating appropriate levels of quality in areas of preventive and corrective maintenance actions. These types of activities could include service manuals, phone support, possible Facetime/ Skype-type technology, parts, etc.” In closing, a collaborative community is the solution everyone needs. “Working together, OEMs, ISOs and HDOs as an HTM community, having oversight of all products that are available and in what condition within each health care facility, will be paramount to our overall success,” Francoeur said. “Let’s use this opportunity to demonstrate to the health care community that we can come together for the sake of the patient to do whatever it takes to ensure the highest level of safety and quality for maintaining ventilators/medical devices that we can. I believe everyone within the HTM community is aware and impacted on their level. What I’m not confident in, is that there is a big picture perspective that is looking for solutions that will have the great opportunity for the overall success and would be most valuable and meaningful across the board.” Patient safety is the goal for all involved. Individuals with the training, knowledge and experience to maintain and repair medical equipment is what health care facilities need, and many think it should not matter if the individual is employed by a hospital, an ISO or an OEM. For now, Kelley said he and his colleagues are here to help. “We feel we are in the medical field. This is what we do. We are around contagious patients all the time every day. This is nothing new. It is time for the biomed industry to stand up with all the medical providers and do our part to make sure our equipment is safe to use and assist with training and user support,” Kelley said.

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MODULAR X-RAY SHIELDING ROOMS FOR TEMPORARY HOSPITAL SITES

s we continue to tackle COVID-19, now more than ever the medical industry requires modular x-ray shielding rooms. These full body shielding units are designed to protect medical personnel from harmful secondary radiation and can be used either at a hospital or an outdoor clinic.

MarShield is a leading North American manufacturer of custom modular x-ray shielding rooms that protect all stakeholders and ensure a safe workplace environment. Our units are ideal for temporary situations as they can be installed in less than a day and be moved around and set up in modular spaces. KEY DESIGN AND CONSTRUCTION FEATURES Our modular x-ray shielding rooms provide industry-leading features for our customers: • Panels extended from floor to 84”, 96” or higher, ensuring effective protection • Your choice of lead shielding thickness • Solid panels are lead-lined and faced with beige ABS • Frames are sturdy, beige powdercoated steel • Sliding doors complete with hardware available • Windows available in door or wall panels • Windows are Lead Safety Glass (Laminated glass with interlayer. This Advancing the Biomedical/HTM Professional

Safety Lead Glass is shatter-resistant glass that meets the requirements of ANSI Z97.1-1984 & 16 CFR 1201 Cat. II) • Wall panels are prefabricated for ease of installation BENEFITS MarShield’s modular x-ray rooms are quick, clean and easy to install. There is no demolition required and the rooms feature attractive neutral décor with clean lines. Additional benefits include: • Durable solid lead-lined panels and solid steel frame are built to last • Customized to suit your application, based on architectural specs or a custom concept we help you create. All units can be sized and manufactured to your requirements • Professional engineering and custom on-site design services available. We can work with you to design a custom solution in a virtual CAD environment • Designed to accommodate future modifications and expansions. Can be removed and/or relocated, if required ORDERING If you’re ready to order a modular x-ray shielding room, contact us and have the following requirements available: • Width, length and height requirements • Width and location of sliding door(s)

• Lead shielding thickness required • Windows – location and size • To learn more, download MarShield’s x-ray room information sheet! To learn more, download MarShield’s x-ray room information sheet! MarShield works closely with our clients to develop customizable low-cost solutions that meet their needs. You can find more information from the MarShield website or you can contact MarShield directly, and we will help you find the most appropriate modular x-ray room shielding solution for your organization. CONTACT US Online: www.marshield.com Continental Toll Free: (800) 381-5335 Telephone: (905) 637-3862 Fax: (905) 637-8841 General Inquiry: sales@marsmetal.com COVID-19 | DIGITAL SUPPLEMENT

SIEMENS FOUNDATION PROVIDES $1.5M TO SUPPORT COVID-19 RESPONSE EFFORTS

he Siemens Foundation today announced it is providing $1.5 million to community health centers across 12 U.S. cities to respond to the COVID-19 crisis. Community health centers are the nation’s largest primary care provider for the medically underserved and uninsured, reaching 29 million of those most in-need. As a result of COVID-19, these health centers face a shortage of funding to stay operational and maintain a sufficient workforce, further crippling their ability to provide affordable healthcare at a critical time. Aligning with its dedication to social equity, the non-profit organization established by Siemens USA, including funding provided by Siemens Healthineers, is committed to supporting these critical healthcare providers so they can continue serving their communities when they are needed most.

“As the COVID-19 crisis disproportionately threatens lower-income and medically underserved communities, it’s vital for us to support the institutions that sustain our social compact,” said David Etzwiler, CEO of the Siemens Foundation. “Community health centers and their staff are on the front lines providing primary care every day and they now play an especially vital role in our medical services infrastructure when emergency services and hospital settings are overwhelmed. Vital services like these are paramount to advancing equity in America.” The following health centers were selected using equity criteria developed by the Siemens Foundation in consultation with the National Association of Community Health Centers, the Minnesota Association of Community Health Centers, and Siemens: • Chase Brexton Health Services in Baltimore 44

DIGITAL SUPPLEMENT | COVID-19

• Chicago Family Health Center in Chicago • Western Wayne Family Health Centers in Metro Detroit • Daughters of Charity Services/Marillac Community Health Center in New Orleans • Delaware Valley Community Health, Inc., in Philadelphia • Stride Community Health Center in Denver • Newark Community Health Centers, Inc., in Newark • WATTS Healthcare Corporation in Los Angeles • Mary’s Center for Maternal and Child Health Care in Washington, D.C. • Morris Heights Health Center, Inc., in New York • Community Health Centers in Orlando • International Community Health Services in Seattle The $1.5 million commitment is funded, in part, by The Siemens Healthineers Fund of the Siemens Foundation, supported by Siemens Healthineers business in the United States. The centers will receive the investments over the next few weeks and will be free to use the funding however they deem it is most needed. “It is a critical time to ensure all patients and families are able to access the care they need,” said Dave Pacitti, Siemens Foundation Board of Directors member; President of Siemens Medical Solutions USA, Inc.; and Head of the Americas for Siemens Healthineers. “The nation’s community health centers are a vital safety net for millions of patients, and these investments will help them to continue providing affordable care that strengthens the entire U.S. healthcare system in combatting the pandemic.” The Foundation’s efforts complement Siemens’ and Siemens Healthineers’ collective efforts to combat COVID-19 by

supporting critical infrastructure and by helping state and local governments address urgent healthcare needs. The company’s employees are maintaining essential operations to support hospitals, power plants, government facilities, military sites, manufacturing locations and data centers. They’re also supporting critical city services such as transportation, water and waste, and national security emergency response systems. “We are all ask asking ourselves a simple question: What can we do?” said Barbara Humpton, Siemens Foundation Chair and CEO of Siemens USA. “Our company has been focused on ensuring that no American, or any community, is disconnected from essential services, and right now, no service is more essential than healthcare. The Siemens Foundation’s efforts will support quality care that everyone in America deserves and that our country needs in order to overcome this crisis.” Siemens is also a part of collaborative on-the-ground effort to support the expansion of existing and new hospital spaces, ensuring these facilities have reliable power, fire and life safety systems, and the tools they need to treat patients. Siemens Healthineers is committed to providing a range of solutions necessary for the diagnosis and monitoring of patients with COVID-19 – from a test kit used to aid in the diagnosis of COVID-19 disease to portable X-ray, ultrasound, and blood gas systems used in monitoring for patients, as well as unique cloud-based platforms and remote monitoring systems to assist front-line healthcare providers. For more information on how Siemens is taking action to support American healthcare, visit its COVID-19 response page. For more information on the Siemens Foundation, follow @SFoundation on Twitter or visit siemens-foundation.org. www.1TechNation.com

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FORD EXPANDS MEDICAL EQUIPMENT PRODUCTION EFFORTS F

ord is expanding its efforts to design and produce urgently needed medical equipment and supplies for health care workers, first responders and patients fighting coronavirus.

In addition to the current production of more than 3 million face shields in Plymouth, Mich., Ford-designed powered air-purifying respirator production began Tuesday, April 14. Ford also is now producing face masks and leading an effort to scale production of reusable gowns for health care workers. Lastly, Ford started providing manufacturing expertise to help scientific instrument provider Thermo Fisher Scientific quickly expand production of COVID-19 collection kits to test for the virus. “We knew that to play our part helping combat coronavirus, we had to go like hell and join forces with experts like 3M to expand production of urgently needed medical equipment and supplies,” said Jim Baumbick, vice president, Ford Enterprise Product Line Management. “In just three weeks under Project Apollo, we’ve unleashed our world-class manufacturing, purchasing and design talent to get scrappy 46

DIGITAL SUPPLEMENT | COVID-19

and start making personal protection equipment and help increase the availability and production of ventilators.” FORD, 3M COLLABORATION LEADS TO NEW PAPR Since late March, Ford manufacturing, purchasing and supply chain experts have been embedded at 3M manufacturing facilities to help increase production of urgently needed products. With this additional help, 3M and Ford were able to increase the output of PAPRs and N95 respirators at 3M’s U.S.-based manufacturing facilities. “3M is dedicated to helping to protect our heroic health care workers and first responders globally, including sharing our scientific expertise to increase supply of needed PPE,” said Bernard Cicut, vice president, 3M Personal Safety Division. “We are proud to stand together with Ford in this effort, as they have helped us increase manufacturing of existing 3M PPE products and, together, we have rapidly designed a new PAPR to help protect these heroes.” Ford will start producing an all-new PAPR design to help protect health care professionals on the front lines fighting

COVID-19. Rapidly designing components and prototyping in accordance with federal guidelines and with 3M expert support and guidance, Ford teams reduced PAPR development time to less than four weeks. “By working collaboratively with 3M to quickly combine more than 100 years of Ford manufacturing and engineering expertise with personal protection equipment design and expertise, we’re getting much-needed technology into the hands of frontline medical workers to help when they need it most,” said Marcy Fisher, Ford director, Global Body Exterior and Interior Engineering. Approximately 90 paid UAW volunteers will assemble PAPRs at Ford’s Vreeland facility near Flat Rock, Mich., with the ability to make 100,000 or more. The newly designed PAPR includes a hood and face shield to cover health care professionals’ heads and shoulders, while a high-efficiency (HEPA) filter system provides a supply of filtered air for up to 8 hours. The air blower system – similar to the fan found in F-150’s ventilated seats – is powered by a rechargeable, portable battery, helping keep the respirator in constant use by first-line defenders. www.1TechNation.com

The development team expects the respirator design will meet the pending National Institute for Occupational Safety and Health (NIOSH) limited-use protocol to respond to the COVID-19 public health emergency, with approval anticipated by the end of April. Pending approval, 3M will distribute the newly designed PAPRs through its U.S. network to help bring these technologies quickly and efficiently to health care workers who urgently need them. 3M and Ford will donate any profits they earn from the sale of the PAPR to COVID-19 related nonprofit organizations.

FACE MASK PRODUCTION Meanwhile, Ford is now manufacturing face masks for internal use globally and pursuing certification for medical use at its Van Dyke Transmission Plant. Face masks can help slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. The CDC is now encouraging all U.S. residents to use masks to curb the spread of the virus. Ford’s global manufacturing and purchasing teams quickly sourced the necessary materials and equipment from its network of equipment manufacturers around the world. Production began earlier this week. Approximately 30 UAW paid volunteers will start making masks in the plant’s ISO Class 8 cleanroom, which is a controlled environment with extremely low levels of pollutants, enabling the safe production of face masks for medical use. Eventually, approximately 80 UAW paid volunteers will make masks as production increases. Advancing the Biomedical/HTM Professional

“UAW Ford members continue to step up and volunteer to work during this difficult time as we expand at the facility across from Flat Rock to make respirators and at the Van Dyke Transmission Plant to make face masks for medical use,” said Gerald Kariem, vice president, UAW Ford Department. “The UAW also continues to work with Ford to follow stringent CDC guidelines and go above and beyond protections for these members who are so proudly volunteering to serve their communities and their nation.” GOWN PRODUCTION To help further protect health care workers, Ford is leading efforts to manufacture reusable gowns with airbag supplier Joyson Safety Systems. The go-fast project has created re-usable gowns manufactured from material used to make airbags in Ford vehicles. Production of gowns will reach 75,000 gowns a week by Sunday and scale up to 100,000 gowns for the week of April 19 and beyond. By July 4, Ford-supplier Joyson Safety Systems will cut and sew 1.3 million gowns, which are self-tested to federal standards and are washable up to 50 times. Ford worked with Beaumont Health in Metro Detroit to quickly design the gown pattern and test for sizing during fit and function trials. More than 5,000 gowns have already been delivered to the hospital. “The need to protect our medical teams is heightened – Ford’s gown production could not come at a better time during this crisis,” said David Claeys, president of Beaumont Health hospitals in Dearborn and Farmington Hills. “Our front line health care workers are working around the clock to treat COVID-19 patients and we need the necessary supplies to support them.” COLLECTION KITS FOR COVID-19 TESTS Ford is helping scale production of collection kits for COVID-19 tests at Thermo Fisher Scientific. Thermo Fisher’s engineering team at the company’s site in Lenexa, Kansas, realized their expertise, combined with the manufacturing expertise of Ford’s nearby Kansas City Assembly Plant engineering team, could help set up additional collection kit production machinery. The Ford

team also helped Thermo Fisher adapt machinery that currently runs glass vials for other products to run plastic vials required in drive-through coronavirus test collection. “Ford’s engineers brought a fresh perspective to production expansion, and together, we’ll more than triple the number of collection kits we can deliver each week starting April 20,” said John Reuss, senior director, microbiology business for Thermo Fisher. “It’s great to see different industries coming together to solve a common problem.” ADDITIONAL EFFORTS “We are doing all we can to expand production and availability of personal protective equipment to help keep the true heroes – medical personnel – and our communities safe in the fight against COVID-19,” said Adrian Price, director, Global Core Engineering for Vehicle Manufacturing. Ford also is continuing to manufacture transparent full-face shields for medical workers. As of April 13, Ford had produced more than 3 million face shields for medical personnel and first responders. Besides the U.S., face shield production also has started globally at Ford facilities in Canada and Thailand and with Ford joint venture partner Mahindra & Mahindra in India. Work at Rawsonville (Mich.) Components Plant is underway to transform a portion of the plant to manufacture a third-party ventilator, in collaboration with GE Healthcare, with production expected to start the week of April 20. Built by paid UAW volunteers, the goal is to produce 50,000 Model A-E ventilators by July 4 to help COVID-19 patients. Ventilator pre-production activities are also underway in the U.K., where Ford and an industry consortium are preparing to make ventilators from Penlon. Ford is providing manufacturing engineering capability, project leadership, purchasing support and assembly of the ventilators at its Dagenham engine plant. This production will help meet demand for 15,000 ventilators ordered by the U.K. government. Additional companies and individuals who are interested in contributing to this effort can submit their information here at www.fordnewideas.com. COVID-19 | DIGITAL SUPPLEMENT

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We are in this together.

The Genesis system includes more than 10,000 pieces of equipment. Two hundred and fifty of these are imaging and oncology devices, representing 60% of the biomed support operating budget. The single largest budget expense was contracts with OEM service providers.

In 2003, Genesis developed an in-house biomed imaging program to contain equipment service costs. The effort was successful. By 2012, the health center was saving more than $500,000 per year (after staff expenses). Then the savings plateaued.

A national consulting firm was called in to identify ways to continue to reduce costs. After extensive analysis, the firm recommended bringing in an outside service management company to build on the success of the biomed operation. After reviewing proposals from four national vendors, Genesis chose Renovo Solutions as its partner.

Let us help you reduce cost and chaos in your HTM program. Renovo Solutions and the Genesis biomed team identified key goals: SOLUTION

Centralize all service and repairs for diagnostic imaging devices.

SERVICING

Expand OVER the technical 400 support capabilities and resources for Genesis

biomedFACILITIES staff where applicable to service and maintain imaging devices.

Analyze different support strategies for contract service agreements where needed, and implement a cost-effective and reliable strategy. Provide ongoing customized coverage on each imaging modality. Maintain service support levels and maximize uptime.

RESULTS MEDICAL

EQUIPMENT SERVICE & MANAGEMENT

Over the last seven years, Renovo Solutions has helped Genesis reduce the diagnostic imaging service spend by more than 20% annually without changing response times and actually improving uptime. Genesis continues to leverage Renovo Solutions’ expertise to generate savings by: Adding additional equipment to the program that has come off previous OEM contracts.

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Including service coverage medical award winning platformfor 100+ Genesis-affiliated will save at least 15%clinics. over to secure your networked your prior year’s total audited Extending the useful life of equipment through life cycle management. medical with devices. service spend. Collaborating many major OEMs toequipment develop hybrid service models.

“Working with Renovo Solutions has been a great experience. They truly worked with us to create a unique model that fits the diverse needs of our health system. Not only are there significant cost savings,

Renovo thanks all the healthcare professionals on the frontline. Lisa Rogalski

but our biomedical department feels they have a true partner in meeting the service needs of our customers.”

Director of Materials Services

To connect with us, email SOLUTIONS@RENOVO1.COM or call us toll-free at 1-844-4RENOVO.

4 Executive Circle, Suite 185 Irvine, CA 92614 1-844-4RENOVO Fax: 866-822-8766

MODEL: NATION NEARS PEAK OF ‘ACTIVE’ COVID-19 CASES, STRAIN ON MEDICAL RESOURCES BY JAMES URTON, UW NEWS

new data-driven mathematical model of the coronavirus pandemic predicts that the United States will peak in the number of “active” COVID-19 cases on or around April 20, marking a critical milestone on the demand for medical resources.

“This indicates an important turning point that each country will reach in the COVID-19 pandemic, and we predict that the United States is on course to reach this point in the coming weeks,” said Ka-Kit Tung, a professor of applied mathematics at the University of Washington. “It is a point of maximum strain on a country’s health and medical infrastructure.” The new model is intended to help health officials and policymakers see at least two weeks in advance how COVID-19 will likely strain medical infrastructure in the U.S. and around the world. It relies on the number of newly diagnosed cases and the number of individuals who have recovered or died in a geographic region — whether an entire country or a subnational level like a state or province. Norden Huang and Fangli Qiao, both from the First Institute of Oceanography’s Data Analysis Laboratory in Qingdao, China, created the model with Tung. Their paper describing the analysis is not yet peer reviewed but has been submitted to a journal for consideration. Their study was posted March 30 to the preprint site medRxiv. For the U.S., this model predicts that: • The rate of daily new COVID-19 cases peaked on April 5-7, a projection that appears to be accurate, according to Tung • The number of “active” COVID-19 cases, which are individuals who have been diagnosed but haven’t recovered or died, will peak on April 20, plus or minus four days, and will then slowly decline as the number of cases entering the medical system 50

DIGITAL SUPPLEMENT | COVID-19

becomes less than the number of cases leaving the medical system • The U.S. outbreak will taper off in the first week of June with projections of 710,000 total cases, but could be up to 990,000, and 28,000 deaths, but could be up to 39,000, if the current U.S. fatality rate of 4% holds Their model also predicts that other hard-hit countries, such as Germany and Spain, have either recently peaked in active COVID-19 cases or will do so soon. The United Kingdom will not peak until the latter half of April, according to the analysis. The model finds that the length of outbreaks will also vary by country. Germany and Italy will take a week longer than the city of Wuhan, China – the earliest epicenter – to reach their turning point in active COVID-19 cases. The United States is projected to take two weeks longer than Wuhan. Wuhan and Hubei Province were placed under strict lockdowns by the Chinese government early in the outbreak, which may explain the shorter

course there, said Tung. Italy was slower to roll out lockdowns, first regionally and then nationally. The United States has no national lockdown, though a majority of states have issued stay-at-home orders. The researchers tested the model’s efficacy using COVID-19 data from China. With an accuracy of a few days, their model predicted key events in the outbreak’s growth, spread and decline of COVID-19 in Wuhan, Hubei and the rest of China – including the peak of new cases, the peak of active cases and the subsidence of the epidemic. Wuhan’s 76-day lockdown was lifted April 8. Scientists at the UW’s Institute for Health Metrics and Evaluation have created a separate data-driven model for COVID-19, which relies on other pieces of information about the pandemic, such as observed death rates. In contrast, the model by Huang, Qiao and Tung uses the number of newly diagnosed cases and the number of individuals who have recovered or died. The Institute’s model primarily www.1TechNation.com

projects COVID-19 deaths in a region, as well as the demand for hospital resources such as ventilators. “Our two approaches complement one another, providing the projections that health officials and governments need to understand when the maximum strain on resources is coming, and to show how the course of the pandemic depends heavily on the level of social distancing measures adopted,” said Tung. Compared to other modeling approaches, such as widely reported projections from the Imperial College London, the model developed by Tung and his colleagues does not require knowledge of the infection rate or the

total number of infected cases — including asymptomatic individuals. These are difficult data to collect or estimate given the relatively sparse testing for COVID-19 in many countries, and the fact that most symptom-free or mildly ill individuals are not entering the medical system for treatment. As a result of these and other key differences, the predictions by Huang, Qiao and Tung differ significantly from Imperial College London projections of a longer outbreak with 40% to 80% of the U.S. population infected and 1.1 to 2.2 million deaths. The results from the model used by Imperial College London differed significantly because it relied on

separate assumptions about COVID-19 and the predictions were generated when key parameters, such as its infection rates, were unknown, according to Tung. “Those types of models do serve purposes, such as moving policymakers into action,” said Tung. “But once the epidemic begins, it is important to turn to data-driven models that incorporate real-time information such as diagnosed cases, recovered cases and deaths – which reflect the effects of policy decisions and the degree of compliance – so that we can more realistically project the pandemic’s course.”

RECORD-BREAKING RIGHT TO REPAIR WEBINAR

he recent “Right to Repair” webinar set new record highs for registrations and attendees for the 2020 Webinar Wednesday series. The webinar saw 455 individuals register with 284 attendees present for the live presentation. The session was eligible for 1 credit from the ACI.

The webinar was presented by Bill Bassuk, CEO and president of the College of Biomedical Equipment Technology, and Larry Nguyen, CEO and CTO of Summit Imaging. The duo provided insights regarding a hot topic. The webinar was sponsored by the College of Biomedical Equipment Technology. Bassuk and Nguyen said “Right to Repair” is among the most important challenges facing the industry. Repair monopolies, created by equipment manufacturers, are driving health care costs up and patient care down. The duo shared their thoughts and insights regarding the issues and challenges the health care sector faces. In a post-webinar survey, attendees were asked “How much new information did you receive from today’s webinar?” “Great perspective considering the current health care climate,” shared P. Vestal, NCOIC, medical equipment repair center. “This is great news for us, that like to turn the screwdriver, apply logical thinking and use troubleshooting skills,” said J.

Advancing the Biomedical/HTM Professional

Click to Watch Webinars Now! Machicao, imaging service specialist. “Nice to see we are all on the same page and moving in the same direction. If this global (COVID-19) crisis brings the healthcare technology community closer together, all the better,” said C. Langmeyer, manager, biomedical engineering. “I found the info on COVID-19 timely, and about the manufacturers’ trend to make their equipment proprietary so we have to have them come in and repair them,” said L. Barton, B.E.S.S. “Really enjoyed the personal insights both panelists provided,” said C. Nieland, manager. “Really informative. I was not aware of the push in our industry by the OEMs to remove third-party services. I utilize these services on a regular basis and without these services it will become harder to meet

the needs of maintaining our devices within the budgets we are given,” Biomedical Engineering Manager J. Piercy said. “Lots of useful takeaways from the webinar with respect to helping our administration understand the importance of asking the right questions of the OEMs before issuing a purchase order to ensure we can service the devices we buy with in-house resources after the warranty,” Director HTM/Biomed C. Hulet said. “Hot topic. Good to see this topic’s importance to us all in HTM,” said M. Kolb, supervisor. For additional information about the Webinar Wednesday series, including upcoming presentations and an archive of previous sessions, visit www.WebinarWednesday.Live.

COVID-19 | DIGITAL SUPPLEMENT

Our Facilities Are Ready For Your Repairs PATIENT SAFETY IS OUR #1 PRIORITY In light of the current climate, our team is following the guidance of global health experts at the World Health Organization (WHO) and U.S. Centers for Disease Control (CDC) on preventing the spread of the COVID-19 virus. We have continued to maintain a sanitary work environment to ensure the safety of our team, your staff and most importantly your patients. Since all elective procedures have been temporarily grounded, now may be a good time to have your equipment inspected. Total Scope offers free shipping and complimentary no-obligation inspections. We have also taken additional safety precautions to ensure all packages are sanitized before entering or leaving our facilities. Safety is our number one priority.

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adcal’s Accu-Gold+ Touch family of X-ray test meters have been used in the field by Biomedical Engineers, Service Engineers, Physicists and Manufacturers for several years and have become the standard for many of them. These instruments are based on Radcal’s 45 years of experience and valuable customer feedback asking that meters should be Easy to use AND Accurate. The Touch X-ray test standalone systems are simply designed for ease of use. By expanding previous capability and adding the largest touch’s screen in the industry, Radcal has created a powerful stand-alone system. These economical systems are ideal for a comprehensive range of applications, including radiography, fluoroscopy, mammography, CT, mobiles, and dental. Of course, the Touch is compatible with the full line of Accu-Gold sensors and accessories making it the most dynamic meter available. Advancing the Biomedical/HTM Professional

ACCU-GOLD TOUCH PROFESSIONAL SYSTEMS For those users interested in the added benefits of a computer interface, Radcal introduces the Touch Professional systems. These systems incorporate wired and wireless interfaces driven by Radcal’s feature-rich and yet userfriendly Accu-Gold Windows application software. Waveform display and analysis tools deliver a deeper understanding of the operation of any X-ray machines performance. Additionally, this application provides the ability to seamlessly export data or direct capture to Excel for further computation, analysis, and reporting. Once in Excel, all of this information can be immediately saved in standard formats for later review or archiving. All of the connectivity features of tablet computers are now readily accessible to the user, including emailing of reports, archiving to cloud-based storage and remote printing.

ACCU-GOLD TOUCH PROFESSIONAL UPGRADE Your diagnostic X-ray instrumentation represents an important investment. Radcal is committed to ensuring that these instruments remain state of the art through continuous product improvements. For this reason, Radcal is offering the option to upgrade your current Accu-Gold+ family products to Touch Professional systems, thus adding standalone data. Don’t have an Accu-Gold? We can also arrange trade-in credit for your meter regardless of make or age. Collectively, these Touch solutions provide a comprehensive and flexible array of instruments to satisfy your quality assurance needs. During these unprecedented times Radcal remains open for sales, service and support. We are here to help you keep patients safe from radiation exposure. For more information please visit www.radcal.com or contact a sales associate at 626-357-7921. COVID-19 | DIGITAL SUPPLEMENT

SURVEY: SUPPLY AND RESOURCE NEEDS INCREASE AMID PANDEMIC

enior nursing and assisted living facilities have limited personal protective equipment (PPE) to care for a greater volume of patients, according to a Premier Inc. survey – indicating a second critical wave of supply shortages, as hospitals move to reserve beds for severe COVID-19 cases and post-acute settings see an influx of patients. While senior nursing and assisted living facilities can serve as excellent sites for less critical cases, such moves cannot overlook supply and resourcing demands, Premier’s survey suggests.

Premier’s survey of nearly 2,500 skilled nursing and assisted living facilities found that 24 percent of facilities do not have N95 masks on hand, and the majority of respondents have fewer than two weeks’ supply of surgical masks, isolation gowns and face shields. Other key products for which they have supply concerns include thermometers, exam gloves, alcohol pads, soap/detergent and hand sanitizer. Ninety-six percent are implementing PPE conservation strategies. “In this next phase of the outbreak, states and healthcare providers are contemplating how they can best provide care for patients who need medical attention but are not critical care status,” says John P. Sganga, Senior Vice President of Alternate Site Programs at Premier. “Senior nursing and assisted living facilities can provide quality care for these patients, but this shift will increase their resource and supply needs, from PPE and tests to staffing. We 56

DIGITAL SUPPLEMENT | COVID-19

already know that active cases of COVID-19 cre- Supply ate surge demand of up to 17x for hospitals’ supplies, and our survey N95 shows that nearly half of Masks* these post-acute facilities are already dealing with Surgical staffing challenges and Masks that PPE remains elusive. Premier’s e-Commerce Isolation marketplace, stockd, Gowns has created a repository of conservation Face Shields guidance and alternative production methodologies for key PPE, and we continue to collaborate on other solutions to help providers through this unprecedented period.” Seventy percent of senior nursing and assisted living facilities in Premier’s survey say they are not fully prepared to treat an increasing number of COVID-19 cases as the virus surges. Furthermore, 48 percent of respondents say they are experiencing challenges with staff attendance as a result of COVID-19. States are approaching capacity planning in nursing homes differently, as determined by hotspots. New York, for example, ordered all nursing facilities to accept hospital discharges, including patients who have tested positive for COVID-19, while Massachusetts is beginning to empty nursing facilities to become dedicated sites for coronavirus treatment. “States and providers must think strategically about how they admit patients from hospitals or move patients across alternate care sites, particularly

Average Quantity on Hand per Facility

Average Quantity on Order per Facility

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3,580

600

3,393

141

2,937

since senior citizens are a population already vulnerable to COVID-19,” Sganga says. “Premier continues to advocate for and work with our members to coordinate across the healthcare system, work with the government, and support programs that help get resources to sites with the greatest need. Our hope is that this survey data provides key early insights for decision-makers who are beginning to map out new care sites for patients through the outbreak.” Survey Methodology Premier’s survey was conducted from March 30-April 7, 2020, and sent to a representative portion of non-acute care providers in the Premier membership. Approximately 183 skilled nursing and assisted living providers responded, representing 2,492 facilities and more than 200,000 beds, or approximately 8 percent of the total skilled nursing and assisted living beds in the United States provided responses.

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• C

Earn CEUs provided by the AAMI Credentials Institute.

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