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SPRING 2014 rsti-training.com News from the Leader in Radiological Service Training > RADIOLOGICAL service TRAINING INSTITUTE > ISSUE 2014.2

29 YEARS OF Maximum Value for Your Educational Growth and Development

NEW! 2014 COURSE INSERT INSIDE! President’s Letter..............2-3 Start with New Training.......4 Climb Higher............................5 Course Schedule....... (pullout) Start with Service..................8 Win with People.....................9 Strength & Purpose..... 10-11 Student Testimonials......... 12 Servicing Philips.................. 13 The Race for ROI.................. 15 Speed Sourcing.................... 16 Used Equipment.................. 18 Course Index........................ 19

SPECIAL ISSUE

GETTING STARTED

Getting Started with Healthcare Technology Management // PAGE 2-3 //

Getting Out from Between a Rock and a Hard Place // PAGE 6-8 //

BREAKING DOWN BARRIERS

TO EQUIPMENT SERVICE INSIGHTS FROM TEAM RSTI

Getting Started with Your Imaging Equipment

Line ‘Em Up and Take on Healthcare Technology Management! INSIGHTS from RSTI PRESIDENT, DALE COVER

t’s no secret, healthcare providers are being pressured to provide better care even in the face of reduced reimbursements. Changing from procedure-based to outcome-based reimbursement is putting even greater demands on hospital budgets. So maintaining quality care and ensuring a positive patient experience while doing “more with less” and reducing costs are a major concern for everyone involved in managing the hospital.

T hroughout the medical community there are very few services that cost as much in terms of dollars and manpower to deliver as diagnostic imaging (DI). Medical imaging also has great potential to improve diagnosis. Is there any wonder why the C-Suite is looking at any cost cutting measure that can save their collective butts and budgets within the halls of the imaging department? The promise of improved throughput and more accurate diagnoses afforded by new technology sings a siren song to executive planners. Advancements in the individual digital imaging suites, PACS/DICOM, mobile computing and complete hospital integration allows for cost savings on several measurable and verifiable levels.

expense of keeping interpretation in-house, or at least reducing the number of staff hours dedicated to this function (operational cost cutting) Mobile computing and hospital wide integration improves access to information, time management and the communication of diagnoses and treatment plans (again operational costs)

Software advancements can allow systems to serve multiple functions and add diagnostic tools (again fewer systems needed)

By reducing the time it takes to get the patient processed, properly diagnosed, treated and back to their busy lives, today’s technology improves their experience and their satisfaction with the hospital. This also should keep them from coming back in for the same issue (returns for the same issue is where outcome based reimbursement hurts hospital budgets). Positive perceptions can also make it an easier decision to return later for their other medical needs, ensuring an ongoing revenue stream, reduced though it may be.

PACS/DICOM (computer based image management) makes it possible for image interpretation to be handled off-site, 24 hours a day, reducing the

With these advances in tech come some risks. Fewer imaging suites mean that when a room is down, there may not be a back-up system or problems

Improved throughput reduces the number of imaging systems needed (direct cost cutting)

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with rescheduling to other rooms will be amplified. Another thing to consider is acquired dependence on technology. Try going through a business day without your computer and cell phone and you will see what I mean. All of this makes it even more important that your Heath Technology Management (HTM) plan includes at least some involvement between Biomedical Services and DI. Here are some steps you can take to integrate more diagnostic imaging and its associated technology into your plans:

1 > T a k e

inventory. Determine how many advanced imaging (CT, MRI, PET etc.), tech driven (Cardiac, Vascular, Digital Imaging), and routine (Mobile X-Ray, C-Arms, Ultrasound, Nuclear Medicine) systems you have. Most facilities have numerous Mobile X-Ray, C-Arms and Ultrasound systems. This is a great entry point to DI service and is a proven area where savings have been achieved by dropping redundant contracts and having in-house technicians provide for the maintenance needs of these systems. Once the HTM plan has had a chance to show value to the C-Suite then there will be opportunities to grow into other, more technical, costly and up-time sensitive systems like Cath and CT.

2 > Gather information. Research how much each

system costs per year to maintain. This includes contract costs, overtime, time and materials, replacement parts, time between failures, average time to repair and up-time requirements so you know where you can have the greatest effect now and where your opportunities for growth are in the future.

5 > In

today’s world of $200,000 X-Ray tubes, $120,000 detectors and $15,000 motor assemblies, aftermarket replacement parts and second source X-Ray tubes deserve the attention they are getting. These items can be purchased for as much as 70% off list if you’re willing to look beyond the OEM for your needs.

There are however, some risks associated with using aftermarket replacements such as X-Ray tubes, image intensifiers and doing things like disassociating your Mobile X-Ray generator from its OEM digital imaging system and replacing it with another manufacturer. Primarily, your OEM service provider may refuse to continue to work on the equipment. Most of the time they will cite the “unreliability” of the foreign replacements as the reason they will not accept responsibility for their piece of the system. Funny, if their equipment were more reliable or cost effective you wouldn’t be replacing it with a different one. So be prepared to go it alone or have a back-up plan like using an ISO if the OEM pushes back. Diagnostic Imaging has great potential to save budgets and done correctly holds less risk than most people think it has. Done correctly and incrementally the chance for success is very high. I wouldn’t suggest dumping all of your contracts, but rather, start with the mobiles, general X-Ray, C-Arms and ultrasound equipment and work up from there.

Dale Cover

Dale Cover, President

3 > Your plan should be based on the systems you

have in inventory weighed against department level talent and not just potential dollars saved. By that, I mean, for example, don’t force your department into taking on CT service if no one in your department has the skills to do it.

4 > Identify the people who have the talent and desire

to learn new systems and technology and give them the opportunity to do the work effectively by getting them trained. WWW.RSTI-TRAINING.COM | CALL 440.349.4700 | 3

Start with New Training CT: Philips Brilliance Air Family By Todd Boyland RSTI Director of Training RSTI is expanding its CT course offerings in 2014 with the addition of the Philips Brilliance Air Family CT Training Course. This course is scheduled to run 7/28/14 – 8/8/14 and 12/1/14 – 12/12/14. The Philips Brilliance Family training course covers a wide variety of Philips CT systems from their Brilliance “Air” product line. The Brilliance “Water” products are 6/10/16 slice systems based on Siemens Sensation CT platform, and will not be covered in the class. The biggest obstacle to this liberation from binding contracts however, is obtaining the appropriate documentation for the service professional to perform the required maintenance and inspection procedures. This has been a problem for many years and considering the federal government made it mandatory that OEMs supply the documentation for every unit, this should no longer be an issue yet it remains a thorn in the side of progress for our multi-vendor field service professionals.

Systems that will be covered in this course include: Brilliance 6 Air

Calibrate, service, align, and use diagnostic tools to evaluate performance of the DAS and detector assembly E v a l u a t e c i r c u i t f u n c t i o n s t o f a c i l i t a t e troubleshooting Perform a complete and thorough preventive maintenance inspection on the unit Diagnose and correct problems in the scanning sequence

Brilliance 10 Air

Perform subsystem diagnostics on various components of the system for the purpose of troubleshooting

Brilliance 16 Air

Perform a system software backup/restore

Brilliance 16 Power

Perform a system complete load from cold (LFC)

Brilliance 40 Brilliance 64

During the course, service professionals will: Perform scheduled system maintenance Perform replacement and calibration procedures for the X-Ray tube, detector assembly, and generator

4 | focalspot.SPRING.2014

This course offers a great opportunity to service a wide array of Philips Brilliance Family CT scanners. Call now to book for classes in 2014.

Call 800.229.7784 for Full Course Details! Prerequisites: Students must have taken RSTI’s CT Phase 1 and CT Phase 2, or have equivalent field experience.

Test and record effortlessly

Measure ionizing radiation quickly and accurately in three simple steps with the 451 Ion Chamber Survey Meter. • Displays values accurately using dependable ion chamber technology –Not energy dependent –No correction factors necessary • Fast measurements of dose rate and dose simultaneously • Simple one-handed operation makes it easy-to-use • Light-weight to reduce hand fatigue (only 1.07 kg) • Log data quickly using Excel® Toolkit

Three steps. Only two buttons. For more information visit:

www.flukebiomedical.com/effortless

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BETWEEN A ROCK AND A HARD PLACE “CLIMB higher” WITH Jim monro, RSTI CHAIRMAN

s you have read through RSTI’s Spring FocalSpot, you can readily see that it picks up where the winter one left off…Most articles this time will be geared to giving you the ammunition you need to move your facility or facilities out of OEM bondage. Clearly, there are risks to be dealt with along the way, but you have to decide if it is worth your personal risk to set in motion an in-house program or stand still and wait for even more cuts in hospital reimbursements to take effect. Every hear someone say that he is, “between a rock and a hard place?” Most in the business world find themselves in this conundrum every day. If you make a decision for next month or next quarter or next year, you are only ignoring an impending tsunami just beyond the horizon that will bury many hospitals in its wake.

6 | focalspot.SPRING.2014 focalspot.Spring.2014

Even if you can survive, you will be doing business differently after 2015 than you are today. The water along the shore recedes to dry land when it prepares for this particular natural disaster. If you haven’t noticed, the tide is out and going to stay out while the power of massive spending cuts is foisted on all medical facilities, cutting the deepest and widest swath out of a hospital’s bottom line. Reduced revenue from reduced reimbursement portends the following additional change:

Cost cutting…Like never before the medical world is going to slash costs in order to survive fiscal disaster. It has been going on for the last 5 years at a methodical, slow pace, and most of the prior pain has been absorbed. Right now, today, 45% of our hospitals are not even breaking even. Smaller, under 50 bed facilities are closing, combining, and re-financing at a record pace just to remain solvent. Atlanta closed four small hospitals recently, the last of which closed in December of 2013.

Judicious expense reduction…It has been done from the bottom, up to the C-Suites. Now that is being replaced by top down frantic work force reduction, just to make ends meet. A few months ago the Cleveland Clinic let go another 3400 employees in one fell swoop. If they have to do it, so will everyone else.

Get ready… Quality of service will be directly affected with the elimination of necessary staff. This includes overburdened OR’s and ER’s. As an example, one local surgery doctor told me that he had to postpone his morning operations, because his instruments had not been cleaned or serviced properly.

Terminating staff and reducing service levels accordingly are just the first signs of hospitals having to deal with bottom line hemorrhaging like never before. Cutting with a dull blade and a bad plan or no plan, is the recipe of a 30ft. Tsunami of confusion that will crush everyone in its path.

At the end of next year, hospitals will be hit hard, patients will be hit hard, doctors will be hit hard, and nurses will be hit hard. Every department will have to do much, much more, with less than ever.

Then our government will step in to bail them out. Sound familiar? Instead of TARP (Troubled Asset Relief Program) money, it will be HARP, (the Hospital Asset Relief Program) and in this program, hospital defaults, late payment or no payment, insurance issues, old equipment and so on will be absorbed to provide financial solvency to medicine. Those deemed, “Too big to fail,” will pick up the pieces, taking advantage of the weak. Just like Goldman Sachs, Citibank, Bank of America, and Chase Bank, the big survivors will feast on the rest. The answer for small to middle size facilities is to change the way you operate before you get there. Here are several ways to not throw out, “the baby with the bath water,” and here a few from the world of RSTI.

Plan your level of service now and work toward expansion of duties with support.

Find people who will buy in to doing much more with much less.

Get help from your suppliers on every level, including lower prices and bulk buying.

Change your terms of payment to match when you get paid, especially by Medicare and Medicaid.

Stretch every dollar as far as possible, before paying any bill. Those suppliers that have steadily benefited from you, now need to share in the pain, while you become streamlined and more efficient.

Never short-change the remaining staff. Take care of them and their morale at every turn. They are the most important asset you have, even though it does not help your balance sheet.

Dump duplication of services. Combine services where possible. Train and cross train now, so that your staff is prepared.

Maintain standards of cleanliness and friendliness. Eliminate hospital borne pathogens like MRSA and C-Diff. Friendliness will go a long way with the injured and sick. Communicate with those waiting in long lines for service. Provide beverages and/or snacks for those who wait hours.

Learn how to use the used equipment markets to reduce capital expenditures on the front end, and train your own staff to service it on the back end.

10 Fill your service staff with qualified, well-trained

men and women that you can count on every day. Educate them so they can reduce your overhead.

By the way, RSTI is where you send your managers and engineers to be trained and cross-trained in diagnostic imaging.

Jim Monro

Jim Monro, Chairman

WWW.RSTI-TRAINING.COM WWW.RSTI-TRAINING.COM || CALL CALL 440.349.4700 440.349.4700 || 7 7

Start with Service How RSTI Hits Accounting Featuring Yvonne Gasper RSTI Staff Accountant When people typically think of accountants they think of a boring bean counter sitting around crunching numbers all day or a CPA working late hours during tax season. Yes, I too, have sat for hours crunching numbers and prepared tax returns all day into the night at previous jobs.

Accounting can be mundane and tedious, however, here at RSTI, being the Staff Accountant is so much more. I would not say that I have a typical day. My normal “accounting” duties include preparing invoices for training classes and equipment sales, entering and posting bills, breaking down income and expenses to the proper accounts and proper months, creating monthly unearned income reports sorted by classes, updating the Capital Assets Inventory for additions and disposals, preparing and entering journal entries, monthly bank reconciliations, and other miscellaneous accounting projects as assigned. Some days I spend an entire day only entering and printing invoices or only entering bills, it just depends on what needs to be focused on that day. We all wear many hats here. I answer phones, grade Phases I & II tests, print equipment reports, complete W-9 requests, sign for packages, assist students, file documents, answer Excel questions, and even refill supplies in the cafeteria if needed. I help all my coworkers when I can be of assistance, but I am the back-up person for three people customarily. When Donna is on vacation I sort and distribute the mail. When Anna is on vacation I take care of the students by gathering their registration information, sending them

Yvonne Gasper

confirmation letters, ordering lunches, processing credit card payments and answering students’ questions. However, I assist Kathy the most with printing reports, filing invoices, pulling bills for payment, mailing checks, making bank deposits, and whatever else may be needed that day. All in all, I say being a Staff Accountant at RSTI is anything but boring!

Win with People How RSTI Serves Students Featuring Anna Morrison RSTI Registrar In the 20+ years I’ve been here at RSTI, I’ve seen and personally met thousands of students. It’s amazing and humbling to think of how many people have entrusted their careers to RSTI and given up personal time and work commitments to spend weeks here at our training center. Without a doubt, that is the best part of my job, welcoming students to RSTI, both newbies and oldtimers, and making sure their experience here is as pleasant as possible. Because RSTI is a small company, we are very flexible in the registration process. Many times, all it takes is a simple phone call or an email to get signed up for a class. Other times, the process may be longer or

Don’t forget to explore our new 2014 Course Schedule Insert, conveniently redesigned and reformatted as a pullout insert in this newsletter! 8 | focalspot.SPRING.2014

more complicated when approvals need to be obtained or additional information is needed to justify the training. In either case, it’s always a good idea to “pencil yourself in” for a class. When a student calls to inquire about class pricing or availability, I generally enter a tentative registration. This is important, because if a class starts filling up, or the date needs to be changed, or minimum enrollment is not being met, a contact list is already established and those students can easily be advised of the class status. So, don’t be afraid to put your name on the list. Until the class is confirmed with PO, check, or credit card, there is no obligation on your part, but it gives us both a head start when it’s time to finalize the registration.

about booking for future classes, or just to chat. I’m full of advice; just ask me!

Here at RSTI, the focus is on you: our students and friends! The classes may change, the training center may expand, the equipment may be upgraded, but the one thing that remains constant is that students continue to fill our classrooms, labs and hallways. We wouldn’t change that for the world!

Grow with Veterans RSTI’s Newest Recruit Featuring Joe geary RSTI Instructor

Anna Morrison In addition to registering students, I work closely with our Management Team to review and finalize the training schedule, review pricing, and manage key accounts. I am the School Certifying Official for veterans training and serve as the liaison to the State of Ohio Board of Career Schools and Colleges. I am involved in placement assistance for those who pay for training on their own in the hopes of entering the career field. I help with internal travel arrangements for trade shows and presentations. I make hotel reservations for students taking advantage of our “Full Coverage Package,” as well as offer recommendations to those seeking alternate hotel arrangements. I provide the necessary paperwork for students traveling from overseas who may require a Visa to study in the States. I coordinate lunch selection and delivery (sorry in advance for the 5 lbs you’re likely to gain while you’re here!). I’ll even help you rent a car if you decide you’d like to get out and about over the weekend. Last, but not least, I’m here to answer any questions you may have about the industry, about what to do while you’re in Cleveland,

RSTI is proud to announce that Joe Geary has joined our team. Joe brings many years of experience teaching medical imaging system maintenance courses. Many of you may know him through his many years teaching at DITEC. You old timers will probably also know that he got his start in medical imaging at RSTI. Even though things have changed over the years and we have different systems installed than DITEC, Joe is showcasing his talents in his new career helping students and other RSTI staff in the labs as he quickly gets ready to start teaching. In fact, by the time you read this Joe should be teaching his “first new” class. Join us in welcoming him to the team.

Joe Geary WWW.RSTI-TRAINING.COM | CALL 440.349.4700 | 9

RSTI 2014 SPRING Course Schedule April 2, 2014

May 12 - 23

JUNE 26

JULY 23

June 16 - 27

June 2 - 13

Introduction to Networking & DICOM PACS Troubleshooting Techniques

MANAGEMENT

PRODUCT SPECIFIC

C.A.M. (Capital Asset Management) 2.5 Day: Intro to Diagnostic Imaging & PACS - For Managers & Sales Professionals GE Advantx 1, Advantx E, Legacy, Compax 40 GE Definium Family: Definium 6000/8000, Discovery XR650/XR656, Optima XR640

June 9-11

AUGUST

SEPTEMBER 25

Aug 4 - 15 July 7 - 18

Aug 18 - 29 July 21 Aug 1 Aug 4 - 15

Sept 8 - 19

Sept Oct Sept 8 - 19

July28Aug1 Aug 4-8

June 16-20

Aug 18 - 29 May 19-23

Sept 8 - 12

GE Precision 500D R/F GE Revolution Family (XR/d 1X & 2X) GE Proteus (JEDI Generator) Philips Bucky Diagnost June 23-27

Private Practice X-Ray Systems GE AMX Portable (IV, IV+)

PORTABLES

LABOR DAY

Principles of Servicing Diagnostic X-Ray Systems (Phase I) Advanced Radiographic System Maintenance (Phase II) Advanced Fluoroscopic System Maintenance (Phase III) Advanced Diagnostic Imaging System Analysis (Phase IV) PACS Engineer/Administrator Certification (Phase I) PACS Engineer/Administrator Certification (Phase II)

INDEPENDENCE DAY

NETWORKING & DIGITAL INFORMATION

MAY 5

MEMORIAL DAY

X-RAY CERTIFICATE SERIES

TRAINING COURSE TITLE

May 5-9

July 7 - 11 July 7 - 11

Sept 22-26

July 21-25

GE AMX 700 Portable June 9-13

Shimadzu MobileArt Portable May 12-16

Siemens Mobilett Portable C-Arm OEC 9600 Multi-Product C-Arm OEC 9800/9900

C-ARM

Apr 28May 9

Aug 18 - 29 June 2-6

C-Arm OEC 9900

July 14-18

Siemens Siremobile C-Arm Philips BV Pulsera C-Arm

CARDIAC

WOMEN'S HEALTH

Siemens AXIOM Artis Family (FP)

June 2-13

GE Innova Family (2100/3100/4100)

June 2-13

Analog Multi-Vendor Mammography (GE, Lorad, Siemens) Lorad Multicare Platinum Breast Biopsy System GE Digital Mammography Family (2000D/ DS/ ESSENTIAL) Digital Mammography (Hologic Selenia)

July 21-25 July 21-25

Aug 4 - 15 July28 Aug 1 May 5 - 16

Aug 18 - 29 June 16 - 27

Lorad MIV Platinum and ACR June 2-6

Multi-Vendor Bone Densitometry

ULTRASOUND

Multi-Vendor Ultrasound Principles of Servicing Computed Tomography Systems (Phase I) Advanced Computed Tomography System Maintenance (Phase II) GE Brightspeed & LightSpeed CT GE VCT

Sept 15-19

June 16 - 27

May 5 - 16 May 19-23

Philips Brilliance Family

NUCLEAR MEDICINE

July 28 -Aug 8 Sep 22 -26

Principles of Servicing Nuclear Medicine Systems

EXHIBITS & PRESENTATIONS NOTE: M-IV Platinum & 500D are 5 full days. Return flights after 6 pm.

10 | focalspot.SPRING.2014

AAMI 5/31-6/2

MD Imaging 7/16 - 7/17

FIME 8/6 - 8/8

NOVEMBER 27

Oct 20 - 31 Nov 3 - 14

Sep29 Oct3

Nov 17-21

Dec 1 - 12

Dec 1 - 12 Dec 8 - 19

JANUARY 29

NEW YEARS

Nov 3 - 14

CHRISTMAS

22 t3

THANKSGIVING

Oct 20 - 31

DECEMBER 24

FEBRUARY 26

Jan 5 - 16

MARCH 23

APRIL 23

Feb 16 - 27 Jan 19 - 30

Apr 6 - 17 Apr 20 May 1

Mar 2 - 13 Feb 2 - 13 Mar 16 - 27

Apr 27 -

Dec 1-5

Jan 26-30

Oct 6-8

Dec 15-19

Mar 16-20

Oct 20-24

Apr27 May 1

Oct 20 - 31 Nov 10-14

Sep2 Oct 3

Dec 1-5

Oct 13-17

Feb 2-6

Dec 8 - 12

Jan 26-30

Nov 3-7

Mar 23-27

Feb 2-6 Feb 9 - 13

Nov 10 - 21 Dec 15-19 Dec 15-19

Mar30 Apr3

Feb 16-20

Jan 19 - 30

Oct 6 - 10 Sep29 Oct3

Feb 23-27

Feb 2-6

Mar 16-20

Mar 23 Apr 3

Apr27 May 1

Jan 19-23

Oct 27 Nov 7

Apr 20-24

Oct 6 - 17

Mar 9 - 20

Jan 12-16 Dec 1 - 12 Oct 6 - 17

Feb 16 - 27 Jan 5 - 16

Apr 6 - 17

Nov 17-21

Mar 9 - 13

Oct 13 - 24

Feb 16 - 27 Oct 27 Nov 7

Mar 2 - 13 Nov 10 - 21 Dec 8 - 12

Mar30 Apr3 Mar 23 Apr 3

Dec 1 - 12

Apr 6 Apr 17

Feb 23-27 RSNA 11/30-12/5

State of OH Reg. No. 93-09-1377T

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Start with Strength How RSTI Grows Talent Featuring Josh Mericle RSTI Service Engineer

am the youngest and most recent hire to RSTI’s amazing team. I was born and raised on the west side of Cleveland. I worked in the food industry for 6 years after high school but always had an interest in electronics. I spent some time working at an automotive coatings factory. At the factory I obtained skills in packaging, shipping and meeting deadlines. When I left the factory, I started working for a major appliances retailer. This is where I learned customer relations and installation skills. Construction has always been a big interest of mine. I have learned many trades including siding, roofing, framing, along with deck and fence construction.

RSTI has given me the opportunity to utilize my skills in a way that will help the company, as well as myself, grow. I was introduced to the company by Kenneth Brady. Ken brought me on to do some temp work involving the merger between Ditec and RSTI. My first week working with RSTI was intense. There was a pretty overwhelming task at hand and a deadline which needed to be met. We worked our hardest and met the deadline with time to spare. About a week later I got a call from Ken asking if I would like to come into RSTI and do some more temp work in the used parts department. Pleased to hear that I had another opportunity to work with the company, I came in as soon as I could. During my first month at RSTI, I disassembled units and added their parts into the parts inventory. Most of the parts were foreign to me in the beginning. Many RSTI employees helped me learn about the parts and their functions. There was plenty of storage for the parts at the time however, something had to be done for when we ran out of room. Using my skills in framing and building decks I rebuilt a floor space in which more shelves could be placed. Stairs were also needed to access this area that we now call “the loft.” So I went 12 | focalspot.SPRING.2014

to work on the stairs after the floor was finished. Near the end of the build I was approached by the president of the company, Dale Cover, and offered a full time position at RSTI. Since finishing “the loft,” I have focused a good portion of my time on building the new sets of bays at RSTI. Many members of the RSTI team have put time into these bays, which are now near completion. The new bays will provide the students access to learn from a wider variety of installed units. It will also create more room and opportunities to hold more classes. The back half of the new bays will give us the space we need in order to test units and prep them to be utilized in the classrooms. When I’m not working on the new bays, I find myself anxious to obtain all the knowledge that I can about this business. I have spent a great amount of time in the shipping department learning how to receive and send out units. At RSTI it’s important to have the equipment needed to teach classes. Occasionally I go on trips to de-install and bring back units to RSTI. More experienced team members usually go with me and I have learned a lot about the de-installation and transportation of radiological equipment. I have recently taken a course at RSTI to better understand the machines I work with. I am looking forward to taking more classes and learning as much as I can in the field. My experience thus far has been very rewarding and I look forward to my career with RSTI and the continued success of this team.

Jose Mericle

Ken Brady

Run with Purpose How RSTI Leads Logistics Featuring Ken Brady RSTI Service Engineer

f you have visited RSTI in the past six years, you have probably crossed paths with me. Many students believe that I am another student, until I tell them otherwise. Most of the time we share a laugh and a short conversation about how absurdly large my coffee mug is. I have worked at RSTI for 6 years, and have met a countless variety of people from around the world in that short time. The best part of it is that we all have something in common, our career choice. I started at RSTI at age 22, after graduating from electronics school only four years prior. I was given the opportunity to work in the shipping and receiving department, and learn as much as I possibly could about x-ray. Since starting at RSTI, I have gotten engaged, married, became a homeowner, became a father to twins, have a 3rd child on the way, and learned an awful lot about a field that was foreign to me a few short years ago.

Working in the shipping and receiving department at RSTI may not be exactly what you think. We are also responsible for installing and testing most of the equipment that enters the building. At times, a large part of our day is spent troubleshooting problems that we find in the equipment. Finding the root cause of an issue is very important, to ensure that the problem does not recur. This helps ensure that RSTI live up to its quality reputation to both customers of RSTI Exchange, and students of training. Because I work at a training center, and a used equipment distributor, I have had the opportunity to get down and dirty with the full range of OEMs and modalities. There is always some sort of machine that is new to me, coming through my doors with problems that need to be addressed. There have been many moments when I know right away what the problem is. There have also been many moments of beard-scratching, head-shaking befuddlement. As x-ray equipment continues to evolve and expand, the need to keep current with the technology remains. As I said earlier, many students believe that I’m another student. Truthfully, I don’t believe that any of us ever stop being students.

Education Endurance How RSTI Stays the Course FEATURING donna hastings RSTI Manager, Documentation I am a graduate of Cleveland State University where earned a B.S. in Education. After teaching elementary school for four years, I got married and began raising a family. Once my three sons had entered school, I started working at RSTI in 1989. My brother, Terry Speth, founder of RSTI, asked me to help with the mailings and copy the student manuals for the then fledgling company. It very quickly developed into a full time career. Over the last 25 years, as manager of the Documentation Department, I have been responsible for the following:

Donna Hastings

• Copying the class manuals (soon to be in color) • Maintaining the technical loaning library • Assigning the film badges • Assembling and mailing the CRES Self-Study packages • Proofreading the quarterly newsletters • Ordering the office and shipping supplies • Preparing the classrooms for the upcoming classes My tenure here has given me the opportunity to appreciate the radiological service profession and to form many friendships. WWW.RSTI-TRAINING.COM | CALL 440.349.4700 | 13

Student Testimonials Ed Wunderlich, Engineer AGFA

rior to coming to RSTI, Ed was briefed by other service engineers about RSTI. Most was positive, and some, not so much…Ed has 32 years in imaging and has spent the last 26 years with AGFA. When asked why he stayed there so many years, he simply said that they never gave him a reason to leave. It has been a good relationship for him and his family for many years. Certainly this kind of loyalty speaks volumes about the company he has given 26 years of his time and effort. He believes that his experience at RSTI was better than he imagined and said that he would be going back to his management to detail his positive experience. In particular, he was made to feel at home by our staff and considered his instructor one of the best he has seen. When I told him that David grew up in the wet processor and laser imaging business, he was even more impressed with David’s grasp of diagnostic imaging. David kept it alive at all times, and even though he has nodded off in classes elsewhere, that was not the case with RSTI. He learned more than anticipated in the classroom, but his time in our labs sealed the deal for him. The class was larger than expected, but there was plenty of equipment to work on every day. The only flaw he could see was that one day his test equipment needed new batteries. Finally we ended on discussing classes he would be coming back to take in the near future, so here they are: 1. Phase II 2. PACS Phase 1 3. PACS Phase 2 In his opinion these three are absolutely necessary for him to alter his chemistry. He is hard wired for analog, and AGFA’s world is changing dramatically. He will soon be responsible for AGFA installs and maintenance of their new line of DR systems.

14 | focalspot.SPRING.2014

Joe Koehn

Ed Wunderlich

Joe Koehn, CBET

Agnesian Healthcare, St. Agnes Hospital Joe had 6+ years experience doing in-house biomed when an opportunity for imaging came up. The Healthcare System employs 6 biomeds (Electronics Technicians) and 1 imaging engineer and is comprised of 3 hospitals (each under 150 beds) and 8 clinics. There is Toshiba Rad and R/F at all 3 hospitals, along with Philips FD-20 Cath Lab, Pulsera, some GE and OEC equipment and RadPro, Sedecal, Del, and Canon digital. They are in talks to replace some older Bennett and Gendex equipment. Joe’s goal in coming to RSTI is to be able to do PM’s and not have to call in the manufacturer. Although he has not had a chance to do much fluoro, Joe is looking forward to applying what he has learned in Phase III. He said “The Residence Inn is great,” and he would like to return for PACS and Pulsera.

Breaking Barriers Servicing Philips BV-Pulsera By Mike Petelin RSTI Instructor

e have recently held our first two successful Philips BV-Pulsera courses. In this class, students gain AIAT (Assemble Install Adjust Test) service access to the BV-Pulsera though BV scope, allowing them to do the necessary service and preventative maintenance on the system. This access also affords the student many of the Level 0 documents for many other Philips medical imaging systems. Many times Service Engineers and Managers hear of the “barriers” to entry into the imaging service world with certain systems, like the BV family of C-arms. These barriers can be overcome, and in the US and Canada they are required by law to allow access to service and test your equipment.

RSTI’s innovative courses provide students with the knowhow to “break down the barriers” to servicing certain imaging equipment.

TECHNOLOGYLIFE

It’s something you’ll only find here at Aramark. The opportunity to work side-by-side with a team of outstanding biomedical technicians, imaging service engineers and professionals—fixing, not just clinical equipment, but the workflow challenges our customers face every day. So they can better care for patients, and healthcare can work better for everyone. We’re seeking talented, experienced professionals: • Biomedical Technicians (all levels) • Imaging Service Engineers (all levels) • Senior Technology Managers • Technology Managers

Visit aramarkhealthcaretechnologies.com/join-us to apply online. (EOE)

WWW.RSTI-TRAINING.COM | CALL 440.349.4700 | 15

Many Replacement Parts

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Re-Engineered Devices

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nne Classic_Co Restored Parts

CONNECT WITH A WORLD LEADER. CALL CLASSIC. FACEBOOK: SEARCH FOR CLASSIC IMAGING TWITTER: FOLLOW @CLASSICIMAGING REMADE IN AMERICA

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Deliver the best — with the industry’s best X-ray QA • Easy • Fast • Accurate

RaySafe ThinX

RaySafe Solo

RaySafe X2

RaySafe Xi

Unfors RaySafe, leader in X-Ray Quality Assurance, is used by more biomeds, X-Ray manufacturers and physicists than any other solution. Simple, single exposure measures kVp, time, dose, dose rate, HVL, pulse, pulse rate, mA, mAs. R/F, Mam, Dental, CT 508-435-5600 www.raysafe.com

16 | focalspot.SPRING.2014

In-house C-Arm More Than Pays for Itself “The Race for ROI” By Dave Domanski RSTI Instructor

n many hospitals capital equipment like the OEC surgical C-arm is often seen as ancillary and not given much thought. Just put it under contract and forget about it. This is 100% the wrong approach.

Simply taking a few c-arms off of contract can justify the salary of a quality imaging service engineer. Let’s look at a common full tertiary care facility with a mix of C-arms. The annual contract for an OEC C-arm can range from approximately $15,900 for a 9” system to $17,900 for a 12” system including glass, even MORE if that C-arm is an MD (Motorized Drive) or Cardiac option. A PM only contract will set you back about $3400 a year per unit. That might not seem like much compared to the contract cost for a CT scanner, but chances are you won’t find six to nine CT scanners in a given facilities inventory. Five C-arms, on the other hand, is not uncommon at all. So let’s say we have five OEC’s with a mixture of options fully covered for an average annual contract cost of $17,000 each. That’s $85,000 a year! Chances are, the manufacturer will have a single engineer covering an entire territory, not just your facility. If that territory includes say 30 C-arms, now we’re looking at over half a million in revenue! That makes for a tidy profit even if they do have to replace an X-Ray tube or Image Intensifier here or there. When you get right down to it, laying out $17,000 for a service contract is like making a bet that your glassware will fail and prepaying for it! That’s not what I would call a good bet when you take into account the average lifespan for these items is easily five years.

So how do we start saving money? We start by getting the Imaging department the respect it deserves. More often than not, a hospital’s accounting department sees the imaging department as a liability instead of an asset. If you look at the numbers the way that they often do in such departments it makes sense. The accountants see a department that costs them a substantial amount of money in the form of replacement parts, salary and benefits that does not bring in any revenue. What they do NOT see is the massive potential for cost prevention that the imaging department provides and how this potential MORE than pays for the department many times over. Smart imaging departments keep track of not only their costs, but also the savings that they generate. Replacing a $45 hard drive in house actually generates $3500 to $5000 in cost avoidance. Simply doing a software reload in house can not only save $500 to $1000 in immediate savings, but the ultra quick response time that in house service provides assures more equipment up-time and THAT translates directly into increased revenue. When you start keeping track and generating some hard numbers you will find that respect will follow. Justification for necessary service tools and training becomes easier and the roadblocks often encountered with budget requests start to disappear.

www.rsti-training.com WWW.RSTI-TRAINING.COM | CALL | CALL 440.349.4700 440.349.4700 | 17| 17

Speed Sourcing

RSTI

How RSTI Sources Parts By Darrell Kile Sales, RSTI Exchange Hello all, I have been in the medical imaging business for ten years and one thing has not changed. You need to be able to locate items at a moments notice to ensure your facility is running at the highest level it can. It really doesn’t matter if you need full pieces of imaging equipment or replacement parts, you are always going to need something. There is an art to sourcing these items. I was fortunate to learn early in my career how to locate and purchase both parts and equipment not only from OEMs but also through a network of brokers, dealers and parts recyclers. There are literally hundreds of places you can find anything from spare cables to light bulbs to PCBs to full blown imaging suites. Sourcing is all about relationships. First you need to know who has what you need. Second you need to have a good relationship with them to ensure you are getting the best price. The object is to locate those who truly own what they are selling to you. There are many companies out there that really don’t own anything. Sure they promote items such as parts and equipment but don’t even have a warehouse let alone the inventory they are promoting. By far the most cost effective way to obtain these items is to find “the” source who truly owns them.

Visit Us Online! RSTI-Exchange.com

Sometimes this is more difficult than one would expect. With all the listing services, websites and magazines it’s hard to know who has what. Generally through conversation you can find the true source of what you are looking for. Once you work through finding a few items you will start to realize who has what you need. Good luck sourcing and let us know if we can help with anything!

The All-New RSTI-Exchange.com lists our full catalog of pre-owned medical equipment! 18 18 | focalspot.SPRING.2014 | focalspot.Spring.2014

vc_RSTI_ClrAd_8x5_14Mar10.pdf

3/10/14

12:39 PM

Finally, Smaller is Better! New and improved Radcal RAPID-GOLD+ Smallest sensor available today with improved stacked sensor technology. Now, one sensor for radiography, fluoroscopy and mammography diagnostic measurements!

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With Dunlee, You Get More

For over 65 years, Dunlee has built its business around being more than just a CT tube manufacturer. We provide the highest quality products and a wide range of services to help our customers take more control over their service - like industry exclusive replacement tube programs, unmatched customer support, and extensive educational resources. Contact Dunlee for information about how our programs and services can benefit your organization. 555 North Commerce Street, Aurora IL 60504 USA +1.630.585.2100 I www.dunlee.com

WWW.RSTI-TRAINING.COM | CALL 440.349.4700 | 19

Used Equipment Choose Wisely The used equipment market can be compared to the used car market – BUT we don’t want the same reputation as a used car salesmen. No offense to them!

Do you have the most efficient

X-ray QA solution?

Here’s how: The old adage: you lose 10% off the sticker price once you drive a new car off the lot. That can be applied toward new medical equipment. Buying a used Aston Martin (I haven’t had much experience there) with 20,000 miles on it will save you thousands of dollars right off the bat. Same as a digital mammography unit… Buying a used car can still come with a warranty. So can used medical equipment. Buying a used Audi A6 gives you flexibility to get service maintenance with the Audi dealership, OR with a cost saving German auto mechanic. Flexibility. Which brings me to my next point…. Third party service cost vs. manufacturer service cost – do I need to rant about the savings there? (Oh yeah – did I tell you we train service engineers how to fix medical equipment?)

Piranha. The Complete X-ray QA Solution kV, time, dose, dose rate, HVL, TF, mA, mAs for R/F, Dent, Mam, and CT.

Used by hospitals and manufacturers

in over 60 countries

Quality used parts can be used for a car, and for medical equipment. More cost savings! Choosing the right company to deal with is always tricky. RSTI has been in the business of saving healthcare professionals money for almost 30 years through service training, quality used equipment, and quality used parts. Visit our website: www.rstitraining.com www.rsti-exchange.com Learn about our reputation through other service professionals, and understand why we are the best. Get educated by buying used! Call RSTI for equipment, and parts. We can save you money. (Do I sound like a used car salesman?)

Cobia Smart. A Simple and Smart Solution for Measuring Reliability kV, time, dose, dose rate, pulses, HVL for R/F

From Radiation to Information

Terry Speth, tspeth@rsti-training.com Darrel Kile, dkile@rsti-training.com

20 | focalspot.SPRING.2014

RTI US Office

33 Jacksonville Road, Bldg. 1 info@rtielectronics.com

Phone: + 1-800-222-7537

RTI Inc

Towaco, NJ 07082, USA

www.rtielectronics.com

Phone: +1-973-439-0242

2014 Course Index & Registration X-RAY CERTIFICATE SERIES

WOMEN’S HEALTH

Phase I…………….……………………………………………...............….….$4695 (for 2 weeks) Phase II…………………………........……………….……………………….….$4795 (for 2 weeks) Phase III…………..……………………………….…………….……..………….$4895 (for 2 weeks) Phase IV…………..……………………………………………….….……….….$4995 (for 2 weeks)

Multi-Vendor Mammography Systems (Analog)...................$2995 (for 2 weeks) Multicare Platinum.......................................................................$2995 (for 1 week) Hologic Selenia (DR) ...............................................................$12995 (for 2 weeks) GE Digital Mammography Family (DR) ...............................$12 995 (for 2 weeks) (2000D, DS, Essential) Multi-Vendor Bone Densitometry..............................................$3995 (for 1 week) Lorad MIV Platinum…………………………………………………………….$1995 (for 1 week)

PACS Administrator/Engineer Certification Phase I…………….…………………………………...........................….….$2995 (for 2 weeks) Phase II……………………………………….………………….……………..….$3995 (for 2 weeks)

Mobile C-Arms OEC 9600/9800..........................................................................$6995 (for 2 weeks) OEC 9800/9900..........................................................................$7995 (for 2 weeks) OEC 9900.......................................................................................$5995 (for 1 week) Siemens Siremobile C-Arm ........................................................$3995 (for 1 week) Philips BV Pulsera C-Arm ............................................................$3995 (for 1 week)

RAD & R/F PRODUCT SPECIFIC GE Precision 500D………….……………………………………...……..….$7995 (for 1 weeks) GE Revolution Family: XR/d 1X & 2X (DR) …………….….…..….$7995 (for 2 weeks) GE Advantx Family..……….…………………………….……………....….$2995 (for 2 weeks) (Advantx 1, Advantx E, Legacy, Compax 40) GE Proteus XR/a .………………………….……………………..………...….$3995 (for 1 week) GE Definium Family (DR).............................................................$9995 (for 1 week) (Definium 6000/8000, Discovery XR650/656, Optima XR640) Philips Bucky Diagnost….……………….……………………..………...….$2995 (for 1 week) Private Practice X-Ray Systems….….……..……………..………...….$2995 (for 1 week)

Ultrasound Multi-Vendor Ultrasound Systems...........................................$5995 (for 2 weeks)

Management Capital Asset Management.........................................................$1995 (for 1 week) Introduction to Networking & DICOM.........................................$1995 (for 3 days) Intro to Diagnostic Imaging for Managers & Sales Staff…….$1250 (for 2.5 days)

Cardiac CATH LABS Philips Integris R/F Cath Lab System.......................................$9995 (for 3 weeks) Siemens Axiom Artis (DR) ......................................................$14995 (for 2 weeks) GE Innova 2100/3100/4100 (DR) ........................................$14995 (for 2 weeks)

CT (Computed Tomography) Phase I..........................................................................................$4995 (for 2 weeks) Phase II.........................................................................................$5995 (for 2 weeks) GE LightSpeed/BrightSpeed......................................................$7995 (for 2 weeks) GE VCT............................................................................................$5295 (for 1 week)

Portable X-RAY GE AMX Portables: IV and IV Plus...............................................$2995 (for 1 week) Shimadzu MobileArt Portables…….............................................$2995 (for 1 week) Siemens Mobilett Portables........................................................$2995 (for 1 week)

Effective 01.01.14

Cancellation Policy - Tuition is only refundable if cancellation is received in writing by RSTI at least 14 calendar days prior to the course or seminar date. Allow 30 days for receipt of the refund. Registrants who cancel within 14 days of the course or seminar date will have the tuition transferred to another course or seminar on a space available basis. In the event that a course does not attain our minimum enrollment, RSTI may postpone it. Paid tuition will remain on account to be applied to the rescheduled class.

Payment Due Policy - Payment for all courses and/or seminars is due three full weeks in advance of the course start date. Purchase orders are accepted, but also must be paid one week prior to the course start date. We also accept VISA, MasterCard, American Express, and Discover as a method of payment. All past due invoices will be assessed a late fee of 1.5% per month on any unpaid balances.

Schedule - Typically, courses run from 8:30 am-4:30 pm Monday through Friday. You will receive a detailed schedule when we confirm your registration. You should schedule your incoming flight to arrive Sunday afternoon or evening. On the last Friday, class ends at 12:00 noon. You may schedule your return flight any time in the mid- to late-afternoon.

Full Coverage Package - You are responsible for expenses you incur while attending courses. However, RSTI has negotiated a reduced package rate that includes 12 nights hotel accommodations, transportation between the hotel and training center, breakfast, and lunch. We will notify you of this rate when you enroll; if you wish, we can add the full coverage package cost to your tuition.

Course Materials - In addition to specially designed manuals and daily course handouts, you will also receive where appropriate:

• •

Document package of the lecture Flow diagrams

• •

Troubleshooting charts Performance evaluation forms

Class Photograph Certificate of Completion

Due to copyright issues, some courses require that students bring their own manuals. These may include, but are not limited to, Operators Manual, Service Manual and Schematics. We will advise you of this when you enroll.

Make checks payable to: Radiological Service Training Institute (RSTI)

•

Tuition and Full Coverage Package rates are subject to change.

HOW TO REGISTER: Phone 440.349.4700 • Fax 440.349.2053 • www.rsti-training.com/register How to register: Phone 440.349.4700 • Fax 440.349.2053 • www.rsti-training.com/register.htm MAIL COMPLETED FORM TO: RSTI 30745 Solon Rd. Solon, Ohio. 44139 Mail completed form to: RSTI 30745 Solon Rd. Solon, Ohio. 44139 Course Name

Dates

1._________________________________________________________________ _______________________________ Course Name Dates

1. ____________________________________________________________________________________________ __________________________ 2._________________________________________________________________ _______________________________ ________ Full Coverage Package (Yes or No) ___________________________________________________________________ 2. ____________________________________________________________________________________________ __________________________

____

Bill my organization P.O. ________ Full________ Coverage Package (Yes or No)

____

Registration enclosed: $________ Bill ________ my organization. P.O. No.fee __________________________

____

Registration enclosed: $ card: __________________________ ________feeBill my credit _____MasterCard _____Visa

____

Bill my credit card: ___ MasterCard ___ VISA _____AMEX

_____Discover

___ AMEX ___ Discover Number: __________________________ Exp Date __________ Number: _________________________ Si t ( i d)

Exp. Date: __________

Signature (required):___________________________________________ State of Ohio Reg. No. 93-09-1377T

Name of class attendee Title ___________________________________________________________________ Company/Organization Phone ___________________________________________________________________ Name of class attendee Title Address Fax ___________________________________________________________________ Company/Organization Phone City State Zip ___________________________________________________________________ Email Address FAX

City

State Zip

WWW.RSTI-TRAINING.COM | CALL 440.349.4700 | 21

CRES Certification RSTI has made it easy for you to become CRES certified. Our CRES self-study package is a powerful tool to help you focus on specific certification objectives. There are nine different criterion-referenced modules that give a comprehensive review of subjects covered on the exam. The nine modules are entitled:

• Anatomy and Physiology • Radiographic Physics • Electricity and Electronics • Radiographic Equipment Applications • Fluoroscopic Imaging • Radiographic Circuit Operation • Regulations and Laws • Technical Problem Solving • CRES Exam Review

Mastering these topics will enable you to succeed on the final CRES Certification Exam. With RSTI’s self-study CRES package you can learn anytime, anywhere, at your convenience and on your schedule.

Visit http://www.aami.org/certification/journal. html for Certificate Renewal details. The modules contain both practice exams with answers and exams which can be returned to RSTI for grading. We are offering a 20% discount off of the list price of $398. The sale price is $318.40. Call (800) 229-7784 for info or visit www.aami.org/certification/exam.html for detailed exam info.

Presorted Standard Mail U.S. Postage Paid AKRON, OH Permit #286

30745 Solon Road Solon, Ohio 44139

www.rsti-training.com Address Service Requested

22 | focalspot.SPRING.2014