HTM Magazine PDF

The future of medical equipment maintenance p.
64
Your Industry Source for Healthcare and Equipment Coverage

August 2020
At your
service
Do your equipment
maintenance contracts
need a tuneup?
In our Special Parts

& Service Issue
REST EASY WITH OEM SERVICE PLANS
• Nobody knows your equipment as well as
the manufacturer. Get to know the latest
offers and trends shaping OEM maintenance
contracts. p. 30
SCANNING THE CT TUBE TECHNOLOGY

AND SERVICE MARKET
• Like all X-ray equipment, your CT scanner is
useless without the right tube. We talk to the
manufacturers to see how these vital
components are evolving. p. 40
RIGHT TO REPAIR AND THE IN-HOUSE HTM

• As the ‘right to repair’ debate continues to heat
up, COVID-19 illustrates how timely the conver-
sation is for medical equipment service. p. 44
THE VALUE PROPOSITION OF A

DEPENDABLE ISO
• The coronavirus pandemic has made the cost-
saving benefits of an independent service
organization clearer than ever. We check in with
a few of the leading companies. p. 48
DUNLEE IS YOUR PARTNER
NOW AND IN THE FUTURE
Dunlee announces a new product development: a CT
replacement tube with liquid metal bearing. The new tube
will join the popular DA200Ultra and DA200P40 tubes
in the DA200 Series product portfolio. Now and in the
future, you can rely on Dunlee’s CT replacement tubes as
an excellent, cost-effective solution and as an alternative
to OEM tubes.
DA200ULTRA DA200P40 Cutted Model: Insert with

Liquid Metal Bearing
Visit dunlee.com to learn more

BUY - SELL - PARTS - SERVICE

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© 2020 Midmark Corporation, Miamisburg, Ohio USA

CONTENTS
August 2020
FEATURES EXCLUSIVE Q&As

30 18
Rest easy with OEM service plans Dr. Ed Sabanegh
Nobody knows your equipment as well as the manufacturer. President of the main campus and
Get to know the latest offers and trends shaping OEM main- regional hospital system,
tenance contracts. Cleveland Clinic
How a military background provided
36 effective healthcare leadership skills.
Are you prepared for a major medical equipment
moving job?
Installing and de-installing capital equipment is a major col- 20
laborative operation. Here we speak to the experts about Tracy Means
what your facility can do to be prepared. Director of regional operations,
north market,
40 Henry Ford Health System
Scanning the CT tube technology and service market Building a stronger hospital team by
Like all X-ray equipment, your CT scanner is useless without implementing a culture of change.
the right tube. We talk to the manufacturers to see how
these vital components are evolving.
44 50
Right to repair and the in-house HTM
As the ‘right to repair’ debate continues to heat up, CO-
VID-19 illustrates how timely the conversation is for medical
equipment service.
48
The value proposition of a dependable ISO
The coronavirus pandemic has made the cost-saving benefits
of an independent service organization clearer than ever.
Here we talk to a few of the leading companies.
54
It is time for a revolution in healthcare supply chain
management
The impact of COVID-19 requires immediate attention be
given to hospital finances, securing and building a more
resilient supply chain and addressing the enormous amount
of medical waste created.
Visit DOTmed.com/news for breaking
news daily, to comment on stories in this
issue, to participate in surveys and more.
HealthCare Business News I august 2020 3

ASTRO’S 62ND ANNUAL MEETING
OCTOBER 25-28, 2020
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therapy in a changing world.
• An interactive Exhibit Hall featuring the latest products with the ability to fully engage
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PUBLISHER DOTmed.com, Inc.

CEO Philip F. Jacobus
PRESIDENT Matt Ulman

EDITOR IN CHIEF Gus Iversen
16 48 212-742-1200 Ext. 233
giversen@dotmed.com
EDITORIAL
CONTRIBUTING EDITOR Sean Ruck
SENIOR REPORTER John R. Fischer
CONTRIBUTING WRITERS Lisa Chamoff

Valerie Dimond
Lauren Dubinsky
Al Gresch
Dr. Kevin Kathrotia
J. Scot Mackeil
COLUMNS & SECTIONS Daniel J. Vukelich

COPY EDITOR David Imber
6 Daily News Round-Up PRODUCTION ASSISTANT Mai Hiraoka
Some of the top current events stories from our Daily News online
DESIGN
15 Upcoming Events DESIGN DIRECTOR Stephanie Biddle
Mark your calendar for these medical industry conferences and meetings DESIGN CONSULTANT Oscar Polanco
16 Hospital Spotlight SALES

Behind the scenes at Cleveland Clinic’s main campus SALES DIRECTOR David Blumenthal
212-742-1200 Ext. 224
dblumenthal@dotmed.com
21 Infection Control KEY ACCOUNT Susan Minotillo
Changing hospital work practices — alert for construction workers MANAGERS 212-742-1200 Ext. 261
sminotillo@dotmed.com
22 Imaging Department Manager Connie Goon

A look at the often overlooked importance of humor in healthcare 212-742-1200 Ext. 289
cgoon@dotmed.com
23 People on the Move ACCOUNT MANAGERS Colm Ford

212-742-1200 Ext. 241
Familiar faces in new places shaking up the industry cford@dotmed.com
George Persin
24 HTM Perspectives 212-742-1200 Ext. 260
Is your in-house service team properly disinfecting equipment? gpersin@dotmed.com
25 Cost Containment Corner Have News For Us?

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The case for employing physicians via contract management groups you would like to see published, please submit it to:
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A dose of prevention for reducing radiation exposure or email us at auctions@dotmed.com
HealthCare Business News is published by DOTmed.com, Inc.,
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56 Gold Parts Vendor Guide Copyright 2018 DOTmed.com, Inc. All rights reserved.
Special section highlighting DOTmed.com parts vendors who are
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64
Future of Healthcare
Medical equipment maintenance insights from Al Gresch, vice president DOTmedSM provides HealthCare Business NewsSM to its registered users free of
of customer success for healthcare at Accruent charge. DOTmedSM makes no warranty, representation or guarantee as to the
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Letter from the Editor
The immediacy of equipment maintenance

In your hands is the annual Parts & Ser- 64 pages, value-based care means taking what you’ve already got
vice issue of HealthCare Business News and stretching that dollar a little further.
magazine. This is always a particularly fun If your facility has a brand-new scanner then you’re probably
issue for us to put together, because it gives us working with the OEM for equipment service. Even if it’s an older
a chance to highlight a unique type of medical piece of technology, you may find that the OEM is your best bet for
expertise. For all the exciting capabilities of preventative maintenance, but the manufacturer is just one of the
cutting-edge technology, whether it’s a 7-Tes- three main service avenues. In the past there was a sense that third-
la MR scanner, or a promising new theranostic party servicers were a "wild west" frontier, but today many of these
PET tracer, or flash therapy for cancer treatment, servicing and main- companies have national footprints and sterling reputations. And
taining these technologies are often overlooked in the conversation. then, as a third option, there’s always the possibility of overseeing
Unlike other issues of our magazine, this one focuses on technol- service in-house with your HTM team.
ogy that is widely available. Many of the CT and MR scanners we In this magazine, we try and lay out the pros and cons of these
discuss throughout these pages, like most of the diagnostic imaging options. No two facilities will want to make the exact same choices,
equipment installed throughout the world, have been on the market so there’s no “right” answer to equipment service, but as the U.S.
for many years. Rather than emphasize their medical capabilities, we tries to correct its missteps in fighting the coronavirus, smart health-
are concentrating on what’s under the hood and — more specifi- care finances are more critical than ever.
cally — what your options are for keeping them operating to spec.
I guess what makes this fun for us is that maintenance is ground- Thanks for reading,
ed in reality and gives our reporting an immediacy that you don’t
Gus Iversen
find with equipment that is only being used in academic institutions.
Editor in Chief
Maintenance also reframes the old "value-based care" conversation
giversen@dotmed.com
in a different light. Sure, brand new equipment might work faster
Twitter: @dotmedcom
and generate better outcomes, but who has money for that? In these
GE launches AI suite for detecting COVID-19 from

X-ray scans
Posted online June 23, 2020 by John R. Fischer
GE Healthcare launched a collection of bile radiography and artificial intelligence, The solution carries a 97-99% accuracy
eight AI tools this month designed to told HCB News. “Thoracic Care Suite pro- rate (Area Under the Curve) that enables it
identify potential signs of COVID-19 in vides much needed support by automatically to detect findings within seconds and allows
X-ray scans. analyzing images for the presence of pneu- radiologists to quickly identify high-risk cases
Known together as the Thoracic Care monia indicative of COVID-19 — as well as and monitor patients showing progression
Suite, the algorithms offered by the solu- seven additional chest X-ray abnormalities and regression of mild respiratory symptoms.
tion flag abnormalities for review, including — and providing much needed support to Results in one study showed a 34% reduc-
pneumonia, which may indicate the pres- help quickly identify high-risk cases as well tion in reading time per case.
ence of COVID-19. The group can also be as monitor patients’ respiratory symptoms.” The partnership between GE and Lunit is
used to detect tuberculosis, lung nodules, Thoracic Care Suite can use AI to detect one of the first of its kind to bring commer-
and other radiological findings. The tools pneumonia, tuberculosis, atelectasis, calcifica- cially available AI products from a medical
were designed by Lunit Insight CXR, as part tion, cardiomegaly, fibrosis, mediastinal widen- AI startup to an existing X-ray equipment
of a collaboration with GE. ing, lung nodules, and pleural effusion. Flagged manufacturer, according to both companies.
“With approximately 1.44 billion chest X- reports are sent to the PACS system where radi- Thoracic Care Suite is now available to
ray exams taking place each year, radiologists ologists can quickly find the abnormality score thousands of providers who use GE’s Health-
are overwhelmed, especially as they may be for each of the eight possible abnormalities, an care fixed, mobile and R&F X-ray systems
looking for multiple indications per exam,” image overlay, and a written location descrip- worldwide.
Katelyn Nye, general manger of global mo- tion to expedite diagnosis and treatment. Share this story: dotmed.com/news/51605
6 HealthCare Business News I august 2020 www.dotmed.com/news

HealthCare Business Daily News Online
Top trending headlines
• Breaking news as we went to print:
Nuclear medicine physicians break
• M&A activity down COVID-19 game plan at SNMMI
dotmed.com/news/51838
• FDA approvals GE Healthcare and Lunit expand AI
partnership to improve COVID-19
• New studies care
• Market analysis Alternative reimbursement model
in Oregon leads to less low-value
Did you know this magazine is just the • Exclusive imaging
tip of the iceberg? Healthcare industry interviews dotmed.com/news/51815
Virtual SNMMI showcases virtual

current events impact your facility and technology on the exhibit floor
• 16 personalized
they happen when you least expect it. silos
That's why we cover them every day in Penn State University develops
disposable stethoscope
our 100% FREE Daily News online. • 100% FREE dotmed.com/news/51829
New mobile bus to bring lung
dotmed.com/news cancer screenings to east

Tennessee, north Georgia
Merit Medical to pay $18 million to
Register today settle whistleblower False Claims suit

and never miss NorthShore to merge with

Northwest Community Healthcare
another story dotmed.com/news/51816
Detecting metastatic cancer with

total-body PET scans
CHI Franciscan and Virginia

Mason health systems explore
possible merger
As cancer imaging ramps up in

academic settings, local US
communities lack access
Ten-year study confirms long-term

safety of larger radiation doses for
breast cancer
VIDEO INTERVIEWS dotmed.com/news/51873
In a new segment called Five Study reveals cost disparities and

trends among COVID-19 patients
Minutes in Healthcare, HCB News dotmed.com/news/51874
publisher Phil Jacobus chats with At virtual annual meeting, SNMMI

industry leaders about the president encourages continued
collaboration
COVID-19 impact via Zoom. dotmed.com/news/51830
Imaging volume for US healthcare

Check it out at: system tanks by 55% due to COVID-19
dotmed.com/news/jacobus dotmed.com/news/51902
@dotmedcom
Daily News Online > dotmed.com/news
GE Healthcare layoffs
ensue amid increased
production
Posted online July 06, 2020 by Valerie Dimond
While manufacturing jobs continue to increase at GE

Healthcare, some in sales, marketing and support at the
Wauwatosa, Wisconsin location will be dissolved on Au-
gust 31. Some 123 people will be laid off, reported the Mil-
waukee Journal Sentinel, rather than transfer to the company’s
headquarters in Chicago or other regional offices.
GE Healthcare, maker of MR, CT, ultrasound, bedside moni-
tors, neonatal intensive care incubators, ventilators, and other
products employs 5,700 people located in Wauwatosa, Wauke-
sha, Milwaukee and Madison. But in January, the company an-
nounced plans to move about 250 jobs from Wauwatosa. The
layoffs are among those who decided not to go.
“We remain committed to Wisconsin, home to more GE
Healthcare employees than any other state,” a spokesperson
told MJS.
In April, the company says it increased its global manufactur-
ing capacity and output for critical medical equipment important
in the diagnosis and treatment of COVID-19, including respira-
tory, computed tomography, monitoring solutions, X-ray, anes-
thesia, and point-of-care ultrasound. It has also been doubling
its capacity of ventilators.
“GE is leveraging additive manufacturing to alleviate sup-
ply chain constraints, speed up production, and produce
personal protective equipment for employees and healthcare
workers on the front lines,” according to a press statement.
“GE continues to prioritize innovation. For example, in the
first quarter Healthcare introduced its LOGIQ™ E10 Series
ultrasound, which can process 10 times more data and gen-
erate images faster than GE’s previous systems, to help clini-
cians bring fast, precise answers to their patients.” They’re
also collaborating with Ford Motor Company to further scale
ventilator production.”
“As the global pandemic evolves, there is unprecedented
demand for medical equipment, including ventilators,” said
GE Healthcare president and CEO Kieran Murphy in a previous
announcement. “We continue to explore all options to support
this increased need. Direct actions we are taking include: Adding
manufacturing lines to ventilator production and increasing the
number of shifts to produce around the clock, hiring additional
manufacturing employees and shifting current employees to
support increased demand immediately.”
Share this story: dotmed.com/news/51747

Healthcare M&A activity expected to rise despite
COVID-19
Posted online July 07, 2020 by John R. Fischer
Mergers and acquisitions among hos- recorded, at more than $800 million. Total ment’s 90% ownership stake in the 35-hos-
pitals and healthcare systems are ex- transacted revenue was also high, at just pital health system; a non-binding letter of
pected to rise, despite the impact of over $12 billion, despite the smaller number intent by Advocate Aurora Health to explore
COVID-19. of transactions. a possible merger with Beaumont Health,
In fact, the pandemic has raised aware- Some notable announcements that which would generate $17 billion in annual
ness of the advantages of scaling up, coordi- helped pave the way for these milestones revenues; and resumed talks between Lifes-
nating, and forming partnerships among dif- included an acquisition by a group of physi- pan and Care New England Health System
ferent entities, according to Kaufman Hall’s cians led by Steward Health Care CEO Ralph in Rhode Island about a possible partnership.
M&A Quarterly Activity Report: Q2 2020. de la Torre, of Cerberus Capital Manage- Share this story: dotmed.com/news/51743
“We are observing that M&A activity is
being driven more by the positioning of an
individual organization in a market, rather
than their more generic setting,” Anu Singh,
managing director of Kaufman Hall, told HCB
News. “Well-resourced hospitals and health
systems with the ability to redeploy resources
and innovate may be looking for opportuni-
ties for growth, while other organizations
may be focused on achieving integration
and optimization through new partnerships.
Smaller systems or community hospitals
may be reassessing their ability to address
unprecedented situations like the COVID-19
pandemic — where there is no playbook to
turn to — and looking into partnerships as
a vehicle for improving and sustaining how
they provide care to their communities.”
Kaufman Hall’s National Flash Report last
month initially indicated uncertainty around
M&A activity, due to operating EBITDA mar-
gins falling 174% year-over-year in April and
remaining down 9% YOY in May. But with
the pandemic showing the benefits of part-
nerships and scaling, along with the increas-
ing number of restructuring, distressed and
bankrupt hospitals expected, such activity is
expected to increase as providers and prac-
tices open up shop once more.
Evidence to this effect includes the an-
nouncement of 14 transactions announced
in Q2, including two in June. While below
the 29 announced in the previous quarter,
the number for the second is not far off from
the 19 announced the same time last year.
Q2 2020 also had one of the highest figures
for average size of seller by revenue ever

Hospital and physician spending hits lowest point

in more than a decade
Total hospital and physician spending in the ductions for most of the major components gin reversing modestly as the U.S. economy
U.S. sank to just $2.88 trillion in April — the are even larger. The two largest categories, begins to reopen. A recent AMGA survey,
lowest monthly total in over a decade. hospital spending and physician and clinical however, found low expectations of revenue
The drop in spending, attributed to can- services spending, fell by 40.7% and 40.9%, returning to its pre-COVID levels anytime
cellations in elective procedures and low pa- respectively, while dental services declined by soon. Close to 90% of medical groups and
tient volumes brought on by the COVID-19 60.8%, year over year.” integrated health systems report losing a
pandemic, adds up to a 24.3% decline com- Not all areas of spending saw downturns. quarter or more in revenue as a result of the
pared to April 2019. Hospital care spending Exceptions to the trend were nursing home ongoing COVID-19 pandemic. Forty-one
dropped from $1.25 trillion to $746 billion care and prescription drugs, which rose percent of healthcare systems and 36% of
during that time, according to the analysis 6.3% and 5.1% year-over-year, respectively. medical groups predict it will be at least a
by Altarum. The health-spending share of GDP fell year before revenues return to pre-COVID
“While March 2020 exhibited the only to 15.7% in April, compared to 17.1% levels, with many not expecting to see such
previous occurrence in our historical time in March, and a mainly steady trend near results until at least the second quarter of
series (which goes back to 1989) of a 18% over the past four years. This indicates 2021. Nearly 23% and 28%, respectively,
monthly decline from the previous year, the healthcare spending is falling faster than the say it is not yet known when revenues will
April reading dwarfs the March value,” the overall economy. return to normal.
company wrote in its report. “Spending re- Altarum expects spending declines to be- Share this story: dotmed.com/news/51555

Summit Imaging denies hacking accusations by
Philips, files counterclaim
Summit Imaging, a medical device repair of trade secrets, financial damages and an in order to provide its own services. In return,
company, has filed a request for a fed- order barring Summit from using tools that OEMs have argued that the quality of repairs
eral judge to dismiss claims of hacking allegedly go around its hardware controls. made by ISOs and third-party providers may
and stealing trade secrets made against “We can confirm that Philips filed a suit not be as efficient as their own and therefore,
it by Philips. in the U.S. against Summit Imaging Inc. and they cannot be trusted with such informa-
The Seattle-based company denies the Lawrence R. Nguyen for circumventing tech- tion. More than 300 healthcare professionals
accusations that were made in a lawsuit nical measures, modifying copyright manage- signed a letter last month asking state law-
filed in October, in which Philips alleged that ment information, misappropriation of trade makers to remove barriers to repairing medical
Summit built software that could hack into secrets, false advertising and unfair competi- equipment, according to GeekWire.
its ultrasound systems and other devices. tion,” Mario Fante, senior press officer at Phil- “Keeping equipment working under the
It asserts that the Washington state orga- ips Global Press Office, told HCB News. stress of the COVID-19 pandemic is a mat-
nization’s intent was to bypass strict access The accusations issued by both fall in line ter of life and death,” said Nathan Proctor,
controls that regulate how hardware can be with the ongoing debate over the “Right to the Right to Repair campaign director for
used. Summit, in return, has filed counter- Repair”, in which third-party providers and the U.S. Public Interest Research Group, in a
claims against Philips, accusing it of violating independent service organizations have ac- statement. “This is no time to squeeze hospi-
antitrust laws and of copyright misuse. cused OEMs like Philips of not sharing specific tals into paying extra for proprietary repairs.”
“These claims are based on Philips’ ef- information needed to make certain repairs Share this story: dotmed.com/news/51585
forts to prevent healthcare providers and
independent service organizations from be-
ing able to service Philips’ ultrasound equip-
ment,” Per Marc Levy of Seed IP Law Group
and Summit Imaging’s attorney, told HCB
Expert MRI Magnet Service
News. “Summit Imaging intends to vigor- and Replacement Parts
ously defend itself against Philips’ claims and Since 1995
prosecute its counterclaims against Philips
for engaging in anti-competitive behavior.”
COLDHEADS
The suit alleges that Summit views its
solution as a legal way to get around restric- COMPRESSORS
tions that companies like Philips integrate ADSORBERS
within their devices, and that it used this
viewpoint to help sell the software to hospi- FLEXLINES
tals, healthcare networks, clinics, manufac- REMOTE MAGNET
turers and others. It states that the modifica- MONITORING
tions made by Summit give illegal access to
Philips proprietary software and trade se-
crets, and enable Summit and its customers • Average Coldhead Lifespan of 32 Months*
to “force compatibility and interoperability” • OEM Certified Technicians
between Philips medical imaging devices
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and related hardware devices.
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Philips says that Summit requires permis-
sion if it is going to “tamper” with the pro- .. , • !'' '
prietary software of its systems, and that its
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actions misappropriate trade secrets, create
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among other claims. It is seeking the return

Siemens to offer Glassbeam’s Clinsights Service

Analytics module
Providers with Siemens Healthineers lows them not be held captive to one vendor. fusion and a lack of transparency about the
imaging equipment now have greater Besides, in the healthcare market, there are machine health of their entire fleets is common,
access to Glassbeam’s Clinsights Service specialized, unique products that are heavily regardless of the vendor or modality, leading
Analytics module to increase machine sophisticated, built by only certain vendors. to unplanned downtime during peak hours of
uptime, improve productivity and de- So as a buyer in a healthcare provider envi- operation and disruptions in patient care.
liver enhanced patient care. ronment, you always want ‘best of breed’ Glassbeam’s Clinsights applies expert
A web-based application, the solution solutions. All these factors lead to a variety rules and machine learning algorithms to
enables providers to manage large multi- of OEMs, modalities and model types, that analyze logs on a near real-time basis from
vendor fleets for MRs, CT scanners, and cath form the backbone of such healthcare net- multi-vendor, multimodality environments.
labs. It is now available for Siemens to resell, works. Large companies like Siemens are in- It then, based on this information, provides
following Glassbeam’s decision to include creasingly providing multi-vendor equipment proactive and predictive notifications that
the German tech giant within its Strategic services, as an umbrella ‘asset management’ help convert unplanned downtime into
Reseller program. program. In such environments, there is a planned maintenance windows and thereby
“Very few organizations want to rely on strategic benefit for the provider to engage increases machine uptime.
one vendor in any business context if they one OEM entity (or ISO) to provide multi- Glassbeam Clinsights is already in produc-
can avoid it,” Puneet Pandit, co-founder and vendor multimodality service contracts.” tion across several large healthcare networks
CEO of Glassbeam, told HCB News. “It gives Because most providers have more than and imaging centers in the United States.
them leverage on price and discounts and alone source for their imaging equipment, con- Share this story: dotmed.com/news/51624
PMB launches FLASH US primary care practices

radiotherapy system for use face shortfall of $15 billion in
in clinical trials 2020 due to COVID-19
Posted online June 29, 2020 by John R. Fischer Posted online June 30, 2020 by John R. Fischer
PMB, a subsidiary of the ALCEN Group, has launched FLASH- Primary care practices across the U.S. could face a shortfall
KNiFE, a FLASH radiotherapy system developed for clinical trials. of $15 billion in 2020 due to the impact of the ongoing
A supplier of medical machines, PMB-Alcen designs radioactive COVID-19 pandemic.
tracer production solutions for medical imaging as well as radiothera- Such facilities are projected to lose more than $65,000 in revenue
py systems. Its latest solution through PMB, FLASHKNiFE, will be used per full-time physician in 2020, following drastic declines in office
to administer a high single dose of radiation to test clinical applica- visits and fees for services between March and May, says a new
tions such as skin cancer treatment and intraoperative radiotherapy. study conducted by researchers in the Blavatnik Institute at Harvard
“We are currently working with surgeons in head and neck, vis- Medical School. They warn that these losses could substantially rise,
ceral and gynecology,” Philippe Liger, Radiotherapy Product manager should a second viral peak emerge later in the year, or if reimburse-
at PMB-Alcen, told HCB News. “Other clinical applications could ment rates for telehealth visits revert to pre-COVID levels.
include superficial lesions, for instance in dermatology. These indica- “Practices have saved money by putting staff on furlough,
tions cover a vast field, from superficial nodes in the case of external but doing so may leave practices unable to care for their patients,
treatment, to the pancreas, the ovaries and other parts of the body.” especially in the context of pent-up demand for services and the
“We have been working with the pioneers of this fascinating sub- ongoing pandemic,” author Russell Phillips, director of the center
ject, Lausanne University Hospital, for several years now,” said PMB and professor of global health and social medicine at HMS, told
CEO M. Marc Delmas in a statement. “We believe that FLASHKNiFE is HCB News. “Practices also need help with the costs of PPE which
a breakthrough device in the field and the right tool to develop clinical is absolutely necessary to have, but expensive for individual prac-
applications and go on writing the history of FLASH radiotherapy.” tices to obtain at reasonable cost.”
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UCSF pays ransom of $1.14 million to online

hackers in order to retrieve encrypted data
Posted online July 06, 2020 by John R. Fischer
As cyberthreats continue to wreak incident from the core UCSF network,” said it conducts. In exchange, the attackers pro-
havoc on healthcare providers, another the university in a statement. “Importantly, vided it with a tool to unlock and retrieve the
ransomware attack has paid off for bad this incident did not affect our patient care encrypted data.
actors infiltrating medical servers. The delivery operations, overall campus network, Ransomware attacks have cost health-
University of California, San Francisco has or COVID-19 work.” care organizations more than $157 million
paid approximately $1.14 million to hackers The university stopped the attack as it over the past five years, according to a re-
behind a malware attack that compromised occurred and has since hired a cybersecu- port released in February by online services
a number of its servers and data. rity consultant and other outside experts to firm Comparitech. Another report by Mi-
The incident occurred in a limited part investigate the incident and evaluate the de- crosoft found that several dozen hospitals
of the UCSF School of Medicine’s IT envi- fenses of its IT systems. have become especially vulnerable to such
ronment on June 1 and was detected and It believes the attack did not target a spe- attacks on their gateway and VPN appli-
disclosed by UCSF IT staff two days later. The cific area, though attackers did obtain some ances as a result of the COVID-19 pandemic.
attack encrypted a number of servers, mak- data that they used as demand for a ransom UCSF expects to fully restore the affected
ing them temporarily inaccessible. payment. While it does not believe patient servers soon, and will provide further up-
“We quarantined several IT systems medical records were exposed, the university dates on the situation as the investigation
within the School of Medicine as a safety chose to pay the ransom, due to the infor- proceeds.
measure, and we successfully isolated the mation being important for academic work Share this story: dotmed.com/news/51741
Canon gets clearance for FDA gives nod to RapidAI’s

iterative reconstruction tech stroke analysis system,
with 1.5T MR system Rapid ASPECTS
Posted online June 16, 2020 by John R. Fischer Posted online July 09, 2020 by John R. Fischer
The FDA has given Canon the green light to integrate Com- The FDA has given RapidAI the green light to proceed with
pressed SPEEDER technology for image reconstruction into the release of Rapid ASPECTS, the first neuroimaging analysis
its Vantage Orian 1.5T MR system. system in the computer-assisted diagnostic software (CADx)
The technology reduces scanning time and improves through- category.
put by applying iterative reconstruction to reconstruct full-resolu- The solution is the only neuroimaging device capable of improv-
tion images from under-sampled data. ing physicians' interpretations of strokes from non-contrast CT scans
“Canon Medical’s Compressed SPEEDER can reduce scan times using a standardized ASPECT score and determination of whether a
by a factor of 2.5,” Tom Naypaur, senior manager for MR Solutions patient is eligible to undergo thrombectomy.
Marketing of Canon Medical Systems USA, told HCB News. “In cer- “For the first time there is a software that allows MDs to improve
tain instances we’ve seen overall scan time reduction of up to 60% their accuracy for reading CT scans of the brain in stroke patients,”
comparing acquisitions with and without Compressed SPEEDER.” Dr. Greg Albers, professor of neurology at Stanford University, director
COVID-19 has left many providers with a backlog of MR im- of the Stanford Stroke Center and co-founder of RapidAI, told HCB
aging exams due to delays and deferrals, as well as the need to News. “This is especially significant for less experienced readers.”
disinfect systems and rooms in between patients. Rapid ASPECTS is based on the Alberta Stroke Program Early CT
In reducing the time of MR scans, Compressed SPEEDER en- Scoring (ASPECT) system, and is equipped with a validated machine-
ables more scans to be conducted in a day and allows providers learning algorithm to automatically detect the ASPECTS regions of
more time in between each exam to help clean and disinfect scan- the brain. It then generates an ASPECT score to indicate early signs
ners. Reducing scan time also improves patient comfort, which of brain infarction on NCCT scans, which helps physicians identify
may help reduce movement from patients caused by discomfort areas of irreversible brain injury and determine if a patient is eligible
and thereby enable higher quality images. for thrombectomy.
Share this story: dotmed.com/news/51525 Share this story: dotmed.com/news/51793

Upcoming Events
Due to the ongoing coronavirus outbreak, all events are being held virtually.
Health Connect Partners Virtual Average attendance: 1,000+ The Association for Medical
Fall Conference Who should attend: VP’s & Directors of Imaging Management 2020
Hospital & Healthcare IT / Hospital OR & Supply Chain, Directors of Materials Man- AHRA
Surgical Dates: September 8 – October 1 agement, CFO’s, Resource Officers, Supply Dates: August 11-13
Radiology & Imaging / Hospital Supply Chain Managers, Materials Managers, Con- Years in Existence: 48
Chain Dates: September 28 – October 22 tract Administrators, Military Logisticians, Average attendance: 1,000
Years in Existence: 14 Operating Room Buyers, any healthcare sup- Who should attend: Medical imaging
Who should attend: Hospital & Healthcare ply chain professionals. leaders.
IT and Radiology and Imaging vendors look-
ing to meet with industry decision-makers in Omnia Health Live Americas The American Society for
a Reverse Expo setting. By Informa Markets Radiation Oncology
Dates: September 28-30 ASTRO 2020 Annual Meeting
Association for Healthcare Who Should Attend: The teams behind Dates: October 25-28
Resource Materials Expo Med (Mexico), FIME (USA) and Hospi- Years in Existence: 62
Management 2020 talar (Brazil) have joined forces to bring our Average attendance: 11,000
AHRMM audiences a 3-day, virtual expo, designed Who should attend: Radiation and medical
Dates: September 22 – October 8 specifically for the North and South Ameri- oncologists, medical physicists, dosimetrists,
Years in Existence: 60+ years can regions. nurses, radiation therapists, researchers.

Hospital Spotlight: Cleveland Clinic
Cleveland Clinic
Location: Cleveland, Ohio
Year founded: 1921
Number of beds: 6,026
Number of employees: 67,500
CEO: Tomislav Mihaljevic, M.D.
2
1. Cleveland Clinic Taussig Cancer Center
2. Cleveland Clinic Main Campus
3
3. Cleveland Clinic Sydell & Arnold Miller Family
Pavilion
4. Cleveland Clinic Main Campus Miller Lobby
5. Cleveland Clinic Exterior
6. Cleveland Clinic Taussig Cancer Center lobby

Noteworthy distinctions: Cleveland Clinic is
ranked as the number four hospital in America 4
in the U.S. News & World Report’s Best Hospi-
tals 2019-20 rankings, marking the 21st con-
secutive year Cleveland Clinic has ranked as
one of the nation’s top five hospitals.
Specialties: U.S. News Best Hospitals ranked

Cleveland Clinic in the Top 10 in 11 specialties
— Cardiology & Heart Surgery (1), Rheuma-
tology (2), Gynecology (3), Gastroenterology
& GI Surgery (4), Nephrology (4), Urology (4),
Cancer (6), Pulmonology & Lung Surgery (7),
Geriatrics (8), Neurology & Neurosurgery (10),
and Ophthalmology (10).
Recent developments: In 2019, the Cleve-

land Clinic health system decreased serious
safety events during surgery by 46 percent. Be-
tween January 2017 and August 2019, Cleve- 5
land Clinic reduced central-line infections by
23 percent, sepsis mortality by 12 percent, and
patient falls with injuries by 11 percent. 2019
clinical accomplishments included in-utero
spina bifida surgery, uterine transplant, lapa-
roscopic living liver donor transplant and ro-
botic single-port kidney transplant. In 2020, a
new Center for Immunotherapy and Precision
Immuno-Oncology will develop personalized
cancer treatments. The health system added
four hospitals and nearly 1,000 beds in Florida
with the addition of Florida’s Cleveland Clinic
Indian River and Cleveland Clinic Martin Health
in January 2019.

Hospital Spotlight
Q&A with
Dr. Ed Sabanegh
President of the Main Campus and
Regional Hospital System
Cleveland Clinic
By Sean Ruck
This month, HealthCare Business News As you progress into leadership, learn how founders came out of the same army medi-
spoke with Dr. Ed Sabanegh, president to listen and communicate with people and cal unit in WWI. They valued teamwork and
of the Main Campus and Regional Hos- understand their needs. wanted to create an experience where medi-
pital System for Cleveland Clinic, to After serving in the Air Force, I was cho- cal experts came together as a unified group.
learn about his background and what sen to be department chair of urology at That was embodied in the phrase, “to act as
the organization is focusing on in these Cleveland Clinic. I had the fantastic fortune a unit.” What you find at the Cleveland Clinic
unprecedented times. to work with a great team, and together we is that we have three integrated missions. First
built a department that moved to the top of and foremost is striving for clinical excellence.
HCB News: Who or what inspired
the national rankings. Together we worked Second is innovation (research and changing
you to follow a career in healthcare?
to develop clinical service lines, and manage the face of medicine). The third is teaching the
Dr. Ed Sabanegh: I have long believed
financials of an organization. I was then of- next generation. I was inspired by those mis-
that working in healthcare is a calling. No
fered the opportunity to lead our hospital sions and their amazing legacy. For example,
one in my family had any medical back-
and ambulatory system here in Ohio encom- many of today’s commonplace procedures
ground. Along the way in high school and
passing 12 hospitals and almost 200 outpa- were pioneered at Cleveland Clinic includ-
early college, I became fascinated with the
tient locations with over 52,000 caregivers. ing kidney dialysis and cardiac angioplasty to
privilege to help people, seeing medicine as
It has been a terrific journey and I continue name a few. It’s a place that continues to be
a crossroad between science and humanity.
to learn new things every day. innovative and puts the patient first.
I was a science-focused engineering student,
but I loved the humanity aspects of medi- HCB News: Do you feel your military HCB News: Other than being con-
cine. I started volunteering as an orderly in experience and its regimented structure tinually ranked as one of the top hos-
college at our local hospital. I saw people has benefited you in the hospital setting? pitals in the nation for a number of pro-
at their most vulnerable, and I was very at- ES: While many think of the military as cedures and specialties, what else sets
tracted to the concept that you could apply an environment where direct orders are re- Cleveland Clinic apart?
science to improve someone’s life. quired, in the vast majority of situations, it ES: Cleveland Clinic continues to have a
is the same leadership style that you need laser-focus on the patient. There is early rec-
HCB News: What was the career path
to be successful in civilian settings. That in- ognition in all of our experiences here that
that led to being the president of Cleve-
volves working well with teams, understand- the patient is the center of our universe. We
land Clinic’s main campus hospital?
ing how to listen, how to communicate a were an early system to look at patient expe-
ES: I was in the air force for 21 years. I
vision, how to set strategic course with a rience and to work to improve it.
started as a urologic surgeon with a busy
group, and how to inspire them. All of those We also clearly recognize the value of
clinical practice. During my time in the air
are skills that parlay well into successful lead- the team in delivering healthcare. Every one
force, I moved through the leadership struc-
ership in civilian healthcare. of the 52,000 folks who work at Cleveland
ture and was privileged to lead large medi-
Clinic are called caregivers. It doesn’t mat-
cal teams culminating as the chief operat- HCB News: What attracted you to ter if you’re a nurse, doctor, environmental
ing officer of the largest Air Force hospital. Cleveland Clinic? services, administrator, revenue cycle staff or
I think the key fundamental for the start of ES: I think the purity of the mission. The any other employee — we’re all caregivers
my journey was to work hard to become a Cleveland Clinic was founded by four clini- and play a role in making sure the patient
good clinician. Learn the skills of your field. cians almost 100 years ago. Three of the four has the best possible experience.

It also goes back to the founders’ vision for almost two-thirds of our patients. new world. All of these things are growing
of medical professionals working together as We take care of all patients from birth in importance as we adapt to this hybrid of
a team. Cleveland Clinic was built as a clini- up through our geriatric population. Rough- inpatient, outpatient, and home healthcare.
cally integrated system, led by physicians, ly 30 percent of our patients are over 65.
and doesn’t have some of the silos that you Our patients come from all 50 states and HCB News: Cleveland Clinic is recog-
may perhaps observe in other places. throughout the world. nized not only as a leader in healthcare,
but in environmental stewardship as
HCB News: What goals do you per- HCB News: Has there been any in- well. Can you detail some of the work
sonally strive for as president of the crease in a particular disease or diseases done as far as environmental impact?
main campus and regional hospitals? in recent years among patients that ES: We’ve worked hard during the last
ES: For me, it’s fairly simple. I want it to be you’re particularly concerned about? decade to achieve that recognition. Our op-
where I want to get care for myself or my fam- ES: There are two. Behavioral health is erations team is extremely focused on im-
ily. I want to have no question when I come in the most concerning to me. For the past proving the efficiency of our facilities. We’ve
the door at any of our facilities that I am going number of years, we’ve seen accelerating reduced energy intensity by 22 percent de-
to get the best care. My experience and out- growth in those needs. We’re seeing wide- spite growth over the last nine years. We’ve
come should be the same whether I go to a spread increases in our state in alcohol and reduced our carbon footprint in the same
facility on the east side of town, or a two-hour substance abuse paired with reduced ac- period by 30 percent. We’ve built six mil-
drive south. Toward that end, we have worked cess nationwide in community mental health lion square feet of LEED-certified buildings.
to standardize our care across our enterprise, walk-in clinics. Behavioral health needs to We’ve improved our recycling to where over
culminating in over 90% of our facilities earn- stay at the forefront of our thoughts and one-third of our refuse is recycled.
ing a leapfrog “A” safety rating. plans for the future. It is a common element As we design new facilities, we’re taking
The second thing for me is the need to in many chronic diseases. progressive approaches. We’re incorporating
make a big place feel small. We’re a very large The second is chronic diseases. We con- more natural lighting and we’re increasing
network of hospitals, but it is really important tinue to see an increase in the incidence of the flexibility of how a space can be used.
that when you come in, you feel like you’re in high blood pressure, obesity, and cardiac dis- So as we design inpatient space, we inten-
your family doctor’s office. You should expect ease in our community. These will remain a tionally design with the ability to convert
that we know your name, and why you are major focus for us. to outpatient space with minimal changes
here. We should demonstrate how much we required. It allows us to avoid renovations.
care in everything we do. Bottom line: we need HCB News: How do you predict
to treat you like you are in our own family. healthcare may change due to the les- HCB News: Are there any recent de-
sons learned during the pandemic? velopments or plans that you’d like to
HCB News: What attracts staff to ES: It’s important we preserve the things talk about?
Cleveland Clinic? we cannot compromise on — the focus on ES: We remain focused during this pe-
ES: We strive to “keep the main thing — safety, quality and experience. We also need riod on growing our understanding of CO-
the main thing.” In other words, our focus is to keep care affordable and remember to VID-19. In the past four months, we have
on safety and quality. Every leadership team take great care of our caregivers. published almost 120 publications related
meeting starts with a discussion about how With regard to what needs to change go- to different therapies and ways to approach
we’re doing on quality and safety. While finan- ing forward, we need to work relentlessly treating this disease.
cials will always be important in healthcare, if to keep care at home wherever possible. In We’re also expanding virtual care in
you don’t focus on quality, safety and experi- every service that we have, one of the ques- ways that were never possible before. Two
ence right, you will not do well as a system. I tions we need to ask is whether it needs to be months ago, almost 75 percent of our out-
think this is the “secret sauce” that attracts done in the facility or can it be taken care of patient interactions were virtual. We have
the best in the nation and the world to join us. in an outpatient setting? So many things that created navigators to assist with the virtual
we do today were not believed to be possible experience. We have educated our patients
HCB News: What is the makeup of to perform at home as recently as a few years and providers on how we can provide value
patients at Cleveland Clinic? ago. We must accelerate the efforts to keep and quality care through a virtual network.
ES: We are the largest outpatient Medicaid our patients where they are most comfort- Finally, we have made extensive efforts
provider in the state and second largest inpa- able — at home with their families. to extend outreach to our communities.
tient provider in the state. We are a not-for- We also need to learn to work in new Whether through testing programs or com-
profit organization and we’re privileged to take ways. This is evolving, with things like the munity-based primary care, we’ve worked to
care of all different populations. Managed care workforce at home. We need to continue to take our care to our patients where they live.
and commercial makes up about one-third of learn how to stay connected as a team in this Share this story: dotmed.com/news/51916
our patients. Medicare and Medicaid account

Leadership Matters
Q&A with
Tracy Means
Director of Regional Operations,
North America, for Henry Ford Health System
Creating a culture of change
By Gus Iversen
HCB News: For Henry Ford West and rapid response to sustainability, regula- worked into current processes and be used
Bloomfield, a culture of change tory readiness and workplace wellness. to transform culture to where it becomes
started with a 100-day workout. Each of the workouts requires team part of your day-to-day work activity. Lead-
Can you tell us what that workout en- members to complete two changes per ers are excited with brainstorming and iden-
tails and how the idea originated? month. We have always followed that pace tifying innovative changes and seeing them
Tracy Means: The 100-Day Workout of change with speed to implementation. put into action. Departments embraced the
Productivity Cycle, more commonly known When talking about change, it is a small collaboration, trust improved and work re-
as the 100-day workout, is a tool that can be action rather than a project, program, or lationships improved. Accountability was
used for culture transformation. It is a proven piece of education. Together, our efforts commonplace and seen in a positive way.
approach for achieving rapid gains in hospi- have resulted in meaningful change in our
tal performance and sustaining incremental culture and how we operate. We have HCB News: Has the culture of change
increases in productivity. The workout in- found that a collection of small changes impacted Henry Ford’s ability to respond
cludes essential elements of Lean-Six Sigma, can yield big results. to the ongoing COVID-19 pandemic?
non-negotiable goal setting, and project TM: Our ability to change and adapt
management. Combined, these elements HCB News: Are there situations has been critical to our COVID-19 response.
provide an effective system for maximizing where a change is taken on that doesn’t Early on, changes were being implemented
all aspects of your productivity cycle while help achieve the goal of greater effi- almost hourly. So having gone through the
transforming the culture of your organiza- ciency? How does failure factor into a 100-day initiative prepared us for what the
tion. We implemented the initiative as part culture of change? pandemic brought.
of a cost containment strategy in 2014. TM: It is inevitable that some changes
The foundation of the 100-day work- may prove unsuccessful. That’s part of the HCB News: What advice do you have
outs is around small changes, accountabil- process and from that you learn and grow. for other hospitals interested in tak-
ity, rhythm and rigor around change. We When a change is tested and turns out to ing on similar initiatives to the 100-day
identified our targets and goals during three not yield the results desired, you evaluate workout?
months of planning, including how to mea- why it didn’t work and adjust accordingly. TM: It takes a village. Having leadership
sure success. support is crucial, as is having a clearly de-
HCB News: Has anything in particular fined work and accountability structure. I
HCB News: What are some of the surprised you regarding the workouts would encourage other hospitals to be open
specific small changes implemented and what has been achieved? to considering the tool for process improve-
through the workout that have yielded TM: What surprised me was the energy ment. You may encounter resistance, as of-
big results? it creates within the organization. At initial ten happens with managing change. Once
TM: To date, Henry Ford West Bloomfield orientation, it can seem overwhelming. Truth you see the results, though, the path getting
Hospital has conducted a total of 12 work- be told, it’s a lot of work. The key is how you there will be worth it.
outs ranging from waste, patient experience implement the work. This tool can easily be Share this story: dotmed.com/news/51926

Infection Control
Changing hospital work practices

— alert for construction workers
By Thom Wellington
Hospitals depend on incoming patients and are preventable. It was in every hospital’s understood the message”. This eliminated
for all types of procedures and evalua- best interest to educate workers on control- an inconsistent message delivered at different
tions, its how they stay in business. With ling dust and keeping patients safe. times by the facility or general contractors, and
the advent of the novel coronavirus (COV- Now, after the world’s experience with put record keeping in one convenient place
ID-19), no one wants to go to a hospital for COVID-19, it is mandatory for workers enter- — the cloud. Rather than waiting for the next
anything. Hospitals are experiencing huge ing the hospital to have this training, under- training session to be offered, workers now
losses in revenue due to the governmental stand it, and participate in making it happen. can be trained 24/7 from any smart device.
restrictions on elective procedures and related Besides general infection control awareness, Besides the benefit of a consistent and tai-
services. As the restrictions are slowly rescind- new rules need to be added for workers to lored message, the data center in the cloud
ed, hospitals will still be faced with convincing follow. For instance, The Joint Commission tracks training dates for the annual renewal
the public that their facilities are safe. is advising universal masking. This means requirement and sends out reminders to par-
To assure the public the environmental workers should be wearing masks while ticipants and to the hospital if participants do
safety inside the hospital has improved it will performing work in the hospital. Distancing not respond. All these tasks were previously re-
require everyone working in unison following from other workers when possible, wearing quired to be performed by hospital personnel.
the same established safety protocols. Just re- gloves, and adding disinfecting stations at Now it all happens within the system without
cently people were turning in neighbors that each work area entrance are just a few of the hospital’s time. All of the compliance issues
were not properly social distancing, if they the new items. Regular protocols such as are addressed and maintained — hands free.
see something improper in a hospital they wiping the wheels on all carts prior to en- As the future evolves, some changes
will react with alarm. The public has under- tering the hospital or exiting a construction brought on by the COVID-19 virus will re-
gone a tremendous education in contagious area, and covering tools and waste contain- main entrenched in how work takes place
diseases and they will be ready to point out ers when traveling through the hospital are in healthcare settings. The infection pre-
any improper activity when they see it. Con- still important, but now will be enforced. ventionist who was once an unknown part
sequently, hospitals are already implementing Some facilities may continue to require of clinical quality deep inside the hospital
new safety protocols to demonstrate proper daily documenting of workers’ temperatures is now front and center, and a necessary
actions and to keep everyone safe. and filling out medical questionnaires before all-star leader. In the aftermath of the virus,
Two groups that will also need to be entrance into the healthcare facility. In ad- the public now knows the role an infection
educated on new safety requirements are dition, the general access to hospitals was preventionist plays in producing policy and
the construction workers and vendors that already getting more restrictive in the last few protocols for patient safety. Outside vendors
perform work inside hospitals. Even with years due to crime, but COVID-19 immedi- and contractors will also understand the role
the Centers for Disease Control & Preven- ately closed the doors to random visitor entry. of the Infection Preventionist and must fol-
tion (CDC) existing recommendation that Hospital Systems such as INTEGRIS Health low the new protocols established or these
all personnel entering a hospital to perform cannot afford the time requirement to train hospitals will remain under public scrutiny
work are to have Infection Control Aware- every worker and vendor that enters the hos- and will have a difficult time convincing pa-
ness training, many facilities overlooked it pital on the new protocols as well as Infection tients to re-enter the facility for treatment.
or sporadically provided the training. Even Control Awareness so the logical choice was to About the author:
though the training is required annually, find a solution to meet the needs. Since group Thom Wellington is
overburdened hospital personnel neglected training sessions that required assigned rooms co-founder of Infec-
to provide the refresher training. The pur- and dedicated personnel were not allowed tion Control University,
pose of the CDC guidance on providing the due to social distancing policies, online training LLC, which provides
training was to educate workers on the spe- did that. According to James DeHaven, CEM cloud-based custom-
cial requirements and conditions in a hospi- CHSP System Disaster and Recovery Special- ized vendor-paid
tal environment. The ultimate goal was to re- ist, “the training program for INTEGRIS was compliance training
duce healthcare associated infections (HAIs) customized to the needs of the organization programs to hospitals across the country.
which have become a large cost to hospitals and testing was added to verify the workers Share this story: dotmed.com/news/51919

Imaging Department Manager
An Rx for laughter
By Sean Ruck
phone rang. “She said she’d get it, but “We’re talking about humor, but it’s actu-
I dragged myself, drooling and doubled ally a serious subject,” he says. “The health
like the Hunchback of Notre Dame, to benefits are evidence-based. People who
the phone,” he recalls. “She was so busy laugh hardily on a regular basis have lower
laughing, I beat her to it. I was also crack- standing blood pressure, reductions in pain
ing up and I realized, I have to live in this and more.”
painful body, but there’s no rule saying I Jacobson says humor enhances his
still can’t have quality of life and experi- leadership skills as well. Staff members
ence joy. From that moment forward, I are comfortable bantering and joking, but
decided to use my sense of humor and they keep to guidelines of appropriate hu-
laugh as much as I can because it was go- mor — meaning nothing racist, sexist or
David ing to help me get better.” ageist. “There’s a lot that can be divisive,
Jacobson
Jacobson started his healthcare ca- but appropriate humor is great. I’ve always
reer as a medical social worker at Banner, fallen back on self-effacing humor, poking
We’re all familiar with the old adage, worked in trauma for many years before fun at myself and my staff does the same
“laughter is the best medicine,” and moving into administration, becoming thing now. This has led to them not being
there is enough scientific evidence of manager of the social work department afraid to make mistakes, knowing that if
it that Banner University Medical Cen- and then chief of social work for the VA in they share that with their sense of humor
ter’s director of behavioral health case Phoenix and Texas before coming back to it’s going to help everyone learn and get
management, David Jacobson, uses Banner as director. better,” he says.
humor in his daily interactions with In addition to his personal experience, For patients, Jacobson says a little fi-
patients and staff. Jacobson says there’s been a growing nesse is needed. “It’s not for everyone, but
Jacobson is the author of the 2018 body of research, especially over the past most patients can appreciate a good sense
book, “7 ½ Habits to Help You Become 20 years, much of it originally done by of humor. Those who do, I encourage it
More Humorous, Happier & Healthier.” friend and colleague Dr. Lee Berk at Loma with them. I had one patient, a cardiology
His book and his work in healthcare are Linda University, which points to humor as patient in his 30s, in for some time due to
firmly rooted in personal experience. Forty a beneficial treatment. “Dr. Berk is what his heart condition. We started to banter
years ago, Jacobson was diagnosed with you might call one of the grandfathers of — it was little things. One day, I walked
a severe form of psoriatic arthritis. “I was researchers into therapeutic humor, doing in and saw he looked frightened. He told
in pretty serious condition with rheumatic a lot of hard science — measuring people’s me he was having his surgery that day
fever, which caused some damage to my tear ducts and saliva for Immunoglobulin and wasn’t sure he was going to make it.
heart and heart valve. I was 22, an athlete A and certain substances that have health- I asked what I could do and he told me
and overseas in Israel. I came back to the boosting properties in the human body I could tell him he was going to make it.
States in a wheelchair, 25 pounds lighter that are the result of laughter and the re- I couldn’t guarantee that, but I told him
with a skeletal version of my former Olym- sult of using your sense of humor for cop- when he came out of surgery, I’d have a
pian body. I was in extreme pain and I ing,” Jacobson says. sign on the wall saying, “You are Here,”
moved back in with my Mom.” Jacobson also referenced the Associa- and then he’d know he made it. It’s a little
His mother doted, wanting to do ev- tion for Applied and Therapeutic Humor, thing, but he remembers waking up after
erything for him, meanwhile he was try- which consists of range of professionals surgery, seeing that sign, smiling and being
ing to regain his independence. He was holding the common interest of apply- oriented because of it. He said he’ll never
learning to walk again and pushing him- ing therapeutic humor to patient care as forget that moment of feeling that every-
self. The moment that changed every- a resource. In addition, he’s part of a hu- thing was going to be okay, just because of
thing was a phone call. Who was calling mor academy where a three-year gradu- a silly sign on the wall.“
and why isn’t important, it’s just that the ate program in humor studies is offered. Share this story: dotmed.com/news/51918

People on the Move
People on the Move are the healthcare innovators and thought leaders bringing outstanding reputations with them as
they take on new challenges in their careers. We spotlight a different person every day at: dotmed.com/news/on-the-move
Les Edsall Petra Zalabak Dan Mosher
Innovatus Imaging welcomes general manager Guerbet appoints human resources VuMedi appoints new chief
and director of quality and regulatory assurance vice president operating officer
Jennifer Young Matt Bourne Oliver Reichardt
icometrix welcomes chief Midmark appoints vice president Royal College of Radiologists (RCR) ap-
commercial officer global sales points new chief executive
Dr. Jeff Patton Rajni Natesan Dr. Leslie Jurecko
OneOncology appoints new CEO Braid Health appoints chief medical Cleveland Clinic appoints chief
officer safety and quality officer
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HTM Perspectives
Chem tales: Cleaning and

disinfecting
By Sean Ruck
with appropriate cleaning, sterilization and can be difficult to keep track of what’s used
high-level disinfection taking place. on what device. So they’ve devised a visual
Cleaning is important, but cleaning with cue to keep things straight. “We came up
the right chemicals or methods is nearly as with stickers placed on devices that are col-
important. “There’s really two thresholds,” or-coded to the chemical type that we’re
Heusser said. “Lack of cleaning can be a using. And it’s shaped to the individual. So
Michael
Heusser
health risk for patients or staff. It may also squares are for users, circles are for EVS, and
impact how well a device functions. But we educate on what each sticker means.
there’s also cleaning with the wrong chemi- There’s also writing on them to identify. This
cals, whether it’s because that’s all you have way, when the individuals are using the de-
on hand or it’s what staff prefers to use.” vices in the rooms, there’s a reminder about
According to Heusser, ECRI has had inap- who is responsible and what chemical to
propriate cleaning chemical use on their top ultimately use.”
With the infection rate of COVID-19 in- 10 health technology hazards list for years, As far as having the proper cleaning solu-
creasing in nearly every state, sterilizing and for good reason. The wrong cleaning tions on hand, the COVID-19 pandemic has
and cleaning are on the minds of many. chemicals may not actually get a device as made that a particular challenge.
Of course cleaning and disinfecting has exist- clean as it should be or may threaten the Heusser has seen some price gouging,
ed since before the pandemic — dating back integrity of the device. Harsh chemicals can but more typical is just the shortage of
to at least 150 years ago, with Joseph Lister. react with materials in undesirable ways cleaning supplies. “We’ve had to go and
The level of cleaning, the efficacy, the — plastics may become brittle and cause buy various products that are equivalent
methods and process can differ, and cer- potential harm to patients or equipment if of what we’re used to from different ven-
tainly do, depending on the medical device pieces break off, or pitting or cracking of sur- dors. It’s been a constant search, we might
being cleaned, what the device is used for, faces can occur and ultimately harbor more order 10 cases, but we’re only allocated to
what materials are used in its construction, germs in harder to clean areas of a device. receive two. Fortunately, we’ve been able
and guidelines put out by the CDC and oth- There have even been documented cases to make the solutions we need based on
er organizations. of fires occurring after fluids have come in bulk supplies and things of that nature,
With so much to cover, it’s important that contact with the electronics of a device. Of but other places probably aren’t as lucky,”
hospitals look to experts for staff training course, that’s getting back to the first thresh- Heusser says.
and to implement procedures and protocols. old — if cleaning is done at all. He’s also noticed some changes in
Michael Heusser, clinical engineering man- A white paper Heusser referenced, how staff carries out the cleaning tasks. “I
ager at Middlesex Health, in Middletown, “Methods for assessing the adequacy of wouldn’t say they’re cleaning more thor-
Connecticut is one of those experts. practice and improving room disinfection” oughly, they were already doing that well.
At Middlesex, Heusser says different in- by Philip Carling M.D., said that only about It’s more that they’re being more cautious
dividuals are in charge of cleaning different 32 percent of objects are cleaned within — wiping over the same spot they already
devices dependent on the use case for the institutions — which means some locales cleaned for instance, just because.”
device. For instance, if it was something at a would exceed that percentage, but others If Lister were alive today, it’s hard to say
fixed site in a patient’s room, environmental would fall even further below. “This also how he’d react. While a global rate of only
services would be tasked with cleaning it raises the question of whether or not it was 32 percent seems low, prior to the pioneer-
upon discharge of the patient. If the device cleaned correctly,” Heusser said. ing work he did to educate about the impor-
was mobile and traveled with staff between For his part, Heusser makes sure staff is tance of disinfecting and cleaning, that rate
patient rooms, it’s cleaned by the clinical trained to clean and disinfect devices us- was even lower. And in facilities fortunate
staff. In terms of surgical instruments, the ing the proper cleaning agents while do- enough to have professionals like Heusser
cleaning for those devices is done through ing their day-to-day jobs. However, with so on staff, the number is significantly higher.
the central sterile processing department, many different types of cleaning solutions it Share this story: dotmed.com/news/51917

Cost Containment Corner
The case for CMGs as opposed

to employing physicians directly
By Dr. Kevin Kathrotia
Hospital staffing models for physicians brought in by the practices. This is due, in CMG. Think of it as quality over quantity
have been hotly debated for years as large part, to not managing these practices — because there is a smaller admin cost,
healthcare costs continue to rise and effectively through lack of physician organi- there is less overhead being passed on to
quality of care comes into question. As zation, standardized staffing and effective the hospital, making it more cost-effective,
costs to maintain private practices increased scheduling systems — all processes that are especially for those with smaller volumes.
due to various policies and legislation under provided and streamlined by CMGs. For example, hospitals with smaller NICU
the Obama administration, more physicians volumes are more at the mercy of their
began migrating to direct employment by Benefits of working with a CMG contract with the CMG. Regardless of the
hospitals and were met with open arms by By uncovering all the inefficiencies and rev- number of patients, the CMG will provide
hospitals needing to fill gaps in care, take enue lost by employing physicians, hospitals enough to meet hospital and patient needs,
business from competitors, receive better and healthcare systems are able to establish but it’s often at the expense of the hospi-
rates from insurers and end negotiations goals for the physician enterprise that can tal. Lower overhead costs by smaller groups
with contract management groups, among then be translated into a contract with a allow them to be more cost-effective to fa-
other reasons. However, while hospitals may CMG to ensure all needs are met within the cilities in these circumstances and provide
believe hiring physicians saves money and allocated budget and hospitals are receiving better service at the same time.
brings in additional revenue — it can actually the necessary returns. Additionally, a local focus means in-
do the opposite. While some larger contract Because CMGs negotiate directly with creased access and a more personal touch.
management groups have gained a poor hospitals and healthcare systems, they can Smaller companies are more nimble, and
reputation for surprise billing and unreason- ensure the physician staff is sized and locat- more adaptable to a locale/territory or to
able contracts, depending on your facility, ed appropriately, and is providing all services a culture for a particular hospital. Working
it actually makes more sense in terms of fi- necessary to maintain and improve hospital with a smaller CMG offers a “boutique-like”
nances and efficiency to work with CMGs. success. Many CMGs provide staffing for experience, whereas a larger national com-
An important caveat, though, is to make inpatient services, specifically specialties pany is very rigid in their processes.
sure you sign with the right one. such as neonatology, anesthesia and high-
risk obstetrics, which ensures that the care Conclusion
How directly employing physi- provided within the hospital is performed While working with a CMG can save hos-
cians costs hospitals by extensively trained professionals and is of pitals and healthcare systems a significant
According to findings from the American the highest quality. Not to mention, CMGs amount of money by making the contracts
Medical Association, over 25% of U.S. phy- additionally provide one-stop shopping for work for their specific needs and budget,
sicians practiced in groups wholly or partly hospital admins to eliminate time and mon- it’s important to proceed with caution
owned by hospitals in 2016, and another ey spent on the vetting and hiring process. before going into negotiations. Hospitals
7% were direct hospital employees. This is a However, before diving into negotia- and healthcare systems will want to make
significant, and somewhat shocking number tions with any CMG, it’s important to thor- sure that the CMG will be cost-effective,
of physicians across the country, considering oughly research options and find the one provide exceptional care and flexibility,
multispecialty physician groups lost almost that best fits outlined criteria, especially since and work together
$196,000 per employed physician. In some some larger groups can lose focus on their in the hospital’s best
larger health systems, physician operations strengths and are guilty of balance/surprise interest to ensure
are resulting in nine-figure operating losses billing (especially those backed by private continued success.
and a major hit to hospital earnings. equity firms), which can result in unhappy
patients and insurance providers. Dr. Kevin Kathrotia
As outlined in the Harvard Business Re- is chief operating
view, hospitals are losing money on their em-
What to look for in a CMG officer for Millennium
ployed physicians because the accumulated Neonatology.
When vetting CMGs, look for companies
costs of their salary, practice expenses and Share this story: dotmed.com/news/51912
that are small- to mid-size and local in fo-
corporate overhead exceeds the revenue
cus, but have the infrastructure of the larger
Supply Chain Savvy
Will supply chain establish a

new normal?
By Valerie Dimond
sustain because of a tendency to revisit old creation of a new asset account, and a plan
habits after the dust settles instead of a to warehouse PPE inventory, recognizing
bold investment in new strategies. the dependencies, vulnerability, and the
“Emergency preparedness is the most potential volume of products required.”
vital element, and while there are require- This led to the establishment of Stan-
ments of preparedness, assessments, and ford’s Supply Resiliency Program to invest
drills, we must do annual reviews of risk in new technologies such as artificial intel-
and scenario-based planning,” Chawla ligence, warehousing, logistics, procure-
said. “Scenario planning and continuous ment support, an innovations task force,
preparation is not a negotiation for the increased focus on clinical integration, and
next emergency, it is not a matter of if, but other strategies. And yes, they require fi-
Amanda
Chawla a matter of when.” She says Stanford’s nancial commitment.
supply chain is making a commitment to “These types of bold decisions are re-
Just when the U.S. thought it could this stage with a dedicated resiliency lead- quired, even during a time when the eco-
get back to “normal,” the COVID-19 ership role and solid partnership with the nomics may not [comply],” said Chawla.
pandemic raged on with an uptick in Office of Emergency Management.
cases and increasing strains on hospi-
tals. Now, many healthcare supply chain
executives are rethinking what normal
even is — and not only for today but to-
The last stage, post and prevention, may be one
morrow. Working through this crisis has
supply chain reassessing how it responds
of the most challenging to sustain because of a
and operates no matter what’s happening.
Amanda Chawla, vice president of
tendency to revisit old habits after the dust settles
supply chain at Stanford Health Care –
Stanford Children’s Health – Stanford Val-
instead of a bold investment in new strategies.
ley Care in Palo Alto, California recognizes
the lessons learned and she’s using that Other issues had to be assessed as well Health tech: the good and
knowledge to map future success. when developing a plan that would also the bad
“We must take the time in crisis to keep purchasing aligned with Stanford’s There’s no doubt that healthcare technol-
learn from the experiences, uncertainty, overall business objectives. Many hospi- ogy is a game-changer for improving care
and make changes for the future,” said tals, including Stanford, rely on a just-in- and efficiencies and cost-cutting. Analyt-
Chawla, who describes the process in time low unit of inventory, which means ics, automation, connected devices and
stages. “The response stage is perhaps partnering with distributors that carry high communication technologies are a few of
the most visible time in which you are re- stock levels. However, COVID-19 threw a the must-have tools for success, but gaps
quired to be flexible, collaborate, lean in, heavy obstacle onto that path. still exist.
and make quick decisions,” she explained. “With this pandemic and the immedi- “Presently, the use of technologies is
“The next phase is recovery, where we take ate surge of demand and lack of inven- limited as the information available up-
a breath to learn from our wins and failures tory and supply, Stanford felt the impact stream on supply disruptions — from raw
to accelerate the following step: restora- of COVID early on,” Chawla said, adding materials, to manufacturing, to exports —
tion or establishment of the new normal.” that the first COVID inventory order was remains ambiguous at best,” said Chawla.
The last stage, post and prevention, placed in late January. “Within a week of “Healthcare organizations may have an
may be one of the most challenging to the first order, Stanford responded with the understanding of inventory burn rates and

can take this information to volume data to cy to utilization, to demand forecasting.” ing of supply and demand,” said Chawla.
determine some level of predictive model- Stanford uses a customized analytics Looking ahead, she says supply chain
ing. However, linking this type of informa- software program by Tableau to capture could see a shift in global sourcing and
tion to disruption, being able to compre- consumption to volume, but the key is link- logistics, procurement diversification ver-
hend the magnitude, and then complete ing the information to disruption and the sus standardization, just-in-time manage-
ment, changing roles among distributors,
GPOs, 3PL’s, consolidated service centers,
The pressure and reliance on supply chain to and more.
“There will likely be new market en-
succeed have never been higher. It is essential that trants and exploitation of the way we lead
our industry,” she said. “In all of this, our
as leaders, we take care of ourselves, one another work does need to be measured, thought-
fully planned, and expeditiously designed
and our teams as we continue through this journey and executed. This will require resiliency,
transparency, leadership, and collabora-
to continuously improve. tion. The pressure and reliance on supply
chain to succeed have never been higher.
It is essential that as leaders, we take care
advance planning and preparation remains inventory pipeline during a crisis situation. of ourselves, one another and our teams as
a challenge. We must solve and address “This would allow for greater emergen- we continue through this journey to con-
the gaps that will allow for visibility in the cy management planning and ultimately tinuously improve.”
supply chain, linking raw materials resilien- creating a visible end-to-end understand- Share this story: dotmed.com/news/51925
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Interventional Safety
A dose of prevention for

radiation exposure
By Sean Ruck
achievable.’ that is what we were taught,” following their badges a little better than I
Dr. Dipti
Itchhaporia says. think older interventionalists have.”
Itchhaporia
California, which leads the nation in In her cath lab, Itchhaporia says they’re
identifying and labeling cancer risks of vari- using disposable lead aprons to decrease
ous materials, chemicals and products, re- the scatter exposure. Having shields, mak-
quires a fluoroscopy license. “It’s meant to ing sure you collimate, keeping the image
educate all of us in the cath lab or those who intensifier close to the patient, and of course
use fluoroscopy equipment to understand wearing lead skirts and thyroid collars de-
what the risks are and how best to mitigate creases the risk. “I think if you’re a female,
our exposure,” Itchhaporia says. even wearing a sleeve on the left hand is
But the best training only goes so far — a good idea,” she says, though she notes
individuals need to act on that training and that there’s not currently enough research
continue to work to reduce their own expo- to determine if an interventionalist faces an
It’s well-established that radiation ex- sure. Itchhaporia says the obvious first step is increased rate of breast cancer.
posure can impact interventional car- try not to expose yourself to radiation at all, Ceiling-suspended radiation shields have
diologists in multiple ways. HealthCare unless it’s unavoidable. Turn to radiation-reli- also come to market in recent years. Itch-
Business News spoke with Dr. Dipti Itch-
haporia, ACC’s vice president, an inter-
ventional cardiologist with Hoag Memorial
Hospital Presbyterian and associate professor
The younger interventionalists use less magnification,
of Medicine at the University of California
Irvine, to learn about the specific dangers
they use more flouroscopy than cine. They’re more
radiation exposure introduces and how to
mitigate those dangers.
interested in knowing what their exposure is, so
To begin, Itchhaporia says there are many
possible side effects of radiation. One is the
they’re following their badges a little better than I
higher incidence of cataracts, specifically
posterior subscapular cataract, among inter-
think older interventionalists have.
ventional cardiologists. “That’s typically why
we wear the lead-lined glasses,” she says. ant imaging only when absolutely necessary. haporia’s organization installed one of those
There is also reported thyroid disease She also notes that fluoroscopy has less than systems, but she says in her experience, it’s
due to the result of radiation exposure. Re- 10 percent the radiation exposure compared not comfortable for those performing percu-
productive problems have been reported to cine, delivering a significant decrease in taneous coronary interventions. “So we’ve
as well. And most recently, there has been dose. “Utilizing less steep angulation is also actually left it for our EP colleagues who
increased attention paid to reports of left- a way to reduce exposure, though that can have very long cases. Some of the EP doc-
sided brain tumors among the specialty. be difficult in certain cases,” she says tors really like it and I think it may be more
While the body of research surrounding She also says minimizing the use of mag- helpful to them.”
radiation risks to providers has grown over nification modes helps. “The younger in- While not financially feasible for some fa-
the years, the technology and methods to terventionalists have really been attuned to cilities, robotic systems can also decrease ex-
reduce the risks, while improving, has grown these methods of decreasing exposure. They posure. On the other side of the tech scale,
at a slower pace. “I can go back to train- use less magnification, they use more flou- the relatively recent introduction of skullcaps
ing where the principles of ALARA were en- roscopy than cine. They’re more interested to the protective gear wardrobe has been
shrined. It stands for ‘as low as reasonably in knowing what their exposure is, so they’re welcomed by some. “About 30 percent of

interventionalists wear those skullcaps to- collars has gotten thinner, lighter and more attractive to those with back pain and lim-
day,” Itchhaporia says. She has also heard comfortable over the years. Other materials ited mobility due to the heavy lead aprons.
about hand cream that can be used to de- like bismuth, tungsten and metal-infused Although interventionalists hold the main
responsibility for their safety and the reduc-
tion of radiation exposure, manufacturers
New systems continue to decrease radiation dose are trying to do their part and are stepping
forward to help. New systems continue to
and offer dose lowering technologies, often while decrease radiation dose and offer dose low-
ering technologies, often while managing
managing to increase image quality and reduce to increase image quality and reduce noise.
Artificial intelligence is also making inroads,
noise. Artificial intelligence is also limiting the thereby providing another tool to decrease
the number of images needed or the inten-
number of images needed or intensity of radiation. sity of radiation.

Radiation continues to be an important
part of healthcare, but is a double-edged
sword. It’s an invisible enemy even as it helps
crease radiation exposure for hands that are polymers are also being explored as poten- healthcare professionals. Careful planning,
in the field, but she hasn’t had personal ex- tially safer alternatives to lead both in their research into safety equipment and options,
perience with the products. ability to shield users and to limit health and and a healthy safety culture are all ways to
Although lead is still the go-to for protec- environmental issues that can result from harness the good while minimizing the bad.
tive personal shielding, the lead in vests and lead use. The alternatives can be particularly Share this story: dotmed.com/news/51921
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DOTsBuyersGuide_9a_1018.indd 1 11.10.2018 11:31:27

Manufacturer Maintenance
How the coronavirus has

impacted OEM service
By Lisa Chamoff
Dave Matthew
Karcher McCallum Richard L. Fiore
Suresh Todd Rob

Narayan Brown Stevens
As the coronavirus pandemic has shifted For Siemens Healthineers, this meant Healthineers’ own engineers and they
hospital priorities and slowed the case bringing a product to market sooner than were discussing how customers might
volume at some imaging centers, equip- anticipated. use it. When the pandemic hit, they de-
ment manufacturers have also had to The company was in the process of decided to start offering SmartCollaborator
respond by making changes to their ser- veloping SmartCollaborator, which would to clinical engineers.
vice offerings. allow its technical support team in North “We quickly realized when it happened
OEMs are pivoting to virtual training and Carolina to provide support to customers we had to change our go-to-market strat-
assistance and promoting the use of remote over their mobile devices. egy,” McCallum said. “It’s a way for us to
monitoring to predict and prevent outages. “It allows us to augment the view,” ex- provide very direct and hands-on support to
At the same time, they’re making sure their plained Matthew McCallum, vice president customers.”
technicians, now more than ever, adhere to of business management and marketing for The company has also seen an increase in
strict infection-control standards. customer services at Siemens Healthineers. demand for virtual training content.
“As they hold their smart device over a cir- Dräger, which manufactures patient
Virtual classrooms cuit board or panel of switches, the technical monitors, ventilators and anesthesia ma-
Just as the pandemic has pushed more com- support team can use an artificial finger to chines used for long term ventilation, all key
panies to embrace working from home, it circle and point to things.” equipment when treating patients with CO-
has also accelerated quicker adoption of vir- The technology was in the process VID-19, has been in a unique position when
tual support and training. of being adopted internally by Siemens it comes to service.

Key content
Multi-Vendor Services
Collaborative partner for Why Philips

Multi-Vendor Services?
continuous improvement Predictable cost savings
Through our Multi-Vendor Service offerings, we can provide 10-25%

a customized approach to help you address your specific average day one
challenges. We offer vendor agnostic, multi-modality solutions OpEx savings
for maintenance, lifecycle, and performance services for your
imaging and biomedical assets. Designed to cost-effectively
Quality and accountability
manage all of your clinical assets across one or multiple sites
of care, we help simplify data and insight gathering, drive
operational excellence and enhance the patient and staff
Certified
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sets you on a course for continuous improvement. 13485:2016
There’s always a way to make life better.
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#1
ServiceTrak™ Study
While preventive maintenance, repair
services and training on equipment such as
ventilators requires a hands-on component,
and migrating to online training has proved Interest in remote
to be challenging, the company has joined monitoring capabilities
forces with other global ventilator manufac- are on the rise. Photo
courtesy: GE Healthcare
turers to form a Ventilator Training Alliance
(VTA) and has launched a remote anesthesia
clinician support with Intensive Care On-line
Network, said David Karchner, senior direc-
tor of marketing in North America for oper-
ating room solutions, enterprise monitoring
solutions and enterprise services for Dräger.
“Our Dräger Training Academy has
implemented a new process based on the
Centers for Disease Control and Prevention
guidelines in order to protect our students
and trainers when visiting our Telford facil-
ity,” Karchner said. “With that said, we have support, as well as advanced learnings. We portunities it had already offered.
just recently invested in local dedicated staff have also ramped up to deliver more webi- “The push for remote training has defi-
to focus exclusively on expanding our digital nars. The webinar series complements the nitely accelerated,” Brown said.
training capability.” live events and provides education and in- Siemens Healthineers offers a suite of
Philips is also transitioning to more virtual sights for a variety of topics, both COVID-19 remote tools, including one in which techni-
training solutions, after suspending opera- and non-COVID-19 related.” cians can take over the operation of a device
tions of its training facilities in March due to and do some basic troubleshooting.
the COVID crisis, adding nearly 1,600 addi- The rise of remote monitoring “We do not scan patients remotely, but
tional virtual training opportunities as of June. Manufacturers have long promoted remote we can help with image processing and im-
“A significant number of courses have monitoring of equipment, and the pandemic age quality troubleshooting,” McCallum said.
migrated from on-site instructor-led to virtu- has made the technology even more attractive. The company’s Guardian remote moni-
al instructor-led,” said Rob Stevens, service “Our first course of action, no matter toring tool measures CT tube current, cool-
operations leader for services and solutions what, is to try to solve the problem remote- ing flow, and cooling capabilities, providing
delivery for Philips North America. “The vir- ly,” said Richard L. Fiore, director of U.S. an early warning when something is not
tual clinical events are live and cover equip- and Canada service and service sales for Car- working correctly to help facilities mitigate
ment essentials, configurations and go-live estream. “We can dial into our equipment the damage.
to observe settings and critical parameters Siemens Healthineers has even begun to
of operation. If we cannot solve the prob- make guarantees on its prediction of failure.
lem remotely, then more often than not, we “If a tube fails and we didn’t predict it,
are able to obtain a solid diagnosis for the we refund the money for remote monitor-
field engineer. This knowledge will equip the ing,” McCallum said.
field engineer with important information Philips is taking the opportunity to ac-
to ensure a timely and efficient customer tively enhance its remote capabilities.
workflow recovery.” “At our Customer Care Solutions Center
Ventilator systems GE Healthcare saw more demand for re- in Atlanta, Georgia, we are increasing and
like the Dräger mote monitoring and diagnostic capabilities, improving our connections to systems via
V500 have been
such as its OnWatch and Tube Watch predic- our Philips Remote Services (PRS) secured
critical in the fight
against COVID-19. tive analytics technologies, and more usage internet connection,” Stevens said. “Con-
Photo courtesy: of its iCenter cloud-based asset maintenance nected systems can ‘phone home’ to alert
Dräger and management software tool, said Todd remote engineers that a system may be ex-
Brown, the U.S. and Canada service leader periencing an issue that is not visible to the
for GE Healthcare. operator. In these cases, we can proactively
The company has also seen greater de- initiate service to improve system perfor-
mand for the online and virtual training op- mance. Our remote capabilities continue to

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To learn more visit WeAreISS.com or call 888.667.1062

evolve as a means of collaboration with our

With SmartCollaborator, the Siemens Healthineers technical
field teams and our customers.”
support team can coordinate with on-site clinical engineers.
Photo courtesy:
Safety first Siemens Healthineers
When working in facilities battling a highly
infectious disease, manufacturers have had
to ensure that their technicians adhere to
strict infection control protocols.
Fiore of Carestream said when the virus
first emerged in China, the company im-
mediately began making sure an adequate
supply of masks, gloves, shields, and suits
were available for customer-facing service
personnel in the U.S. and Canada.
Carestream field engineers also contact
customers before visits to check if there are
any special protocols beyond face masks McCallum of Siemens Healthineers said and documentation.
and gloves. Some facilities, particularly in some facilities have required technicians to Dräger has had to implement special pro-
hotspots, added questionnaires and tem- test for COVID-19 before coming in. tocols to avoid contamination when testing
perature checks. Brown said that while GE already had sol- and servicing ventilators.
“We have to be cognizant of their pro- id infection control protocols in place, they “When going on site, the use of personal
tocols and how they’re doing things,” Fiore had to rethink things that require a physical protective equipment is obviously a must in or-
said. “It just underscores the need to be signature from customers and make sure to der to protect employees, customers and pa-
aware of everything.” secure the appropriate electronic signature tients,” Karchner said. “Additionally, we had
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Celebrating 10 years of changing the face of patient safety

to design new filtering setups to protect our trend is continuing as it had pre-pandemic. clinicians or in-house service teams.
test equipment for the rare instances when “Large IDNs want to develop their own Karchner of Dräger said the company has
cross-contamination could not be ruled out.” biomed or clinical engineering groups to always been interested in supporting its cus-
do the first level of service,” Narayan said. tomers’ service strategy, regardless of who
A break in routine “Generally, what happens is there are 10-, performs the service.
While service providers did see a change in 12- or 15-year-old systems [and] that’s what “While many vendors have separate
what customers wanted for service during clinical biomeds take care of. The newer sys- classes for customers versus their own ser-
the pandemic, it varied. tems — seven or eight years and newer — vice teams, with Dräger they sit in the same
Some of Carestream’s customers delayed they would like the OEMs to service their classroom and learn how to service Dräger
regular service activities. systems. That trend has not really changed equipment together,” Karchner said. “It’s a
“Their focus was on critical service situa- because of COVID.” differentiator for us, and it’s one that we’re
tions or new installations,” said Fiore, who Companies expect to continue balancing very proud of.”
noted that as the pandemic progressed, the needs of all customers, whether they are Share this story: dotmed.com/news/51923
more hospitals began opening up for pre-
ventative maintenance, upgrades and other
non-critical service needs.
Suresh Narayan, director of installed
base programs in the service division of Can-
on Medical Systems USA, said that during SIMPLE SOLUTIONS FOR
the earlier part of the pandemic, custom-
ers suspended system upgrades and major
changes to their systems, and focused on
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minimal physical contact with workers.
“They just wanted to keep their systems
running,” Narayan said. “We adapted to
what the customers’ needs were at that
point in time.”
Canon Medical technicians made sure
the visits were short and to the point.
“We ensured our customers got their
preventive maintenance, but we had mini-
mal physical contact with people in the facil-
ity,” Narayan said.
Some companies were already shifting
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vice, Narayan of Canon Medical said the ISO 9001:2015 Certified

Install / Deinstall
Are you prepared for a major

medical equipment moving job?
By John R. Fischer
“Sometimes when the client goes to partner with Sigma for either
an installation and deinstallation, we use that as a clarifying moment
Hospitals should cover and wrap and explain, ‘This is our role in the process’,” Kathy Empie, senior
protective materials around any project coordinator for Sigma, told HCB News. “We specifically inter-
cabinets and other items they can-
act with the equipment only. The responsibility of the client will be site
not remove from the room during
an installation or deinstallation. preparation. That means hiring your own general contractor. Some
examples of work that needs to be subbed out, depending on the
project, could be getting a licensed electrician to install the new 480v
or an HVAC service provider to disconnect and drain the MR’s chiller.
Sigma does not provide those services, but we can make recommen-
dations based on contractors we have worked with previously.”
Contractors and electricians are just two of the additional parties
that may be involved in installations or deinstallations. If these parties
do not continuously communicate their needs, many problems can
occur. One problem that Gustavo Polo, owner and president of GP
Medical Equipment, has seen is when the electrician shuts off the
electricity during a deinstallation job. This prevents the service provider
from testing the system to see if it works, should the client want to
resell it, and makes it harder to remove.
“On a fluoro room you need to pull the rear bolts on the table,”
he said. “If your unit is locked in center position, you can’t get to the
center bolts. All bolts need to be out to slide out the 4,000-pound
table. The only way you’re getting to these bolts is when you rotate
the table at a 90-degree angle. If you don’t have the power or if the
power is shut off on the system, you have to manually rotate. If you
don’t know what you’re doing and you’re dealing with a bunch of
As some hospitals begin to contemplate a post-pandemic different modalities at one time, you got yourself into a headache.”
reality, there is more to consider than just resuming elective
and non-urgent care. For many facilities, it means getting back Prep the room, floors and hallways
to planning capital equipment installations and deinstallations that The first step of any job is to develop a plan and timeline for the proj-
were deferred indefinitely by the crisis. ect. This according to Craig Diener, director of sales, marketing and
Such projects are collaborations involving multiple parties, and procurements at Universal Medical, begins with a room inspection to
a well-executed job requires a lot of preparation on behalf of the measure dimensions.
provider facility. HealthCare Business News sat down with some “This involves more than just length and width of the walls but
experts who specialize in installing and deinstalling medical imaging also those of the door frame, hallway outside the room, and any cabi-
systems, to talk about the roles and responsibilities a provider can nets or objects that will remain inside the room during construction,”
play in a successful job. he said. “We need to measure every possible dimension in the room
and pathway to ensure the new system will fit. During the planning
Communication is key process a room drawing of the new system should be done to ensure
The most common issue that arises in any medical equipment logistics the system will fit in the room and that it can be operated in a man-
job is a lack of communication among all parties. This often leads to ner that allows for proper workflow. Any construction needs to be
confusion around who is responsible for what, with the healthcare coordinated so that it occurs between removal of the old system and
system or hospital unaware of what it needs to bring to the table. installation of the new system.”

Install / Deinstall
Avoid delays
Polo recently encountered a situation in which a wall needed to
be knocked down to remove an MR magnet through a second
story window. The project came to a halt when it was discov-
ered that the wall in question contained a number of gas lines
and air lines.
“For them to take out that wall will cost them $100,000,” said
Polo. “A job that should have been easier is now 10 times harder
because we have to cut the machine out piece by piece. A three-day
job turns into a five-day job with a lot more work.”
A lack of careful planning not only delays construction, but can
create risks to individuals involved in the work if not relayed to them.
It can also raise costs and ultimately delay patient exams and conse-
quently create more lost revenue for the facility.
Some installations require an elevator if taking place on floors

above the first. Some may even need to be brought in through a
window using a crane.
He adds that it’s best to remove as many objects as possible from the
room, to avoid damage and to make it easier for the moving team by not
having to work around as many items. Those that cannot be removed
should be tagged and covered in protective materials to minimize risk
of damage.
Loading docks also need to be measured and assessed for trans-
porting systems, as do elevators in jobs that take place multiple floors
up. This means having the service provider measure the dimensions
and weight capacity of the lift to ensure it can safely deliver the
system to the desired location. If it cannot, the facility may need to
contact the elevator company for external assistance.
“We try to maneuver it through the same route it came in,”
said Bob Iravani, president of Chicago Medical Exchange. “For Some deinstallations require the service provider to take apart
instance, there are circumstances where the old system was put in the machine and remove it piece by piece, such as when it is too
with a crane. We therefore have to use the same method to install big to fit through the door or when a wall cannot be knocked
down to take it out.
the new system.”
Once measurements are written down, the service provider draws “If a customer wants to get something done in a very short
up a blueprint for how to transport the system through the hospital amount of time, it’s not that it’s impossible. It’s just that everything
and shares it with the client to ensure all weights and capacities have needs to line up perfectly,” said Empie. “If we don’t have a project
been accounted. coordination meeting with the customer and contractors to review
The client must then prep the site of construction, by cleaning the final drawing of where electrical panels are being placed, how
the room and hallways, removing objects from the room, and help- cables need to be run, and what else must be done, that can cause
ing the service provider acquire the right troughs, cabling, conduits delays. We want to work as a team with the contractors to ensure a
and power. The right dollies with the right wheels are also needed to timely delivery.”
avoid scuffing floors during transport. For heavy weights, it is often Tiedemann says that one common issue he sees is when a person
wise to put Masonite down, says Don Tiedemann, CEO of Opti- realizes the morning of a deinstallation job that the system being
mum Medical Imaging Incorporated. removed still has private information saved on the hard drives. “A lot
“Follow any type of infection control that they choose to use to of times when we’re scheduled to pull these things out, someone will
seal up any doorways to make sure construction doesn't interfere say we have to get IT down here because we need to get patient data
with any other patients or staff,” he added. off and that could violate HIPAA if we don’t,” he said.

that. A lot of times, our schedules are made out for 30 days already.”
Sometimes, when there are middlemen involved in a project, such
as brokers or project managers, they will assume that everything is
going to be a piece of cake. This, of course, is not a smart mentality
for embarking on an equipment construction job.
“They assume you have large entry doors, a straight run to
the room. Sometime it’s easy, sometimes it’s not,” said Polo. “The
biggest factor is when you’re dealing with a bigger facility, get-
ting [the system] in and out of the room can be a problem. When
you’re dealing with major hospital chains, a room could be on the
third or fourth floor. Often they share the loading dock but it may
be on a different avenue, meaning you have to go down to the
basement floor, shoot across and come out on the other side of
the building.”
Any job should end with a final walkthrough to ensure the work
is successful, all areas impacted are clean, and that no damage has
been done to the room or hospital. Tiedemann takes it one step fur-
ther by taking photos — and the hospital should do that too.
“At the end of the job, we take completion photos where we
It is important to communicate with the electri- have photos of the room,” he said. “We send that info to the project
cian, plumber and construction crew to avoid manager and the OEM to make sure they’re happy. When we do
any issues that could lead to costly delays.
that, we don’t get that call a few days later saying there’s a problem.”
A few more things to keep in mind
Completing an installation and/or deinstallation requires all parties
to be in constant communication with one another. One of the best
ways for ensuring this is to have multiple meetings, and to not be
afraid to ask questions after the project ends.
“Call with any questions,” said Empie. “Don’t be afraid to reach
out for clarity on the system. I think the fear that customers have is
that once the job is done, that’s it and we’re gone for good now.
What we like to do with our customers is have some check-ins, espe-
cially if they’ve been silent after two weeks. We reach out to say, ‘Hey,
how do you like your system?’; ‘Is it working for you guys?’; ‘Does
your staff need any more training?’ Our goal at Sigma is to be your
partner and see your practice thrive.”
The most successful projects are the ones planned well in advance
from the beginning, according to Iravani. “To us, the biggest recom-
mendation to the customer is to plan, plan, plan, plan and plan. The
more planning you do in the beginning, the smoother the job will
be,” he said. “The sooner we get involved with the contractors and
the powers that be in the organization, the smoother the job will go.”
Diener says another key responsibility of the provider is to keep
tabs on the different schedules of each contractor involved to ensure
they do not conflict with one another. Otherwise, delays or problems
can occur.
“Often I’ll get phone calls from people who are frantic,” he said.
“They don’t know what to do and have to have their system taken
out next week, because whoever is installing the new system is going
to deliver and start installing. It’s difficult at that point to get a crew
together, go to the site and remove the system at short notice like

Tube Technology
Scanning the CT tube technology

and service marketplace
By Lauren Dubinsky
Alexander
Eitel
Aaron Jason
Goryl Launders
Patrick Jerald
Fitzgerald Olsen
Philips Healthcare was the first to bring ing X-rays, but it’s what we have,” he said. erational capabilities, including faster access
liquid metal bearing CT tube technology “You have to get rid of that heat as quickly to CT scanning, given the tube rotor is rou-
to the market 30 years ago. The innova- as you can, and liquid bearing is one of the tinely spinning, and lower audible noise.”
tion resulted in a collective sigh of relief from technologies used to do that.” An increasing amount of new CT scan-
cardiologists, who often feared the tubes Conventional ball bearing tubes have ners are using liquid metal bearing tubes.
would overheat while a catheter was in their mechanical bearing components that wear Some OEMs have incorporated it into their
patient’s heart area. over time and can potentially shorten the entire platform and others are using it exclu-
“If they suddenly got an overheat alarm lifespan of the tube, whereas liquid metal sively on their high-end systems.
on the tube, they were going to power bearing technology provides a lubricant to “Of the major companies, there are very
through and destroy the tube if they had keep bearing surfaces separated while the few who aren’t using liquid metal bear-
to in order to get through the exam,” said scanner is in use. ing tubes to some degree,” according to
Patrick Fitzgerald, president of Chronos “At the end of the day, the true ad- Fitzgerald.
Imaging, a replacement tube provider. vantages are those that help support an Dunlee (owned by Philips) and Varex Im-
Ninety-nine percent of the energy pushed improved patient experience,” said Aaron aging Corporation, a leading independent
into CT tubes comes out as heat and not X- Goryl, general manager of in-house and tube manufacturer, have both succeeded in
rays, according to Jason Launders, director on-demand service for the U.S. and Canada deploying their own liquid metal bearing CT
of operations of device evaluation at ECRI. at GE Healthcare. “Liquid bearing tubes can tube technology.
“It’s a remarkably inefficient way of mak- potentially deliver enhanced clinical and op- Dunlee’s CT4000, CT6000 and CT8000

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Tube Technology
tubes feature its CoolGlide liquid metal bear- In addition, liquid metal bearing technol- this type of capability and solution,” said
ing technology, which continuously circu- ogy may limit the gantry rotation speed. As GE’s Goryl. “Remote fix and monitoring
lates fluid transferring heat away from the gantry speed is increased, it requires a more technologies are being implemented to as-
anode. The CT4000 tube was designed for precise liquid metal bearing to handle the sist in reducing direct human contact within
mid-range CT scanners, the CT6000 for mid- increased G loads, according to Olsen. patient and clinical environments in an ef-
range to high-end scanners and the CT8000 “A liquid metal bearing requires a special fort to help minimize potential exposure to
solely for high-end scanners. drive motor for the anode and these need COVID-19 for the patients, clinical staff and
At the 2019 Radiological Society of North to be incorporated into the design of the CT service personnel.”
America (RSNA) annual meeting, Varex intro- scanner,” he added. The torque required to With resources like OnWatch and Tube
duced liquid metal bearing technology to its start the bearing in rotation is high, and up- Watch, GE has expanded its remote tube
X-ray tube portfolio including its FP-1596- to-speed time is not as fast as a conventional maintenance capabilities by providing di-
LMB tube for cardiovascular applications ball bearing.” rect healthcare technology management
(HTM) support through its service manage-
ment system.
Since it’s challenging to determine when a CT tube

OnWatch is fully automated and continu-
ously monitors critical subsystem elements
is at the end of its life, OEM remote monitoring

within the CT scanner to detect any devia-
tions from normal performance. If there is an
technology has historically helped facilities avoid

issue, a GE engineer can remotely diagnose
it and may be able to fix it remotely as well.
unplanned downtime.
Tube Watch leverages artificial intelligence,
machine learning and software analytics to
monitor and analyze tube health.
“We have just been taught a lesson, over
and its G-507X-LMB for CT applications. For These tubes tend to last longer than the past [few] months with COVID-19, where
the first time, Varex offers a lease option on conventional ball bearing tubes, but in gen- a lot of support shifted from an on-site visit to
these new tubes. eral, CT tube life varies greatly. A tube in remote monitoring support,” said Dunlee’s
Also at the 2019 RSNA meeting, Dunlee similar scanners can last anywhere from two Eitel. “I think our industry has been slow in
announced plans to launch a liquid metal months to two years, according to Launders. catching up to this trend [of digitization] and
bearing tube in the replacement space. “One of the issues I see is that the I think it’s a very important thing to do.”
“Currently, all dealers and customers have manufacturers own the data on the lon- Dunlee is also helping during the pandem-
no choice but to buy from the OEM, because gevity of the tubes,” he said. “Unless you ic in other ways. Since CT scanners can detect
today there are no alternatives for liquid bear- have your own biomeds that service your the opacities in the lungs that are indicative of
ing technology in the market,” said Alexan- CT scanners and you’re a large hospital, COVID-19, there is an increasing demand for
der Eitel, head of marketing and business you probably have very little idea of the tubes. Therefore, the company has escalated
development at Dunlee. “By bringing the longevity of the CT tube because you the production of its CT4000, CT6000 and
product to the market, we are giving them a won’t have enough CT scanners at the CT8000 liquid metal bearing tubes.
choice to manage their cost and it means they same site to track that data.” Busy imaging departments don’t have
don’t have to be as dependent on the OEM.” the time to wait for the tubes to cool down
Remote monitoring during between CT exams, Eitel explained. By in-
The case for conventional tubes the pandemic creasing production, Dunlee is ensuring
Despite its revolutionary cooling benefits, liq- Since it’s challenging to determine when that CT system manufacturers that use their
uid metal bearing technology does come with a CT tube is at the end of its life, OEM re- tubes can supply hospitals with CT scanners
a few drawbacks — cost being the main one. mote monitoring technology has historically that can tolerate high patient volumes.
Replacing one of these tubes can cost be- helped facilities avoid unplanned downtime. Varex, which is based in Salt Lake City,
tween a third or half of the cost of the origi- However, the current global COVID-19 pan- Utah, is also seeing a spike in global orders
nal CT scanner, according to Jerald Olsen, demic is highlighting the importance of this due to the pandemic. The company’s global
vice president of sales and business devel- technology in an entirely different way. manufacturing facilities currently remain
opment at Richardson Healthcare. Because “Remote monitoring is playing a sig- open and in operation, including its facility
of that, a service contract with the OEM is nificant role to which COVID-19 has only in Wuxi, China, which resumed normal op-
needed to mitigate that risk. strengthened the need and importance of erations in early March.

Big picture challenges for anything to do with it and will take the risk different characteristics of the scanners and
tube service themselves, said Launders. tubes and how they typically fail, said Olsen.
The question still remains: under normal “Remote monitoring is essentially insur- In order to install a replacement tube,
conditions, is remote monitoring technol- ance, and if you are big enough then you the in-house biomed needs to be trained on
ogy necessary? It’s something not everyone can self-insure and save money that way,” that specific CT platform. The OEMs can lock
seems to agree on. he added. out those service features until the biomeds
Chronos’ Fitzgerald, who held posi- Richardson’s Olsen acknowledges the ben- have gone through the proper training, said
tions at Richardson Healthcare, Dunlee, efits of remote monitoring, but also points to Launders.
TREX Medical Corporation, Continental the challenges that in-house hospital teams If a hospital doesn’t have a service con-
X-ray and Eureka X-ray Tube Corporation, may face when they want to do things them- tract with the manufacturer, they may also
doesn’t think the technology is worth the selves. He said sometimes OEMs don’t give face issues when trying to get a replacement
price tag. control to individual hospitals because they tube. It doesn’t make sense to have an in-
“I know some OEMs are doing this and want to maintain the software control. ventory, because the tubes can cost up to
I’m sure their solutions work well, but for me, “In some cases, remote diagnosis is not $200,000 and they will deteriorate over time
I would have to think twice before I used a widely available to anyone but the OEM,” he while in storage.
solution like that if I had to pay a lot for it,” he added. “It’s not that the hospital wouldn’t like “If you don’t have a service contract with
explained. “Tubes are so much more reliable it — it’s that they either didn’t pay for it or it a manufacturer, they will probably put you
now than they used to be, and can last years.” isn’t available to someone outside the OEM.” low in the list because they are going to look
Many OEMs offer remote monitoring Remote monitoring also comes with a after their own customers first,” said Laun-
services as an option when purchasing learning curve. If a hospital has one CT scan- ders. “The manufacturers hold most of the
service contracts. Yet there are large hos- ner, that makes it difficult to learn; but if they cards when it comes to tubes.”
pital groups out there that refuse to have have 20 scanners, then they start to learn the Share this story: dotmed.com/news/51913
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In-House Service
COVID-19 and a BMET’s right

to repair
By J. Scot Mackeil
Just as 9/11 changed the way the facilities on a single day, stopping for a meal with hospital-based biomed, clinical, and
world looks at travel and security, the between visits, or perhaps taking public healthcare/IT engineering departments
“new normal” after COVID-19 will re- transit. These individuals are not part of the and their third-party partners.
quire changes in the ways we do many hospital’s rigorous occupational health sur- To support these efforts, the FDA could
things, particularly in healthcare. Access veillance systems and as such, service vis- adopt NFPA-99 by reference as CMS did in
to sensitive patient care areas by non-hospi- its by non-hospital-based service providers support of the healthcare sector. They could
tal employees will be more limited as stricter carry recognizable control risks. also formally define “product labeling”, also
visitor entry protocols, entry point screening, Fully enabling our hospital’s in-house known as “service manuals”, and clearly
and hand hygiene and mask policies become technology support staff to support, re- signal to manufacturers that providing
more commonplace. Does someone really pair, maintain, upgrade, and install es- service information and designing service
need to be there? Are they an exposure risk? sential technologies will go hand in hand models that are equitable and inclusive, is
Have they recently been in contact with oth- with keeping our healthcare technology required, and that locking hospitals out of
ers that may have given them an infectious workforce safe and healthy. Our national servicing their own technology is not an ac-
disease? Could they be a silent carrier of and global medical equipment manufac- ceptable practice.
COVID-19? turers, and the powerful lobbies that rep- Use of in-house or on-site hospital tech-
Historically, a wide array of manufac- resent their interests, must understand nology service providers creates a much
turer and third-party medical technology this, and put patient safety ahead of lower risk for infection prevention strategies
service providers and technical sales reps service and revenue models designed to because they’re well vetted and are under
have had almost unlimited access to the exclude hospital-based service providers the organization’s occupational surveillance
most sensitive areas of hospitals to service from support, repair, and maintenance and health screening programs. They know
and/or support products and technologies of their medical technology. That will and practice the institution’s infection con-
there. In many cases they will visit multiple mean collaborating more constructively trol and access control procedures.

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In-House Service
A contradictory business model must also consider ways to reduce service when contacted, the manufacturer refused
There are many medical technologies in done by shipping and receiving devices that to send a part overnight to get this ventilator
hospitals that can readily be serviced by the in-house biomed departments can repair. on the front lines.
hospital-based biomed, IT, and facilities staff, Boxes and parcels should not go in or out Their representative was adamant that
but often are not. This is because, for manu- of the hospital unless necessary. Therefore, regardless of my years of experience as a se-
facturers, service and maintenance repre- manufacturers should curtail the use of nior BMET, I was not “qualified” to buy the
sents one of their most lucrative revenue mandatory “ship it to service it” models and part and perform this simple repair because
streams. They have designed digital, physi- collaborate more extensively with hospital my organization had not paid for me to at-
cal, engineering, and mercantile controls to biomed departments and technical staff to tend their service training school. The rep
prevent hospital-based technical staff from repair equipment at the BMET’s workbench. insisted they could not and would not make
providing basic servicing to many hospital-
owned critical devices.
Imagine if you, your local mechanic, the
AAA employee, and the corner gas station
Their representative was adamant that regardless
attendant were all unable to change your
car’s oil, replace your battery, change your
of my years of experience as a senior BMET, I was
tires, or open your hood to put in a new air
filter? This is essentially the case for many of
not “qualified” to buy the part and perform this
our country’s hospitals with respect to many
mission-critical medical technologies.
simple repair because my organization had not paid
When a manufacturer’s service model ex-
cludes the hospital-based biomed staff from
for me to attend their service training school.
device service, requiring a member of their
company’s service staff to enter the hospital, In the clinical environment, equipment any exception to their policy including for
they are creating unnecessary risk solely in downtime can have broad effects on patient urgent medical need during the COVID-19
support of their financial objectives. This is far care and safety. If a mission-critical system is pandemic.
from an optimal approach to providing tech- down, ripple effects spread across the hos- Ventilators have long been a core com-
nology support services in conjunction with pital where care must be rescheduled, de- petency for in-house biomed programs.
the hospital’s infection control imperatives. layed, modified or not provided. Why should Yet increasingly, OEMs have locked hospi-
This also contradicts the statements of manu- a hospital have to wait for an outside techni- tal-based providers out of the devices with
facturer trade groups, which often claim to cian to repair a device when its own biomed digital encrypted service keys, charging ex-
be motivated entirely by patient safety. department could do the job more quickly orbitant fees for “service schools”, bundling
There will be cases where the hospital’s and without the added risk of infections? inexpensive individual parts into expensive
in-house or on-site biomeds will not be able “field replaceable units”, and by blockading
to repair or support certain essential tech- Ventilators as an example access to repair and maintenance parts and
nologies without the help of manufacturer- Recently, in the context of COVID-19, some information. The same can be said of other
based or third-party service company staff. manufacturers have curtailed field service key device categories such as ultrasound ma-
But in many cases, the first level of service operations, leaving hospitals to either stop chines, lasers, X-ray systems, lab analyzers,
support could be done via mobile phone using a device, or perform patient care us- anesthesia machines, surgical systems and
and/or video chat using the in-house BMET ing a device that is past due for scheduled many more.
as the on-site resource. Good service tech- maintenance. In one case I have experienced, a compa-
nicians can talk their fellow service profes- In the second week of April, I was tasked ny charged my hospital nearly $5,000 for an
sionals through many types of problems and with assisting the Massachusetts Emergen- annual visit to do a preventive maintenance
level one physical repairs. Only when internal cy Management Agency with functional (PM) check on what is essentially a 4-channel
providers reach their limit should external screening of ventilator shipments coming bipolar electro-surgical unit. The rep drives
providers be carefully brought into the hos- into the state from the federal stockpile. I from an adjacent state, uses a digital service
pital to provide services. found one unit with a crushed DC power key to access service mode, attaches a resis-
This common sense approach is more plug and was asked by a state official if I tor network box to the device, generates en-
aligned to hospital infection control practices could repair it due to the urgent need. I re- ergy in each treatment mode, writes down
and an example of what the “new normal” plied that I could, after all, it’s a simple “re- the observed values and reviews log files,
in medical device service must evolve to. We move and replace” repair for any BMET. Yet, and 20 minutes later, completes his report.

He only “worked” in the hospital for 30 minutes, but the majority of access to parts, service manuals and digital service keys be provided
his cost is the travel charge. as a condition of purchase in all purchase orders. These should be fea-
This $5,000 spent on the back end has offset nearly $20,000 tured components of all vendor agreements. Vendor access systems
in front end hospital income from patient, insurance company and should have visiting sales reps attest they understand these require-
government payers. I am well skilled in energy device support and ments and accept these terms on behalf of their company. There
PM, and could easily do this PM in 30 minutes for a vastly lower should be clear and open channels healthcare technology managers
cost to the healthcare system. Avoidable costs like this compound can use to communicate to materials managers in cases when a
daily in hospitals everywhere. Most, if not all BMETs can share similar vendor has not met these key elements of the purchase order, and
experiences. implement any steps needed to bring the vendor into contract and/
or regulatory compliance.
Collaborating to bring real value to hospitals COVID-19 and the danger of spreading deadly infectious disease
The “right to repair” issue has been dividing hospital-based service has provided further evidence of the need to move away from the
providers and medical equipment manufacturers for some time now. existing medical device service paradigm and toward greater sup-
Key turning points occurred when CMS incorporated NFPA-99 by port for hospitals and their in-house service teams. It is my hope that
reference and when the FDA issued the May 2019 FDARA 710 report by working together, lawmakers and regulators will usher in a new
that found that medical equipment repair by hospital biomeds and era where equipment manufacturers and in-
third-party companies was safe, effective and essential to the health- house service teams partner with the basic
care industry. It would also be very helpful if our nation’s FDA were goal of improving patient safety and reducing
to adopt NFPA-99 by reference and support the fair-trade concepts healthcare costs.
presented in this article and modify their regulatory frameworks in About the author: J. Scot Mackeil is a CBET in
support of these concepts. Quincy, Massachusetts, and the 2018 AAMI
Materials management groups should also become more actively BMET of the Year.
involved in securing the hospital’s right to repair by stipulating that Share this story: dotmed.com/news/51924
FOR YOU, MEDICAL

IMAGING ENGINEERING
IS A SCIENCE.
FOR US, REPLACING

PARTS IS AN ART.
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Independent Service
The advantages of third-party

service in a COVID-19 world
By John R. Fischer
The COVID-19 pandemic has forced service provid-

ers to become more flexible in when they perform
preventative maintenance, with many now making
appointments around the schedule of the provider.
Photo courtesy: Richardson Healthcare
As the COVID-19 pandemic continues to by the manufacturer), independent service A decrease or shift in services?
spread, healthcare providers worldwide groups can provider excellent service at a Elective and non-urgent procedures repre-
face an uncertain financial future. Many competitive price for technology that has sent a lucrative source of revenue for provid-
have been afflicted with shrinking margins been around for a few years. ers, but many of these exams (and scans)
and dried up revenue streams from delaying Cost effectiveness and efficiency have have seen dramatic cutbacks in utilization.
non-urgent procedures and shifting their always been top priorities in equipment ser- This, in turn, has affected both the need and
resources toward the novel coronavirus. vice, but never before has it been as urgent affordability of services.
In many cases, third-party equipment ser- as during the coronavirus pandemic. From “Because they’re seeing decreased rev-
vice partners offer a desirable value proposi- modifying their hours of operation, to imple- enue, we did receive calls requesting sus-
tion and significant savings over their OEM menting social distancing guidelines for their pensions of service contracts and reduced
counterparts when it comes to servicing cap- service teams, HealthCare Business News cost of annual contracts based on scan vol-
ital equipment such as imaging technology. spoke to a few leading independent service umes,” Mike Black, vice president of sales
Although they may not maintain some of organizations to find out how they’re sup- for Alpha Source Group, told HCB News.
the newest technology entering the market porting their healthcare clients during these “We did everything we could to meet those
(usually, those systems can only be serviced challenging times. requests and partner with our customers.”

WORKING
AT THE
SPEED OF
LIFE
H
ospital staff moves at the speed of life, across all areas of healthcare. Racing patients to the technology,
services, care they need. Yet when critical diagnostic products are not operating to their OEM performance
standards, the race for help, healing or life can hit a brick wall.
At Innovatus Imaging, we know how critical speed is to getting your ultrasound probes repaired or replaced. It is
why we are investing millions in improving infrastructure and staff, accelerating our training programs, increasing
efficiencies and developing proprietary processes that get the most popular makes and models of probes into our
Ultrasound Center of Excellence and back to your technologists and patients faster than ever before.
We call it Rapid Repair. You can call it Life.
For information on our Rapid Repair programs and loaner inventory, email us today at
TedL@innovatusimaging.com.
| CONTACT US |
www.innovatusimaging.com
Call us at 844-687-5100
Pittsburgh | Tulsa | Denver
Independent Service
Providers are implementing additional infection

control and social distancing measures that differ
by location and that service teams will have to
adapt to and follow. Photo courtesy: Crothall
Imaging rates have been hit especially in-house teams are well positioned to sup- Robert Moorey, Trimedx's senior vice
hard by COVID-19. A study out of Yale in port this changing landscape.” president for customer delivery, added, “So
April warned that radiology groups should These third-party providers have also expe- it really wasn’t a decrease from a clinical en-
expect a dip of 50% to 70% over a mini- rienced changes in the services they provide as gineering point, as it was a shifting of re-
mum of three to four months. That means a result of the pandemic’s effects. X-ray tube sources from one area of need to another
paying for service at a time when the tech- replacement, for instance, is dependent on area of need.”
nology isn’t bringing in the revenue it’s sup- utilization rates. Decreases in scanning will Changes and decreases in medical ser-
posed to. reduce the need for this service, along with vices are seen as short-term, and although
“Hospitals suffering from a significant other corrective maintenance tasks. Rather different parts of the U.S. are having vary-
decline in revenue are questioning all of than doing less work for their customers, ing degrees of success in their fight against
the costs of service delivery — including some independent service organizations are the virus, many providers are beginning to
existing OEM programs — they were using focusing their support in new areas. resume their normal workloads.
prior to the pandemic,” said Jerald Olsen, “While there has been a reduction in “We did see a decrease in service needs
VP of sales and business development, and elective procedures and while that work from our customers, but have experienced
Wendy Diddle, EVP and chief operating may be less on the repair side, what we did a steady increase since mid-June,” said Ted
officer for Richardson Healthcare. “When a see was an increase in projects to support Lucidi, CBET and clinical marketing and
system operates at half its intended capac- COVID-19 response efforts and increased commercial specialist for Innovatus Imag-
ity, it no longer makes sense to keep do- focus equipment being used for treatment, ing’s Centers of Excellence forUltrasound
ing what you have always done. You have like ventilators and patient monitors,” said and MRI Coil Repair, Radiography, Design
to look at other cost-saving options and LeAnne Hester, chief marketing officer and Manufacturing.
third-party service organizations as well as at Trimedx.

Prepping for onsite visits
Many service providers have
The need for social distancing has led many ramped up their use of telecommu-
service providers to avoid on-site visits and nications and remote monitoring
preventative maintenance unless absolutely to diagnose problems from a
necessary. In such situations, service engineers distance. Photo courtesy: Philips
will don masks and other PPE to stay safe and
keep the people they interact with safe.
Many service organizations have adopted
their own policies around the use of PPE, but
Pete Strimaitis, chief operating officer for
Alpha Source Group, says the best approach
is to abide by the protocols implemented by
the healthcare facility.
“We’ve seen a lot of hospitals and im-
aging centers create more stringent poli-
cies to come on-site and do work, and so
we have to adapt to those local and facil- Service providers also have to be more The need for social distancing has also
ity policies,” he said. “Sometimes those flexible in when they perform preventive forced independent service organizations
differ tremendously from one facility to maintenance, scheduling it around the to rethink the way they do business at their
another. It was a little complex for us, but needs of their customers. This has led to own facilities.
we wanted to make sure we were follow- some working during off-hours, including “We recognized that what we needed
ing those local policies in addition to our on weekends and even as late as midnight, to do was spread people out,” said Moo-
customer policy.” to avoid delays when care is critical. rey with Trimedx. “Find other locations or

Independent Service
While some service providers did initially experi-

ence a drop in service, many see this as short-term
and expect services to pick up as elective procedures
resume. Photo courtesy: Innovatus Imaging
split shifts and limit the number of people in Service from a distance variety of purposes, including monitoring
the shops. If we did have a person come into With hospitals limiting the number of people equipment, troubleshooting problems,
contact with a positive patient, we made sure in their facilities and service providers looking performing diagnostics, database resets
that they did not put everyone at risk. This to avoid on-site visits, remote monitoring and cleanups, and in some cases, even
has helped Trimedx limit the number of as- and telecommunications have become cru- equipment repair.
sociates who could be potentially exposed.” cial preventive maintenance tools. Meanwhile, service providers are using
Crothall addressed this issue by setting “We are actively enhancing our remote telecommunications technology to institute
up a system for identifying which vendors capabilities,” Rob Stevens, service opera- more online training for their service teams
are available and safe to do on-site jobs. “To tions leader for services and solutions deliv- during the pandemic. It is a trend that is ex-
provide optimum transparency in our sys- ery of Philips North America, told HCB News pected to continue even after the pandemic
tems, Crothall instituted a specific code for regarding Philip’s multi-vendor service offer- has ended, and extends beyond indepen-
PMs impacted by the pandemic to identify ings. “At our Customer Care Solutions Cen- dent service engineers to healthcare systems
which device vendors could not come on ter in Atlanta, Georgia, we are increasing and their own in-house service teams.
site to conduct preventive maintenance, or and improving our connections to systems “There is a piece of technical training that
which PMs were otherwise deferred due via our Philips Remote Services (PRS) secured is pure classroom,” said Moorey. “I think
to the pandemic (allowed under the CMS internet connection. Connected systems can there is an opportunity for the pure class-
Blanket Waiver),” said Sheila O’Donnell, ‘phone home’ to alert remote engineers that room, the lecture portion of that class to be
VP, Technical Resources Group, and Shashi a system may be experiencing an issue that more virtual, which would limit the amount
Avadhani, regional vice president of Cro- is not visible to the operator. In these cases, of time a technician would have to be away
thall Healthcare Technology Solutions. “De- we can proactively initiate service to improve from their job site.”
ferred PMs affected by COVID-19 will be system performance.” He warns, however, that there’s ultimate-
reported separately through the EOC and The use of remote monitoring reduces ly no replacement for hands-on learning.
other governance structures for regulatory the need for bringing service people on- “For the technical aspect, it really is im-
compliance.” site at the facility and can be used for a portant to be in front of that device and to

have the benefit of a peer or instructor and share those experiences tinue to support them in that process — as they continue to expand
to help solidify the technical part of that training.” and distribute care — which will increase the need for technology and
data we have, like remote monitoring, utilization and cybersecurity.”
Servicing a post-pandemic world Improvements in emergency preparedness protocols will also be
COVID-19 is certain to have long-term ramifications even after the a big focus moving forward in case a resurgence or other pandemic
pandemic has ended. Learning the lessons and being prepared the should occur.
next time something like this happens will require a fundamental shift “We will continue to work closely with our client’s lead on these
in the way many aspects of healthcare operate. Equipment service protocols,” said O’Donnell and Avadhani. “We will continue to bol-
will be one part of the “new normal” we embark on. ster internal processes as not to be totally reliant on ‘local’ contingen-
“Long term we do not foresee a time when outside service cies and to provide a standard and consistent message to HTS staff
employees will be able to enter a medical facility without additional on how to manage/prepare for the next pandemic and/or respond to
health and wellness screenings,” said Richardson Healthcare’s the next emergency situation.”
Olsen and Diddell. “The rules will be IDN / Health system specific. Strimaitis says that independent service organizations should look
If you do not follow their rules on entry, you cannot come onsite at the pandemic as an opportunity to rethink their strategies going
and do service work.” forward and invest in additional services and equipment to cater to
the needs of providers now and in a post-pandemic world.
“The one thing we did as the pandemic started to take a foothold
Service providers and hospitals alike in the U.S. and globally, is to look at other solutions and other services
we could provide to our customers,” he said. “One part of our solu-
will continue to rely more on remote tions is around imaging services but there are other ancillary types of
products out there that we can provide relevant solutions for.”
monitoring. Share this story: dotmed.com/news/51922
More-stringent disinfection policies and limiting the number of

servicers arriving on site for a particular job may also be long term
consequences.
“As part of our standard operating procedure, customer products
arriving at our facilities are disinfected upon arrival and cleaned with
hospital-grade disinfecting products exiting our facility,” said Lucidi
ENHANCING
with Innovatus Imaging. “Operationally, we’ve implemented work
from home for certain roles which has allowed us to minimize the
number of individuals in each facility. Furthermore, our teams have
THE CLINICAL
EXPERIENCE
taken additional steps, such as implementing workspace distancing,
limiting access to common areas, actively cleaning workspaces, and
high-touch areas and maintaining strong hygiene practices.”
Service providers and hospitals alike will continue to rely more on
remote monitoring to limit exposure, as well as online classes to educate
not just independent service engineers but hospital in-house service
teams, too.
“We have transitioned many of our classes to online learning
and have opened nearly 1600 additional online, virtual training op-
portunities as of June,” said Stevens. “Philips continues to invest in
e-learning by developing virtual machines for a better remote experi-
ence, increasing communication quality and cadence to keep engi-
neers informed, and developing training content specific to remote
diagnostics and repair.” See the difference for yourself at
Hester with Trimedx expects COVID-19 to speed up the transition www.crothall.com/our-services/healthcare-
of patient care (and equipment service, with it) beyond hospital walls. technology-solutions-hts.
“Providers are looking at telehealth as well as hospitals at home—
how they can get care closer to the patient," she said. "We will con-

Reprocessing
It is time for a revolution

in healthcare supply chain
management
By Daniel J. Vukelich
Many healthcare workers will never workers at risk. This is nothing short of a national tragedy. And while
take hospital supplies for granted again. we were underprepared with PPE, we overspend in the supply chain
Forced reuse of disposable respirators, gowns generally. The American Hospital Association’s (AHA) Sustainability
and face shields has heightened attention to Roadmap for Hospitals indicates that the “second largest expense on
inefficient and wasteful practices in health- a hospital’s balance sheet (following labor) is supply chain costs.” And
care. COVID’s impact requires immediate at- much of that is made up of billions on unnecessary spending. A 2019
tention be given to hospital finances, securing Navigant analysis found over $25 billion being spent on unnecessary
and building a more resilient supply chain and hospital supply chain spending” — each year!
addressing the enormous amount of medical waste created.
We now can hit reset. I imagine a revolution in healthcare where
providers insist that medical devices and supplies be designed and
built to be reused or reprocessed and ultimately recycled. This trans-
formation requires healthcare providers to adopt a new mindset, that
The COVID response is creating a
medical devices and supplies are valuable assets, not consumable,
disposable, and easily replaced.
staggering amount of medical waste,
From my position representing single-use medical device repro-
cessors for 20 years, I am all too familiar with inefficiency and waste
in part due to unprecedented levels
in healthcare. In 2018 alone, our members helped hospitals prevent
nearly 16 million tons of medical waste through reprocessing. I am
of used PPE. But healthcare was creating
also intimately familiar with the immense untapped potential we
have before us.
a staggering amount of waste before COVID.
Near-term challenges
Financial Environmental
Health Affairs reports that the direct cost associated with the pandem- The COVID response is creating a staggering amount of medical
ic could be $654 billion. “Hospitals’ already-thin margins plunged into waste, in part due to unprecedented levels of used PPE. But health-
the red as volumes and revenue fell and organizations prepared staff, care was creating a staggering amount of waste before COVID. AHA
supplies and capacity for a surge of coronavirus patients,” according also reports that hospitals generate “nearly 7,000 tons of waste every
to James Blake, author of a Kaufman Hall report. Further, hospitals day and $10 billion annually in disposal costs.” Spending money to
have lost revenue because of their inability to perform elective proce- dispose of needless waste, is itself, also costly.
dures — a revenue stream that normally keeps hospitals afloat. These
factors have created a financial disaster for U.S. hospitals, which has Solutions
led to layoffs and furloughs. The healthcare industry lost 1.4 million To address the immediate challenges of healthcare — while simulta-
jobs just last April. This will likely mean hospital closures, and sadly neously building a better system for the future — previous assump-
perhaps include up to a quarter of all rural hospitals. tions and practices must be rethought and reevaluated to prioritize
reuse, reprocessing and recycling. These efforts can:
Supply chain • Reduce costs, freeing up resources to fight COVID or protect
The healthcare supply chain was not prepared to deliver the PPE against future disruptions, protect healthcare jobs and, for many
needed to protect our healthcare workers. This put our healthcare hospitals, keep the doors open.

• Build a more resilient supply chain so that we have a controlled, • Healthcare professionals must treat devices and supplies as assets,
reliable system of ensuring we have supplies, especially when dis- not garbage, taking care of such products so they can be reused
ruptions occur. or reprocessed.
• Reduce the environmental impact of healthcare. • Health professionals must prioritize proper reuse in central sterile
departments and fully maximize reprocessed device usage to ex-
Immediate savings opportunity tract the greatest value. As with all belt tightening, first using what
Looking through the lens of single-use medical device reprocessing, you already have alleviates the need to tap into the supply chain for
while reprocessing has been saving hospitals a tremendous amount of more new equipment.
money and reduced the per-use cost of medical devices, we’re doing a • Healthcare organizations can better control their inventory of medi-
drop in the bucket of what we can. Often, complacency and inertia have cal device assets and supplies if there is greater internal coordina-
led hospitals to simply throw away their single-use devices because the tion and cooperation with reprocessing firms. By doing so, hospi-
manufacturer says so. This is despite FDA’s conclusion that these devices tals are less reliant on outside firms having to ramp up production
can be reprocessed safely and effectively. That means hospitals are and ship from across the globe.
throwing away billions of dollars of assets. For those not intimately famil- • Medical device makers should be encouraged and incentivized to
iar with these devices, laparoscopic surgical instruments costing upwards consider device reuse or reprocessing in the earliest design phases
of $500 and diagnostic cardiac devices, sometimes costing over $3,000 of research and developing and in the marketing of new products.
are labeled for single use and often thrown away after only one use. • Regulators, such as FDA, and payors, such as CMS and insurers,
By some internal industry estimates, the average U.S. hospital is should incentivize total life-cycle assessment of products to ensure
leveraging reprocessing only to about a third of the potential. The those with longer value are used more than those with lesser value.
immediate savings reprocessing can provide for U.S. hospitals is in the
billions of dollars. One specific estimate from a policy paper published Environmental
by the Commonwealth Fund estimated that, on just one procedure Green Hospitals may be better prepared to deal with COVID and,
type, based on existing data on price and procedure costs, U.S. hos- at the same time, not contribute to making people sick with the
pitals could save another $540 million annually, or $2.7 billion over environmental pollution they create. Incinerated medical waste is
five years. One AMDR member estimate pegs nationwide A-fib case considered a top source of dioxins. “Exposure to dirty air, carcino-
savings potential at over half a billion dollars a year. gens produced by burning waste, and neurotoxins such as mercury
Reprocessing is not a singular solution to our supply chain prob- has caused significant harm to people, including birth defects, brain
lems, but it is powerful, immediate, and still underutilized Maximizing damage, and learning disabilities,” according to the Boston Globe.
the immediately available impact of reprocessing reduces costs to And “given the health care sector’s enormous impact, its healing mis-
make up for lost revenue and extends the life span of existing assets, sion, and its Hippocratic oath, hospitals ‘have an extra responsibility
thereby reducing the need to buy more. compared to other industries...’ says Gary Cohen” who co-found the
group, Health Care Without Harm. This holistic view, from cradle to
Long-term supply chain resilience grave, of our medical equipment improves environmental sustain-
Reprocessing can also build resiliency into the supply chain. Strength- ability, and improves health.
ening the supply chain both saves money and can ensure we’re not
in the future situation of unsafely reusing disposable PPE. Excessive Conclusion
and wasteful supply chain spending deprives our providers resources Medical device reprocessing is not a silver bullet that will control all
in other areas. Our front-line personnel are reusing N95 respirators healthcare spending, but reprocessing is a powerful example of an
right now, raising attention to things we took for granted in the past. immediate solution to reduce costs, promote a more resilient supply
Going forward, the use and the purchase of all device and supply as- chain and reduce environmental waste. Reprocessors are eager to
sets must be given a hard look. Waste not, want not. move forward with our healthcare partners to build a more holistic
By transitioning to a focus on medical device and supply reuse or view of medical technology utilization, shifting from viewing single-
reprocessing, hospitals can reduce costs, build supply chain stability, use devices as disposables to renewable assets.
and reduce waste. To do so:
About the author: Daniel J. Vukelich, Esq., is the president of the
• Hospital executives and purchasers must begin by making it a prior-
Association of Medical Device Reprocessors, or AMDR. AMDR repre-
ity to purchase devices and supplies that can be reused by hospitals
sents single-use medical device reprocessing companies. Reproces-
or reprocessed by reprocessors.
sors are regulated as device manufacturers, ensuring all products are
• Incremental changes made by manufacturers need to be evaluated
safe and effective. AMDR’s mission includes promoting reprocessing
closely to ensure subsequent iterations of existing device and supply
a cost saving and environmental solution for hospitals.
stocks will not adversely impact medical device reuse or reprocess-
ing operations.

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The Future of Healthcare
Future of equipment maintenance

By Al Gresch
As facilities management in healthcare artificial intelligence (AI), healthcare service thousands of dollars in labor and materials
continues to advance and evolve, predic- departments will move into a “closed-loop” over time-based activities. Medical equip-
tive maintenance (PdM) strategies will support process where the signals from IoT ment, much of which is already connected
likely be the ultimate destination for ef- devices will generate an automated action. and monitored, will shift to proactive notifi-
fective, efficient, and safe environment Let’s take that harmonic sensor on the medi- cations and generation of service requests.
of care management. Getting there will be cal air compressor; after identifying a read- Some companies are already looking at avail-
the result of continued data collection and ing that is out of the normal range, AI could able streams of data from modern devices to
standardization, regulatory evolution, and sys- compare that reading to historical values to identify anomalies and initiate proactive re-
tems integrations that ensure a safe and com- determine if a repair is needed now or just an pairs. It’s quite possible that automated status
pliant healthcare ecosystem and support staff adjustment on the compressor itself. If either identifications will occur, where an asset (while
eager for efficient and effective processes. is needed, AI will produce a work order iden- not in use) will identify as “not available” due
The Internet of Things (IoT) gives environ- tifying the needed action, identify the best to some needed servicing to prevent an un-
mental management (design, control, support, resource to perform the repair and assign safe use condition. Even when in use, status
maintenance) activities opportunities for im- them to the work, then notify that individual notifications will occur allowing clinicians to
provements in myriad areas. Today, the airflow through electronic communications. If a re- proactively replace that asset with another be-
and temperature of a space can be prepro- pair is needed (a new bearing), AI will pro- fore an unsafe condition arises.
grammed for times of day and days of week duce the needed requisition for the part and/ As these capabilities expand and are
to allow for variations in need. In healthcare, or identify where the part is located for easy proved to enhance the safety and reliability
IoT will expand beyond basic environmental retrieval. AI and IoT could eliminate most en- of equipment and spaces, we will see regula-
use and into support and maintenance. Today’s vironmental condition issues by monitoring tory and oversight agencies adapt. As with
mostly manual process of a human perform- ambient temperatures within spaces, collect- alternative equipment management pro-
ing repetitive checks and inspections will be ing capacity values, reviewing external condi- grams, the Centers for Medicare and Med-
replaced with connected IoT devices. An IoT tions affecting air quality, and automatically icaid Services (CMS), National Fire Protection
sensor on a medical air compressor will moni- adjusting airflow and temperature settings Association (NFPA), Occupational Safety and
tor the harmonics of the shaft and signal when every ten minutes to ensure optimum condi- Health Administration (OSHA), and others
a bearing is due for servicing. An IoT sensor on tions for patients, staff, and visitors. will codify PdM and allow healthcare orga-
an air handler pulley will monitor the belt ten- AI and IoT will eliminate most needed pre- nizations to embrace the proven benefits of
sion and signal when an adjustment is needed. scheduled maintenance activities by proac- this maintenance strategy.
IoT sensors on fuel tanks will signal refueling tively monitoring equipment conditions and About the author: Al Gresch is vice presi-
needs. IoT sensors throughout environmental automatically generating needed services. dent, customer success, healthcare at Accru-
spaces will signal temperature adjustments for Like with modern automobiles, IoT and AI ent, the world’s leading provider of physical
each affected zone. will monitor fluids and produce service work resource management solutions.
But more importantly, when coupled with orders when viscosity levels dictate, saving Share this story: dotmed.com/news/51914

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CT Solutions in Sight
MeVis Veolity Software
www.VarexImaging.com | www.Veolity.com

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The future of medical equipment maintenance p.

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SCANNING THE CT TUBE TECHNOLOGY

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