VBA News - April 1999

The Virginia Biomedical Association begins 1999 with momentum and enthusiasm generated from the last half of 1998. We have built a solid foundation of dedicated board members with a commitment to make our association one of the nation's best. Our goals for success are clearly stated in EDCOMM 1999 - EDucation and COMmunication for Members. If we can achieve these goals, we will meet the needs of our members, fulfill our mission and build a larger, vibrant and active member organization.

In addition to focusing within, we are beginning to work more closely with our biomedical brethren in North Carolina on projects and issues which are of benefit to both organizations. (See mention in this newsletter of an NCBA certification class being offered in April.) We will coadvertise events and work together where the synergies of our two societies will complement each other on educational opportunities and the sharing of resources. By working together, we make both organizations stronger.

Enjoy reading the VBA newsletter. Large amounts of volunteer energy and time go into making it useful. If you have ideas or articles you would like to contribute, please contact any of the board members.

1999 promises to be a year of growth. Come grow with us!

Al Strickler
President

Education and Communication for Members

After conducting extensive focus groups, the following goals for 1999 were adopted by the VBA board in February. These areas of concentration are essential to the growth and core mission of our organization. By achieving these goals we will be satisfying the demands of our members and providing tangible benefits. Please contact me, or any board member with your feedback or comments.

-Al Strickler, President

EDUCATION - Affordable local classes and/or speakers accessible to all.

Tidewater- class in 2nd quarter - MEDEX Syringe Pump Class April 13th.

Central- class in 2nd or 3rd quarter

West- class in 3rd or 4th quarter

Goal- 3 classes total per year

Certification Classes- geared toward technicians for passing of certification examine. Combine with NCBA classes.Goal- 1 class per year (NCBA class is April 26-30th)

Management Workshop- MBA in a Day! Provide a full day seminar for department managers with focus on business strategy, planning, management, budgeting, human resources, asset management, legal issues, technology, etc. Possible alliance with a university (ODU,VCU,ECRI, etc.)

Goal- 1 workshop per year

COMMUNICATIONS

Newsletter- Printing frequency to 4 times per year, highlight member news (promotions, school credentials, degrees earned, awards), jobs available, new members joined. Keep track of quantitative goals (# of classes, # of members) etc. Goal-printing 4 times per year

Other communication tools to focus on- training tapes, press releases, hospital newsletters, lapel pins, Biomed Listserve. Goal- increase VBA presence and image

MEMBERSHIP- Target third party and large in-house accounts with board member contacts. Bring a friend to a class or meeting.

Target West Virginia biomeds Membership survey in 2000. Goal- double membership by Annual meeting 2000

I feel confidant that everyone in the biomedical industry has heard all they ever wanted to about the Y2K 'bug'. As a matter of fact, most of us probably had our fill well over a year ago. For those still who are still plodding along or have some fine tuning to deal with (present company included), here are some points that I have heard debated, discussed and dissected and are worthy of mention.

Depending on who you talk to, there are more dates to be concerned about than just 1/1/00 (sorry, my word processer hasn't been upgraded yet and "00" is the best it can do. ). In chronological order, here are some generally agreed upon dates to be aware of; 12/31/98+, 9/9/99+, 12/31/99+, 2/28/00+, 2/29/00+, 12/31/00+. The '+' indicates that the rollover from the date to the next day.

In addition to the dates, other information is now readily available from a plethora of websites. Here in Lynchburg, we have taken all of our information and placed it on a database accessible via the hospital's intranet. One of the handier websites I have used is TDI's (www.tdibiomed.com/links/newlinks/devlinks.htm). My hat is off to their webmaster and while It doesn't have every manufacturer, it probably has most that we deal with and the format made getting to their information very simple. . Also, check out the VBA's website (www.vabiomed.org). Mark Freeman has put together a fine website and the resources continue to grow.If you have access to email I encourage you to join the biomedical listserve maintained by Mike Kauffman (if you aren't already). This has proven to be a very successful forum for airing issues as they pertain to our profession and with over 1,000 participants, the knowledge base is considerable. I know our department will be on hand for the 1/1/00 transition to manually reset some devices and to 'manage' some y2k pizza (anchovies forbidden due to MSDS and environmental considerations).

A group discussion on Y2K and different approaches from VBA members and vendors was held at the recent Winter meeting at Wintergreen and some valuable information was exchanged. A question frequently asked is how much physical testing is being done on devices-every device? Every software revision? Only life support or mission critical? None-just documenting manufacturers' information? I would like to hear responses from members around the state and beyond as to what they are doing. Have you rec'd any/all software or other upgrades? Have you run into any dead ends (equipment that really does stop operating properly) or equipment that must be replaced? Do you have a specific 'contingency' plan for biomedical devices? Drop us a line, email us, call us, fax us. Share your thoughts.

Brian Blackwell, CBET
brian.blackwell@centrahealth.com
(804) 947-4603
(804) 947-7096 FAX

Those of you tuned into the BIOMEDTALK-L Bulletin Board may have already seen this, but for those who aren't it was felt that it was worth repeating. The first statement is quoted from a posting on the bulletin board and then the response in it's entirety. The topic was ICC Certification.

>>> Biomed Techs both certified and not. I have yet to see a difference in PERFORMANCE between certified and non-certified, it all depends on the technicians will to perform.<<<<<<<<

The statement that certification does not make a good tech is getting a little old. I know plenty of professionals with all types of licenses and certification that are incompetent - we all do. However I would think a little more carefully about going to a doctor that has no license or using an electrician for my home that is not licensed. ( And one of the best doctors I ever knew had been kicked out of the AMA)

The certification for BMETS is not perfect and even in some aspects is not relevant but the point is to work towards making it relevant and viable. Like the standards of practice we have been discussing here lately - certification is a move towards a standard, a move forward in becoming a recognized profession. How many times have your clinicians gotten what they wanted because they were able to bring to administration that it is a standard of practice for their profession ? I can remember when BMET job offers never mentioned certification , now it is hard to find one that doesn't. Especially being female in this profession I have benefitted from being certified because people found it hard to believe I could "do" electronics. When I got my certification and made it known, I didn't have to fight their assumptions anymore ( Of course I still could have not known which end of the soldering iron to use). The argument can't be anymore whether to be certified or not but how to develop certification into a "power tool".

Mary Coker
Techserve

The basic concept of DICOM is actually pretty simple, but unfortunately most people have been misled by rumors and horror stories. We need an industry standard like DICOM in order to connect digital imaging equipment on a network and ultimately create a PACS. Without an industry standard, you will buy a PACS from a single vendor, and must buy all equipment from that vendor, or their "partners". In other words, short of replacing your PACS and all

equipment connected to it, you will be locked in to a single vendor for ALL equipment on your PACS system. At this point, you can say goodbye to the benefits you get from competition between vendors.

DICOM is a set of standards to enable interoperability between imaging equipment (including those of different manufacturers). The standard specifies TCP/IP as the network protocol, and consists of a set of specific services. DICOM 3 (the current version - previous versions are obsolete) is implemented in software, it is NOT a hardware standard.

Conformance is defined as conformance to a specific set of DICOM services for each piece of equipment, and this must be matched to the equipment that you want it to interact with. Manufacturers must provide "DICOM conformance statements" to define these services for each piece of equipment that they claim is DICOM conformant. Incidentally "compliance" is NOT defined in DICOM, only "conformance" to specific DICOM services. A statement from a vendor using the term "DICOM compliant" is meaningless.

For example, a CT scanner, which is DICOM conformant as a "print service user" can communicate with a printer that is DICOM conformant as a "print service provider". No piece of equipment needs to use all of the DICOM services - a printer does not need storage services, either as a user or a provider.

These examples are a bit simplified, but the bottom line is that if the equipment correctly conforms to the services that they claim, they will interoperate correctly. Problems that arise are not due to the DICOM standard, but due to incorrect implementation of the standard in specific pieces of equipment, or by trying to get equipment to communicate that do not conform to compatible DICOM services.

I have had training on this subject, so if anyone has specific questions, e-mail me privately and I will try to answer them.

Mark Freeman
Virginia Beach General Hospital
mfreeman@tidehealth.com

What do you know about CCOW?

The Clinical Context Object Workgroup (CCOW) publishes standards that allow information applications with graphical user interfaces to operate together on PC's and workstations. What this means is that CCOW compliant applications will synchronize on a selected patient so the healthcare worker can window into multiple applications and automatically view data of the selected patient. There is no need for multiple passwords or patient lookup tables.

CCOW is not HL7

Clinical Engineering Departments should be familiar with DICOM and HL7. What DICOM is to image database management, HL7 is to synchronizing databases of multiple hospital information systems. But HL7 likes demographic data and requires support of legacy systems which may not be PC capable. Applications interfaced according to HL7 protocol allow the patient name (for instance) in one application, to be transferred accurately to other applications. However the user typically has to sign on to the various applications. CCOW is the integrated approach within the workstation to this problem. CCOW is for desktops what HL7 is for mainframe computers.

CCOW does what?

Using CCOW technology, cardiologists can select a patient of interest once and obtain complete information from diverse applications such as ECG Management, Cath Lab, Stress Test, Echocardiology, and PAC's. All of these applications (no matter what vendor manufactured the equipment) will automatically "tune" though a data exchange for the selected patient. The result is less time spent navigating through applications and immediate access to all patient information.

CCOW History

CCOW is a new standard. The first set of standards was published March 1998. HP founded the standards group, which is now comprised of many healthcare system vendors, providers and consultants. Spacelabs claims to have the first patient monitor to offer support for the CCOW standard. Duke University is the web site sponsor.

CCOW Future?

It appears that total industry acceptance is uncertain. However the days of stand-alone systems with proprietary architecture are over. Integration strategies must be a part of every medical equipment systems purchase. CCOW is a possible solution for integration and Clinical Engineering Departments must position themselves to be a part of that integrated environment.

Want more information on CCOW? - http://www.mcis.duke.edu/standards/CCOW/

Ben Clark
Centra Health, Inc
ben.clark@centrahealth.com