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V.B.A. NEWS - December 1999
A Message From the President
Comparisons are inevitable. Whether we compare the size of our hospitals, our departments, our
budgets, our salaries, our houses, or our families, it is a convenient method in measuring our
accomplishments. Your Association¹s President and Vice President (Virgil Smoot) attended the North Carolina
Biomedical Association¹s annual symposium in Greensboro in October to observe, learn and compare. We
observed a vibrant association in its 20th year with attendance approaching 300, supporting almost 90
exhibitors and 25 classes. We learned that while they are big, they have similar operating challenges that
we have- class snafus, scheduling misprints, program typos,and limited volunteer resources to name just
a few. And when we compared, the VBA should feel proud of our organization as many NCBA board
members commented on our unique ideas and programs we are establishing. Our Biomed/IS roundtable, the VBA MBA,
jeopardy game, EDCOMM marketing plan, and renown keynote speakers are just as substantial as those offered by our
southern brethren in an effort to promote and provide educational opportunities for those in the
biomedical industry. While the NCBA constitutes a high standard in the industry, the VBA has made
immense strides over the past 6 years to organize and develop an innovative association which is fast becoming an
association leader in the biomedical market.
Please take a moment to review details of upcoming events in this
newsletter. I am particularly excited about the VBA MBA taking place February 25th at the VCU School
of Business in Richmond. We will offer MBA course material and professors in a dynamic and
stimulating one day seminar. Additionally we have a new venue for our annual meeting scheduled for September 20-22 at The
Homestead in Hot Springs, VA.
With the holiday season upon us, I want to wish everyone a joyous and safe holiday and a happy
New Year.
Al Strickler
President
THE VBA MBA
“When we cease to learn, we cease to live.” -Anonymous
Come hone your skills and broaden your knowledge base at The VBA MBA program for
managers and high achievers at the Virginia Commonwealth University School of Business Center for Continuing
Education. Three MBA style classes will be offered-
#1- Accounting and Financial Practices for the Non-Finance Professional
Summary- Focus on three areas-
A. Understanding company financial statements,
B. Implications of budget decisions,
C. How to communicate with superiors on capital expenditures and equipment cost justifications.
Included are real world biomedical scenarios. Professor Ed Spede specializes in this topic and is a former corporate
controller, CPA, ex-Navy Commander and current handball champion.
#2- Motivation, Teamwork and Leadership of Technically Oriented Employees
Summary- Focus on how one leads, manages and sets team oriented departmental goals for
employees who are primarily production, contract and task oriented in the healthcare field. Discussion of human behavior,
motivational techniques, and understanding group and individual communication to improve performance. Professor Randy
Barker is the winner of the 1998-99 Distinguished Teacher Award for all of VCU and specializes in organizational
communication and behavior.
#3- Negotiation and Communication- Getting to Yes with Vendors, Contractors, and Your Boss
Summary- Focus on four areas-
A. The three principles of perception- recognition, interpretation, and expectation,
B. Getting from “No” to “Yes”,
C. How to win yourself a “hearing” to establish your views,
D. How to work to a joint solu tion through “idea building”.
Professor Bob Trumble is a former director of the National Institutes of Health and presents to
hospital administrators on this subject.
Friday, February 25, 2000 at the VCU School of Business, Richmond, VA.
8:30am Registration and continental breakfast
9:00am Welcome and introduction
9:15am-12:00am Accounting and Financial Practices for the Non-Finance Professional
12:00am- 1:00pm Lunch
1:00pm-3:00pm Motivation, Teamwork and Leadership of Technically Oriented Employees
3:00pm- 5:00pm Negotiation and Communication- Getting to Yes with Vendors, Contractors and
Your Boss
Seating is limited. VBA Members $160.00 per person includes lunch. Non- VBA members $175.00 per
person includes lunch.
Parking available in the VCU deck for $4.00 per day. To register- send check payable to the Virginia
Biomedical Association
with the form below to Al Strickler, 503 Libbie Ave, Suite 2C, Richmond, VA 23226, 804-282-6167.
Technology is changing the Biomedical Career
The future of the Biomedical Technician field
Exactly where we are going in the next 50 years? No one can say for sure. However there is
some writing on the walls. The mood is set for a revolution in medical equipment technology and all the
models for support from the past and present will be modified, or thrown out altogether. Technology is
changing in many different ways.
The size of components continues to be reduced. This miniaturization is producing devices small
enough to be implanted in the body. Cardiac pacemakers are not new but the controls for pacemakers will
be much more sophisticated. Devices in the future will allow on-board computers to change rates of
discharges automatically based on chemical sensors in the bloodstream and provide on demand
defibrillation in a very small implantable package. What could we be implanting in the future? Micro
servos and artificial joints are easily on the horizon. They have already figured out how to let the human
brain talk to electrical sensors. In our lifetime, we may see artificial limbs on the order of the “Six Million
Dollar Man”. I hope they offer a service training school! Another change caused by miniaturization will
be a growing complexity of diagnostic devices. Today we have dozens and dozens of different types of
analyzers in the medical laboratory. As technology reduces the cost and size of sensors they will be
combined into one automated testing machine. I can see it evolving in a few decades to a single robotic
system that will test for whatever the doctor orders. After performing the tests, the patient sample will be
put automatically into cold storage for additional tests that may be called for during a person’s hospital
stay. The analyzer will get commands from medical records software when the doctor orders a test from
the bedside or his office. Then the machines will run the tests based on priority 24 hours a day, and pull
the sample out of storage by itself, no operator interaction may be required. Biomedical Technicians will
be needed more then ever to keep these analyzers running. Although the reduced costs of sensors will
give many devices self-diagnostics that will warn of approaching failures before the analyzer actually
breaks down. Total system failures will be less frequent, but everything made by man will fail, at least
today it does.
Another major change in technology that will steer the field of medical equipment maintenance
in the future is the birth of the information age. Machines of yesterday and today mainly output
information about a persons body functions to a display. Many parameters such as information about
blood pressure, heart rate, oxygen saturation of blood etc. Today each machine gives the clinician this
information and it’s up to them to respond to it. Medical devices only talk to each other if the system was
purchased from the same manufacturer and it’s specially designed to network. Machines don’t usually
talk to each other. That will change. We will see networks of multi vendor devices all using the same
interface. Networks using the same electronic language, outputting their data to the medical record
making it available throughout the hospital for others to use in supporting the patient. Doctors will be able
to access secure patient data at home or in their office. The change over to totally filmless Radiology
systems will be slow at first, but computers are fast enough now to handle the data crunching. A large
portion of the equipment used today in the Radiology department to support X-ray film will soon be
obsolete. The medical information systems of the future will use real time interactive artificial intelligence
and give clinical interpretations and treatment recommendations for the doctors to evaluate. I hope the
physicians will always get the final say.
Impacts to the career field
How will the businesses of maintaining medical equipment change as a result of this technology
infusion? Some devices will remain low tech. Physical therapy machines will still work with original
equipment muscles and joints that have not improved with technology. General therapy equipment will
still heat water; pumps and vacuums will still do the same job. But the devices that take readings from
patients or analyze fluid and tissue samples will be very different. Not only will the methods of measurements
change with new types of sensors but also the things we look at will be different. Cellular level analysis
will require extremely sophisticate devices we don’t see today. Most electronic controls will be too
miniaturized to repair. The days of component level troubleshooting are numbered. Today it’s usually
not economically feasible but tomorrow it will be impossible. Only board swapping and complete device
replacement will our repair options. The role of Biomed will expand in teaching the users in how to
operate the machines.
I see most in house programs being outsourced to huge ISO companies. The reason is simple,
with most hospitals trying to stay financially viable they will concentrate their efforts on their core
competency. The business of caring for people is what they do best. The support services infrastructure
drains energy and money from a hospital. As Xerox outsourced Information Management, hospitals will
outsource Biomedical, Engineering, Housekeeping, Dietary and Security. For those in-house programs
that do survive they will shift out of the contracted side and fall under the command of the Information
Services departments. Most health systems hang on to IS departments as their life’s blood. Biomedical
devices will become an IS function as a result of their riding the hospital information highway. IS will
need Biomeds to do what we do best and they don’t do at all, manage equipment. IS service providers
frequently see computers as dumb boxes. If an e-mail server goes down, people may get angry but no one
is going to get fired. They don’t understand the life threatening urgency of the information they control.
Biomedical people on the other hand have learned from the school of hard knocks how important this data
and hardware really is. Technicians learn to value equipment the first time they receive a STAT call from
the Operating room. Once you have held a machine together to allow the surgeon to finish an operation,
you never again look lightly at a medical device. IS departments will need Biomedical Tech’s to support
the clinical systems as they support the rest of the information systems. In the future we will have to work
as a team. Today we are very separate.
The ISO will thrive in this field. They will need to invest heavily in training
to support new technologies. They must become risk-taking partners with health systems in order to
survive. By grabbing up the experienced technicians discarded by hospitals who are getting out of the
business of in-house maintenance, they will continue to meet the contracts of the future. Perhaps they to
will use some of this new networking technology and be able to have a technician located in one state
service a machine located in another state. It could be done with teleconference technology, robotics and
video equipment already available. This would allow a smaller force of highly specialized technician’s to
support areas that don’t have that expertise.
The role of the manufacturer Biomedical Representative will evolve as well. Smart companies
will continue to broaden their responsibilities and move into more hospitals. When they start working
together with other manufacturers they will truly break new ground. Picking the best of each other’s
product lines and building the machines of the future will require teamwork rarely seen today. And
sharing service support will be a must.
How do we deal with new technology
As equipment maintenance and repair technicians we are on both sides of the technology curve.
We must learn fast when new devices show up to be installed and the operators need to be trained. Soon
after we are called to service these new technologies. Our survival mechanism is to be always learning,
going to manufacturer schools, and talking with our fellow repairmen in the industry. Finally we must
read everything we can get our hands on. We need to learn not only about the nuts and bolts of new
technologies, but as much about computers and different operating systems as possible. I see the future
steaming down on us and I’m calling to it. I encourage every technician to learn outside the box of the
past. Go and get IS type software certifications (i.e. A++, MCSE). You will be more valuable to your
organizations and more survivable on the rocky roads ahead as a Biomedical Technician.
Andy Holden
Mary Washington Hospital
Capital Asset Management
This is the first in a series of articles about the various aspects of Capital Asset Management in
Hospitals for Biomedical Technicians. Biomedical Technicians play a vital role in the management of the
hospital’s capital assets. Biomeds are currently required to bridge the terminology gap between the
Engineering and Medical disciplines. Now you are being asked to comprehend the terminology of the
Financial disciplines.
What are Capital Assets?
To better understand “Capital Assets” let’s first define what it is. Capital Assets are long term
assets of significant value to track by means of a property ledger. There are four basic types of capital
assets: Land; Building, Equipment and Land Improvements; Natural Resources; and Intangibles. As
Biomeds we are only concerned with the asset type “Building, Equipment and Land Improvements”,
unlike the other three, these are the depreciable assets.
Depreciation is a process designed to match the asset’s loss in value against the revenue
generated over the life of the asset. This means that the wear and tear of an asset becomes the
depreciation cost. It also means that the asset has a limited useful life. Ideally when an asset wears out it
is fully depreciated.
What can be capitalized?
For a new building, you can capitalize architectural fees, building permits, contractors’ charges,
as well as, payments for material, labor and overhead. For an existing building, you can capitalize the
purchase price, brokerage commission, taxes, and costs related to the preparing of the building for its
intended purpose.
For equipment, you may include the purchase price (less any discounts), delivery charges, taxes,
installation costs, and any expenditure to test the asset before it is placed into service.
Although land can not be depreciated, the improvements to it can be. Assets like parking lots,
sprinkler systems, or even trees can be capitalized because they, unlike land, have a limited useful life.
Once again all the costs for putting the asset into production can be capitalized.
What is the policy?
Each hospital is required to have a policy concerning Capital Assets. These policies will vary as
to the criteria of what is a capital asset. A typical policy statement might go like this: “An item can be
considered a capital asset if it exceeds $750, has a useful life of 2 or more years, and is not for resale”.
Under Medicare rules, the dollar limit can vary up to $5000, the cost must be spread over multiple
accounting periods, and all inventory items are an expense. There are many gray areas for these policies.
One area worthy of note is that repairs are not capitalizable because they restore the asset to its original
operational expectations, while overhauls are capitalizable because they either extend the depreciable life
or increase productivity of the asset (depending on the type of overhaul).
James Anderson
[James is the Corporate Assets and Technology manager for the MediCorp Health System in
Fredericksburg, VA]
VBA 7th Annual Meeting
Plan for the VBA 7th Annual Meeting at The HOMESTEAD in Hot Springs VA,
September 20-22,2000. Below (reprinted with permission of The HOMESTEAD) from
their website, www.thehomestead.com, are some of the things you can enjoy during your
stay at The HOMESTEAD. We will be a bit early for the ski/snow season but check out
all the other offerings.
From the website:
“Check Out Our Golf and Ski Getaway!
Since 1766, The Homestead has offered visitors an incomparable retreat; an incredibly grand
escape, located amidst the beauty of Virginia's Allegheny Mountains. When you visit, you will find
luxuriously appointed rooms and suites, superb dining and exquisite shopping, in addition to traditional
Southern hospitality in a gracious atmosphere.
The Homestead is 15,000 acres of relaxation and recreation for the whole family. Here you may
choose to do as little or as much as you desire. There are three premier golf courses - including the
acclaimed Cascades Course - as well as our renowned Spa and Spa Salon. Along with horseback and
carriage rides, shooting sports, 100 miles of hiking and biking trails, fly fishing, falconry, bowling,
skiing, ice skating, snowboarding, and a year-round children's program.”
As you can see there are many things to occupy your “free”
time. Also for your family to enjoy if you bring them along.
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