By K. Richard Douglas
Indianapolis is famous for more than a 500-mile auto race; it’s the home of Eskenazi Health. The health system dates back to 1855, starting as City Hospital, and treated Civil War solders in its early days. Named after Sidney and Lois Eskenazi, who provided a $40 million gift to build a new hospital, the 315-bed health care facility partners with the Indiana University School of Medicine. Indianapolis is famous for more than a 500-mile auto race; it’s the home of Eskenazi Health. The health system dates back to 1855, starting as City Hospital, and treated Civil War solders in its early days. Named after Sidney and Lois Eskenazi, who provided a $40 million gift to build a new hospital, the 315-bed health care facility partners with the Indiana University School of Medicine.
According to the health system’s website, Eskenazi Health was named one of the nation’s 150 best places to work by Becker’s Hospital Review. It is also home to the first adult Level I trauma center in Indiana.
Besides the main campus, the health system includes 13 major offsite clinics. The system’s biomedical engineering department consists of 20 employees, three of which are dedicated to imaging service.
The imaging technicians include Matt Dimino; radiology service technician-IT, Anthony Phoenix; radiology service technician-IT and Greg deJong; imaging/biomedical service technician.
Supported equipment includes two MRIs, three CTs, five fixed X-ray rooms, two fluoro rooms, three nuclear medicine systems, five IR/cath labs, six mobile X-ray systems, 12 C-arms, four mammography rooms and four offsite locations. They also maintain and service all injectors and dental X-ray equipment.
The imaging team stays current by utilizing a combination of manufacturers’ training, third-party training and in-house training. They also receive internal and external training for IT certifications, such as cyber security, PACs, A+, medical device integration and healthcare information technology.
Matt Royal, CHSP, CHEP-FSM, CHTM, CLSO-M, CHC, CHFM, CBET, director of biomedical engineering says that “all purchasing, planning, and construction is consulted on by the technicians and management.”
“Contract negotiation is supported by supply chain with the terms and conditions requested by the biomedical engineering department. The technicians typically source the parts and labor. Basic user training is provided by the department; however in-depth training is relied on from the manufacturer,” Royal says.
He adds that the imaging service technicians do all the work unless they require the vendor as a supplement; they have mostly manufacturer training but also utilize third-party training as needed. The team is fully trained on Siemens Aera MRI, Siemens Symbia Nuclear Medicine, Philips Brilliance CT, Philips DigitalDiagnost X-ray, Philips Alura FD IR/cath labs and Hologic Dimensions mammography, according to Royal.
All three imaging service team members have skills and competencies beyond their daily work duties.
“One of the imaging techs (Matt Dimino) teaches HETM courses as an adjunct professor at IUPUI.” Royal says.
“Matt Dimino brings his students to the hospital for lecture as well as utilizing the shop as a lab environment. Matt’s part-time role as an adjunct professor helps develop the internal education programs at the organization and ensures a strong relationship with the IUPUI HETM program. The students receive real-world classroom experience by attending the classes at the hospital. Students sometimes become future employees through the internship partnership,” Royal adds.
Anthony Phoenix owns his own HTM company.
“Anthony Phoenix started his career as a biomedical technician and continues it part-time as an entrepreneur who provides biomedical services to health care providers not related to Eskenazi Hospital. His business employs several biomedical equipment technicians who provide onsite and depot repair services,” Royal says.
“The newest member, Greg deJong, is in a hybrid biomed/IT role which I think is unique for succession planning,” Royal says.
“Greg deJong took an interest in ultrasound service which was a gateway for him to the imaging modality. This unique role allows for continued mentoring with the more experienced imaging technicians. Greg is gaining experience on general X-ray and is gaining knowledge on CT and MRI,” Royal explains.
He points out that as part of a succession plan, deJong can move up to a full radiology equipment technician in the future.
“Since the market is lacking experienced imaging professionals, the hybrid position ensures the organization doesn’t have a gap in in-house imaging support,” Royal adds.
The imaging team is recognized for more than its specialization in various imaging modalities. The imaging service technicians are viewed as potential leaders as well. They have also been involved in projects to assure that there are contingencies in case of failure and to protect the hospital’s equipment.
The team participated in the development and installation of electrical protection for radiology equipment and contingency planning for imaging devices that included assurance of hard drive clones for all imaging devices.
“The electrical protection for the imaging equipment project had the technicians working with the electricians on sizing, procurement and installation of surge protection. They also identified additional protection needs for CT and MRI that included an uninterruptable power supply system,” Royal says.
He says that the contingency planning project included the assessment of the imaging equipment inventory and utilization to establish communication and service protocols to ensure back-up plans for equipment failure.
“Other contingency planning was based on ensuring hard drive clones were made for all imaging devices to ensure faster repair times, hard drive failures often require software reloads that may take long periods to install and configure,” Royal says.
The imaging team is participating in ongoing leadership training.
“The hospital supports an internal leadership program for managers and above, however the imaging team has been asked to be a part of this program to continue to develop leadership skills as well as project management skills,” Royal says.
“They also make project management part of their goals each year. These projects generally include new purchases of technology and optimization of current technology. They are heavily involved in projects that improve the educational processes in the department and serve in as many roles as needed,” he adds.
The hospital opened in December of 2014 and one challenge the team has been pondering is building a replacement calendar for the equipment, most of which has a useful life of seven years.
They are trying to determine whether to upgrade, to extend the life of the imaging equipment, or replace it.
“With the high cost of replacing or upgrading equipment we obviously can’t replace everything at one time. So, the replacement plan is a tiered approach, where currently we are looking at the oldest equipment first,” Royal says.
“For example, we moved existing cath lab and mammography equipment from the old hospital. We are currently involved in the upgrade or replacement of those systems. We also are analyzing utilization of our ultrasound equipment, although it is not end of support, some of the equipment receives excessive wear and tear and failures on some units are high. We have looked at rotating less utilized equipment or replacing the equipment that receives the excessive wear and tear,” he explains.
Royal says that the imaging service techs are also involved in improving infection prevention and safety through lead garment management. They have partnered with a company that specializes in the cleaning and repairs of lead garments.
“Often, this is managed by the radiology staff, but the technicians manage this for multiple areas that use X-ray such as the operating rooms, cath labs, dental and the trauma areas. The risk and safety department has endorsed the management of the lead garments by the team because of the effectiveness of the current service program on the imaging equipment,” he says.
All the imaging technicians are part of the Indiana Biomedical Society (IBS). Matt Dimino is a past president of the IBS. He also speaks at medical device cybersecurity workshops.
Eskenazi Health’s imaging service team has proven that they are a well-trained and capable team with diverse abilities that empower them to keep equipment maintained and in proper working order. They are proud of their work and their ability to help Eskenazi Health deliver quality health care and positive outcomes to patients from throughout the Indianapolis area.