Protecting Your Nuclear Medicine Imaging System Investment

October 14, 2015

Presenter Bio: Craig Diener

Craig Diener

Senior Product Manager

Universal Medical Resources, Inc.

Mr. Diener has more than 22 years of experience innuclear medicine, including 19 with Philips Healthcareand ADAC Laboratories in multiple roles in product and production management. Previously, he worked for JD Technical services, which was acquired by ADAC in 1995.

Universal Medical Resources is an independent service provider located in Washington, Missouri.

Agenda

• Introduction

• Environmental Concerns

• Preventive Maintenance

• Daily / Weekly Quality Checks

• Service Contracts

• “End of Life / Service” Notification

• Hard Drive Failure Concerns

• Critical Product Recovery

• Question & Answer Session

Protecting Your Nuclear Medicine Investment

• Significant pressure on radiology departments / practicesdue to lower reimbursement rates

• Throughput and uptime are the keys to profitability

• More facilities are keeping older equipment to lower overhead

• Key to protecting your investment:

Environmental Concerns

Preventive Maintenance

Quality Control

Regular Service

Sudden/Unexpected Issues

• Temperature, humidity fluctuations / extremes impact electronics

• Older circuit boards are particularly vulnerable, though newer electronics and semiconductors are susceptible too

• Fans can’t run forever, bearings fail = overheating

• Optical grease is sensitive to temperature, thinning can cause image degradation & tuning instability

• Dust & other debris Impacts fan efficiency

Wear mechanical components(e.g. gears, motors, joints)

• Dedicated HVAC & regular cleaning

Environmental Concerns

Environmental Concerns – Proper Shielding

• Sources from other nuclear imaging systemscan affect image quality

• Consider shielding of:

Injection locations

Other Nuclear Medicine rooms

Patient waiting areas

• Hot lab placement / material control can affectimage tuning & quality

• Proximity to MRI, X-Ray, & CT units can also impacttuning & cause image artifacts

OEM shielding characteristics and regulatory requirementsshould be factored into facility layout

Uninterruptible Power Supply (UPS)

• More than 3,600 outages in 2014, affecting 14M people*

• Power surges, brownouts, unstable power, and noise are extremely harmful without proper protection

• Hard shutdowns can corrupt software files & stressor permanently damage electronics / electrical components

*Eaton Blackout Tracker, United States Annual Report, 2014

Environmental Concerns – Power Quality

California, 525 New York, 399 Texas, 335 Michigan, 328 Pennsylvania, 294

Ohio, 265 Illinois, 251 Washington, 226 North Carolina, 225 New Jersey, 225

Environmental Concerns – Power Quality, cont’d

• Power conditioning UPSs absorb spikes & fill in voltage sags on the incoming AC power

• UPSs ensure better performance, longer life of the entire system

• Should be part of any purchase – new or reconditioned

• Proper UPS sizing: Provides time to finish current scan

and proceed with an orderly shutdown Never use for continual operation Is based upon make/model of system

• Battery life is approximately 3 yearsbased on normal usage

Preventive Maintenance

• If your system is working fine now, it doesn’t mean it will continue to do so down the road

• Setting aside time for preventivemaintenance is an insurance policyagainst future downtime

• Establishing periodic inspection& service can be based on timeand/or volume of activity

• Extending the life of system is paramountgiven cost of acquisition (capital investment,facility upgrades, etc.) & lower reimbursement

Preventive Maintenance, cont’d

• Recommended regular maintenance:

Image Quality Checks – indicates current operating condition of the detector electronics. Used as a benchmark for determining the need for adjustmentsor recalibrations.

Greasing/Lubrication – extends the lifeof critical mechanical parts. The removal of old grease & applying new grease is simple & cost-effective insurance.

Fans Replacement – ensures proper cooling of the system. Overheating is the most common cause of component failure.

Preventive Maintenance, cont’d

• Simple steps to ensure patient safety & reduce liability:

Patient Tables – inspect critical stress points for cracksand fractures that could lead to a patient catastrophe.

Safety mechanisms – collision sensors & e-stops should be tested periodically to ensure proper operation and safety.

Daily / Weekly Quality Checks – DIY

“How can you ensure your system runs smoothly throughout a patient-filled day?”

Establish a Daily / Weekly Quality Routine!

• Use Cobalt sheet source for extrinsic daily floods

• Verify the Cobalt energy peak

• Performing a daily flood imaging

• Checking QC numbers

• Verifying that QC numbers arewithin specification & haven’t varied from the past day’s reading

Your service provider should customize a plan that makessense for your system & budget.

• Full Service Maintenance: complete coverage of system& peripherals.

• Co-Op First Pass: on-site equipment coverage split between customer’s in-house engineers & our field service engineers.

• Preventive Maintenance Only: covers preventive maintenance required to maintain highest quality system operation.

Service Contracts

• Capped Camera Coverage: predetermined capped service hours, parts, and technical support basedon equipment type & pricing schedule.

• Time & Materials Preferred: multi-system billable service discounts for labor hours, parts, and travel.

Service Contracts, cont’d

Support “End of Life” Notification

“Have you received an ‘end-of-life’ or ‘end-of-service’ notification from the system OEM?”

Start Planning for the Mid- and Long-Term

• Find out what their obligations are under current contract

• Search for independent service organizations with expertise on your make/model system

• Look for parts inventory, especially known faulty parts

• Keep new staff trained with certified classes taught by experts that can provide hands-on experience

• You’ll save money in the long run!

Hard Drive Failure Concerns

• In the event of a hard drive crash, your system could be downfor days or weeks!

• Back-up your patient data, using an external archive solution

• Follow HIPAA & HITECH guidelines for patient data storage

• Catastrophic hard drive failure issues can be mitigated using a special system archive solution calledCritical Product Recovery (CPR)

Critical Product Recovery (CPR)

• Software application that backs-up camera/system specific data

• Reduces downtime = more revenue

• Provides restoration of system quickly, instead of days

• Information saved includes: Acquisition protocols

DICOM configuration

Network roles & bindings, IP addresses

Processing applications & protocols

Display defaults & normalization files

Gantry & detector corrections / calibrations

Specialized OEM software (ex. AutoSpect+, AutoQuant)

Conclusion

Purchasing a SPECT system is the most important investment your department will make.

To maximize the life of your investment, a program must include: proper planning, regular maintenance,

and a trustworthy service partner is essential.

Question & Answer

Thank You!

Craig DienerSenior Product Manager

Universal Medical Resources, Inc.cdiener@uni-med.com

+1 636-239-3510, ext. 139