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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 in nuclear medicine, including 19 with Philips Healthcare and 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 / practices due 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 Environmental Concerns • 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 – Proper Shielding • Sources from other nuclear imaging systems can affect image quality • Consider shielding of: Injection locations Other Nuclear Medicine rooms Patient waiting areas • Hot lab placement / material control can affect image tuning & quality • Proximity to MRI, X-Ray, & CT units can also impact tuning & cause image artifacts OEM shielding characteristics and regulatory requirements should be factored into facility layout Environmental Concerns – Power Quality Uninterruptible Power Supply (UPS) • More than 3,600 outages in 2014, affecting 14M people* California, 525 New York, 399 Texas, 335 Michigan, 328 Pennsylvania, 294 Ohio, 265 Illinois, 251 Washington, 226 North Carolina, 225 New Jersey, 225 • Power surges, brownouts, unstable power, and noise are extremely harmful without proper protection • Hard shutdowns can corrupt software files & stress or permanently damage electronics / electrical components *Eaton Blackout Tracker, United States Annual Report, 2014 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 years based 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 preventive maintenance is an insurance policy against future downtime • Establishing periodic inspection & service can be based on time and/or volume of activity • Extending the life of system is paramount given 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 adjustments or recalibrations. Greasing/Lubrication – extends the life of 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 cracks and 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 are within specification & haven’t varied from the past day’s reading Service Contracts Your service provider should customize a plan that makes sense 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, cont’d • Capped Camera Coverage: predetermined capped service hours, parts, and technical support based on equipment type & pricing schedule. • Time & Materials Preferred: multi-system billable service discounts for labor hours, parts, and travel. 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 down for 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 called Critical 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 Diener Senior Product Manager Universal Medical Resources, Inc. [email protected] +1 636-239-3510, ext. 139