By the time you receive this, it will be autumn in Solon, Ohio. It is by far our best season here in the Midwest, with the temperature moderating and the leaves changing color.
Yes, we get all four seasons here at the training center, sometimes we get two or three of them in the same day, and we have had many weeks with all four seasons combined. Where else can you get snow on opening day and at the October playoffs in baseball? Where else can you get sleet, driving rain, then snow and then hail, all in the same day…We are a meteorologist’s worst nightmare.
In autumn of 2011 RSTI is making another bold move in the diagnostic imaging training business based on some startling statistics about our industry. Did you know that the Labor Department of the US Government recently published their traditional growth predictions for all industries?
Believe it or not, over the next 10 years they anticipate that the category of biomedical/clinical engineers will be the fastest growing segment of the employed population. Twelve thousand, that’s right.
There will be 12,000 more people entering our field in the next decade.
That’s a 72% growth factor being predicted, despite all the pressure being applied by the Healthcare Affordability Act or better known as Obama Care.
At RSTI we have felt a surge in people attending our PHASE training. New recruits are showing up in record numbers from Hospitals and major OEM’s on a regular basis. Based on this and the trend in our underlying course enrollment, we have gone out and updated our labs and curriculum again. Please read the details in the articles provided in this Newsletter. By the end of 2011, you will see an amazing list of new DR digital classes such as the following:
1. Servicing and Maintenance of the GE definium 6000 dR RAd Room
2. Servicing and Maintenance of the GE innova 2000 cardiac cath lab
3. Servicing and Maintenance of the GE definium 5000 dR RAd Room
4. Servicing and Maintenance of the GE Revolution/Falcon dR RAd Room
These additions are being made, because the students not only have requested it, but their facilities are demanding more and more current equipment, even for PHASE 1. That’s why we have added some DR and CR experience in all of the PHASE classes. Prices will continue to fluctuate based on the costs we incur by providing you with hands-on experience with all of this equipment. Our goal is to have all of the equipment installed here at the training center, so that you will be able to rip it apart, troubleshoot, repair, and PM until you get it!
Imaging technology continues to change rapidly. RSTI will give you the best learning environment available today. If you are sending your people elsewhere, it’s time to wake up and book early.
RSTI is now capable of training your service engineers on any version of the XR/d system installed at your facility. In an unprecedented move to widen the gap between OEM and RSTI training, RSTI has installed a second GE XR/d at our training center. This is an important step forward in our training offering.
This second system we are installing is the 2x platform. It utilizes the Jedi generator where the 1x platform used the SCPU from the Advantx. So what that means to you is two generators in one class! In addition, the 2x platform uses the HP computer with two flat panel monitors. The older 1x utilized the Sun Ultra 10. Again, both software systems will be learned.
The main differences are the generator and the computer. Hands on with both systems includes but is not limited to the following:
System identification
power systems
Block diagrams
Software reloads
complete calibration
common troubleshooting
unix and networking as applicable to the xR/d
Pricing for this class will not change. So you will actually benefit in a couple of ways, information and price. They will be in adjoining bays for your convenience. Don’t miss this exciting opportunity to receive training on two systems in one class.
Give Anna a call at 440.349.4700 or go online at www.rsti-training.com and register now.
Automated Digital Radiology (ADR)By LARRy CORNeLL, meRIDIAN [ARTICLe 1 Of 4-PART seRIes]
An Insider’s IntroductionWhen I was asked to write a series of articles on Digital Radiography (DR) for the RSTI Newsletter I jumped at the chance. After all it’s now been ten years since I left my teaching position at RSTI and I appreciated the opportunity to once again talk about imaging and have the opportunity to pass along some information to my old students as well as the imaging professionals I have yet to meet.
For the past forty years I have been teaching, fixing, or upgrading imaging systems in one way or another. I’ve seen many strange new products enter the diagnostic imaging market. This included CT, MRI, Diagnostic Ultrasound, PET CT and PACS to name a few. But as important as each of these modalities are, none can compare with the impact Digital Radiology (DR) will have on hospital imaging departments in the near future. Although DR has been around for more than ten years, it is only now that the technology and cost of flat panel detectors have put DR in the mainstream. It seems strange that radiographic equipment is the last imaging modality to go fully digital, especially since radiographic exams represent about sixty percent of the studies performed in imaging departments today. But finally, say good bye to CR and hello to dynamic new workflow, lower patient dose and better image quality.
Now the big question is: should you upgrade existing analog radiographic systems or replace them with new DR technology? The answer is probably do both. The purpose of this and future articles is to give you the knowledge to make the right choices as you begin or
continue on this DR journey. There will four articles in this series. They will be as follows: What is Automated DR? How to upgrade to Automated DR; DR Servicing and Image Performance; Remote Monitoring and Diagnostic Service of DR Systems.
WhAT iS AuTOmATED DR?Automated Digital Radiography (ADR) is a software/
firmware package that is integrated into a new Digital Radiography (DR) System or DR System Upgrade in which all or most systems functions are fully automated. This includes generator parameters, collimator size, anatomical program, study enhancement, positioner location, RIS and PACS commands, flat panel control, and a host of other parameters. With automated DR the technologist basically positions the patient and shoots. Everything else is controlled by the system.
When the study series is identified by the RIS, the APR for that study is selected and the generator parameters are set up. This includes kV, mA, mAs, phototiming, focal spot size, field selection, patient size, and a host of other generator parameters. The equipment automatically is positioned toward the correct bucky, the proper SID, the correct tube rotation and other distances. The workstation parameters are set to include enhancement algorithms, series display, window/level, electronic shutters and a host of other functions. The collimator is automatically collimated for the selected anatomical area. The flat panel detector is prepared for exposure leaving the technologist with little to prepare. Once the first exposure in the series is taken, the system automatically prepares all parameters for the next exposure. After the series is complete, it is automatically sent to PACS for further distribution. The graph below shows the average time taken to complete an exam for the different systems.
AvERAgE LENgTh Of PROCEDuRE TimE
Process Time film (seconds) CR (seconds) DR Cassette (seconds) Automated DR (seconds)
Preparation 60 45 45 30
exam (2 views) 58 64 64 25
Image Processing 195 195 34 22
Image Review QC 30 30 30 30
Repeat films 22 0 0 0
Post exams 60 90 60 60
Total exam Cycle Time 425 424 233 169
Total Exam Cycle Time (Min.) 7.1 7.1 3.9 2.8
WWW.RSTI-TRAINING.COM | 5
uPgRADiNg ExiSTiNg SySTEmSIt is possible to upgrade many analog systems to
some level of Automated DR. For the most part, the upgrade will be able to control everything except positioner location. This is generally called a Smart Upgrade. There are many companies selling non-automated DR upgrades. In this case the only communication with the generator is the exposure and prep signals. These are non- intelligent upgrades that seriously impede streamlined workflow.
Although you receive some of the advantages of digital flat panel, you will not improve on your workflow, you will not have automated generator control parameters, and you will be missing important information that is needed to adequately populate the DICOM header.
On all new DR systems, you must insist on fully automated solutions. This includes auto-positioning, auto generator parameters, worklist control of APR’s, automated acquisition parameters to include electronic shutter calibration, auto enhancement, and a host of other features.
Wireless detectors that fit in the bucky seem to make sense for a quick solution. If you are evaluating this upgrade, more than likely it will not have automatic control of the generator and you will still have to rotate the panel or remove it for various exams. Simply placing a wireless cassette into a bucky is not a good workflow decision and many problems can exist including: fitting the panel into the cassette holder in the bucky, wear and tear on the panel, damage to the panel, no automated control of generator, limited RIS interface, limited size (14x17 only). You will definitely need wireless for certain exams, but it comes with limitations.
WhAT TO CONSiDERThere are several factors that you should consider when looking to upgrade an existing analog room to DR.
Do you have a RIS and will you be selecting anatomical programs from the work list?
Make sure the collimator automatically sizes to the study for each APR selected.
Is the upgrade you are looking at capable of full Automated DR Integration?
Can you perform all exams on the system?
Consider the workstation and its capability.
What does it control? Generator, Collimator, Positioning Systems, APR’s.
Acquisition: How many panels can I hook up? What types? Wireless, tethered, fixed. What sizes, what performance, what cost?
Display/GUI Full featured Intuitive, Smart
Distribution, PACS, Web, CD, Archive
Warranty
Service Training
Support/Remote Diagnostics
CONCLuSiONThe purpose of DR is to improve workflow, reduce
patient stress, reduce dose rate, simplify processes, improve uptime, improve image quality, eliminate retakes, improve reliability and profitability: All at an affordable cost. It is very important that you insist on as many of these factors as you can. It will make your life much easier. The next article will be a little more detailed on Automated DR upgrades.
I hope this edition of the Focal Spot finds you in good health and spirits. As mentioned in our summer newsletter, I am the new Lab Instructor here at RSTI. With 8 years of electronics experience working on F/A 18 Hornets in the United States Marine Corps as well as teaching aviation electronics, I have a lot to offer both RSTI and our students as an instructor.
My first mission, as many of you may have seen, is reorganizing the labs to make them more student friendly. The labs have been worked over and are prepped and ready for the new wave of highly anticipated imaging equipment due in later this fall and into the spring. We look forward to being able to train you on some of the newest equipment out there today.
In addition to fine tuning the labs, I have also addressed some tool cart and test equipment issues. Tool accountability should be a major issue in your workplace and so it is important to us here as well. To provide you with the most complete, in depth training, we have established a few simple procedures to track
Focalspotters: The Lab ReportNew Gear is the Name of the GameRePORT By mATT mONDeLLO
tools before and after each class to ensure everyone has the equipment they need to promote higher education here at RSTI. Along these same lines, all the test equipment is being scheduled for calibration to ensure accuracy and functionality. New equipment has also been acquired to make more equipment available to our students during lab instruction.
In closing, a lot of time and effort has gone into making the lab environments better for the student’s learning experience. I am excited to be a part of RSTI and this ever evolving industry and look forward to working with each and every one of you in the labs!
“It is the supreme art of the teacher to awaken joy in creative
expression and knowledge. “ — Albert Einstein
Over 25 Digital laboratories in full session. Now that’s engaged and engineered for learning!
At RSTI, modern technology is the focus that pushes us to add new equipment to your training labs. The need for our students to master these new technologies fuels our drive to offer new training classes. The introduction of this new technology lends itself to new presentation and teaching methods. Major changes in the way these systems work require training that overlaps into topics that would traditionally be covered in other classes, for example, connectivity and working with operating systems like LINUX, UNIX and Windows.
An eye for the future is a great thing to have in today’s business environment, but, in the medical imaging service business it’s not always that simple. Recently, I had the pleasure of teaching Phase II (one of our basic X-Ray service classes) and I came to realize that while we are making great progress on our goal to modernize our labs there are still a significant number of people that have responsibility for many aging systems. Some, in fact older than nearly every
system we have at RSTI. It’s because of the needs of these students that we keep a couple systems around that have technologies similar to what they will have to work on.
Even with this disparity of technological need the quality of training must be the number one concern. As the old saying around here goes, “we only have three rules, #1 is Quality, and #2 is Quality and #3….refer to #1.”
As we go through our lives the quality of our work is a reflection of the quality of our education, experiences and our character. RSTI is glad to have been a part of the foundation of so many service professionals’ education and hope that we have helped all of our students to advance in their careers. Even as RSTI grows and moves towards the future we will always be mindful of our “three rules” and focused on your needs.
Cover’s ColumnMore Things Change... More They Stay the Same
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Training smarterThe Quest for ROIBy JOhN DRew
It seems appropriate as we move into fall, closer to October, and a new fiscal year for many, that we discuss factors that go into deciding where to allocate your training dollars. As these monies are harder to come by for most these days, how you spend them is more important than ever.
In the past couple months, RSTI has been making some major changes. These are consistent with our commitment to improve the overall experience and give a better value for the dollar spent. For example: when you attend Phase I –IV you expect to learn on equipment that will directly relate to your work environment. That includes:
Current analog, digital, CR, and Rad/Fluoro systems.
Test equipment that is modern and works when you need it.
Instructors that are friendly, knowledgeable, current and cool!
Recently, we held a meeting at RSTI to re-evaluate what makes a first class training experience. There are certain topics that always resurface when we have this discussion. Not in any specific order, they are: equipment, personnel and training environment. So it seems appropriate to address these here.
Many of these changes are taking place in the lab. So first, I will discuss equipment. After all, this is where most of time is spent performing hands-on tasks. A recent purchase of the following systems should be in place by mid-October. Some of these are new for RSTI and some are a second system.
GE thorax xR/d with the proteus generator: This is a second system so now we will train on both 1x and 2x systems in the same class. Better value for the training dollars spent.
definium 5000 & 6000: These are new additions to the RSTI training arsenal. Now your systems
can be taken off contract if you are in-house, or serviced better if you are an ISO. Either way you will be saving money.
innOVA 2000 & 2000 l/c: Another new addition to the training arsenal. Classes to start in late 2011.
GE Essential/2000d class combination: Both systems are now offered in the same two-week class. Significant dollars saved.
These represent just some of the changes taking place in our labs. There is much more to come in 2012 so stay tuned!
Second, personnel are crucial to the learning environment as well. The training center you use must have personnel that fulfill a couple of roles, specifically instructors with in-depth knowledge about a system and broad knowledge of many different topics in general. Often a discussion on imaging can cover everything from image quality to networking to optics. Just as important is the ability to transfer this knowledge to the student which sometimes means relating to things that have nothing to do with X-ray to get a point across.
having a full support staff that really does provide support is vital. It has been our experience that many things can arise when a student is at the training center. The ability to take care of these is critical to a successful class.
At RSTI we understand the only reason we are here is to help provide the best training experience for you.
If you are wondering how this actually contributes to the bottom line, here is what recently happened at RSTI with twenty-four students in a Phase I class. (Which by the way, has been filling up very fast so if you are interested give Anna a call). To address this we added two extra instructors to the lab portions of the class. The students attending received this very well. Because our instructors are qualified in many different modalities the quality of lab time was not compromised and was actually enhanced.
Third is the training environment where you spend your dollars. I highly recommend if you have not
visited the training center where you are sending your staff that you do so. In today’s age of the Internet and electronic media it is easy to look like a big dog when you are not.
there are many things a visit can provide that can not be had any other way. What is the personality of the training center? Yes, it is true when you walk into a business you get an immediate feel for it. Is it positive or negative? Is the staff friendly and inviting? Do they actually want you to come by and take a look? Is it clean? These are some of the questions that should be taken into consideration before deciding where to spend your training dollars. I could go on and on. Do they have the actual equipment and does it work? I think you get the point.
Where you have your engineers trained is one of the most important decisions you will make. I bring all this up because at RSTI we know that. We get it! It is all about you. We will ensure that your training dollars are well spent. Each and every one of them counts. Every single person that works at our training center understands this and works everyday to ensure it happens. come see us and experience it first hand.
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CLassiC is nOw isO 9001:2008 CeRtiFied!Classic Diagnostic Imaging has been awarded an ISO 9001:2008 Management System certificate for the design, manufacture, sales, distribution & repair of new and used components for ultrasound and imaging equipment.
ThE myTh The following changes to FDA regulated medical systems require FDA approval or void current FDA approval:
installing antivirus software
upgrading service packs
installing patches, updated, etc…
Many of you have heard someone say, at one time or another: “we can’t install that on our system because it’s against FDA regulations”.
ThE fACT: The FDA reminds the industry that the responsibility
to protect networked medical devices is the shared responsibility of the OEM as well as the healthcare facilities. The FDA has the responsibility to protect and promote public health through regulation of medical devices, among other products. The FDA regulations on this topic fall under “Cybersecurity”.
What is cybersecurity with regard to medical devices? The FDA defines cybersecurity vulnerabilities as those that “open the door to unwanted software changes that may have an effect on the safety and effectiveness of the medical device.”
Properly maintaining cybersecurity for medical devices is important for patient care because it ensures the integrity of the computer networks that support today’s medical devices. The FDA has admitted that cybersecurity regulations have been misinterpreted and wants to emphasize the following:
Medical device manufacturers and user facilities should work together to ensure that cybersecurity threats are addressed in a timely manner.
The agency typically does not need to review or approve medical device software changes made for cybersecurity reasons.
All software changes that address cybersecurity threats should be validated before installation to ensure they do not affect the safety and effectiveness of the medical devices.
Software patches and updates are essential to the continued safe and effective performance of medical devices. Typically, FDA approval is not required before installing changes, updates, or patches that address cybersecurity issues. Software patches usually do not involve FDA review because most patches are installed to reduce the risk of a cybersecurity problem and not to address a risk to health posed by the device.
The need to be alert and responsive to cybersecurity issues is part of the device manufacturer’s obligation. FDA recommends that purchasers and users of medical devices that may have a cybersecurity problem contact the device manufacturer with their concerns.
TAkE ACTiONThere are some simple ways to help to protect against cybersecurity threats like viruses and worms that affect medical devices:
Prior to installing any computerized equipment involving medical devices, make sure that the equipment is virus free.
Make sure that you have adequate anti-virus software and firewalls installed, properly set up and current.
Update your operating system and medical device software. Software updates offer the latest protection against harmful activities.
Validate all changes, updates, and patches, including operating systems, before installing them to ensure the safety and effectiveness of the medical devices.
Purchasers and users of medical devices that may have a cybersecurity problem should contact the device manufacturer with their concerns.
FdA (FOOd & dRuG AdMiniStRAtiOn). MEdicAl dEVicES. in REMindER
FROM FdA: cYBERSEcuRitY FOR nEtwORkEd MEdicAl dEVicES iS A ShAREd
RESpOnSiBilitY. REtRiEVEd AuG 31, 2011, FROM http://www.FdA.GOV/
Hey Gang! Here is the much anticipated procedure for restoring the cal data to your OEC 9600 SRAM! This can either be performed on an older WinXP laptop with a PCMCIA slot and a floppy drive, or any WinXP laptop in conjunction with an OMNIDRIVE and a floppy drive.
WhAT’S NEEDED:
WinXP computer with floppy and available PCMCIA slot or an OMNIDRIVE
OEC 9600 generator backup floppy for your C-Arm
SRAM card from your C-Arm
OEC 9600 boot disk
1) install pc drivers for SRAM card (unless using Omnidrive. if using an Omnidrive follow its included instructions and go to step two).
a. Insert card in PCMCIA slot
b. Go to device manager
c. Find generic pcmcia card with yellow (!)
d. Right click and select update driver
e. Select “no not at this time” then –click next
f. Select “install from a list or specific location(advanced)” then –click next
g. Select “don’t search” then –click next
h. Scroll down to “PCMIA misc memory devices”(not the adapter one) highlight the selection -click next
i. Select “generic PCMCIA ???” in the left box then select “generic PCMCIA memory device” in the right – click next
j. Close device manager
2) Restore SRAM from backup
a. Open my computer and find the drive letter for the newly installed SRAM
b. Insert floppy in drive
c. Open command prompt
d. Type “a:” then enter
e. Type “copy *.* (drive letter for SRAM):\ Click enter (i.e. copy *.* E:\)
f. If overwrite prompt occurs, click “a”,then enter
g. Verify no errors occurred
h. Exit command prompt
i. iMpORtAnt:“Safely remove” the sram device from the computer
j. Remove the SRAM and place into OEC 9600
k. Start OEC
l. When requested insert OEC 9600 boot disk into workstation floppy drive
m. Hit <esc>
n. Enjoy!
Dave’s Rave: OEC 9600 WinXP sRAMReloading from Backup Floppy
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Conversion. More than just a process, it’s a complete and cost-effective solution for delivering innovative digital upgrades to your entire portfolio of radiology systems. It is what you get when you combine powerful industry partnerships and a team with deep expertise in the field – all driven by a leading network of technologists and engineers.
RsTI EquipmentAt the end of a fiscal year money is always hard to come up with. When it comes to training dollars, especially, engineers are on the back burners of budget meetings. It’s easier than you thought to find your way to the training center.
Give us a call about your used equipment that is for sale. If you are disposing any equipment now or in the next few weeks, I can give you training credits towards a new class! It’s easy… fill out the short questionnaire below, and fax it back to one of us: Terry Speth, or Darrel Kile. We handle the purchasing of equipment, and we can give you a good idea of the value of the equipment over the phone. It’s that simple!
Cancellation PolicyTuition is only refundable if cancellation is received in writing by RSTI at least 14 calendar days prior to the course or seminar date. Allow 30 days for receipt of the refund. Registrants who cancel within 14 days of the course or seminar date will have the tuition transferred to another course or seminar on a space available basis. In the event that a course does not attain our minimum enrollment, RSTI may postpone it. Paid tuition will remain on account to be applied to the rescheduled class.Payment Due PolicyPayment for all courses and/or seminars is due three full weeks in advance of the course start date. Purchase orders are accepted, but also must be paid one week prior to the course start date. We also accept VISA, Mas-terCard, American Express, and Discover as a method of payment. All past due invoices will be assessed a late fee of 1.5% per month on any unpaid balances.ScheduleTypically, courses run from 8:30 am-4:30 pm Monday through Friday. You will receive a detailed schedule when we confirm your registration. You should schedule your incoming flight to arrive Sunday afternoon or evening. On the last Friday, class ends at 12:00 noon. You may schedule your return flight any time in the mid- to late-afternoon.Full Coverage PackageYou are responsible for expenses you incur while attending courses. How-ever, RSTI has negotiated a reduced package rate that includes 12 nights hotel accommodations, transportation between the hotel and training cen-ter, breakfast, and lunch. We will notify you of this rate when you enroll; if you wish, we can add the full coverage package cost to your tuition.Course MaterialsIn addition to specially designed manuals and daily course handouts, you will also receive where appropriate:• Document package of the lecture • Flow diagrams• Troubleshooting charts • Performance evaluation forms• Certificate of Completion• Class Photograph Due to copyright issues, some courses require that students bring their own manuals. These may include, but are not limited to, Operators Manual, Service Manual and Schematics. We will advise you of this when you enroll.
Make checks payable to: * Radiological Service Training Institute (RSTI)* Tuition and Full Coverage Package rates are subject to change. * Please confirm rates with our Registrar when you enroll.
REGISTRATION FORM
How to registerPhone 440.349.4700 • Fax 440.349.2053 • www.rsti-training.com/register.htm
Mail completed form to: RSTI 30745 Solon Rd. Solon, Ohio. 44139
Mastering these topics will enable you to succeed on the final CRES Certification Exam. With RSTI’s self-study CRES package you can learn anytime, anywhere, at your convenience and on your schedule.
The modules contain both practice exams with answers and exams which can be returned to RSTI for grading. We are offering a 20% discount off of the list price of $398. The sale price is $318.40.
CREs Certification
RSTI has made it easy for you to become CRES certified. Our CRES self-study package is a powerful tool to help you focus on specific certification objectives. There are nine different criterion-referenced modules that give a comprehensive review of subjects covered on the exam.
thE ninE MOdulES ARE EntitlEd:
• Anatomy and physiology• Radiographic physics• Electricity and Electronics• Radiographic Equipment Applications• Fluoroscopic imaging• Radiographic circuit Operation• Regulations and laws• technical problem Solving• cRES Exam Review
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