Keri Stephens (00:10)
Hi, welcome to the HTM 24×7 podcast. I’m your host, Keri Stephens. For this episode, I’m joined by someone I’ve wanted to talk to for years, Maggie Berkey, a senior BMET at Bioelectronics and a certified biomedical equipment technician or CBET. Maggie, thanks for joining me today.

Maggie Berkey (00:29)
Thank you for having me, Keri.

Keri Stephens (00:31)
Of course. So just to start, can you tell a listener a little bit about yourself and your background?

Maggie Berkey (00:39)
Well, I’ve been in the field about 15 years now. I’ve held various roles and just kind of

been in awe of how neat this profession is and surprised by the fact that people still just don’t even know it exists.

Keri Stephens (00:59)
Definitely, definitely. Well, I would say that you’re someone that’s really trying to make sure that people do know that it exists and you helped create the BMET apprenticeship. And I really want to delve into that because I think that’s so interesting. So how has the BMET apprenticeship evolved since its national registration?

Maggie Berkey (01:22)
Well, I would say that before we even got it fully approved through the Department of Labor, we vetted it by over 100 people in various roles in the HTM profession to make sure we got it right. And it’s been adopted, I would say, hand over fist in the field. There are several large ISOs that are

currently using the apprenticeship approach. There’s been a lot of modified versions that people kind of built to fit their organizational needs which is a really cool piece of that apprenticeship that those competencies are available for anybody anytime on the AAMI website so take what you like add to it what you need take

and remove whatever doesn’t apply to your organization. And I want to make sure our listeners know that there are still several interest candidates that are on an AAMI waiting list just looking to get started in our profession.

Keri Stephens (02:35)
No, great. Can you tell people just for those who don’t know kind of how the apprenticeship program works?

Maggie Berkey (02:41)
Absolutely. the first step is really reaching out to AAMI, more namely Danielle McGeary and she will kind of vet your organization to make sure that you have the means and should be in this realm. And so you find a candidate in your area that works and

you hire them at your organization and then you work closely with AAMI they can help you identify some funding availability some grants and other monies that are there especially for our VA folks or our vets sorry and just kind of go through that program there’s a level system so after you’ve gotten to a certain

competence level, then you’re going to get a raise, at least one raise throughout the apprenticeship. And by the time you’re done with your training and have checked off all your competencies, you’re going to be a really strong BMET one.

Keri Stephens (03:55)
know that it’s an amazing program and some what I’ve really, you know, at 24 seven tried to highlight because I think it’s so important, especially, obviously, you know, we know from the salary survey, how important it is to get more fresh blood in the field as people retire. So I think it’s an incredible way to just attract attention and, you know, to retain some good talent too, because they’re apprentices. so the reason I wanted to have you on is I worked with you, gosh, it’ll be a

year and a half ago, probably, because it was AAMI 2023. But you hosted a Fuel to Thrive session at AAMI. And I was lucky enough to partake in it. And I thought it was a great session. And I mean I kind of want to just go back to that. And what were some of most innovative ideas discussed for preparing for the future of HTM? And can you just talk about this session as a whole?

Maggie Berkey (04:51)
Absolutely. And I will correct you and say that was actually in 2022. So time does fly, just like they say. And actually, after we did the AAMI session, there were two more sessions, one in Nebraska at my local biomed association, the HBA, and then we did one out in California at the

Keri Stephens (05:01)
wow, you’re right. Yeah. 2022. Wow. You’re right.

Maggie Berkey (05:21)
Tech Nation event. And we took all the data from those three sessions and compiled them, collated them, and really had some interesting key takeaways that really focused on the candidate shortage that we’ve been experiencing for a while now, lack of standardization,

cross functionality with other departments in the hospital, what corporate responsibility, and then just some miscellaneous that didn’t really fit in any of those boxes. And some things that we really heard loud and clear was that we need a media campaign to just make people aware of the BMET profession.

you know, a 22nd commercial of some sort, you know, get us trending on TikTok or something to really just kind of blast us out there and get that visibility we’ve been looking for. Looking at hybrid roles and how, you know, today we look more like IT than we did 20 years ago. We looked a lot more like maintenance. And now we even

teeter into some materials management things. we also looked at community involvement and how just being in the community, doing speaking engagements, showing people, kind of showing off our work, how we get to almost play day to day. Things like that will help us be able to

really put that re-engineer HTM.

Keri Stephens (07:25)
So part of that too is attracting people to young age. And so what strategies do you suggest for attracting middle school students, military professionals, and career transition transitioners to fill the HTM employment gap?

Maggie Berkey (07:41)
Well, I would say the one thing I do on a very regular basis is use my voice, my passionate voice. And I think if each of us was just to ask a friend that’s not in the field to talk to somebody that they know that doesn’t know about biomed, when we get out in the community and just wear our swag from these events, you know, my bright green AAMI hat, my USOC t-shirt.

makes people ask questions and get some curious, get some thinking. We can make an impression, a big impression if we go to career fairs and our kids’ middle school and grade school and give a presentation, loop each team in a box in the background, make sure that when we’re talking to audiences, even if they’re not the interested participants,

ask them if they know somebody who likes to tinker, who’s a problem solver, who thrives on adventure and has good customer service skills, can they send them our way?

Keri Stephens (08:47)
Thank

No, I think those are all great. And I think it’s wonderful what AAMI’s doing to increase the visibility of the field for people, because that’s something I hear all the time, especially in my role as an editor. Like, what is this industry? I’ve never heard of it. And I think the visibility problem seems to be one of the main ones. So this is amazing.

Maggie Berkey (09:07)
Thank

We are the best kept secret, that is for sure.

Keri Stephens (09:16)
I agree, I definitely agree. okay, so kind of switching gears, about the best kept secret, what are some best practices you recommend for HTM professionals when communicating with the C-suite executives to gain support and resources?

Maggie Berkey (09:35)
Well, if you don’t already have your elevator speech put together, make sure you’ve got something where you can kind of talk to and if you should be, if you aren’t tracking the money that you not only save, but you avoid spending because you’re able to kind of bridge some of those costs and they just need to be aware of the value that you and your team add. We do cradle.

to grave equipment management in HTM. It’s not just PMs, it’s repairs, it’s projects. We sit in on meetings like capital and environment of care. We remediate recalls. We can do contract management. So they just need to be aware of and know that we’re in the trenches every day to make them look better. We’re focused on safety. We’re focused on quality.

that adds value to the organization.

Keri Stephens (10:37)
No, I completely agree. everyone’s trying to do more with less right now. And how can HTM professionals, departments make better use of limited resources? As discussed in one of the sessions at HTM Fuel to Thrive, one of the sessions on technician efficiency. So again, how can HTM professionals and departments make better use of limited resources?

Maggie Berkey (11:02)
That’s a great question. I would say we’ve got to be a little more strategic. So I think rounds with our customers is invaluable. It just builds that rapport and makes us so when they do accidentally drop something or if they are having an issue, they’re going to call us right away versus putting it in the cabinet and then we have to deal with it on a more reactive basis.

So some things that I’ve personally done is when it’s infusion pump month, I set up my shop on the floor so I’m not spending time running back and forth, back and forth. If that’s not something you can do, another option is to grab your pumps, walk them, you know, as you’re doing your rounds, drop them off, pick up the other pumps and bring them back to the shop.

So at least your time is being spent more wisely. Really, the AEM has been something that we’ve been talking about for over 10 years, but we’re still very much in the infancy of building strong AEM programs. In a lot of cases, that low-hanging fruit, we’re still touching thermometers and otoscopes and…

know, clinic tables when it doesn’t necessarily make sense. It’s not adding value. We also can be looking at some of those gray areas and deciding is that something that should be negotiated for our IT partners or maintenance friends to maybe take on that work.

Keri Stephens (12:40)
Yeah.

Well, I think it was interesting what you just said about the AEM So to you, how important is it for H-Team professionals to shift from a reactive service management to a more proactive approach? And how can this transition be made, in your opinion?

Maggie Berkey (13:12)
It’s critical. I think anybody who’s been in the field in the last five years know we’re trying to do so much more with so much less. We’ve got this retirement exodus. We’ve got the ongoing issue with name recognition. We have to be proactive, period. We can start today. We need to start partnering up with

our frontline clinical staff and do some of the education for anything that appears in the user manual that tells you that the users are expected to and capable of doing that work. I was reading an article about some Six Sigma, Mark Cuxley talked about, you know, the PM on a VersaCare bed.

It’s the function checks that are being done in the PM are being done by frontline staff every single day. So an otoscope basically you function check it every single time you use it and if you can just educate your staff to be looking for you know some kind of damage to the case then you’ve checked that box too. Don’t do that work anymore if somebody else is already doing it. Have your

partners in security maybe do your AED checks. They’re walking around the facility anyway and they can look for a green check mark just like you can. I’ve seen places use, you know, different staff to go around and bring the broken equipment back to the shop. My CMMS ticketing system allows me to kind of know what I’m going into.

So I can either email the person who created the ticket to say, materials can get you a replacement probe, or I can bring my power cord and my safety analyzer with me when I’m going to take that first look. Things like that are just huge. if you’re sketching out a 10-year capital plan, making sure that materials has the proper accessories

on their shelf and that there’s some backups for the weekend, then you’re going to save a ton of time and money on on call.

Keri Stephens (15:45)
Yeah. No, that’s great. As a final question, because you’ve been so, you just have so much knowledge of this. What scares you most about the field right now? What excites you most as, know, we’re kind of wrapping up 2024 looking ahead. What are your thoughts? Okay.

Maggie Berkey (16:02)
one answer. A, I would say it does both for me. I can definitely see some of the huge wins we can get day one. I also can see some of the scenarios that, you know, if we’re not ahead of it, and if we’re not, we don’t have a plan to manage it, we might get out of hand a little

Keri Stephens (16:06)
Right. OK.

Yeah.

Yeah.

Maggie Berkey (16:31)
faster than I would think we should. So I would say we’ve got all this technology and it can really be helpful. We’ve got to be working on value added activities and stop doing what I call stupid work. That doesn’t really help anybody. It’s just checking a box because that’s a box that we’ve always been expected to check.

Keri Stephens (17:01)
No, that’s really good. I have the same concern, so I see that. Well, thank you so much, Maggie. I know our listeners will be really excited to hear what you have to say. And to our listeners, thank you as always for your listenership. And be sure to check out www.24x7mag.com for the latest industry insights and news. Take care. Thank you.

Maggie Berkey (17:25)
Thank you. You take care.

Keri Stephens
hi, welcome to the HTM 24×7 podcast. I’m your host, Keri Stephens. For this episode, I’m joined by someone I’ve wanted to talk to for years, AAMI’s president and CEO Pamela Arora, who took over in 2022. Pamela, thank you for joining me today.

Pamela Arora 
Thank you, Keri I really appreciate the opportunity to visit with you and your listeners. And I am honored to be here. We love 24×7

Keri Stephens
Well, we love AAMI And again, you are someone that I really wanted to talk to for a while. And, you know, just to dive in, let’s talk about your role. So you have been in your role for about two and a half years. So what has been your primary focus since taking over as AAMI’s President and CEO in 2022?

Pamela Arora 
Good question. Since stepping into this role, my primary focus has been ensuring that AAMI continues, and I use that word really with respect, continues to serve as a critical leader in advancing health technology. AAMI has been around for over 55 years, so we don’t want to break what has been just a great recipe over the years.

AAMI is uniquely positioned as a neutral convener of all the major stakeholder groups involved with medical devices and sterilization. That includes manufacturers, sterilization services, regulators, and healthcare delivery organizations. AAMI’s work related to HTM is driven by our Vice President of HTM, Danielle McGeary who is heavily involved with our strategic initiatives that support the HTM community.

and promotes the safety, innovation solutions, and evolving needs of the industry. I know that Danielle has been on your podcast several times, and we just love your 24×7.

Keri Stephens 
Well, and we love AAMI and Danielle. mean, she’s amazing. I respect her so much and you too. And no, we love AAMI here.

Pamela Arora
Yeah, I do want to clarify some things though, because in the HTM community in particular, they’re not as familiar with what is AAMI’s core, which is being a standards development organization. And that really actually puts us in a great position to advance the HTM profession by leveraging these standards processes. In my role, what I’ve been doing is putting an emphasis on these processes relative to HTM.

And standards are consensus -based. Some of the, I would say some of AAMI stakeholders are really versed and that’s why they come to AAMI. In the case of HTM, it varies quite a bit, but our standards are consensus -based and followed a structured development process using ANSI, the American National Standards Institute. Now there are also international standard processes, but in the HTM space, we’re primarily using the ANSI processes.

And that works in collaboration, not only within the HTM community, which is like BMETs clinical engineers, healthcare providers, but it’s broader than that. It’s third -party servicers, manufacturers, regulators, really, really partner well with the FDA Joint Commission. This actually ensures that AAMI standards are comprehensive, relevant, and reflect the latest technology and clinical advancements.

This structured approach is rigorous. It includes public commenting, revisions, balloting. And because of all of that aspect, it creates a well -rounded and widely accepted standard. And for the most part, we’ve been driving that process within the HTM community by enhancing the quality, safety, education, and innovation. But that one I want to call out because I think the HTM professionals

They know a lot about our education and our certifications, but these standards actually help them manage the complexities of modern healthcare technology, so we really want them to be aware of it.

Keri Stephens 
No, I’m glad you’re mentioning the standards because there’s one that I really want to talk about in this podcast. So EQ103, which is a standard on alternative equipment management. Can you talk about that and what inspired its development and what are its key features?

Pamela Arora
Yeah, great question. And I’m glad you asked because it’s so relevant to our HTM professionals and clinical engineers. EQ 103, it’s a forthcoming standard about alternative equipment. And I would say the HTM folks really know AEMs well. And really working through that, the development of EQ 103 was inspired by the need to create a more flexible

and practical element for managing equipment and healthcare studies, but do it in a standardized manner. So the Centers of Medicare and Medicaid Services, CMS, they permit HTM professionals to use their expertise and equip history data to develop maintenance strategies that may differ from the OEM’s recommendations. Now, our HTM group knows that quite well.

The thing about it is CMS has not been specific on how to safely and effectively deploy this flexibility, and that is crucial in certain situations. At the same time, you have the OEM maintenance procedures, and they may not consider all the possible uses, environmental conditions, or availability of alternative diagnostic or monitoring tools.

AAMI and our stakeholders aim to outline effective implementation approaches that provide flexibility while ensuring safe and effective choices. AEM programs that comply with EQ 103, it will help with the performance and safety of the equipment and make sure that they’re not compromised. And as all of us are patients and our loved ones are patients, we want to make sure that the devices are working appropriately.

from the standpoint of healthcare organizations, if they include the AEM program with EQ 103, it’ll provide that framework for assessing equipment eligibility, emphasizing adaptability, risk -based assessments, and thorough documentation. So there’s been a lot of work that has gone into this standard, but it impacts the front lines within the health delivery organizations.

on a day -to -day basis. So we’re very excited about it.

Keri Stephens
And I think one thing that’s notable is that EQ 103 has been developed and published in less than a year. Can you talk about the speed of that? Because that’s pretty impressive.

Pamela Arora
It is impressive, but I want to emphasize that standards can take years in the making because you’re bringing in all these voices to make sure that the right standard is being created. The rapid development of EQ 103 is notable because basically it’s showing the commitment of AAMI and our stakeholders and their ability to respond to these emerging needs in healthcare. This accelerated timeline, it was made possible through close

collaboration with industry experts, regulatory bodies, all of whom recognize the urgency of establishing this new standard, partly because there’s so much complexity out there with MED devices. So for the AEMs, this is a highly efficient, yet rigorous standard that was comprehensive and practical for immediate implementation. I credit our great stakeholders for the energy that they put

forth to make this happen. don’t, for those that aren’t heavily involved in standards, they may not realize sometimes it could take five years for a standard to come together. And for this to come together in about a year is really, really a testament to the stakeholders in the community.

Keri Stephens 
Right. No, absolutely. And I just have one more question because I know our listeners in healthcare technology management are going to be very interested in this, but how do you see EQ 103 standard influencing current practices and alternative management of existing equipment?

Pamela Arora
No, it’s a great question. And I will say that with the processes, we had comments throughout. And the public comments, there was just a groundswell. Because when you’re affecting day -to -day operations that way, you can expect there’s opinions, right? Well, it is going to significantly influence current practices. And part of it’s because it provides a structured framework that healthcare organizations can adopt to enhance their existing projects.

processes. It’s not like get rid of everything you’re doing. It’s take a look at what you’re doing and here’s how it can be improved to reduce risk. So this risk -based approach allows for more targeted maintenance strategies and this actually improves safety and reduces downtime and better resource allocation. The standard also as it’s promoted across organization

it’s gonna help to bridge the gaps in practices and ensure that all equipment receives appropriate attention. Over time, EQ 103 will become a cornerstone of alternative equipment management, and we believe setting a new benchmark for best practices in the field. And again, we’re all patients, we have loved ones that are patients. I believe that the patients will see the outcomes of this.

Keri Stephens 
No, that’s wonderful. And so I want to switch gears completely now. I want to hear about AAMI’s involvement in the Women in Leadership Project and its significance for the HTM field. I know because we do our salary survey every year, we know that this industry is predominantly male dominated. But to me, as a woman in this industry too, you know, in some capacity, I think it’s amazing. know, having you as a female president of AAMI, having Danielle, I think it’s…

It’s a really big message to the industry, but I want to hear about this project in particular.

Pamela Arora 
Absolutely. And I love this community. is just AAMI’s involvement in the Women in Leadership or WIL that’s their short name, community is a testament to the commitment around diversity, equity, and inclusion within HTM. And AAMI is incredibly grateful to Women in Leadership President and Founder AAMI April Lebo Have you talked with April Lebo as of yet on 24×7?

Keri Stephens
No, but I would love to.

Pamela Arora 
Yeah, I think that would be brilliant. Also, Kim Rowland, Amber Sportsman, Adriana England, and AAMI’s own Danielle McGeary were big leaders in making this all happen. But the president and founder is April Lebo. The community is designed to support and amplify women’s voices within HTM and help address this gender gap that you just brought up, Keri.

By providing mentorship, resources, and network opportunities, it empowers women in HTM and ensures their contributions are recognized and they have the tools to advance their careers. But I have a stat for you that just was eye -opening to me. In 2021, AAMI conducted an HTM demographic survey and found that less than 10 % of the field was female.

Keri Stephens 
that’s on par with ours too, yeah.

Pamela Arora
Yeah, 10%. And when you look at just how many people are moving out of HTM as they conclude their careers, we can’t afford to not have women. We need to really get that number up and encourage that. AAMI is committed to ensuring women in the HTM field have successful career trajectories through connection with Will.

This community is going to be crucial for creating a more inclusive and innovative HTM field. Ultimately, we hope to, this will lead to better health technology management outcomes. I strongly believe that we really need to have new entrants into the field. And AAMI is so honored to support this community. We love them.

Keri Stephens
I think it’s wonderful. Okay, so what are some other upcoming initiatives or projects that AAMI that you’re really excited about?

Pamela Arora
Well, I have a long list, but I’m going to try to run through it quickly. I’m excited about a number of initiatives at AAMI One is the expansion of our digital health and cybersecurity programs. Obviously increasingly critical as healthcare embraces technology at an accelerated pace. Everybody knows it and there’s so many opportunities that come with it. So we need to go there. We can’t slow down that pace.

We’re also working on new standards and guidelines for emerging technologies such as AI and machine learning and medical devices. We want to make sure that when it’s applied, AI and ML, they are implemented safely and effectively. Additionally, I want to call out AAMI’s Vice President of HTM, Danielle McGeary. She’s been an integral part in enhancing our education and certification programs.

that support HTM professionals at all stages of their career. Now I have a bit of a list here too. These courses and certifications, they provide HTM professionals with the skills and knowledge needed to navigate the changing landscape of health technology. And they include AAMI’s BMET Apprentice Program. That’s starting to get more and more momentum where these apprentices are being taken into the field, which we need that given.

some of the folks that are concluding their careers and we need those resources. Two, we’ve launched a new CEO online journal. Now with that, active certified individuals can more easily submit their CEUs for recertification. And while it doesn’t sound that exciting, if you’re trying to submit it and it’s fussy and it’s difficult,

This is one our stakeholders are going to enjoy because they really do focus on certification, which is great and important for the industry. Third, AAMI’s training and expert insight courses. Also a key one. And then fourth, upcoming offerings such as our CBET study course and our HTM live on September 17th on cybersecurity adoption, really important.

But there’s an overarching fundamental initiative that I’d like to share. It’s AAMI is ensuring the HTM community understands AAMI’s role in health technology space. Our role as a standards development organization, it actually affects what we can and cannot do. We’ve seen some confusion in the course of the time that I’ve been here at AAMI. And in order to develop consensus based standards,

AAMI needs participation from all stakeholders involved in the medical device life cycle. That includes OEMs, HTM professionals, third party services, regulatory agencies, clinicians, healthcare employees. The list keeps getting long. Because of this, AAMI cannot advocate for law or legislation. That’s the part that gets confusing because we’ve had some of our stakeholders,

really upset because we’re not advocating for one position versus another. And that’s really our strength, but also what we offer to the community because that actually helps these great standards come forth. Our neutrality, neutrality allows us to maintain credibility and effectiveness as an SDO, a standards development organization, making sure all voices are heard. But ultimately that actually does

help with safety and efficacy rather than political or even commercial interests. So we’ve been spending a lot of energy to make sure that that’s clarified, especially with our HTM audiences, because in some cases, they’d like us to advocate in a particular direction. And it’s not uncommon in associations where they have a public policy group, right? In our case, our neutrality is our strength.

Keri Stephens
No, that’s really helpful because especially I know the right to repair is so contentious. I’ve noticed that AAMI has taken the neutral stance, which honestly, as a journalist, I’ve had to do the same thing. So I can respect that completely. okay, so for my last question, and I think you’ve covered this a lot, are there any, like, what are the biggest challenges and opportunities currently facing the HTM field and how is AAMI addressing them? If you haven’t already covered that.

Pamela Arora
Yes it is.

Really, HTM has significant changes. And with change, that does create challenge in the field. But really, those changes, I believe, will benefit both patients and HTM professionals. I’ll give you some examples. Accelerated pace of technology investment. That’s going to make it harder to maintain that equipment. But really, it really is a powerful way to have better tools for care delivery.

The complexity of medical devices comes with that interoperability and cybersecurity concerns as things are more networked and the data flows across the continuum of care. Safe implementation of AI and ML, we already talked about that. But from the standpoint of all of these types of things, even take different care settings. So now you’re going to have home health, but you’re going to have acute care health in the home setting.

That really rocks the world of what maintenance looks like in an HTM world. So you look at this and it presents exciting opportunities for growth and innovation. And we’re looking at these challenges, looking for robust standards, best practices to help HTM professionals with these changes and really work those partnerships and collaborations that I mentioned earlier and

bring together these diverse perspectives, expertise to tackle these issues head on. We really believe that HTM can remain resilient and adaptive to these change and as care receivers, as patients, and as their loved ones get care delivery, that’s really the true winner in all of this change that we’re talking about, but it doesn’t simplify the world of the HTM professional.

It’s going to complicate it, but AAMI’s going to be there along their side to help them along the way. We believe in it.

Keri Stephens
Well, thank you so much, Pamela. I know our listeners will be really excited to hear what you have to say. And to our listeners, thank you as always for your listenership. And be sure to check out www .24x7mag .com for the latest industry insights and news. Take care. Thank you.

Pamela Arora
Thanks so much, Keri.

Keri Stephens
Hi, welcome to the HTM 24/7 podcast. I’m your host Keri Stephens. For this episode, I’m joined by a good friend of the podcast Chace Torres, aka the Bearded Biomed. To talk about a really big award he recently won, AAMI and GE Healthcare’s BMET of the Year award. In our July/August print issue, we’ll do a deep dive into the award, but we want to talk to Chace about this award and kind of, you know, see what’s been going on in his life. So thanks, Chace. Thanks for joining me today.

Chace Torres
It’s good to see you, Keri, it’s been too long.

Keri Stephens
It’s been way too long. I know, like at least over a year, and that is not okay. So Well, first of all, congrats on your award. That’s a big deal.

Chace Torres
Thank you. But it surprised me to be honest. Yeah. You know, we do the work without the thought of recognition for the most part. I mean, it’s always nice to be awarded. But, you know, it’s one of those things that only one person gets it a year. So I can think of many people that are probably just as if not more deserving. So it’s an honor to get it?

Keri Stephens
Well I have to say, I’m not surprised you got one. I mean, you’re doing so much for the industry, so much advocacy to me, you seem like a no brainer. So congrats again, though.

Chace Torres
Thank you, it’s, I’m looking forward to being in Phoenix. It’ll be my first time in Phoenix too. So from what I hear, it’s going to be a pretty cool event, there’s going to be doing a lot there. So besides getting an award, there are many other things there. So people have an opportunity to, you know, really get to see the show. And this couple of things that me and AAMI have brewing together.

Keri Stephens
So I would love to hear about that. So we know you, you’ve been on the podcast many times, but I don’t think people really know your backstory that much. We’ve really just talked about big topics. So I want to take a deep dive into you. Because we will have a full length feature on you and the July/August issue. But I want to do this for now and just learn more about you here. So to start, how did your experience in the US Army shape your career in biomed.

Chace Torres
And not only just shaped it, it laid the foundation. The career started in the army, the opportunity to learn the craft of biomed and really get entrenched and troubleshooting and learning different modalities and the documentation importance of it. And just learning how to be a technician. And by the time I had gotten out of the military, I had had all those intrinsic values. And, you know, skill sets built into me that most people probably on the outside in the civilian sector going through biomed more than likely won’t be able to, you know, just pick up on their own, operating under duress, working with limited resources. You know, there’s the, there’s the added stress factor of doing everything, no matter what the job is in the military. That’s just something that can’t really be taught. It’s more of an experience thing. So it has served me quite well, especially nowadays. So

Keri Stephens
Especially nowadays. Yeah, let’s talk about that. Let’s talk about your podcast because personally, I think your podcast has been so influential on reaching the new biomed and, you know, this seasoned biomed and just bringing them together and really giving a platform to an industry that people may not know about. So what led you to start your Bearded Biomed podcast?

Chace Torres
The podcast started with two things, one with the want of people to stop asking me, what is a biomed? Because if they knew about the profession, they probably want to ask that simple question. But as we all allude to, the question exists, because the majority of people within the United States and outside even don’t know what the biomed technician profession is. So there was that aspect of it, and everybody I met across the field feels my pain in that they’ve all had to answer that question several times to even family members. The other aspect of that was I needed something to spark the will to want to put myself out there because when I first started, I was not good at public speaking, I wasn’t comfortable in front of a camera, which is why the podcast started audio only. And that initial spark that drew everything towards me was one, I’ve been a frequent follower of Justin “Better Biomed” for years, you know, I was already aware of what he was doing. I appreciate what he did. And then I saw somebody get into the podcast space, which was surreal, with MMS. And her podcasts really inspired me to think, you know, I like how she’s doing it, but I would do it a different way. And those two things just kind of mixed together and pushed me to do it.

Keri Stephens
That’s awesome. And I, personally, I’ve, I love listening to your podcast myself. So I give you all the credit for that. And another thing you recently got is you wrote a children’s book, let’s talk about that. And just, what, why did you decide to write a children’s book? And can you talk to me more about it?

Chace Torres
The children’s book was because we didn’t have one and to fill the void of what’s not there, and I don’t mind being the first to do something. So that’s, that’s always a legacy thing for me as well. You know, after I found out that I was going to be a father. That just more that was the spark to drive me to do it, the will to want to do it was already there. And, you know, it’s a simple way to outreach to kids to, you know, break it down in a simplistic way of what our day to day is. It’s become very beneficial for my fellow biomed’s out there for them, for their kids, to see what mom and dad do. And, you know, I’ve been sent pictures of them reading them for bedtime, I’ve been sent pictures of actually doing read alongs in a kindergarten to three, you know, class setting of all the kids sitting there and the book being read to him like, it’s, it’s pretty amazing. You know, I hope that it continues to just get larger and larger in scope. But for the initial year, year and a half, it’s been out. It’s done pretty well. And I’m okay with that.

Keri Stephens
Honestly, I mean, the fact that you have used your platform to really just branch into so many new ways, the podcast, the book, I mean, it’s pretty incredible, because I don’t think people, obviously they think it’s the biomed field would think that these would be any avenues that people would really go for. But you’ve done it. So bravo to you.

Chace Torres
Thank you.

Keri Stephens
So I want to get into your thoughts of the field as a whole. As you know, you won this award, and you’re obviously influential in the industry. So what are some things that are keeping you up at night about the industry as a whole?

Chace Torres
Okay, you could have cut it halfway and I would say my son is what’s keeping me up at night. It’s just I think there is noticeable progress, or at least I would hope. So. When it comes to people entering the field a little bit. I’ve had outreach from many people that have either listened to my show, or listen to Brian’s or found better biomed or, you know, resources to AAMI, 25×7 or, you know, all the different resources out there. And they’re like, Yeah, I want to do this. And from what I can tell, too, there also seems to be more of an influx of more demographics. So different races. I keep seeing more and more women get into the field, which is encouraging as well. And, you know, when I talked to Danielle, my last episode, I asked, When do you think you might do another survey? And she said, Well, probably every five to seven years. So we’re coming up on another, another run of their survey. And I’m very encouraged to see what those numbers are going to outline because that will give us a snapshot of everything that has been done in the past five years. Are we making progress? It’s very hard to see the progress. So I guess the things that would keep me up are, is the work that we’re putting in, you know, myself and everyone else and people in industry that are trying to put themselves out there to generate hype. about the field and acknowledgement of it, is what we are doing actually working? I guess that would be the thing, which, you know, I’m encouraged to think that it is just based on personal interactions. But you never know. And that’s, that’s the What If?

Keri Stephens
Especially with you writing a children’s book, I mean, you might not know now the impact because it could be in 20 years, 15 years, you know,

Chace Torres
That was to address the, you know, AAMI is doing a lot of great things. But by the time we’re going out and speaking to high school students speaking to possibly, you know, career changers and all that they’ve pretty much made the decision on what they’re going to do already, you have to reach out to younger audiences. Going to high schools, which I’m actually planning on doing later this month. is fantastic. But if we’re not at least putting the little suggestion that, Hey, there’s this cool job out there that exists when they’re younger than we’re not going to see those changes that we need to see.

Keri Stephens
Right? Yeah, I know, for my son, he’s about to be six, he says he wants to be a fixer when he grows up. So I will definitely read to him your book and show him kind of, you know, another fixer, a medical equipment fixer. So

Chace Torres
I think for your son, too. I would probably, for folks out there that have kids that want to tinker and put stuff together and fix things. Look up HTM workshop, facilitated by Brian Bell, he puts together a lot of different kits for kids to create circuit boards and create their own patient sim and soldering kits. Like he has a lot of these that he’s invested his time to actually create for folks. And it’s a really good way to get your kids into that technical aspect really early. How old’s your son?

Keri Stephens
He’s about to be six.

Chace Torres
Okay. I would think if not now, probably the next couple years, he should be within that age range to where he could, you know, dive into some of that, but I would just check it out. htm workshop. I’ll give you Brian a little plug there. Because I think it’s really cool what he’s put together for kids to learn off of?

Keri Stephens
No, that’s wonderful. Okay, so any parting thoughts? Anything people need to know what’s next for you, just give us a little teaser.

Chace Torres
The first thought is, I think I speak for a lot of people. And Keri, as always, you and your team do an amazing job. And I would encourage folks to subscribe to 24/7 If you haven’t already. I’ve been a subscriber for years, and you guys have a lot of valuable information, which, you know, it’s always good to be plugged into what’s going on. You know, there’s a lot of different media sources out there. And you know, we’re not all doing the same thing. We’re not capturing all the same thing. So it’s good to have a healthy mix of, you know, what’s available out there for folks. So that’d be one thing, and I appreciate you having me on here. And we need to, you know, revisit and relink more often. So the first year of fatherhood has been interesting. You never, you know, I was active duty for quite a while. So I was pretty used to not sleeping. And this is a different level, I will say that it’s hard to, you know, keep up with the industry sometimes. I will say folks probably will notice that my episodes are not dropping as frequently as often just because I just have a lot going on. And I’ve always been of the mindset that I would rather do a quality over a quantity product. So even though I’m not dishing out episodes every week, that is because I’m not just going to put out trash. I have some encouraging changes coming to where there’ll be more frequency of episodes, the format of beard balm is actually going to be changing here very soon. I just recently did a survey to a lot of the people that follow me and people want to have more of a format change so I’m gonna give them what they want. There will still be interviews from here and there but uh, we’re going to take this to two points Oh, so stay tuned in, keep an eye out for that. Other than that, that’s pretty much what I have going on. So I’ll be at AAMI. I’ll see you there. Any of you folks that are listening? I will also be at the Omaha symposium for the biomed symposium out there in August. I’ll be doing a keynote speaking out there. And yeah, I’m still seeing what other speaking engagements I’ll be doing later this year. But for now, that’s probably the most upcoming thing.

Keri Stephens
Well, thank you so much Chace. As always, it was great to have you on and to our listeners. Thank you so much. And be sure to check out www.24x7mag.com for the latest industry news and insights. Thank you. Take care

Transcribed by https://otter.ai

Keri Stephens
Hi, welcome to the HTM 24/7 podcast. I’m your host, Keri Stephens. For this episode, I’m joined by Dr. Scott Lucas, ECRI’s Vice President of device safety to talk about an issue that’s garnered a lot of headlines lately, racial equity and medical devices, particularly Scott is going to talk about pulse oximeters. Because ECRI experts say people, people with darker skin tones may receive less accurate information than their white counterparts. And it’s a subject we really want to delve into from a medical device standpoint. So Scott, thanks for joining me today.

Scott Lucas
Thank you. It’s great to be here. Appreciate your time.

Keri Stephens
Yeah, this is this is really an interesting subject. And to start, how do pulse oximeter’s accuracy vary based on skin tone, and what does this mean for patients? That’s a

Scott Lucas
great question. So I think it would help to understand possibly how pulse oximeter is work. And then we’ll get into the skin tone piece of this. And it’s very, very, basically a pulse oximeter, as you’re used to it with a probe on your finger or adhesive on your finger. It shines two beams of light by led through your tissue, and then a sensor on the other end picks up the light. So your oxygenated blood absorbs infrared light, deoxygenated blood absorbs the red light. And that ratio is then calculated as a pulse ox or blood saturation level. So ideally, it would be nice that we’d have nothing else absorbing the light. So we were just looking at the blood, whether it’s oxygenated or not. But in reality, we have bone and other tissue that’s absorbing some of that light. So it’s a little bit more difficult to comprehend. Now skin tone, if it’s darker, that also absorbs light. So what happens is potentially, you get a situation where you have a normal reading for pulse ox, when in fact, the actual blood oxygen saturation is a few percent less than that normal reading.

Keri Stephens
Okay, no, that makes sense. So what recommendations exists to make pulse oximeters more accurate for everyone?

Scott Lucas
Yes, good question. So and just to continue a little bit from the prior, I mean, if we have to think about it from clinical significance, right, so in most of the time, if a if a patient is adequately perfused, and adequately saturated, then a couple percentage of their variation isn’t that big of a deal, because it doesn’t require clinical intervention. The problem becomes when the pulse, the actual pulse ox may drop to like 88%, or something where clinical intervention is generally needed. In reality, the pulse ox will read something higher like 91% 92%, and then a clinical decision might not be made. So that’s one component of accuracy. And the broader component is how do Pulse ox is how do we you know, ensure their accuracy and I think of it from several different perspectives, you know, usability human factors, interoperability, the pulse ox very, I mean, a simple example should be that, it the probe needs to be tight on the finger or the ear lobe or the toe, and not move around, have motion artifact. Interoperability, the connections should be secure. If it’s a, you know, a standalone unit that’s different. But if it’s a has a console, or if it’s connected to a patient monitor, all those connections should be secure. The software’s associated with them should all be compatible. So pulse oximeters have alarms built in, and that should be compatible with the patient monitor that’s, that’s connected to. So it’s a system is a system approach to make sure everything’s playing and working together properly. There’s also more advancements, I mean, pulse ox has been around for many years, let’s say the modern technology even for decades, but now we’re getting more sophisticated. So it’s an which improves accuracy. So things like being able to identify noise and filter it out of the signal, or being able to account for poor perfusion and still give a appropriate saturation level. You know, things like that are now improvements. iteratively as the technology gets more mature, yeah.

Keri Stephens
You mentioned, you know, the technology obviously getting more sophisticated. So why do you think now the public has been more made more aware of the racial inequity and pulse oximeters?

Scott Lucas
Good question that, you know, it’s, this has been a kind of a known issue, at least anecdotally, for a long time. Like, if you talk to nurses in the field or clinicians They may anecdotally say, Oh yes, I was aware that if we had a patient with a darker skin tone, I just needed to be extra careful. pulse oximetry, by the way is always an adjunct and complement to care. It’s not the only diagnostic tool. So it’s always considered that way. But it’s been sort of a known issue. But, you know, I think recently, it’s risen because or escalated because of the pandemic. And you think about how prolific pulse oximeter is where at home, and people using pulse ox and he said, to get a saturation level and a temperature as a diagnostic tool to help determine if we had COVID or not, and talk to our provider. So there was all this, these issues, then around that. And then there’s some recent studies, too, that have shown have done this comparison to, you know, using pulse oximetry, from the device with actually a blood draw, and determine that there is a variability in a scientific method. So yes, it’s an issue. It’s been addressed, raised and addressed. And now the FDA is really focused on it.

Keri Stephens
Well, I also want to focus on what ECRI is doing, what exactly is ECRI doing to understand and improve pulse oximeter accuracy?

Scott Lucas
So like any medical device or patient safety issue, we take a comprehensive approach to that, you know, and that ranges from understanding what the market is, what the devices are out there doing market intelligence reports and things like that. doing clinical understanding clinical evidence, and clinical outcomes associated with the use of devices. And, and benchtop testing human factors, testing it through our device safety program. So we have engineers, clinicians, human factors, engineers, all looking at Pulse ox and other devices from a comprehensive approach, then post market to so we want to analyze and look at all the recalls of hazards and safety, communications, anything post market, we tried to grab and have reported to us through our patient safety organization, or straight from our users that that can help us understand all these issues. So we put it all together, come up with the best recommendations possible on safety with pulse ox and then any device and just publish it, send it out to our customers send it out to the public. Talk about it at the FDA, or any any kind of professional societies, any forum that shares our mission. You know, we want to share this information.

Keri Stephens
I want to get back to the FDA now. So what were the main points discussed in the FDA meeting about pulse oximeter performance? Can we delve into that a little more?

Scott Lucas
Sure. So in up until now, or I guess the last, let’s say 10 plus years, the guidance for development of pulse oximeter is included to have a patient population represented. But it was somewhat has been somewhat vague as far as how many people with different skin tones should be represented in that cohort. So it’s like two who was I think two patients or two patients who subjects should be of a darker skin tone. But that’s, that’s vague. What does that mean? So now, it’s more the recommendations from the FDA, which are out for public comment, and were being discussed in this meeting include increasing the number of subjects, and also having a more accurate representation of the patient population, included in the subjects that are used to help design that device. So it gets more specific that in that there are two methods proposed to test for skin tone in that cohort. And those are one of them’s called Monk Skin Tone, MST. So that’s a more comprehensive assessment of the different kinds of skin tones across the population, and more accurate. And it’s gotten the attention of nationals security, Google, using Google images, all these other broad platforms have recognized that this is a more up to date and more accurate representation of skin tones, especially in the darker continuum with skin tones. So that’s that’s what the FDA is discussing. And then basically how to do it, how to how to assess the skin tones how to use colorimeter devices and to quantify skin tone, you know, and how to go about that. So we’re having that we had a meeting meeting recently at the FDA with with multiple stakeholders, we were there. device manufacturers, were there, patient safety advocates, and it was really a good comprehensive meeting. And everybody was essentially in agreement that yes, this is a good idea. Now it’s how do we get it done? So that’s where we’re at now.

Keri Stephens
That’s interesting and helpful. So how can the lessons learned from pulse oximeter accuracy help address racial disparities in healthcare as a whole?

Scott Lucas
Yeah, that’s a that’s a great question. It’s, it’s so important. I think one thing that has come to light in this example is that the whatever the population that the device is intended to be used on should be represented in the design and development of the device. It should not the color of someone’s skin should have no impact on the quality of health care that they receive zero, it should all be the same. Yeah, so we have to that has to be represented in the design of the device, especially now you think about these are standalone devices, Pulse ox is right. Right, especially if you start thinking about artificial intelligence, and where we’re going with that the data that that technology is trained on should be representative of the of the patient population in which it’s deployed. So that’s it, I mean, we have to be accurate in the development of the device to better represent our patient population.

Keri Stephens
Great. So as a last question, our audience is the healthcare technology management profession. So what would you like to tell the members of the HTM profession about this, or just racial equity in general, and healthcare? Well,

Scott Lucas
I think that we love to hear from everyone for one and htm and in other venues about these types of issues. And I know that a lot of folks listening to this are our partners and customers. And so we love to hear from all stakeholders. So I mean, contact us with these issues, we’ll work to develop, you know, safety strategies and recommendations. And that could be individual to folks or just being able to publish broader on a broader scale to forums like the FDA, but I’d say just stay vigilant. I mean, it’s if a device shows up from a vendor and a facility then question it, you know, where, what’s the data? Where’s the data? What’s this device validated on? Is this appropriate for our patient population and have healthcare disparity front and center when when considering a big purchase? It’s important and we shouldn’t take it for granted.

Keri Stephens
Well, thank you so much, Scott. I mean, this was very informative to me and I know to our listeners as well, and to our listeners, thank you as well and be sure to visit www.24x7mag.com for the latest industry news and insights. Thank you again, take care.

Keri Stephens
Hi, welcome to htm 24/7 podcast. I’m your host, Keri Stephens. For this episode, I’m joined by one of the biggest names in htm right now, Danielle McGeary, who is AAMI’s vice president of htm. Danielle, thank you for joining me today.

Danielle McGeary
Hi, Keri, thanks for having me today. I always love coming on your podcast,

Keri Stephens
we love having you. And we had a really good conversation. I think it was a little over a year ago. So I’m just glad to have you back. So I’m glad you invited me back. Oh my gosh, you’re always welcome. So whenever you want to come on, please do. But um, so let’s just start get into this. AAMI just developed an htm leadership guide. Let’s talk about that.

Danielle McGeary
Yeah, absolutely. So we’ve actually had the HTM Leadership Development Guide for, I don’t know, about eight years now. But what we did was we refreshed it, we’ve had so many new resources come out over the years new certifications, that the guide was really outdated. So we took the time to update the guide. And it’s really a great resource for anyone that’s looking to move up in the HTM field take on a leadership type position, a manager position. And it’s also great for managers in the field to want to be able to mentor and lead, you know, they’re up and comers into the next position in their organization.

Keri Stephens
Yeah, and one of the things we’ve really found, you know, from our HTM salary survey is, you know, people are retiring and there is a massive need for new blood to come into the field to learn new skills or new leadership skills. Was that part of that, too, that, you know, the refresh looking at the demographic change? Absolutely.

Danielle McGeary
I mean, we also did a demographic survey that kind of parallels your salary survey. And we found that about 60% of the fields managers are over the age of 55. So that shows in the next 10 to 15 years, there’s going to be a huge mass exodus, and those people leaving are our long term seasoned technicians, and managers with all that historical knowledge and skill set that you just can’t learn, you know, day one on the job. So we really have to do a good job at preparing our future workforce to take on those senior technician and managerial type roles. So this guide will really help htm professionals move into those types of positions. So it really gives like a step by step process, like suggestions, like getting certifications, like your CHTM, your CBET or the CAPT if you’re just entering the field, obviously, you know, that’s the entry level certification, but it really starts that trajectory. And that process of getting, you know, starting certification from the beginning of your career. It also talks about good skills to have, such as you know, public speaking, you know, leadership development, project management, all things like that. So, it’s really a great resource.

Keri Stephens
Yeah, and I did want to talk about the step by step. So in the guy, there’s a section on getting started. So can you share some key insights from the section for listeners who might be interested in advancing their careers and htm?

Danielle McGeary
Yeah, I mean, I think, you know, it always starts with a willingness to learn, right. And in the leadership guide, there’s also in the back, there’s a checklist in like a note section where you can actually evaluate yourself against the matrix that’s in there. So you can kind of say, Okay, I need to really brush up on my project management skills, or maybe difficult conversations and things of that nature. So you can really go through it and kind of rate yourself, I think it’s on a one to five scale. And you can kind of see where you feel you’re good at, where you need some development. And it’s really a way to really open a conversation with your existing management because you can say, hey, you know, I need the skills, but I feel like, I need help really getting to the level of being able to, you know, feel comfortable having a difficult conversation with an employee, maybe I need to take a course or maybe I need some mentoring on that. And that’s really what this guy does, it really shows you those bare bones skills that are really needed to become a good leader.

Keri Stephens
And I think too, especially in this industry, because it’s such a tech, heavy interest industry, you know, it’s important to really talk about the soft skills because those are necessary to move up. I mean, you can’t just be technically proficient, you have to have the soft skills, the emotional, you know, EQ skills. So I think this is really great.

Danielle McGeary
agreed in it. I think that’s you know, you can be the best, you can be the best technician, but if you can’t communicate, you know, especially even understanding like what the C suite needs to know, and what clinicians want to know, right? When they’re, you know, MRI is down, for instance, they don’t care what specific component is broken on the MRI, it’s great that you know that to be able to fix it, but they want to know, you know, what’s wrong with it? How long will it be down? You know, when will we get parts? And how does it affect patient care? You know, do we need to divert patients? Do we need to send them elsewhere? Is this going to be down for a week? Or for a few hours? How do we, you know, figure out, you know, in a, you know, an emergency plan, if we need that to send patients elsewhere, maybe you know, you’re at a place that have multiple MRIs, and you’ll have to run off with one, but how does that affect, you know, patients scheduling, you know, so there’s, you know, the clinicians are really thinking about patient care, not that, you know, a part of a little what particular part of the board is broken, inside it or whatnot. So, you know, it’s really important, you know, those soft skills and being able to effectively communicate and speak their same language. No,

Keri Stephens
absolutely. And so the guide also addresses interviewing for leadership roles. Can you share some of the top techniques for interviewing for senior level positions? And what are some common mistakes that people interviewing should avoid?

Danielle McGeary
You know, I would say the common mistakes, even from people that I’ve interviewed in the past is really coming off too cocky. Okay, no feeling like, they know more than you. And, you know, I also in and I would also say, when you’re interviewing for higher level positions, it’s really important to be able to, like I said, effectively communicate that clinical talk to be able to translate technical jargon into clinical talk. And in just to be able, I think, to really come across as sincere and have a sense of empathy. You know, at the end of the day, you know, when you we interview so many people, and you can tell just from their voice, their demeanor, who really cares about this role, who really understands the path to the patient, and who doesn’t. And I think, you know, I remember interviewing someone once and asking them, you know, what their weakness was, and they told me, they didn’t have one. And I think, you know, in their mind, they thought, wow, you know, I’m going to show her that I’m perfect. But the fact that they said they didn’t have a weakness is a weakness in itself. And being able to admit, you know, when you know, you need mentoring or counsel or maybe being able to say, I’m sorry to apologize when you’ve done something wrong, and just being able to relate to others around you, you know, when, when you come off that arrogant, probably, for lack of a better word, that doesn’t sit well with others, that doesn’t sit well in health care. And, and I think at the end of the day, just being genuinely passionate about what you do, you know, say fueled by passion, will, will really get you much further, and people can see that in interviews, whether you’re on the phone, or whether you’re in person. And I think just really being able to connect with others that way, I think really goes a long way and makes a difference.

Keri Stephens
So if you had to rate in your opinion to and input the guy, like the top three soft skills that you think every biomed should have, what would you say they are the

Danielle McGeary
top three soft skills, I would say being able to communicate verbally being able to communicate in writing, and also being very organized and detail oriented, because, you know, you need to be able to, to follow a process, whether it’s healthcare process, or the process to, to maintain or fix a device. You

Keri Stephens
know, I was having a talk with a friend the other day about this, because it’s like, you know, as artificial intelligence, you know, so much. And I’m not saying that’s in the biomed field, specifically, but so much is being automated with artificial intelligence, but really, it was what sets people apart. And what’s going to continue to set them apart is those soft skills, those human skills that people need to do their job that a computer could never do?

Danielle McGeary
Agreed, I mean, you’re never gonna, you know, I think you keep saying empathy, but I think computers are never going to replace, you know, empathy. And, you know, when it comes down to the clinicians and the people in the hospital, and I think just us being able to understand, you know, I always say, you know, when I talk to students, and I think this also applies, you know, while we’re talking about leadership and leadership development, is being able to understand the equipment and how it’s used clinically. I always tell the students you know, when you’re interning if you have the opportunity to scrub into a case and see how the equipment is being used, you know, on the patient’s understanding all the people in the O R in their functions. What’s done to get that device up and running. You know, it just makes you more valuable, because you’re not just talking about a device, now you’re talking about a workflow, you’re talking about patient care, you understand more than just the device. And when you’re able to really, you know, connect with the clinicians and really understand their jobs, I think that’s really when you become a leader, right? Because now, you’re not just thinking my optically in your day to day job and just, you know, break fix, you’re thinking about the whole continuity of care how that device affects the patient, the clinician in whole HDO in general. So you know, it’s really important, if you have the opportunity to learn that, and really take the time to see clinically how everything is used. It just makes you that much more valuable. And when you think about even moving up beyond, if you want to move outside of htm, until like a hospital C suite, you know, you need to understand that you have to understand how everything ties together from the financial piece to the, you know, coding, HR, you know, the engineering side, everything works together harmoniously. So hospitals work, and we have a piece in that, but understanding how those other pieces of the puzzle fit together. So everything works harmoniously is really important as well.

Keri Stephens
No, that’s great. And just for a final question, so this documents free to AAMI members, but can be purchased for the AAMI store for those who are not members of AAMI. But why should people use this resource? How can it help those in the HTM field? Well, it was developed

Danielle McGeary
by htm leaders for htm leaders, so you’re really getting an inside view of what the best of the best really feel you need to do to succeed. These are people who have done it who have succeeded in their positions. And you’re getting in the insider scoop almost. And it really is a step by step guide, it was really created to help. We also have, we have the leadership development guide. And we also have the career guide as well. The Career Guide is more focused on those starting out in htm understanding what they need to succeed in their career as they are and the leadership guide takes that career guide to the next level, and how to move into that next level position. And it also just want to be clear, too, that, you know, being a manager and being a leader are two different things. You know, you can be a manager and not a good leader. So this really helps you to lead. And you can be a technician and not have direct reports or be in a manager role and be a leader. So this helps you be a leader. So don’t sell yourself short either. And I think it’s definitely worth checking out. You know, it definitely makes you sit down and think about where you’re at in these key competency areas for being a leader. And you can score yourself and I think it’s just a great exercise for everyone to do. And really see, okay, this is where I’m at. And this is where I need development. And I think no matter where you are in your career and never hurts to take a step back, focus on you work on you, evaluate where you are, and see how you can be better. Now

Keri Stephens
that’s great. Thank you so much, Danielle. It’s as always, it’s such a pleasure to have you here. We love AAMI at 24/7. And we support all your endeavors. So just thank you.

Danielle McGeary
Oh, and we appreciate 24 x 7 too, we love your support of us. You know, thank you for doing the salary survey. We’re so happy to support it year after year.

Keri Stephens
It’s instrumental and just again, please everyone take the salary survey your insights really helped shape you know, salaries and htm field it’s so important that everyone just embraces a salary survey and takes it because we want to make sure everyone’s being paid fairly. So thank you so much, Danielle and to our listeners. Thank you all so and be sure to visit www.24x7mag.com For more industry news and insights. Thank you, take care.

Keri Stephens (00:06):

Hi, welcome to the HTM 24 7 Podcast. I’m your host, Carrie Stevens. For this episode, I’m joined by No Mosh, a vulnerability researcher at Clarity’s Team 82. Noam, thank you for joining me today.

Noam Moshe (00:20):

Thank you so much for inviting me. I’m super excited to be here today.

Keri Stephens (00:25):

Yeah, and I really just want to jump into this. So your team recently discovered [00:00:30] multiple critical vulnerabilities in connected iOS ER 2000 edge routers, which serve as gateways for internet of things or IOT devices. So can you talk about this in the context specifically of medical devices and why this area was chosen for your research?

Noam Moshe (00:48):

Yeah, for sure. So basically as intimidate two, we want to look at some kind of critical devices and interesting devices that could be somehow [00:01:00] very big and allow big exposure in the industry. And that’s why we chose looking at three and 4G routers, which basically act as a gateway, meaning you need to connect some kind of site to the internet and you might not have a physical cable or physical internet connection. Well, in those cases, you might want to implement and use a three or 4G router that acts as an internet gateway connecting your sites to the internet. Now this is actually pretty cool because when we’re talking [00:01:30] about these sites that are used in iot, basically connecting iot devices, be it manufacturing, remote site connectivity, medical, you name it, these sites are remote, are somewhere out there, and sometimes there’s not a way for attackers to go into these sites and leverage the way into these sites. However, some critical infrastructure is kept on these sites. So we thought to ourselves, how can we devise the new exploitation technique or [00:02:00] basically attack vector that could affect these sites and allow attackers, malicious attackers to leverage a way into the internal networks of basically any kind of organization, be it medical, be it in the realm of manufacturing, you name it, and that way we could see how attackers could basically infiltrate an internal network, an internal device network of such organizations.

Keri Stephens (02:26):

Well, our brand is obviously for medical devices, [00:02:30] so let’s get into the critical nature of medical devices, of patient’s safety concerns. So what are some of the risks associated with the vulnerabilities you discovered?

Noam Moshe (02:39):

So basically they could allow attackers to gain access to the actual physical devices. For example, a medical device that sits somewhere and might not be connected to the regular network, and that way it could allow attackers to access and leverage the way and basically get network access to these devices. [00:03:00] Now, a lot of the times, especially in the medical realms, we see kind of a realization that the devices are not secured by nature, not inherently secure because it might be the protocol is not secure. For example, if we’re talking about DICOM, for example, which is the protocol for medical imaging and modality test, it might not be the most secure protocol inherently, and in order to secure it, a lot of medical organizations choose to implement a very strict network rules basically denying any kind of attacker [00:03:30] into accessing their devices. Now, because we exploit the actual router that might actually block and drop the packets from the internet, the exposed internet, we are now able to access internal network that is very internal and only contains devices, and that way we can interact with networks and devices we are not supposed to. And that puts a lot of risk because these networks are not protected, sometimes not even monitored. They are sitting somewhere [00:04:00] basically not exposed. However, by abusing the vulnerabilities, we are able to expose them and attack them through the internet without requiring direct access, which is pretty cool.

Keri Stephens (04:13):

No, very cool. Yeah. So how did your research findings not only impact the routers but also the cloud-based device management platform use in healthcare settings?

Noam Moshe (04:25):

So we identified some actually architecture flaws, meaning we not [00:04:30] only found some vulnerabilities in a specific device or in the cloud platforms, although we did find some of these. We also find flaws within the architecture itself, meaning how devices connect, authenticate, and basically exchange messages with the cloud. And because we identified this architectures flaw, it means that basically we found flaws in the architecture and the infrastructure of connected iOS cloud. Along with that, we managed to basically gain access [00:05:00] to actual patient, not patient, but customer information, meaning all of the information that the devices are sending to the cloud, we were able to see them, meaning we are able to use and see the customer information of the connected devices, as well as actually we managed to identify some vulnerabilities that allow us to fully take over connected as IO cloud, meaning we’re able to execute code on their cloud servers.

Keri Stephens (05:29):

So with connected [00:05:30] IO providing firmware updates to address these vulnerabilities, what steps can healthcare organizations take to make sure their connected devices are secure post update?

Noam Moshe (05:43):

Yep. So like you’ve said, connected IO have done something pretty amazing and that shows their care for their customers because they actually work with us and fully fixed all of the we identified. [00:06:00] And because of that, they made sure that all of their customers are safe and are no longer vulnerable in regards to how can you protect yourselves in front of this kind of attacks? I believe the most important thing is knowing what kind of devices you have. If we’re talking about the medical network, a lot of the times the network admins are not even aware of all the different kinds of the iot [00:06:30] devices that are connected to their network and might introduce basically exposure and risk. So that’s the most critical stuff. And define and understanding what devices are at your network and how can you protect against those rogue devices that might make compromise by attackers.

Keri Stephens (06:54):

I mean, it seems to me that all of this kind of starts from the beginning with the medical device manufacturers. So [00:07:00] how do you want to address medical device manufacturers to making sure that their devices are secure before they put them out there?

Noam Moshe (07:07):

So I see a very increase in the industry of security. I mean, companies, especially medical companies, understand the inherent risk of vulnerabilities in their products, and they put more and more effort and put the products into more tests and more Q quality assurance and vulnerability researchers, et cetera, to make sure that the customers [00:07:30] itself, which might involve actually real life patients and might have physical damages, they want to ensure they are safe. And we are seeing an increase in the world of medical devices in regards to security concerns. However, I believe the most important stuff is being more transparent and working with the industry and allowing [00:08:00] people to test their devices. And we are seeing an increase of medical companies allowing us and other companies to work with them and basically present them vulnerabilities. We find, and I believe this is a critical step into making sure that the entire industry is safer.

Keri Stephens (08:17):

I know we do a salary survey every year and it kind of just looks at the whole industry and the people tell us the thing they’re most concerned with other than the aging out of the biomed field is cybersecurity. [00:08:30] I mean, that is always what these HTM professionals are telling us, but I always don’t think that the general public knows how insecure some of their medical devices are. So can you just talk about that? Should people be as concerned as a lot of the HTM professionals are about this? I mean, is it really that big of a deal?

Noam Moshe (08:54):

Well, I think we are seeing a more focus on cyber medical attacks [00:09:00] because when we’re talking about cyber medical attacks, we’re talking about physical damages, physical actual damages that could involve actually human lives or even when we’re talking about data leakage is a very, very sensitive data that should never be exposed. And we are seeing an increase in attacking groups and different kind of hackers or ransomware gangs that are targeting the medical field. In the past, [00:09:30] I believe that this field was less focused on which actually allowed it to be less secure, and we are seeing a lot of less secure, less encrypted, less security focused devices and protocols in the medical industry. And it is very concerning. However, I think the field is moving in the right direction, however, not fast enough, and it needs to move faster to make [00:10:00] sure that no actual damages actually could occur.

Keri Stephens (10:06):

Is there anything we didn’t cover that you want to tell our audience who are members of the HTM field?

Noam Moshe (10:13):

I believe the most hard part is understanding the risk because you are never aware what is running at your network and what is running under the hood. I mean, I’m buying a router, for example. I am not sure what’s actually [00:10:30] running there behind the plastics. And that is a very major security concern because it might be compromised and I’ll never know it. In order to remedy this risk, we must basically expand our security posture and build a security by layers, meaning we must do proper network hygiene and say, if this kind of device or this edge router [00:11:00] might be compromised, how am I protecting my network and making sure that all of my patients and all my customers are safe? I believe it needs to be built in layers, meaning let’s say this thing is compromised, how am I basically covering it in another field? And that’s the only way making sure your security posture itself is very robust and protected against all of these kind of attacks.

Keri Stephens (11:30):

[00:11:30] Well, thank you. Thank you so much Noam. And to our listeners, be sure to check out 24 7 x mag.com for more information. Thank you. Take care.