As COVID-19 vaccines roll out and the world eases into a new normal, all industries are building on lessons learned during the pandemic.

For imaging equipment manufacturers, who have had to adapt their service offerings to new standards, this means more of a reliance on virtual training and troubleshooting, continuing to advance remote monitoring and shoring up cybersecurity.

Some manufactures are resuming in-person training, in order to best prepare service technicians for the real world — but with some changes.

Virtual is reality
The pandemic has led to some companies expanding their remote offerings.

Andrea Weaver, director of national clinical applications for Canon Medical Systems, said that during the pandemic, the company developed a two- to three-day remote training that provided an overview on the system interface with customer interaction.

“The success of this training prompted us to review other possible remote training options, which lead to the creation of a remote upgrade training along with remote Phase 3, follow-up training. Due to the success of this training we will be adding these as purchasable options to the price book.”

Canon also utilized FaceTime and remote desktop access to view the customers’ systems and walk them through resolving issues.

“This has continued, which is instrumental in expediting a resolution and reducing travel expenses,” Weaver said. “When it comes to service training, the team did a great job in converting material and content into online modules, virtual classes, and online prerequisites. The good thing about this is that we have now created a culture of online learning before coming to the Center for hands on education. This will now allow for engineers to be out of their zones less, and in training for a shorter duration at the Center. The common theme is that change always accelerates under pressure.”

The shift to virtual support has been rapid in Latin America, where in February 2020, the remote resolution of equipment problems stood at 19.6%, according to Dawn Bruce, services and solutions delivery leader for Philips Canada. The current rate of remote resolution in Latin America is now 42%, according to internal data from Philips.

For example, a healthcare provider partner in Argentina that was located more than 600 miles away from field service employee support in Buenos Aires, reported one of its MRs was down during the COVID-19 outbreak. It was a complex failure, so Philips, working with remote employees, a field service employee, and the hospital’s biomed, used the remote monitoring system REACTS to detect a failure in the MR’s gradient power supply. In just an hour, the faulty part was identified and a replacement was ordered.

“Before the pandemic some hospitals were reluctant to have remote connectivity or any remote operation, due to perceived privacy and security risks,” Bruce said. “Now it is a must. … We are now doing more proactive and predictive work remotely — equipment resolution, fixing, troubleshooting — rescheduling maintenance as required, while also having the ability to help manage system performance at a distance. And we are not sending employees to a site if it is not needed. For COVID-19, it is much better and safer to do it remotely.”

Training classes can also accommodate more students in a virtual setting.

“People are a lot more hesitant to travel,” said Matthew McCallum, vice president of business management and marketing for customer services at Siemens Healthineers. “While there’s still a significant benefit to in-person training, we can allow more customers in the classroom when it’s virtual.”

McCallum said the company has taken the opportunity to look at the way people consume information and translated its technical training into virtual.

Some in-person changes are likely to continue.

During the pandemic, Canon Medical had to reduce class sizes to maintain social distancing, while being able to still accommodate customer demands.

“Prior to the pandemic, we would be able to teach at 8:1 ratio, but now had to reduce class sizes to 4:1 with a shorter duration course,” said Mona Farokhpay, director of education operations for Canon Medical Systems. “This has continued to work out well, and we have been able to provide our customers with even more of an individualized atmosphere of adult learning at the Education Center with more exclusive hands-on time.”

Moving forward, Philips is shifting to a mix of virtual and in-person training.

“In Canada alone, we delivered 4,000-plus virtual hours in demos and clinical training,” Bruce said. “We have also established local, bilingual technical training for biomeds and internal field staff to reduce cross border travel and enable our customers to learn in their language of preference (French/English) helping them avoid expense and time required to travel outside of Canada.”

Richard Fiore, director of US&C Field Service Delivery and Service Sales at Carestream, said the company increased its remote and virtual training, as travel to its training center in Rochester, New York was impeded by the pandemic.

“With the current technology there continues to be a need for some level of hands-on work in the classroom,” Fiore said. “However, we are exploring AI training applications and we are shifting to a more continuous hybrid training model, whereby we offer virtual training where it will meet customer needs as well as classroom training where it is necessary.”

Even manufacturers that saw high demand during the pandemic will be continuing their remote collaborations with customers.

David Karchner, senior director of marketing for North America operating room, patient monitoring and enterprise services for Dräger, which manufactures ventilators and anesthesia machines, said the integration of online collaboration platforms, such as Zoom and Microsoft Teams into their services will be the largest long-term benefit to their clients.

“The pandemic created a scenario where the demand for Dräger's services and solutions were higher than ever at a time where face-to-face interaction was being asked to be kept at a minimum,” Karchner said. “Dräger invested heavily in digital tools and regional remote clinical training hubs for implementations and ongoing training, and our sales and service teams utilized these platforms for consultations. The long-term customer intimacy benefits of these investments will continue long after the pandemic.”

Remote monitoring expands
Remote monitoring of equipment has long been touted by manufacturers, and the pandemic has prompted further adoption of the technology.

GE Healthcare’s remote monitoring technologies, such as Tube Watch, which can help predict an impending tube failure for CT scanners, and OnWatch, which monitors critical subsystem elements within imaging equipment, as well as Imaging Insights, which uses data to optimize workflow and increase performance, were heavily utilized during the pandemic.

“These were in the works before the pandemic but all of these have taken on new meaning post pandemic,” said Todd Brown, president of CoRE Partnerships & Service Growth for the U.S. and Canada with GE Healthcare.

Artificial Intelligence (AI) is also playing a role in remote monitoring. Canon Medical has partnered with a company called Glassbeam, using its Clinsights product to provide predictive service analytics and learning algorithms that can increase machine uptime and fleetwide operational efficiency.

“Unplanned downtime and suboptimal performance of diagnostic imaging systems can create significant challenges to provider finances, but the introduction of AI is giving them an edge,” said Andrea Hearn, senior life cycle marketing manager at Canon Medical Systems. “Through dashboards and reports from across facilities, vital usage insights are becoming more accessible than ever. I think that trend will continue into the future, with proactive maintenance alerts playing a bigger role in service decisions. This data could even facilitate benchmarking against other organizations to identify opportunities for greater efficiency.”

Addressing the backlog
As patients pushed off screening exams during the pandemic, imaging centers braced for a flood of appointments. Service providers had to address service needs accordingly.

“We had a slow period for applications training requests just after the pandemic restrictions were easing up,” said Mel Travers, applications manager for MR at Hitachi Healthcare Americas. “Over the past two to four months after customer sites had taken care of their backlog of patients, a big wave of on-site applications requests had come in.”

Remote monitoring was key to handling the backlog. Customers of Canon Medical Systems used InnerVision Plus, which allows engineers to remotely troubleshoot imaging systems, to help catch problems before they affect performance.

“In many cases we were able to effectively support our customers with our remote services,” said Hearn of Canon Medical. “We continued to support our customers remotely by providing 24/7 access to specialists to help with both engineering operations or clinical queries or issues. These experts helped secure our customers’ workflow with live person interaction (and) real-time resolution during patient studies using (a) remote user-interface. Internal studies showed that in some modalities our real-time problem resolution ranks above 90%.”

Brown, of GE Healthcare, said the backlog of exams made improving throughput and avoiding downtime even more important. The company also responded to the demand for a need for more flexible hours with service support.

McCallum of Siemens Healthineers noted that the company and its technology can help customers manage their workflow and optimize protocols to reduce scan time and better handle a backlog.

“How a room is laid out, how clinicians move around the patient, all that affects workflow,” McCallum said.

Links in the supply chain
Supply chains continue to be challenged, but some companies employed specific strategies to get through the rough patches brought about by the COVID-19 pandemic.

Canon Medical officials say its parts supply and inventories have been maintained throughout the pandemic and, like consumers, healthcare providers have gotten used to online shopping. The company recently launched a new e-commerce website called Marketplace, which allows customers to explore the company’s parts inventory at their convenience and take advantage of special online pricing.

“Very early in the pandemic, our company decided to increase inventory stocking levels in anticipation of potential supply chain issues,” Hearn said. “During the pandemic, a lot of us experienced some sort of lock-down work scenario. Also, our customers often had to work from a virtual office and regular work hours no longer determined rigid business hours. As a result, customers may browse for parts any time of the day, educating themselves about their options and pricing. … Moving forward, customers will likely continue to seek the convenience of online parts shopping, and don’t want to be restricted to just parts.”

Focus on security
The pandemic has been an accelerator in embracing new technology, which has led to new security threats.

“The pandemic forced us to do a lot of things online, and left us more open and vulnerable to cyberattacks and intrusions,” said Hearn of Canon Medical, noting there were twice the number of ransomware attacks in 2020 compared to 2019 globally, according to Statista. “Ransomware attacks continue to occur at high levels, causing challenges in patient care, economics, and reputation for our customers.”

As medical data breaches become more advanced, Canon is partnering with technology company Barracuda to support its Gateway Platinum security solution.

Philips is also focusing on cybersecurity and strategic technology management, and provides an OS patching service that keeps medical equipment up-to-date via regular patching with either remote or on-site installation, which can be a step toward minimizing cybersecurity risks.

“Philips OS patching service offers a proactive, controlled, and semi-automated way to roll out the latest security patches for medical devices running the Microsoft operating system,” said Bruce of Philips. “Removing the time-intensive need to manually identify and install relevant fixes to keep devices up to date, Philips OS patching provides access to security patches exactly when and where you need them. In addition to this, Technology Maximizer, is a software subscription and hardware refresh programme that keeps imaging systems running at state-of-the-art condition for a full five to eight years after installation”