Chris Gaerig

Chris Gaerig

In the competitive world of third-party medical equipment repair and supply, Axess Ultrasound knows squarely where it stands and what its goals are. Founded in August 2005, Axess offers parts sales and training, and both in-house and on-site repair work to the ultrasound industry. When the market shifts or competing companies enter the market, Axess knows what to do: stick to its core values and do not worry about what anyone else does; just continue to offer the best quality and value as possible to your customers. 24x7 recently sat down with William Gulley, executive director at Axess Ultrasound, to talk about the company’s mission, training offerings, and the industry as a whole.

24×7: Can you tell me a bit about the history of Axess Ultrasound? How has it grown throughout the years?

Gulley: Axess was founded as a dba under our current sister company, Trimedx. Since then, we became a stand-alone LLC underneath Medxcel, an affiliate of Ascension Health. Every year on an annual basis, we have increased revenues of 15% to 20%, and on some years, more than that. We’re on track to do that again this year.

24×7: Was there anything that drew you to the industry specifically?

Gulley: Obviously in health care, you want to help people, and that ties into the company’s mission. We have revenue goals, profit goals, and all of those things that every company has, and we work toward those. But Axess is very much focused on making sure that the medical personnel can get a quality diagnostic image that is necessary to properly serve its patients. Especially ultrasound, and some of the things that we do with cardiac ultrasound, the focus is making sure that the patient—number one—and the patient’s family—number two—have comfort knowing that the images they’re getting are going to help obtain the correct diagnosis.

24×7: How much of your business is service versus parts sales?

Gulley: Service is 80% plus.

24×7: Is more of your service offered in-house or on-site?

Gulley: The vast majority of our service is on-site in a hospital, physician’s office, or imaging center. We have field service engineers who cover most of the US. Our emphasis is on the East Coast, South, Midwest, and Southern California regions.

24×7: Does the company have any international clients?

Gulley: Yes, Axess does have international clients.

24×7: Can you talk briefly about your training offerings?

Gulley: Most of the major boxes—the i-boxes, the GE lines, the Voluson 730 and E-8s, the LOGIQ E-9 and the Vivid E-9, the Siemens line, the Sequoias—we have training classes on. We offer hands-on training on the most popular ultrasound machines, including IU22/iE33, LOGIQ E-9/Vivid E-9, Sequoia, S-2000/Antares, and Voluson 730 and E-8.

If travel is a barrier for training, we have the capability to bring the training to you. Our experience has shown that most often, the travel budget for training is one that is overlooked. We’ve done regional training classes in many different areas across the country, from New York to Tennessee to Texas. Currently, we are planning regional training sessions in California and other areas around the country.

William Gulley

William Gulley

A Quick Take

24×7: What’s your personal history with the company and in the industry?

Gulley: I started with the company in late July of 2009 and came with an extensive financial management and operational background. The medical device and ultrasound industries were new to me at the time, so I continue to grow and learn as the market changes.

24×7: Do you offer any training via the Web?

Gulley: As a matter of fact, we do. We have three present offerings: a basic ultrasound class that gives you the physics and other aspects of what ultrasound truly is and how an ultrasound machine works from a physics and electronics perspective. Then we have the Philips i-box for iU22/iE33, and the Sequoia training courses online that walk you through the proper preventive maintenance of a machine. Soon, we will expand our online courses.

24×7: Do you find that the Web training courses are better attended than in-person courses?

Gulley: It’s mixed. It really depends on the learning style of the individual. Some people like to get away so that they can really concentrate. If you’re getting a training class inside your hospital or down the street, and your facility calls and says, “We have a problem. Can you get over here?” you have to go. If you’re at a different physical location, you’re fully immersed in the training process, so you don’t get those interruptions. Some people learn better online, where they can go at their own speed and can review portions of it two or three times if it’s not making sense to them. It really depends on the learning style of the individual.

We strive to put together courses that cater to the styles and needs of clinical engineers as much as possible. Today’s working environment is very demanding, so we understand the reality of being away from your hospital for multiple days may not be feasible, in which case online training is the best fit. On the other hand, some people enjoy the hands-on learning experience.

24×7: Do you have plans to expand those Web offerings?

Gulley: Certainly. We’ve had a great response to our initial online training offerings. We’re getting more and more people asking us for a subscription-based model in order to train their entire hospital clinical engineering group. We’re finding more institutions are interested in training their entire staff, and online training is a great way to accomplish this.

24×7: Has Axess always had training courses, or is that a relatively new offering?

Gulley: Training has been a part of Axess Ultrasound since I have been with the company.

24×7: How do you design the training offerings?

Gulley: Customers dictate a lot of our course structure. Often we hear, “We have a lot of these systems. Can you help us train our folks?” We also have what we call an internal tech council, which is a cross section of our field service engineers, that determines what units we’re going to offer next and how we’re going to develop those training courses. Our in-house staff is a great resource for us. They are the ones out in the field solving the repair issues, taking the machines apart. In our opinion, there is no better way to start the foundation of a training program than from the input of our own service technicians.

24×7: What do you think is one of the biggest issues facing the industry?

Gulley: We’re in a tough economy, and everyone is being asked to do more with less resources. That’s not exclusive to the biomed community; that’s every community at large right now in this economy.

24×7: Is there anything Axess can do to help remedy this?

Gulley: People are worried about spending excess money and are watching their expense budgets as closely as they can. Axess, internally, even with our growth, is no different. Competitive pricing is always something that’s important. However, price isn’t the measure of value. If you are consistently having warranty issues or consistently having parts delivered incorrectly, or you have a group saying they can service a piece of equipment for X amount of dollars but they don’t have a service technician in your area, you may “save money” by using them, but your machine may be down longer where you don’t have the opportunity to earn revenue with that machine.

So it’s not just the cost. It’s the lost revenue opportunities. In many cases, it’s how you as a biomed are looked at within your hospital. If that machine is not fixed, they’re not going to look at the supplier of the part. They’re going to look at you and ask, “Why isn’t that machine fixed?” That $50 that you saved on that part may cost the facility $5,000 dollars in lost revenue and other costs in the future.

24×7: How closely does Axess Ultrasound work with biomeds on a daily/weekly basis?

Gulley: Every single day. They’re calling in not only for service, parts, and probe repair, but also calling us for technical support, which we’re happy to offer. A technician may call in and say, “I’m seeing this error. Do you know what that means?” “Does this type of board do this?” And they call about other general troubleshooting questions.

24×7: Have there been any noticeable changes in the ultrasound industry since the inception of the company? If so, how has that changed Axess’ business approach?

Gulley: There has been a lot of change. There has been some consolidation in the industry. There have been folks that have come up with new offerings. There are new companies trying to establish a more regional presence, not as much of a national presence as we have. I believe that’s always going to happen in an emerging industry like we’re in now. But as far as how that changes our business approach, it doesn’t at all.

We have a strategic plan that we’re looking at. If you’re reacting to other people, you’re focusing on what they do best. We’re focusing on what we do best and presenting that to the customer. So far, that has been very successful, and the customer has seen the value of what we provide.

From Axess’ perspective, we stay true to our core values and not let wild fluctuations and big announcements from others impact what we’re doing. Obviously, we pay attention. Obviously, we analyze and see where that puts them and ourselves in a competitive situation. However, we’re not going to chase what another company is doing because in all honesty, good competition is better for the entire industry. It’s better for all the ISOs to have solid competitors out there.

24×7: Does the company have any new offerings/training planned for the future?

Gulley: As I mentioned earlier, we have some exciting new online training courses coming out in the next month or two. We have other innovations planned, but at the present time, I prefer not to announce them yet.


Chris Gaerig is the associate editor of 24×7. Contact him at .