Despite the continuing focus on the paperless department and healthcare facility, there is still a significant need for laser imagers in healthcare. Whether the printouts are for patients themselves, referring physicians, or even attorneys, facilities are getting significant use from their workhorse printers. So, price, ease of use, and flexibility are just some of the factors that come into play. Whatever is most important to a facility, vendors have an offering that fits the bill.


A successful run

Fitz Silvera, director of purchasing for Medical Resources, an image management company headquartered in Bloomfield, N.J., says his company has more than 50 DRYPROs from Konica-Minolta Medical Imaging USA Inc. in use around the country.

"We had a longstanding relationship with Konica before they entered the laser imaging market," Silvera says. When the 722 model was introduced, Medical Resources purchased about 30. "We had a very, very successful run with the uptime and performance of these systems." Over the years, he says the company acquired more imagers as new models came out and now has a combination of all the models.

The latest, the DRYPRO 793, has the 25 μm resolution necessary for mammography applications, 120 films per hour throughput (14x17), and film sorting capability. "I think most of the features on these laser cameras are common among the different manufacturers," says Silvera. The determining factor for him is reliability, which includes quality service and throughput. "We've been satisfied in all those areas."

The current configurations and the different models available from Konica "give us all the printing capabilities and throughput that we'll ever need as technological development progresses," Silvera says. "We're looking for a company that can keep abreast of demand for printing that is required for a multislice CT scanner and faster throughput on the newer MRs. I feel that Konica is capable of meeting that challenge."


Smaller space and costs

Space is tight for all imaging equipment. Premier Radiology, a large, busy imaging center with imaging capabilities in all modalities in Nashville, Tenn., recently replaced two imagers with high overhead costs with Horizon Ci and Horizon GS imagers from Codonics. "We are pleased with the small size — it takes up less space in the cramped CT/MRI area," says Bennie Wilson, network engineer. "Space is at a premium" so the fact that the unit sits on a desk rather than the floor and is smaller than a dry imager is helpful.

"With a standard dry imager, you loaded film in and it was a huge floor model — four feet tall and taking up 15 square feet," he says. "That's what we had and replaced with Codonics and nobody can really tell the difference" in the printouts.

Another plus is the lower cost. The imager is priced lower than a dry imager and the maintenance costs are less. With the ability to print paper or film, "we can take advantage of competitive prices. Film costs have dropped significantly in the last several months because paper is making such a strong showing for printing x-rays." Before, Wilson was locked into using film only. If paper happens to be cheaper and the physician does not have a preference, that flexibility translates into savings.

For an imager that prints both film and paper, "Codonics appears to be one of the best of breed in that space," Wilson says. The imaging center sees 150 to 170 patients a day for procedures performed on MR, CT, nuclear medicine, mammography and soon on CR. Physicians all over the midstate area refer patients to the center.

Besides cost and flexibility, the system is easy to use, Wilson reports. With paper trays, the Horizon imagers are much like laser printers. There are three trays so users can set up for any modality. In trying to project future printing needs, Wilson believes the current imagers will fulfill needs for at least the next two to three years. "We are a progressive company and we took our best guess of what we think our business and medical needs will be and went with Codonics."


The need for speed

While some organizations focus on reliability, cost, and size, speed is the primary driver at others. Piedmont Hospital in Atlanta, has Kodak DryView 8900 laser imagers with multi-sorters in use, says Randy Sprinkle, administrative director of radiology. A long-time customer of Kodak's complete product line, the facility chose the 8900 because of its speed and ability to accept multiple film sizes. "The ability to sort the film based on modality as well as being a faster printer were the top criteria," Sprinkle says.

Besides the speedy output rate, another factor helping to improve efficiency is that the 8900 does not require reconfiguration for each new piece of equipment. "Before, we had to add an IP address and have Kodak come in to reconfigure the laser camera," he says. "The 8900 is a true, DICOM laser printer. It doesn't require any type of interface or black boxes as previous models did."

Piedmont Hospital is part of Piedmont Healthcare which is comprised of three hospitals, two of which have PACS and the third is getting ready to install. All three facilities use Kodak for film printing. Having PACS means the 8900 isn't being used to its full potential, says Sprinkle, but "if we were truly having to run on all modalities, the two 8900s we have would meet our needs." The system performs about 285,000 imaging procedures a year and Sprinkle estimates that they print about 10 percent of that volume.

Those printouts are for referring physicians, legal requests, and patients who need to take films to another location or physician.


Looking upright

MD Imaging, a freestanding imaging facility in Poughkeepsie, N.Y., has been using the UP-DF500 FilmStation from Sony Electronics Inc. for about a year. The organization upgraded from a refurbished laser imager that was experiencing degrading image quality, says Fred Ricci, RT (MR)(R), technical director. Ricci and his colleagues liked the Sony offering because of its compact size, price point, ease of use and image quality. The UP-DF500 can be set up on a desktop or vertically. With space at a premium, "the vertical option was a big determining factor," Ricci says.

MD Imaging is a full-service, com-pletely digital imaging facility. "Every-thing except for mammography can be printed to the Sony," he says. When it comes to printing, the PACS is another modality. With that in mind, Ricci says another benefit of the Sony imager is that it can accept multiple inputs without individual set up and charges for each. "When you buy a big laser imager, the manufacturer usually tries to sell you different inputs," Ricci says. Both the extra step and the extra cost are eliminated. "Set up is much more convenient. It's kind of like adding a printer to the network."

Even though MD Imaging is a filmless institution, "that's only internal," says Ricci. "Referring doctors, mainly orthopedists and neurologists, like to have film." Good quality imaging printouts remain important because "we have not gotten away from looking at film, to show patients or to carry into the operating room for reference."

The push for digital imaging rolls on and film printing decreases as technology advances, says Sprinkle, but "there will always be a need for laser imaging," he adds.