Since CD and DVD storage technology entered the medical imaging arena, they have provided a simple way to eliminate expensive film costs by archiving and distributing medical images among patients and physicians. What was previously just a market for simple archival and distribution seems to be transitioning into something more as many vendors are starting to offer image management solutions for static and dynamic images, adding accompanying educational supplemental materials on CD, DVD and even flash drives, to create a more complete, portable patient record.

Recording dynamic images on DVD

Static images are not the only data that imaging centers and departments are archiving and distributing to patients and physicians. High-resolution video recordings of dynamic series are being gathered from ultrasound, C-arms or fluoroscopy. Fluoroscopy is one modality that has steadily gained in output volume over the last four years for Baylor University Medical Center’s diagnostic radiology department, which performs approximately 160,000 to 170,000 imaging exams annually.

According to Glenn Skinner, supervisor for diagnostic radiology at Baylor, there are now approximately two and a half times more fluoroscopy studies being done than in January 2002. To keep up with the volume, and to replace its medical SVHS recorder, the Dallas-based medical center’s department deployed MDR Video from NAI Technology Products to record speech studies to DVD. They have been using the system for about two and a half years.

MDR Video integrates with existing modality exposure controls for automatic, simultaneous image capture of still images and cine loops. “The problem with VCR was that it did not have the resolution that the DVD does; now, image resolution is easily 100 percent better for playback comparisons,” Skinner notes.

They started out just using the system for modified barium swallower dysphagiagrams. “We do anywhere from 10 to 12 a day in one room; now, we can get about 14 to 16 exams done in the same room because of the time savings. We are saving per exam about 25 percent of our time,” he adds.

Burning speech studies now typically takes about 6 to 7 minutes to record and burn, and the entire file room process has been eliminated, he adds. In time-savings alone, using MDR Video has cut 30 to 40 minutes off the schedule each day. Additionally, the department is now dealing with about one-fifth the storage space they were using previously. “One shelf in the file room has two and a half to three years of exams just for fluoroscopy,” Skinner notes.

With the CD/DVD recording system, Skinner says his department gets the benefit of high-resolution rapid sequence imaging without higher radiation doses, and the continuity of video, which ultimately translates to a safer procedure for the patient.

Point-of-care medical records

Keeping up with high-volume imaging is something Banner Desert Medical Center is familiar with. The 549-bed, non-profit facility in Mesa, Ariz., provides a wide range of inpatient and outpatient services and employs more than 3,700 healthcare professionals and support staff. The facility has a medical staff of more than 1,200 physicians representing 65 specialties, with an annual imaging volume of approximately 155,000.

According to PACS Administrator Randy Robbins, utilizing the MediaWriter D200 from PACSgear allows the medical center to create portable medical, DICOM-compliant medical records at the point of care. The software interface allows a user to query multiple DICOM devices by medical record number or name, or it can work in an unattended mode called AutoBurn, which lets you send directly from the modality to MediaWriter, he adds.

The center implemented the D200 about a month ago to keep up with the high throughput. With two CD/DVD drives and a throughput of 200 discs per day, it combines studies and reports from multiple DICOM devices to create a complete medical record that can be accessed using an integrated viewer. The system also can burn data to a portable flash drive, however, Robbins says is not being utilized.

Once the staff realizes it can burn to flash drive, he looks for the feature to increase in utilization, namely for staff doing teaching cases or research.

Empowering patients

The CD and DVD market is beginning to move beyond merely putting images and reports on a disc as a film replacement, and offering additional value through supplemental and complementary content.

According to Chuck Newbry, PACS administrator for Legacy Health System in Portland, Ore., the SmartLine of CD and DVD products from DatCard provides and empowers patients with customizable, educational information to accompany studies and reports. The company is trying to provide more customer-centric applications, integrating their software with hardware platforms from other vendors like Rimage, to provide an overall solution.

He says that Meridian Park Hospital Breast Health Center in Tualatin, Oregon, is using MammoSmart, which includes digital mammography images and the diagnostic report, medical history and insurance information on each patient disc. Customizable educational content can include a glossary of terms, answers to frequently asked questions, live video capture as well as self-breast/family healthcare history for “high risk” patients, or additional educational information that covers the complete spectrum of mammography and complementary services.

“If a simple, cost-effective educational resource as the MammoSmart CD will help to eliminate any personal suffering by providing additional information and resources to the patient, to share with loved ones if desired, it is a step to success,” Newbry says.

 An additional use of the MammoSmart CD is to carry forward imaging records of the patient. “Our CD contains the diagnostic quality, lossless images, as acquired during the study. These can be viewed as comparisons, and imported if desired, by the next physician should the patient move or go to a different breast center for later exams,” he adds. Several years of studies can be placed on a CD, and many years can be placed on a DVD and images can be imported from the CD or DVD back into any PACS.

“It really empowers the patient to help himself or herself a little,” Newbry says. Meridian Park gives them to every patient after their exam. “More information it is better to try and keep things consistent,” he adds.

Within the next three to five years, Newbry forecasts that vendors more and more will be finding ways to put medical records into the hands of the patient, and physicians, with additional educational information to complement their care. “Anything to get cost-effective data in front of the practicing physician so he or she can help the patient,” he concludes. 
 

Meridian Park Hosptial’s Breast Health Center customizes MammoStart CDs to include resources like a screening guide as a complement to a patient’s mammography study.