CR + PACS = Efficiency

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Healthcare facilities that have coupled computed radiography (CR) and picture archiving and communications systems (PACS) have begun to realize the workflow enhancements and improved effectiveness anticipated by deploying these technologic advances. CR vendors have worked to improve throughput while maintaining excellent image quality to facilitate patient care - to the benefit of healthcare facilities and patients.

Efficiency gained

Sally Grady, RT(R), director of imaging services at Florida Hospital-Celebration Health describes their state-of-the-art hospital designed for the digital age of radiography that completed construction and opened in Disney's town of Celebration in 1998. Although they originally designed the department to implement direct digital capabilities in x-ray, they did not believe those systems were quite ready for prime time. So just prior to opening, they installed two CR systems, an Agfa Healthcare CR 25 and CR 75 and an ADC 70 digitizer to meet their needs. The CR 25 is designed as a decentralized single-plate system, while the CR 75 is the high-volume multi-plate system.

Grady says she has not processed film from the day they opened.

The Florida Hospital System, of which Celebration Health is one institution, operates seven campuses under one bed license in the Central Florida area. This system admits more than one million patients per year to their inpatient facilities, and completes between 700,000 and 900,000 imaging studies per year.

"We were looking to solve several issues, such as productivity," says Grady, who also worked to implement Agfa CR installations in the other six hospitals across the Florida Hospital System. "Before I took Florida Hospital Kissimmee live, we looked at FTEs and we found we were 23 percent more productive at Celebration." She believes that is due to the use of CR in their department.

Another benefit to having deployed CR across the entire network is that they can now provide 24 hour-a-day radiology coverage for all hospitals with the 54 radiologists, including a number of subspecialists, serving to read the studies from all institutions.

Grady believes that their combined CR/PACS solution has decreased length of stay for many of their patients because it shortens the interval between imaging studies if physicians decide they need additional examinations because they did not gain all of the clinical information from the first study. Many of the physicians can review images from home, and order additional imaging studies they consider essential.

The technologists are able to spend more time in the x-ray room, which decreases patient anxiety. Once the cassette is loaded into the ADC-Compact (the plate reader right outside the door), they return to the room to review the images on the quality station console.  The ADC-Compact Plus employs stacking methodology, where the technologists can stack up to 10 plates and leave, and the machine will automatically process them in order.

Grady's department uses a PACS team with six people who were chosen to provide both CR and PACS support. Although it is a joint effort between radiology and IT, they have chosen to manage both systems from the radiology side because the expertise in CR technology takes precedence. She notes that other hospitals may place the PACS team within the IT department, but they have followed this path because radiologists were very comfortable with it.

Enhancing workflow

At Illinois Valley Community Hospital in Peru, Margy Frey, BS, RT(R), administrator and director of diagnostic imaging department reports that they have configured their CR network with Kodak DirectView CR 850 and CR 950 systems to manage the images for the patients in their 100-bed hospital. While they do not perform any invasive procedures or angiography, they do complete conventional x-ray and some interventional scans. They went live with CR approximately a year ago.

Illinois Valley installed the CR 850 to provide robust redundancy to the operation in case they would have a network problem or in the event that the 950 required maintenance. Frey describes the system as extremely easy to use with touchscreen functionality.

The CR systems utilize a rigid plate that is tested to 45,000 cycles to insure durability. The system is built on the concept of non-contact scanning where the imaging plate that is inside of the cassette is used without ever touching it.

Both systems feature an internal battery to keep the machine operating to