Computed radiography systems, often in combination with PACS, are bringing cost reductions in film, FTEs, file room space and repeat studies, and driving efficiency and exam turnaround time in imaging centers and across entire healthcare enterprises as well. Six facilities share their real-world productivity gains.
Radiology departments throughout the country are considering whether or not productivity gains justify the deployment of computed radiography (CR), whether in clinic-based settings or across a multi-institutional enterprise. For clinicians interested in taking advantage of the overall benefits of digital image distribution in a filmless radiology practice, CR offers a variety of productivity advantages through increased efficiency for technologists and clinicians, and cost reductions for the enterprise.
Cathy Lechnir, administrative director for radiology at Gundersen Lutheran Health System in LaCrosse (Wis.), describes the benefits of their Fujifilm Medical Systems CR installation. While their first SmartCR unit was installed in an outlying clinic in December 1996, they completed the conversion to a filmless department in July 2003 utilizing the Fuji Synapse PACS. The institution employs a robust network with a Gigabyte backbone and 100 Megabytes to the desktop that they describe as redundant and reliable.
Although the advent of digital image management brought immediate, they have continued to see advantages gains for their technologists and physicians. Because they have several different physical sites, in the past a radiologist would travel to an offsite facility, read x-ray studies for three hours, wait for intermediate steps to completing a report, and then move to another site. Radiologists have recognized productivity gains by having the images come to them, allowing them to stay in one location to interpret studies for a full day rather than waste "windshield time" driving from site to site.
"We have a PACS workstation on all of the hospital floors and in the clinics," says Lechnir. Once an image is processed, it becomes accessible immediately to both the radiologist and the referring physician. For example, in the NICU, once the x-ray is taken and put through the CR processor, the neonatologist and the radiologist can see the results simultaneously.
Susan Einerwold, clinical manager for diagnostic radiology at Gundersen, cites reduced workplace stressors for their technologists, especially in the critical care areas of trauma, intensive care, cardiac care and surgical departments.
"There's a decrease in stress for the technologist due to the fact that images are readily available for providers with multiple viewing options," says Einerwold. This enables the techs to concentrate on performing exams and patient care rather than film management.
Similar productivity gains are described by Sally Womer, radiology quality improvement coordinator at Geisinger Health System in Danville, Pa., for their Fuji CR system they installed two years ago.
The enterprise includes two major medical center hubs with several clinics within a 75-mile radius. The efficiencies afforded by immediate access to digital images has enhanced patient care in their outlying clinics as well as their intensive care units that physically are located at distant sites within the hospital. Womer describes that although their ICUs are located in the same building, they're a block and a half away from the radiology department.
"Our docs used to come in and spend the first two hours of the day out of the radiology department [reading films in the ICUs]," says Womer. Now, they select studies from the list on the PACS, read those images in the department and move to other activities.
OUT OF A JAM
Jeff Pustejovsky, assistant administrative director of radiology at the Carolinas Medical Center in Charlotte (N.C.), installed a Konica Minolta Xpress Dual-Bay CR system in the fall of 2003, after having systems from other manufacturers for several years in their four hospitals in the county.
He describes the speed of processing time as a major benefit. "We didn't want our people to have to wait in line to be able to run a cassette."
With their own radiology engineering group, Carolinas Medical Center has found efficiencies too, in installing the same equipment across the enterprise so the engineers are only required to learn one system.
One of the other features that impacts their productivity is the ease of