With any PACS rollout, there is the promise, the dream of becoming a filmless, digital environment. But eliminating film does not eliminate the fact that people are still printing—the question is to what extent and in what format.
Del Donaldson, clinical systems analyst at Advanced Diagnostic Imaging (ADI) in Waterloo, Iowa, says that even with a PACS in place, the facility is primarily still printing film. “We are doing more business by printing film compared to other facilities that are trying to decrease film costs,” he says. “Film is getting a lot more use here than paper,” he adds, because referring physicians in the area, as well as one of the hospitals in town, do not have digital reading capabilities and commonly request studies on film. Donaldson just purchased his second Sony laser imager because the first one he bought three years ago was just “worn out from printing more than 100,000 film studies.”
They have two Sony FilmStation laser imagers and just last year added a Sony Color DICOM printer to support MR, CT, nuclear medicine, ultrasound and PET/CT. One FilmStation, located at the main ADI site, prints on 14x17 film, while the second one, housed at the University of Northern Iowa, has a dual tray which prints 8x10, 10x12, 11x14 and 14x17 films. They’re currently only using the paper printer for PET/CT studies since many of the images are color—which are printed in color for referring physicians’ review, he says.
Down the road, Donaldson says ADI will most likely start printing less film but “we have the capability with Sony that as the demand for film decreases in our area, the demand for paper will increase and we will be ready.”
Frederick Memorial Hospital (FMH) in Frederick, Md., is a 250-bed community hospital in the Baltimore suburbs with three full-service imaging outpatient centers that perform about 200,000 procedures annually. FMH deployed the aycan x-ray-print solution for multimodality diagnostic images about a year ago to replace film usage at the hospital, according to Brian Petrie, FMH’s telemedicine administrator.
“With four aycan imagers at each facility within the hospital system, combined with our PACS roll out, we have been able to reduce film usage by 60 to 70 percent,” Petrie says. “PACS [brought on] the significant drop, but aycan helped it to drop even more.” Petrie says the hospital was spending close to $200,000 per year on film and now they are spending close to $50,000 per year. “Aycan has really helped us to achieve the cost savings we were looking for,” he says.
FMH chose the aycan solution because it was a true DICOM printer that could print directly from any modality. With the quality of the print and size of paper also comparable to film size, Petrie says it is a “great way to replace film.”
He also says referring physician feedback has been positive—“they like having a piece of paper that they can fold and place in a patient’s chart,” he says.
“Film is on its way out,” says Petrie. “Pretty soon there is not going to be the demand for film due to the proliferation of data that are hitting the medical field—not only in medical imaging, but for patient records as well.”
Doing whatever it takes
“You cannot really say that you will never print again,” says Becky Lamberth, RT, (R) (MR), director of radiology for Plaza Medical Center, a 225-bed hospital in Fort Worth, Texas. She says it does not come down to a need to print, but instead to one thing: customer satisfaction. “If that is what our physicians want, then let’s give it to them,” she says.
Lamberth says that when they converted to PACS and began shopping for a CD/DVD burner, they found that some of their referring physicians were not interested in getting a CD—they wanted the image in hand. “We were looking for a combination of how we could print on paper and a CD burner and we came across Codonics, who offered us the Horizon Imager paper printer and the Virtua CD burner,” she says. The facility purchased both at the same time in June 2007 and has since purchased a second unit for use in the cath lab.
Horizon prints on paper that is FDA approved for diagnostic reads. “Meaning, when we print it out, it is no different than film,” Lamberth says. “If PACS crashed and that is all we had, our radiologists can use that to make an interpretation.”
The system can print an 8x10 color image; 8x10 and 14x17 black and whites; and if necessary, can print on 14x17 film. “It is so interchangeable, so