CD/DVD Recorders across the 'Ologies'
Mike Higgins, a nuclear medicine technologist in the radiology department at Providence Alaska Medical Center, reviews a CT scan.
With the ever-increasing emphasis on integrating healthcare IT solutions across the healthcare enterprise, CD and DVD recorders with their widespread and evolving capabilities have managed to fill much-needed niches within various image-dependent departments—particularly radiology, pathology and cardiology.

Inside radiology

Providence Alaska Medical Center in Anchorage, Alaska, is the state’s largest hospital and part of the Providence Health & Services Alaska network. Each year, its radiology department completes approximately 175,000 studies. Because of its geographic location, the facility often serves patients who travel great distances. To enable patients to take copies of their images and radiology reports back home or to a referring physician, Providence Alaska Medical Center utilizes CD and DVD recorders from PACSGear. 

Late last year, they added a PACSGear MediaWriter D200 that employs the Epson Discproducer, says John Dolbinski, regional PACS manager, at Providence. Previous models of the PACSGear MediaWriter have been deployed at various locations throughout the health system for more than a year.

The larger Providence Health & Services Alaska network extends to more than six facilities throughout the state. All facilities within the network are connected through a common enterprise-wide PACS. This enables any qualified user within the facilities to pull images from the PACS, and send them to be burned to CD or DVD on the facility’s MediaWriter, which is “beneficial when you are covering such a expansive area,” Dolbinski notes

With a high volume of images from a range of imaging modalities feeding into the Discproducer, Dolbinski says it is beneficial that the D200 system has two CD/DVD drives and a capacity of 100 discs. “In general, you can store more discs, and it’s hands-off in that you don’t have to manually add a disc with each burn,” he adds.

Since the Integrated Viewer is embedded in each disc, both the patient and the referring physician can access the images from any PC. This is particularly important for patients who have traveled long distances from rural areas for imaging procedures, and then return to their referring physicians with their discs.

To become even more user-friendly, PACS-Gear is scheduled to release compatibility with OsiriX for Macintosh computers, which he believes will aid the ease of use for many clinicians with that preference.

The CD/DVD process works in reverse as well at Providence Alaska. If a patient brings a CD or DVD from another location, the radiology department can then integrate the report and images into PACS with the aid of the PACSGear digitizer or the MediWriter. Once the information lives within PACS, it also can be pulled into a patient’s enterprise-wide McKesson EHR, thanks to its DICOM-compliancy.

Managing cardiology images

As the number of cardiac imaging modalities grew at Saint Francis Hospital in Charleston, W.Va., they needed an effective means of burning and archiving studies of varying sizes from various systems, such as echocardiography and cardiac CT. The solution was a Sorna eXpedo CD/DVD system, says according to Brian Lilly, RT, MBA, director of medical imaging and former director of cardiac services.

Due to the large image size of cardiac CT studies, Lilly notes that it is beneficial to be able to harness those images to a single technology. The eXpedo system automatically chooses to burn a CD or a DVD based on the size of the imported file, as both formats are located in pre-loaded trays. “Previously, if you sent a file to a CD, and the studies were too large, the burner would kick it out and the technologist would have to load a second CD, or the technologist would be forced to start all over again,” Lilly says. “The burners now act just like a network printer.”

Being able to export studies to the burners from the modality, rather than exclusively from a select number of workstations throughout the facility, also saves the technologist’s time. Previously, they had to burn the images at workstations throughout the hospital. Now, the “workstations are no longer tied up with technologists burning large cardiac CT studies, because now the studies are exported to the burners. As a result of this implementation, those workflow issues now have been alleviated,” Lilly says.

As with the other modalities at St. Francis, cardiac CT images now are processed, sent to the burner and the front-office clinical receptionist to give either the disk to the patient or sends it to the referring physician’s office, he explains. On average, the staff at St. Francis burns about 45 to 50 discs daily.

“A process that previously was very time-consuming, now is carried out through one mouse click, and it is no longer an area of concern—the system labels the CD or DVD, puts it in a HIPAA-protected format and prints out professionally labeled disc,” Lilly says. He adds that prior to installing the CD/DVD burner in early January, the CDs and DVDs were not properly or professionally labeled, nor were they HIPAA compliant.

Lilly also notes that it is beneficial for the cardiologist to have the patient’s entire study on one disc, especially for private-practice cardiologists who are not connected into a provider or an enterprise-wide PACS. “They now have a self-contained unit with the viewer already ingrained on the disc. In general, referring physicians no longer have to be concerned about PACS integration. However, if the physician chooses to integrate the studies into [his or her facility’s] PACS, it wouldn’t be problematic due the embedded DICOM compliancy.”

Inside pathology

The scope of uses for CD and DVD recorders stretches beyond saving, archiving and distributing images for use in radiology and cardiology. Bette Pommerleau, a speech pathologist, and her colleagues at Merrimack Valley Hospital in Haverhill, Mass., needed a means to save and view frame-by-frame analysis on the function of swallowing. The answer was an MDR Video medical DVD recorder from NAI Tech Products.

Through their scans, Pommerleau and her colleagues seek to examine the oral cavity, the pharynx and the esophagus, if needed, to thoroughly assess a patient’s ability to swallow in a real-life setting. The pathologists then add barium in varying consistencies, in addition to liquid. They image the patient to see if he or she aspirates, and what’s happening if that patient does aspirate. They test various techniques under x-ray. She adds that the “quality of the image has increased our success,” which is particularly beneficial to throat cancer patients.

“Previously, we obtained fluoroscopy images that would be translated to a VCR tape that, unfortunately, wasn’t very high quality, making it more difficult to review tapes for a report, or train caregivers or staff,” Pommerleau says. “The MDR Video technology kicked us up another notch.”

The ability to assess images in a “clear, frame-by-frame way has drastically improved. In contrast, when you tried to conduct a frame-by-frame assessment on videotape, the image becomes quite blurred whenever the tape was stopped,” Pommerleau says.

As a result of MDR Video’s implementation, they now have developed a way of marking what consistency [of liquid] has been administered to the patient, “which is tremendously vital in pathology.”

Pommerleau also speaks to the benefits for patient education, especially considering the fact that a disc can be burned immediately. The patient can then take the DVD to a referring facility, where physicians with a PC with DVD capabilities can view the disc.

However, she believes the most beneficial aspect of incorporating CD/DVD burners into the pathology department is having a reproducible record. Previously, the hospital would have a master tape of a fluoroscopy exam with ever-accumulating number of swallowing studies.

“Now, these images can be compressed, and integrated into PACS, where physicians can access them, along with the patient’s report,” Pommerleau explains.

Extending to all ‘ologies

As CD/DVD recorder vendors continue to expand into various specialties, including mammography and obstetrics, as well as ramping up their software, these systems continue to prove their worth in individual department and enterprise wide.