The employees of Scottsdale Medical Imaging (SMIL), an imaging practice with 14 locations throughout the state of Arizona, recently faced a dilemma many other providers in the industry have encountered; they had to choose a vendor to lead their conversion from computed radiography (CR) to digital radiography (DR).
The industry had been trending in that direction for a number of years, and SMIL was already considering an upgrade, but once the Consolidated Appropriations Act of 2016—which hits providers with reimbursement cuts for failing to upgrade their equipment—was signed into law, the practice’s leadership knew it was time to go all in and complete the conversion to DR.
“We took a look at our book of business and realized that eventually we were going to be taking some significant hits with reimbursement,” says Jessica Montgomery, SMIL COO.
Had SMIL not converted to DR, she adds, “the hit that we would have taken in reimbursement was about $500,000 over the course of five years.”
When considering vendors, SMIL looked back at its healthy relationship with FUJIFILM, which began back in 2003.
“We decided to go with FUJIFILM because we looked at our partnership,” Montgomery says. “A relationship is very important to us. We wanted to partner with a company that was well-known in the marketplace and had a great product that was reliable and efficient. We chose Fuji because of their reputation, because of their equipment reliability, because of their durability.”
A smooth transition with many benefits
To accommodate DR, SMIL selected FUJIFILM’s D-EVO II detector and two FDR D-EVO Suite Floor Stand units. FDX consoles are used at all sites.
Michele Arvin, SMIL director of operations, says transitioning from CR to DR began with one plate at the practice’s facilities. Once everyone was comfortable, she adds, they “buckled down protocols and slowly transitioned DR to the other sites, one at a time.”
“Our conversion process from CR to DR has been a very smooth process,” Arvin says. “Our techs already were working on the FDX consoles prior with the CR. All we were doing is putting an imaging plate in and using the same console they worked on, so the techs didn’t really have any training to do. It was a smooth, seamless process.”
Nikki Carstens, SMIL general procedures manager, notes that perhaps the biggest benefit of implementing FUJIFILM’s DR solutions was the reduction in radiation dose. The practice has seen a reduction in dose of approximately 50 percent, and that has come without any sort of drop in image quality, which is critical for radiologists as they make their reads.
“Most people expected [that] since we have lower dose, we’re going to have lower image quality, but that definitely is not the case,” Carstens says, adding that DR is “much more adaptive to over- or under-penetration,” which results in fewer repeats.
Whitney Farris, SMIL radiological technologist, echoes Carstens’ comments, noting that reduced dose and high-quality images are crucial for technologists as well as for patients.
“I go as low as possible with the dosage, and I’m still able to get those really clear, crisp images for the x-rays,” Farris says. “We’re able to manipulate our techniques to get really sharp, clear images with the DR equipment. It’s great for patient care, limiting dose. It’s exciting, and it makes me feel better as a tech.”
Ronald Newbold, MD, one of SMIL’s radiologists, lists reproducibility as another benefit of FUJIFILM’s DR solutions.
“DR has been very good at delivering quality that’s reproducible,” he says. “That is very helpful to determine subtle changes that help me know if it’s getting better or worse, or if it’s stable.”
SMIL has also found that FUJIFILM’S DR solutions rarely experience technical issues, and even when they do, it rarely results in computer downtime.
“We’re a business that takes care of patients, and we can’t take care of patients when we’re down,” Montgomery says. “So reliability and uptime are very important.”
Improving the patient experience
In this modern era of value-based care, healthcare providers are especially focused on a patient’s experience while receiving care. How long did they wait? Were they comfortable? Were they treated with respect?
SMIL employees agree that FUJIFILM’s D-EVO II detectors contribute to patient safety, comfort, and satisfaction. For instance, the technologist can remain in the room with the patient during the entire procedure now, providing comfort every step of the way.
“The patient experience is a lot different,” Carstens says. “The techs are able to spend more time with the patients because they’re not out processing their cassettes like they were with CR. The patients feel more comfortable.”
“DR allows you to have more contact with the patient,” Farris adds. “You can just position them, talk to them while you’re doing it, and focus more on the patient.”
SMIL has also seen patient wait times and exam times reduced. Newbold noted that patients usually wait just 5 or 10 minutes at the most, which helps relieve stress and keeps patients wanting to return if they ever need additional care.
Most of SMIL’s customers are unscheduled walk-ins, so wait time is an important consideration in customer satisfaction. Because the FUJIFILM DR solution produces images faster than CR, patient wait times and exam times are reduced.
“We’ve had about a 30 percent decrease in exam times, and patients are often surprised at how quick their exam is,” Carstens says. “Anytime a patient doesn’t have to spend a lot of time in a medical facility, that makes them happier as well.”
Faster turnaround, improved efficiency
Upgrading to DR through FUJIFILM has also had a significant impact on employee efficiency and productivity at SMIL. Due to the high volume at all of the practice’s locations—some offices report completing 100 exams in a single day—reducing exam time makes a noticeable difference in day-to-day operations.
“Decreased exam time increases our techs’ productivity, so we’re able to do many more patients in a day than we were before,” Carstens says.
“Once I had the DR up in our high patient-volume center, we were able to do about 25 more patients a day,” Arvin adds. “We’re able to get the images right the first time. That’s fewer repeats and fewer patients coming back for additional exposures or retakes.”
An overall wise decision
Overall, upgrading from CR to DR with FUJIFILM has been a home run for SMIL. When Newbold reflects on both the practice’s history with FUJIFILM and its future, he is quick to sing the company’s praises.
“We’ve worked with FUJIFILM for many, many years,” he says. “It’s not just a relationship with the patient and the referring physician, it’s a relationship with the vendor. We’re all in this together to deliver imaging as it pertains to medicine. We’re very happy with the relationship with FUJIFILM and where it has been, where it is and where it is going.”