Is It Time For Your Practice To Go Digital?

(as featured in Kleinert Kutz Magazine)

Digital or film? That is the question more and more physician practice groups are facing. And, much like digital cameras have eclipsed film cameras in the marketplace, digital imaging is quickly overtaking film in the physicians' office.

What are the advantages so many practices are discovering with digital imaging? Is it the right choice for your practice? Tom Walker is the owner of the Raynostix Group, a Louisville-based company that provides imaging equipment and services to hospitals, imaging centers and private physician practice groups across the country. He is an expert in the field, with years of experience in consulting with physicians and practice administrators to help them make the choice that's right for them. Here, he offers information and guidance that may be helpful to you if you are considering the switch to digital.

Understanding the two types of digital

"First of all, when people hear the word "digital," they need to know there are two different types," said Walker. "DR, or digital radiography, requires very expensive technology. A DR system has a digital plate built into the table and wall stand. The digital signal passes directly into the computer system. It is extremely fast, producing an image in just a few seconds. This kind of speed is important in hospitals and large clinics where they do a large volume of imaging and may have many patients waiting in line. However, I have no non-hospital clients who can justify the cost of a DR system, which can be in the ballpark of $300,000.''

"CR, or computed radiography, is the other type of digital imaging," explained Walker. "It utilizes the x-ray technology most practices already have, and converts it into a digital system that is far more practical and affordable for most private practices." According to Walker, "With a CR system, an x-ray is taken the traditional way, using a cassette. However, this cassette holds a reusable phosphor plate instead of film. The image is captured on the plate, which is then placed in a digital reader. The image is scanned into the computer and appears on the workstation screen within one or two minutes." He added that most practices can convert to CR using their existing x-ray equipment with only slight modifications. "If you have an old, standard-frequency generator, you will probably have to upgrade to a high-frequency generator. Even then, the cost of conversion to CR doesn't even approach the cost of DR."

Advantages of digital technology

Digital technology brings you significant advantages over film.

• No need for a darkroom: When film is eliminated from the equation, so is the need for a darkroom. The entire darkroom is replaced by a digital reader that has about the same footprint as your current processor. It frees up space that may be used more profitably and efficiently.

• No more chemicals: Wet processing, plus the plumbing problems and messy, potentially hazardous chemicals that go with it, are eliminated, something staff members appreciate. In addition, wet processors, which have a reputation for being unreliable, are no longer needed.

• Consumables are reduced: Film is a consumable item, as are chemicals, filers, mailers, etc. Digital doesn't require them.

• Retakes drop significantly: A film x-ray that is too light or too dark is useless. Another image has to be taken. Digital images, however, can be manipulated via the software in the computer. Not only do you get excellent resolution, but you can also adjust the contrast, window and level; take measurements; and zoom in on areas that call for closer examination.

• Less storage space is required: Because you no longer need film and all the accessories that go with it, space devoted to storage can be greatly reduced. Lost films are no longer an issue, either.

Image storage and retrieval

Just as you must do with images from a digital camera, you have to offload CR digital images for safekeeping. Walker stresses the importance of redundant storage. "You can offload into a separate hard drive, or onto CDs or DVDs," he said. "But I highly recommend that practices consider the PACS system, which stands for Picture, Archiving and Communication System." As he explained, "Let's say your practice generates 8,000 CR images in a year. You must have backup, so you may choose to burn CDs or DVDs. Then, when you need an image, you have to look them up in your filing system. A PACS system, however, allows you to transmit the images digitally into your network, where they can be archived and made available to workstations throughout the practice. They can also be sent out for review digitally, going directly to the computer screens of outside radiologists or other specialists. Image retrieval is greatly simplified."

Motivations for going digital

Physicians have a variety of reasons for going digital. "The advantages over film, and the return on investment are often reasons for a practice to go digital," said Walker. "For a physician who is planning to retire in a few years, a stronger motivation may be to make the practice state-of-the-art in order to prepare it for sale. Or, when a practice regularly sends images to a radiology group to read, sending them digitally rather than on film is the difference between sending email and snail mail. There are almost as many reasons as there are practices."

The most important question

The single most important question that physicians or administrators Thinking about going digital need to ask is, "What are my goals in going to a digital system?" As Walker explained, "You need to know what you want the system to accomplish before you can make your best decision. That can vary greatly from practice to practice and specialty to specialty."

According to Walker, "One major consideration is return on investment. Right now, you may be spending $10,000 a year on film, chemicals and supplies, and dealing with a less than reliable wet processor. Your staff may be spending an inordinate amount of time processing images. You may wonder if you have too much space tied up in a darkroom and storage. How fast would you recoup your investment in CR?" He added, "Another factor to consider is workflow and how a digital system might impact it. For example, are you okay with not having a piece of film to carry around anymore? In addition, the ability to change the contrast or zoom in on images is extremely important to some practices and specialties. How advantageous would that be to yours?

"I recommend having somebody sit down and educate you on what's possible," said Walker, "and discuss what a conversion to digital will mean to your practice. It's the best way to begin a decision-making process that will lead to the right choice for your unique needs."

Return to Thinking About Going Digital?

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