Thinking About Switching to Digital Imaging?

Thinking About Switching to Digital Imaging?

(as featured in Healthy Spine Resource Magazine)

 

Choosing digital imaging over film is a decision more and more physician practice groups have made because of the many advantages digital has to offer. If you are considering making the switch, there are many things to take into account, and it can help to get some expert advice up front. Tom Walker is the owner of the Raynostix Group, a company that provides imaging equipment and services to hospitals, imaging centers and private physician practice groups. He has years of experience in consulting with physicians and practice administrators about their imaging needs. "I always recommend that they sit down and get an education on what's possible with the various imaging systems," he said. "It's important to learn what a conversion to digital can mean for your particular practice."

According to Walker, "There are several areas that are often overlooked in the initial decision process, including monitor resolution, backup, storage and retrieval. Thinking about them at the start can eliminate surprises down the road."

Monitor resolution makes a real difference

"The level of monitor resolution you need depends to some extent on your specialty," explained Walker. "For example, the American College of Radiology mandates that physicians/radiologists who perform final reads for mammograms have a five-megapixel grayscale monitor to give them extremely high resolution. [A megapixel is made up of one million pixels, or picture elements. The more pixels in an image, the better the image quality.] A monitor with that kind of resolution may cost upwards of $20,000 and is more than any private practice would ever need. However, many physicians are still reading off one-megapixel color monitors. That may be fine for preliminary reads in situations that aren't life threatening. However, if you don't send film out for a final review by a radiologist and you miss something on an image, it could leave you open to liability. For final reads of general x-rays, the American College of Radiology requires a two-megapixel monitor." Walker added, "If you're going to go to a digital system, I would definitely recommend the two-megapixel grayscale monitor. It enhances the x-ray, provides resolution that is crisp and clear, and is a very affordable part of the system."

Consider backup, storage and retrieval

Redundant storage is essential to any medical practice. Losing a patient's records could be disastrous, and leave the physician with nothing to use for comparison in the future. "There are many backup methods ranging from simple to complex," said Walker. "You can, for example, offload your images into a separate hard drive, then back them up monthly onto CDs or DVDs. A CD will hold about 75 individual x-ray studies; a DVD about ten times more. But I highly recommend that practices consider a PACS system."

PACS stands for Picture Archiving and Communication System. "A PACS system allows you to transmit images digitally into your network," said Walker, "where they can be archived and called up at workstations throughout your practice. They can also be sent out for review, going directly to the computer screens of outside radiologists or other specialists. A PACS system makes image retrieval much simpler than if your images were stored on CDs or DVDs. Of course, you can still burn a CD and store the images in each patient's file if you wish."

A CR system uses technology most practices already have

There are two types of digital imaging: DR (digital radiography) and CR (computed radiography). The one nearly all private practices choose is CR. "DR requires very expensive technology," said Walker. "The digital signal passes directly into the computer system from a digital plate built into the table and wall stand. It is extremely fast, producing an image in just a few seconds. While this kind of speed is important in hospitals and clinics where they do a large volume of imaging, for most private practices, the speed does not justify the price, which can be in the neighborhood of $300,000."

CR uses the x-ray technology most practices already have and converts it into a digital system that is far more practical and affordable. The resulting image quality is the same as with a DR system. As Walker explained, "With a CR system, you take the x-ray the traditional way, using a cassette. This cassette, however, holds a reusable phosphor plate instead of film. The cassette is then placed in a digital reader, where the image is scanned into the computer and appears on the workstation screen within just a minute or two." Most practices can convert to CR with only slight modifications to their existing x-ray equipment. "Even if a practice has an old, standard-frequency generator and has to upgrade to a high-frequency one, the cost of conversion to CR doesn't even come close to the cost of DR," said Walker.

Digital offers significant advantages over film

Walker outlined a number of advantages digital technology can bring to a practice.

When the need for film is eliminated, so is the need for a darkroom. The entire darkroom is replaced by a digital reader that is no larger than your current processor. That frees up space that may be used more profitably and efficiently. Switching to digital also reduces your need for consumables, such as film, chemicals, filers and mailers. Because you no longer need film and all the accessories that go with it, storage space is greatly reduced. And, you don''t have to worry about losing films.

A digital system also eliminates the need for wet processing. That means the plumbing problems, less-than-reliable processors, and messy, hazardous chemicals are no longer necessary. That can go a long way toward boosting staff morale.

Something both staff and patients appreciate is that retakes drop significantly with a digital system. 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 using the software in the computer. So, not only do you get excellent resolution, but you can also adjust the window, level and contrast; take measurements; and zoom in on areas that warrant a closer look.

Know your goals

As you make the decision of whether or not to go digital, and of what types of monitor, backup, storage and retrieval to use, it is important to ask yourself what your goals are. "You need to know what you want the system to accomplish, and that can vary greatly from practice to practice and specialty to specialty," said Walker.

Return on investment is a major consideration. "You should have a good idea of how fast you would recoup your investment in digital," said Walker. "Don't forget to take into consideration the money you are currently spending on film, chemicals, and supplies; the time your staff is spending processing images and dealing with the wet processor; and how much space you have tied up in a darkroom and storage." Another factor to consider is how critical the ability to change the contrast or zoom in on images is to your specialty and your practice. And, how would a digital system impact workflow?

As Walker summed it up, "The more you know from the outset about how the conversion to digital will impact your practice, the more satisfied you can be with the decision you make. That's why I recommend beginning the process by getting expert advice about how to meet your unique needs and expectations."

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