Mobile X-Ray Minute: Three Questions with Dr. Roger Eng

Dr. Roger Eng, Chinese Hospital

Dr. Roger Eng, Chairman of Radiology, Chinese Hospital, and President of Golden Gate Radiology Medical Group

Editors Note: Leading up to RSNA 2011 we’ve asked Carestream’s Medical Advisory Board members for their insight into the radiology trends we expect to be hot topics at the show. 

Q: What advantages does mobile x-ray deliver to radiology staff?

A:  It allows a facility to un-tether radiology beyond the four walls of the department into other high impact areas like ER, ICU and OR. The turn around time is much faster without the extra steps usually required between acquisition and placement of the cassettes into a CR reader back in radiology.  This can add anywhere from 5 to 60 minutes in my hospital before the radiologist can read it.

Q: What benefits does wireless DR offer for patient care?

A: More rapid diagnosis by the radiologist, critical care physician, ER physician, surgeon or whomever is reading it. Most of these cases are acutely ill patients, so time makes a difference.

Q: Where is mobile imaging most needed in your facility?

A:  We plan on having wireless DR in our new hospital tower to quickly move the portable x-ray unit between the ICU and OR.

NYMIIS 2011: The Radiologists’ Efficiency Wish List

Belimar Velazquez, Carestream Health

Belimar Velazquez, MBA, Director of Marketing and Inside Sales, United States and Canada, Carestream Health

At last week’s New York Medical Imaging Informatics Symposium, several radiologists shared their productivity wish lists for better patient care:

  • More meaningful use information: During a live poll at the session, 60% of the attendees indicated that theyneeded more information to put a meaningful use strategy and plan in place.  Dr. Dreyer of Massachusetts General Hospital shed some light on compliance requirements and provided some resources to help with this process.
  • Easy patient and physician sharing: The ability to easily share images with the patient and referring physician is still elusive for many.  One idea shared by Dr. Siddiqui of Johns Hopkins University challenged the audience to think about a system in which patients and doctors could privately exchange images “a la Facebook,” thus allowing them to comment on the results while maintaining a record of the “conversation.”
  • Next-generation PACS: Dr. Siegel of University of Maryland School of Medicine presented a comprehensive wish list in his session that ranged from achievable wishes such as vendor neutral archiving to the more innovative idea of having the equivalent of IBM’s Watson as a “radiologist assistant” to help with diagnosis.

I always find the NYMIIS event extremely thought provoking, and the speed at which information and technology is advancing will soon make radiologists’ wishes a reality.

What’s on your radiology wish list?

New radiology systems: You can’t afford not to buy [INFOGRAPHIC]

Steven J. Romocki, Carestream Health

Steven J. Romocki, Worldwide Product Line Manager, Digital Capture Solutions / Digital Radiography (DR/CR), Carestream Health

Capital is a finite resource, and today’s healthcare providers want the best systems and technology. At the same time you’re feeling the pressure of Meaningful Use compliance and the transition towards Accountable Care Organizations.  The challenge is how to allocate funding among competing priorities. You have enough money for one thing. Maybe two things. You need many things.  This is the reality for countless healthcare providers across the country. Radiology systems are on the wish list of many hospitals that I’ve talked to.  While this purchase needs to be balanced against needs across the hospital, there are many situations when you can’t afford NOT to invest in new digital equipment.

A purchase of a new radiology system needs to be considered in terms of total cost of ownership.  When it comes to the newest digital radiography technology, return on investment is a big component of that analysis.  Right now many hospitals are considering a transition from film or CR technology to DR.  Digital imaging supports many of the healthcare reforms that hospitals are grappling with, and your existing x-ray systems may be approaching replacement.  The advent of wireless DR systems makes the decision to buy much different than it was with your last radiology purchase.

By nature DR operates more quickly than CR.  Reducing time between exposures can allow for more exams each day, spreading the initial investment over more patients each year.  Our team in the UK commissioned a study to take a closer look at the productivity gains that facilities can expect by utilizing the DRX detector.  This infographic details the benefits of increased speed of image acquisition compared with CR technology:

Infographic Economic Case for Digital Radiography

Some hospitals do choose to finance or lease their radiology solution.  Instead of paying a significant sum up front, you can spread the cost over time while conserving your funds to address other projects.  In many cases financing can include cost of maintenance, software, and professional services in a monthly payment – further lowering up front costs.

Rather than discussing whether or not to purchase a radiology system, the decision becomes HOW to buy a system that makes your money go farthest.  When you can maximize the return on your investment, a new radiology purchase supports rather than competes with your other capital needs.

Does your organization have multiple initiatives competing for funding? 

3 Challenges of Portable X-Ray: A Tech’s Perspective

Darnell Ramiscal RT

Darnell Ramiscal RT (R) (CT), Edward Hines, Jr. VA Hospital, Hines, IL

Guest Post: Darnell Ramiscal RT (R) (CT), Edward Hines, Jr. VA Hospital,Hines,IL, blogs about diagnostic imaging from a tech’s perspective at

To the untrained eye, a portable x-ray exam might not seem like much of a challenge.  Point, aim, and shoot.  Well, don’t forget everything else in between.  As X-ray Techs, we face many challenges during a shift with portable x-rays almost always near the top of our list. Here are the top three challenges of mobile x-ray from my perspective:

  1. Navigating a patient’s room with a portable x-ray machine can be akin to driving a semi truck…sans trailer…in a busy parking lot.  Although some room renovations are helping to provide a better overall hospital experience for patients, the existing small rooms with multiple occupants make for a tight fit and limited workspace. Our digital portable unit allows doctors to view images in mere seconds.  It also comes with the need for more vertical clearance, a cumbersome tether, and a heavier imaging plate.  Wireless please!
  2. We have many cassettes, but one size does not fit all.  The majority of portable exams are done for adult chest x-rays, followed by x-rays of the abdomen.  The typical cassette size (CR, in my case) is 14” x 17”.  Our digital (DR) portable unit has a plate that measures 16” x 16”.  Unfortunately, not everyone has lungs that can fit perfectly on our standard image receptors. Although uncommon, there are times when techs have to make the “walk of shame” back to a patient for a repeat x-ray because, for some apparent reason, not all of a patient’s anatomy fit on one cassette.  For DR, the image receptor is repositioned and the patient is told that a repeat x-ray has to be done.  What body habitus provides the biggest challenge?  The asthenic body habitus for chests and hypersthenic for an abdomen.
  3. Portable x-ray machines traverse from room to room.  A big challenge hospitals face everyday is infection control with MRSA (Methicillin-resistant Staphylococcus Aureus) and C. diff (Clostridium Difficile) being the major culprits.  Although there has been a much welcome decline in infection rates over the past few years, there is much more that can be done to prevent the spread of infection.  Standard precautions and thoroughly cleaning cassettes along with the portable x-ray unit are keys to preventing cross contamination.  Preventing the spread of infection is a hospital-wide, team effort.  We’re winning some battles, but the war is far from over.

Portable x-rays may just be one of many challenges we face each day, but these challenges not only make our job interesting, they makes us better techs.

Are there other challenges you face when making your portable x-ray rounds?

Is the move to EMR/EHR pushing RIS+PACS upgrades?

William G. Bradley, Jr., MD, PhD, FACR

William G. Bradley, Jr., MD, PhD, FACR, Professor and Chairman Department of Radiology, UCSD Medical Center San Diego, California

Editors Note: Leading up to RSNA 2011 we’ve asked Carestream’s Medical Advisory Board members for their insight into the radiology trends we expect to be hot topics at the show. 

I suspect no radiology department is ever 100 percent happy with their PACS, RIS or Voice Recognition system. We are no exception, and decided to evaluate what we currently have and what might be available. We had not done that since we selected our current system about eight years ago. We started by forming a PACS Evaluation Committee of interested faculty and our PACS manager. Faculty were asked to specify if they were supporters or critics of our current system so we could have some balance on the committee.


Subsequently, we had a full day meeting with another academic radiology department that has the same PACS vendor and is known for its PACS expertise. We have recently requested (and received) the exhaustive RFP put together by another academic radiology department that had an extensive evaluation process – including about 10 field trips to the sites using the top three systems (by their evaluation). I had hoped to do a comparison like I might do for MRI, using a grid with vendor vs. various characteristics (field strength, gradients, RF subsystem, etc.), but this is much more difficult for RIS/PACS due to differences in architecture. So this process is taking a lot longer than we had hoped – and is continuing…


Radiology Image Challenge – What is it?

It’s been a great summer of images!  As many of you guessed, the image for August was the motor of a hair dryer

Congratulations to Boyce Thompson, the first person to correctly identify the image!  Boyce, we’ll follow up with you to be sure you get your Everything Rad mug.

For everyone else – don’t worry, we have still have a lot more images left!  This month we’re doing things a little differently.  The image below is a school bag with a selection of supplies – 11 items, to be exact.  The first person to correctly identify all of the items in the bag will be our lucky winner!

Good luck!

Sorry… Carestream employees and their agencies are prohibited from entering.