Highlights of AHRA 2013 with Marianne Matthews of Imaging Economics

Marianne Matthews, Editor in Chief of Imaging Economics, stopped by our booth on the last day of AHRA to wrap up the key topics of interest from the show. Matthews starts off by talking about quality and the real issues that surround it, such as how providers are going to be measured and meet the CMS mandates. Other key topics Matthews discussed were patient safety and the new tracking tools for radiation dose along with patient satisfaction and how that ties into the consumerization of imaging.

Matthews also offered insights on what she believed were to come for RSNA 2013. Not only does she see further expansion on these topics but we’ll also hear a lot about information technology (IT) and reimbursement.

Hear more of what Marianne Matthews had to say:

AHRA 2013: Gillette Children’s Specialty HC Provides Insight on Carestream Products

Jenny Severud, Lead Technologist of Out-Patient X-ray at Gillette Children’s Specialty HC, sat down with Don Thompson to discuss dose management and the use of the DRX-Revolution in her pediatric facility. In the video Severud discusses how Carestream’s cesium detectors allow technologists to use lower techniques to help lower dose, which is an important factor in medical imaging. She also talks about the new 2530C detector and commends the maneuverability of being able to efficiently get under the patient in a small, limited area.

Severud also discusses the fully automatic DRX-Evolution room at the Gillette facility and how the auto-centering and auto-positioning is her favorite feature.

AHRA 2013: Thoughts on the DRX-Revolution

In this video Anthony Aukes, Radiology Manager at Carle Foundation Hospital, reviews the Carestream DRX-Revolution Mobile X-ray System after seeing it at AHRA 2013. Aukes talks about how the life of any tech at an imaging facility is always fast paced and busy, but the built in features on the portable helps enhance their workflow and make their life much easier.

This year we showcased our new 2530C detector, which is something Aukes feels has a place in the hospitals’ NICU department. Being able to capture and review images quickly allows radiologists to show physicians what they’re looking for without any detrimental impact to patient care.

When discussing converting rooms to DR, Aukes emphasized the “do more with less” motto many healthcare facilities face today and how to stay on the leading edge of technology. The DRX-1 system allows them to upgrade exam rooms to newer technology with lower dose and better image quality without having the expense of replacing a whole room.

Key Trends in Healthcare from AHRA 2013: IT and Big Data

Opening day of AHRA 2013 focused a lot on IT and big data. We sat down with Cat Vasko, Editor of Digital Media at ImagingBiz, to discuss these and other key trends from throughout the day including does reduction and outcomes management.

In the video, Vasko discusses the need for advanced data analytics tools to move forward in radiology and medical imaging. She also talks dose reduction and how IT is necessary to do the cumulative dose tracking and analysis that is needed in the field to enhance patient safety. This is because technologists cannot achieve the same results from a chest CT and a chest X-ray without having the data to analyze.

Looking ahead to RSNA 2013, Vasko offers her predictions on key topics to be seen, placing emphasis on integration between different IT systems and modalities. She believes radiology departments can’t move forward and do the necessary analytical work without easy integration between all these systems.

AHRA 2013: IRIS and the Importance of Dose Reduction Initiatives in Medical Imaging

Rich Pulvino, Digital Media Specialist, Carestream

Rich Pulvino, Digital Media Specialist, Carestream

IRIS (Image Right, Image Safe) is a commitment that started at Dartmouth-Hitchcock Medical Center (D-H) to ensure that not only was dose being reduced, but that patients were receiving only necessary medical imaging exams. Karen Burgess, M. Ed., RTRM, of D-H presented on Monday, July 29, about IRIS and how it takes awareness and education to properly reduce dose to patients while still providing them with quality care.

IRIS was inspired by the Image Gently campaign, which seeks to promote radiation protection in the imaging of children. This is not a new cause in the medical imaging field, but Burgess explained how D-H was a textbook example of how dose reduction can be achieved within a large medical system, and how it takes many processes to make it happen.

Burgess commented on how the medical imaging field has seen a near doubling in ionization exposure over the past three decades. One area this continues to grow is in relation to sports injuries, particularly in children ages 5-14. In total, about 750,000 medical images are conducted per year in this age group on account of sports injuries and that number is only growing larger. With a trend like this, efforts are needed to reduce unnecessary imaging and that involves including the healthcare provider as well as the patient in the education about medical imaging exams.

In 2010, Burgess’s colleague, Dr. Peter Spiegel addressed the imaging controversies and emphasized the need for a more enforced and balanced approach. D-H needed to improve on addressing patient concerns about radiation safety, and from that, IRIS was born. It’s mission statement reads as such:

Promote patient safety in medical imaging by initiating, supporting and coordinating  activities designed to reduce radiation dose while maintaining appropriate standards of imaging quality; ensure that referring clinicians have all necessary resources and incentives to make appropriate decisions in the ordering of imaging procedures; and raise public awareness of the uses, benefits, limitations, and risks of medical imaging.

From this, D-H instituted several key procedures to ensure it was living up to the IRIS mission statement. These included such activities as creating a dedicated position of “radiation safety officer,” requests for CT must be subject to a verification protocol to ensure that low dose or radiation free alternatives (MRI, ultrasound) are ruled out prior to the CT, and adherence to voluntary ACR and TJC guidelines, which are more comprehensive and stringent than required by regulations in New Hampshire.

In her conclusion, Burgess left off with key points that attendees could take away to institute their own initiative similar to IRIS to help reduce dose in their hospitals. These included seeking a physician project champion who could lead the initiative, creating a mission statement, and defining clear and attainable goals for the initiative.

Dose reduction, while an ever-important trend in the medical imaging landscape, can be difficult to achieve on account of the exams being a necessity to diagnostics and patient health. Careful planning and organizational initiatives to make dose reduction a reality can be to the key to accomplishing this and ensuring that patients are taken care of to the highest degree in our facility.

AHRA 2013: Creativity and Overcoming Fear in Medical Imaging—Is It Possible?

Rich Pulvino, Digital Media Specialist, Carestream

Rich Pulvino, Digital Media Specialist, Carestream

“Follow the breadcrumbs from any unmet goal and it usually leads fear.” – Erik Wahl, graffiti artist and business strategist

This was one of the lines that stuck out the most from the keynote session of day one at AHRA 2013 in Minneapolis. FEAR, as Wahl noted, can stand for False Evidence Appearing Real, and it is the main roadblock that holds many back from innovation and new ideas. His message yesterday is one that is valuable to a variety of industries, but tailoring it specifically for medical imaging shined a spotlight on just how difficult it can be getting over fear, and the advantages that come once that is achieved.

Erik Wahl, Keynote Speaker, AHRA 2013

To demonstrate how meaningful it can be to take a risk, he encouraged an audience member to participate in a “Fear Factor” task. The participant, nervous to perform such a task in front of a room full of people, was allowed to delegate the task to any audience member of his choosing. Once he chose someone, the woman who was now assigned the task was ushered up to the main stage where she would perform the “Fear Factor” task in front of everyone. However, when she opened the envelope to reveal her task, it simply stated that she could keep the Abraham Lincoln painting Wahl drew during the introduction of his speech. The lesson: taking a risk can lead to big rewards.

Throughout his keynote, Wahl asked the audience many rhetorical, thought-provoking questions. How do we look for ways to transcend the commoditization and consumerization of healthcare? What will reform look like, internally and externally? How can medical imaging specialists plus into a world of new ideas and creativity? What is an idea worth in healthcare? All meaningful questions that all contain long, difficult answers.

Wahl routinely went back to the point that human beings are naturally resistant to traveling in uncharted waters. He said that it takes three tasks to successfully navigate these waters. One must focus on the mission, commit to it, and ultimately, adapt to any changes. The last responsibility was the one he accented. One cannot evolve if one cannot successfully adapt. The changes we face in healthcare, be it through technology or political reform, are intense challenges, and it will involve getting over fears and adapting appropriately if organizations are to achieve success.

When it comes to relying on creativity to overcome challenges, Wahl led the crowd in an interesting task. He asked everyone who thinks that they can draw/paint to raise their hand. No one did and a laugh was shared throughout the hall. He said he wasn’t surprised but made a couple of key points. When he asks this question to high school students, he said that about 10-20% of students raise their hands. Then he asked us, “If I were to ask this to pre-school students, how many would raise their hands?” At that moment, a light bulb went on over the audience’s collective head.

Everyone is a drawer when younger, and everyone is enthusiastic about it. The key to overcoming fear, embracing creativity, and adapting to change is to sustain that childlike enthusiasm. It can be difficult, and quite scary, but as Wahl stated numerous times throughout his keynote, it is necessary. And those that don’t adapt can be left behind.

AHRA 2013: Patient Satisfaction vs. Quality in Bedside Imaging

Todd Minnigh, Vice President of Digital X-ray, Americas, Carestream

Todd Minnigh, Vice President of Digital X-ray, Americas, Carestream

In the 1980s my spelling was marginal. Readers would need to look past it, focusing on the main point of my letters and papers.  Sometimes it would lead to a mistake in understanding, but usually things were okay.  One day the world changed.  Spell checkers.

How often do we sacrifice quality for speed and convenience?    When we take an X-ray the patient’s time, safety and comfort are along for the ride.  Avoiding clinical errors and improving quality are critically important. Technology may be about to make things easier.

I’ll be giving a presentation a couple of weeks from now in Minneapolis, MN, at AHRA 2013 on the importance of bedside imaging and how we can get to the level of quality imaging that we should expect. When the patient is so compromised they cannot  come to the X-ray room, we really need to take the x-ray room to them.  Several technology advancements are getting us closer to just that. . These result in improvements and ensure that radiologists are equipped with the best capabilities available to provide the best care possible.

  • In my CE presentation on Sunday afternoon I’ll be covering the challenges associated with bedside imaging.  These could be driven by exposure, grid cut off, lost identification, positioning or other reasons.  Most mistakes involve a return trip to the room, disturbing the patient or heaven forbid the OR again, and repeating the image.  To  manage these challenges, most folks focus on a few areas:  : proper identification, infection control, and retained foreign body search  in the OR to name a few.Mobile Xray
  • Patient identification is vital  to preventing medical errors. DR allows verification of the image and patient at bedside, scanning wristbands to ID images can take this one step further.  Mixing up paper requisitions between exposing and processing CR cassettes is eliminated. . Infection control and patient satisfaction don’t always go hand in hand. What is sterile is sometimes a bit cold and unfriendly. But a plastic bag and rubber gloves is preferred to a staph infection.  I’ll have a few suggestions from other Radiographers for how to boost comfort.
  • It is important to  use  a grid often for improving the image quality so that radiologists won’t need to rely on repeat images. The capability exists from multiple sources to make grid alignment easier. Along with grid alignment, it’s important that  departments track exposure to prevent “dose creep”. To realize the improvements productivity, thoughtful implementation and the organized tracking of metrics are needed so operational improvements can be made.   Patients can recognize discomfort when it comes to capturing another image, but what they can’t tell is if they have been overexposed.  This must be managed to follow through on our mission to achieving both optimal patient care and patient satisfaction.

If you’re interested in attending this presentation to learn more, I will be speaking on Sunday, July 28, from 4:30-5:30 p.m. at the Minneapolis Convention Center in Minneapolis, Minn. Looking forward to seeing you there and to another great year at AHRA.

[Infographic] Portals, Access, and Engagement—Patients are Demanding It

Cristine Kao

Cristine Kao, Global Marketing Manager, Healthcare IT, Carestream

With healthcare facilities and medical professionals looking for various patient services to improve communication, allowing these patients to track and share their own medical histories via portals and online access could lead to improved healthcare.

At Carestream, we’ve always been fascinated by where medical images fit within the patient engagement and patient portal environment. To truly understand the patient perception and needs, we partnered with IDR Medical to conduct a direct survey of 1000 patients across the US with various backgrounds.

By learning what patients are looking for, we can provide our customers—administrators, radiologists and executives—with the tools and services that could lead to better and more efficient care. This is because we are ultimately providing patients with more access to their personal health information, and helping them to become more aware of their own health and any issues they may be experiencing. This makes for improved communication with their physicians, which can lead to the improved diagnoses.

The survey asked what patients are looking for in terms of medical images, patient portals, and online access to those images. The infographic below provides an overview of the key insights from the study.

You can click on the following link to download the complete study.

CSH_MythbustPatientPortalInfographicM

AHRA 2013: Providing Dose Reduction to the Patients Who Need it Most

Helen Titus, Marketing Director, X-ray Solutions, Carestream

We are half way through 2013 and radiation dose reduction in medical imaging continues to be one of the most important issues the industry faces. Patients are our primary focus and we at Carestream, as I’m sure many other providers and medical professionals, have been maintaining our focus of putting patients first. The best way to do this is to focus on their safety and provide them with the best and safest care possible.

In an article from DOTMed that focused on dose reduction, the trends among the larger medical imaging companies showed that these providers are producing the technologies that shrink the dose delivered to patients. At Carestream, our R&D team has been focused on delivering dose reduction to patients, specifically pediatric patients, since they are a category more susceptible to the side effects that a radiation overdose can cause.

At ECR this year, our R&D scientist, Sam Richard, Ph.D., presented on reducing dose when capturing pediatric images. The research focused on optimizing image quality across a wide range of pediatric patient sizes. His team’s study concluded that to get the best image quality and lowest dose, pediatric patient size should be taken into account when selecting the kVp. To demonstrate this, a white paper published earlier this year presented principles in X-Ray procedures that should be followed throughout the imaging process to provide safe imaging practices to pediatric patients.

DRX detector

Carestream’s 2530C DRX Detector

Now that we’re approaching July, we’re proud to announce that the DRX 2530C Detector has officially received FDA clearance. The wireless DR detector offers low dose X-ray exams for pediatric, orthopaedic, and general radiology applications without compromising the image quality of the exam. The smaller detector, which measures 25 cm x 30 cm, can provide better care for premature babies and infants in the pediatric ICU. The high detective quantum efficiency (DQE) of the cesium iodide detector can lead to lower dose than CR cassettes or gadolinium scintillator detectors and fits easily into the x-ray tray of neonatal incubators.

A product such as the DRX 2530C, which will begin shipping in the third quarter of 2013, addresses the dose reduction trend that is immersed throughout our industry, but we won’t, and can’t, stop here. While much of the dose reduction focus is aim toward the pediatric patients, it is an issue that pertains to everyone who has a medical imaging exam—especially those who may be prone to having these exams more often than others. The key will be to ensure that we continue to invest in bringing more of these products and services to market that can lead to not only better patient care, but safer care too.