The Cheshire and Merseyside NHS Consortium covers 11 trusts in the UK and chose Carestream to be their new PACS supplier after their existing contracts for PACS and RIS systems, delivered through the National Program for Information Technology (NPfIT), expired. When selecting a new provider, the consortium was aiming to get the most cost effective and feature-rich system to meet their needs. One feature that came equipped with their chosen system was the advanced features of CT reconstruction. Taking steps to be cost effective has allowed Cheshire and Merseyside to pay 40 percent less than their previous national contract.
Cheshire and Merseyside is unusual in that there are multiple trusts in a small geographic area with a number of specialist hospitals. Royal Liverpool University Hospital is one hospital in the trust and for them it has been a challenge between patients moving around to hospitals and keeping images with the patient. The PACS system makes it easy for images to be acquired at one site and reported at another, a high priority for the trusts. When reporting, radiologists have access to previous studies where they can report right then and there, which is a big advantage. Roughly 1.5 to 2 million exams are conducted each year across the consortium and the more studies that are done, the faster the amount of data being transferred increases. Royal Liverpool has greatly decreased their amount of data transfers from about 250 studies per week to around 180 and is looking forward to that number dropping even further than 100 studies per week. This provides lead image transfer teams with more resources to do other things instead of importing such a large amount of studies.
Digital Breast Tomosynthesis (DBT) provides higher quality mammography images and is becoming more vital to breast exams. At RSNA we spoke with Dr. Harmindar Gill, Medical Director of Premiere Women’s Radiology in Bonita Springs, Florida, about the benefits of DBT and what patients get out of having it as part of their exam. Being the first office in Southwest Florida to offer DBT as part of breast exams, Dr. Gill noticed a decrease in patients’ recall rates and found that it’s easier to spot small lesions that go unnoticed by traditional mammography exams. The video below provides more insight on Dr. Gill’s practice and DBT discussion at RSNA.
Delta State University and Teaching Hospital is a 300-bed facility in Nigeria that is actively developing a center of medical tourism to deliver local quality medical services at standards comparable to international guidelines. The objective is to ultimately reduce the number of Nigerians traveling out of the country to seek medical care abroad. The Delta Hospital focuses on special areas such as radiology, minimal access surgeries, orthopedic services, and offers specialized treatments for patients with chronic kidney diseases, which occupies a severe percentage of Nigerians who seek medical care abroad. Kidney transplants will begin to take place in January of next year.
Rendering this level of service requires a well established radiology department. They are one of the first hospitals in Nigeria to acquire a 64-slice Computed Tomography (CT) scanner. The facility is also equipped with a Digital Radiography (DR) department, digital mammography unit, and ultrasound services to aid patient care. Dr. Abraham Inikori, consultant radiologist and director of clinical services and training, Delta State University and Teaching Hospital, further explains the organization’s medical tourism initiative.
Larry Ray, CTO R+I Volume Image Processing, Carestream Health
Precise lesion measurement is important for reliable evaluation of metastatic disease and faster assessment of the patient response to cancer treatment. For radiologists and oncologists, simple quantitative comparisons of historical exams – especially those imported from disparate PACS or modalities – have been a challenge in a traditional PACS, causing many to turn to costly dedicated workstations. Lesion Management is an embedded application tool in our Vue PACS that provides native oncology follow-up capabilities. The precision of the tool can help provide physicians with clearer and more detailed imaging exam results in less time, enhancing their productivity and efficiency to make a diagnosis.
There are several reasons oncology follow-ups are one of the most time consuming and challenging tasks for radiologists:
Relevant priors may not have been acquired by the same modality, thus making it difficult to compare as most PACS cannot correlate with different exam types
Identification, localization and measurements of lesions are often manual, time consuming and inconsistent
Often times lesion management and tracking is performed on a separate workstation or application, without integration to PACS
The lesion tool reduces the need for visual measurement by providing semi-automatic tracking and segmentation of lesions, which can help provide a faster and more consistent means of determining the size and estimating the overall volume of the lesion. The result has the potential to provide a better gauge of disease progression. Typically, when a radiologist first gets a case they mark the lesion and report on it before the data is stored. At a follow-up visit a second set of images with added lesions is read, often by a different radiologist. The lesion management software matches between the two reports and immediately generates a spreadsheet of the patient’s information. The data can be viewed and evaluated on a single exam basis, or a per lesion basis for comparison purposes.
When a patient is diagnosed with cancer it’s really a team effort between them and their care providers to choose the best possible treatment plan. Today, we have access to information almost immediately; questions get responses pretty quickly; we have better tools to fight these diseases. The lesion application is one of those tools. It allows for clearer, more meaningful communication and collaboration between radiologists, oncologists and referring physicians which is a vital step in providing the patient with the best care possible.
Editor’s Note:The Lesion Management application, created by Larry Ray, Edward Gindele & Rick Simon, was a finalists for the Digital Rochester Great Awards in the Optic, Photonics and Imaging Technology category.
Learn more about Carestream’s Lesion Management application:
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.
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.
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.
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.
Helen Titus, Marketing Director, X-ray Solutions, Carestream
Over the Polar Ice.
Right now, Carestream is on a six-month trek across the frigid Antarctic continent. Well, none of our people are actually on the trip – but one of our flagship products is.
On March 21st, a small team of explorers set off on “The Coldest Journey.” They will attempt to conquer the last major challenge of polar exploration: to cross the Antarctic continent in winter. They’ll travel for six months, across 2,480 miles, at temperatures that can fall to –129F. During this perilous expedition, the team needs the ability to provide advanced medical care if needed – including diagnostic X-ray capabilities. The expedition’s doctor, Rob Lambert, knew that any X-ray system going on this journey would need to be exceptionally rugged, small, light and easy to operate. He chose the CARESTREAM DRX Transportable / Field Portable X-ray System.
The DRX-Transportable is a durable, all-in-one digital solution. It includes the DRX wireless detector, all electronics, a wireless access point and a tablet PC – all securely packed in a tough, protective case. Designed for easy portability, this is a system the expedition can depend on. Check out The Coldest Journey’s website.
Under the Desert Sun
The DRX-Transportable is even built to be rugged enough for military applications. This video* (also shown below) demonstrates how quickly the portable system can be deployed to evaluate serious battle injuries sustained by soldiers in desert combat – and in virtually any other environment as well.
The DRX-Transportable’s mobility and and wireless performance also make it ideal for disaster relief, EMT use, and travel to nursing homes and in-home care.
*Video is a bronze winner of the 34th Annual Telly Awards
Ruud Vullers, Director, Global Manufacturing & Supply Chain, Carestream
Excellence has always been a key characteristic of Carestream. From our people, to our products, right down the individual steps in our processes—we ensure excellence is weaved throughout our entire organization. We call this mantra eXceed and it defines the customer centric culture that has been created. The five components of this mission are as follows:
– Commitment to behaviors that create a customer centric culture
– Interviews to collect data on our customers’ experiences
– Analysis to identify and implement customer experience improvements across our organization
– Metrics to track our progress
– Recognition for employees that demonstrate customer focus, and eXceed customer expectations
When it comes to our manufacturing processes, we tackle analysis and metrics with the utmost importance so that we are able to create the best products for our customers in the most efficient way possible. Carestream owns and operates global manufacturing facilities so that products can be produced right where they are being sold. These logistics allow for faster speed of delivery and lower overall costs.
Manufacturing is involved in the earliest phases of the product design process so that cost is affordable and quality is built into the design. We have developed measurement methods for all key focus areas in manufacturing like incoming material quality and on-time delivery. This data is shared every month with our key suppliers to drive improvements. This allows us to live a life of lean manufacturing—a principle that depends on getting rid of all non-value added activities and keep only those that the customer is willing to pay for.
Our production system allows us to manufacture exactly what we need when we need it. Kanban (a proven lean manufacturing concept) allows for automatic replenishment of components. Each day, inventory is communicated to our suppliers to minimize what is kept on-hand and improves quality since any quality problem is contained to a small number of components.
Morning briefings are held for each product line with a cross-function team so any areas of concern can be immediately assigned and addressed. Anyone on the manufacturing floor is empowered to initiate corrective processes and improvement, and feedback from customer installations are brought forward to the morning markets.
Ongoing quality improvement is built into every step of Carestream’s production process. The “Carestream Manufacturing Focus” video below provides some additional details.