Like every medical device seen in hospitals today, contrast media power injectors are becoming much more integrated with other devices, specifically in diagnostic and interventional cardiology.
Traditionally, the connection between an imaging system and an injector has been based on trigger signals to start and stop the administration of contrast. Today, the field is increasingly moving toward sophisticated injectors that record and transmit various types of data associated with contrast administration, including brand, lot number, expiration date, concentration and patient protocols.
Without such sophistication, administering and tracking the use of contrast agents is something less than an exact science. Whether it was the amount, type or brand of contrast used, the system to track and monitor contrast administration was imprecise and subject to “the likelihood of miscommunication” as treatments were recorded and reported, says U. Joseph Schoepf, MD, director of CT research and development at the Medical University of South Carolina, Charleston.
Now new contrast injector data management systems enable physicians to track the use of contrast for both cost efficiency and patient safety. For example, the IRiS CT injector management system (Acist Medical Systems) is set up to display and export data into Microsoft Office Suite for review and analysis. This system, which links all Acist injectors, allows clinicians to have access to historical patient injection information for specific studies such as the amount of contrast filled and injected, as well as the amount wasted. The data also help administrators identify productivity bottlenecks and other sources of inefficiency by comparing operations room-to-room in the monthly view.
“One of the biggest problems we have had in invasive angiography and CT imaging is the inability to be diligent about how much contrast we were using,” says Matthew Budoff, MD, director of cardiac CT at Harbor-UCLA Medical Center, Torrance, Calif. The consequences of delivering too much contrast are well known, including contrast-induced nephropathy (CIN) or renal failure. “If we know how much contrast we are using per patient, we can be much more cognizant of contrast utilization in high-risk cases,” Budoff says.
The newest generation of injectors offers several benefits, including greater accuracy of information exchange, convenience and improved patient safety. The introduction of data management systems also has inventory management implications. Practices should be able to create reports that track and compare contrast purchases against actual usage to maintain their inventory of contrast agents at cost-efficient levels.
“If I have a study where I always use an average of 120 cc of contrast, I’m going to have an appropriately-sized bottle ordered and hung at the beginning of the procedure,” says Budoff. Having the right-sized bottle on the ready also helps eliminate bottle transitions, further enhancing workflow.
According to Schoepf, whose department uses the Stellant D CT contrast injector system (Medrad), the injector software allows departments to accurately stock brands and quantities of contrast so that shortages don’t interrupt workflow. The system stores up to 32 protocols, and can recommend an injection protocol based on certain patient characteristics, such as heart rate and body mass index, that the operator inputs into the system.
Like many components in healthcare, next-generation contrast media injectors are now part of the information flow. It’s only a matter of time before the data recorded by these devices can be transmitted directly to the patient’s EMR. And like so many other technological advances, the priority is not necessarily the capabilities of the device, but what clinicians and administrators do with the information the device delivers. Today’s injectors can help manage inventory, reduce waste, increase profits and improve patient safety.