Feature: The affordable path to DR
When officials at Howard Memorial Hospital in Nashville, Ark., started drawing up plans for a new facility that opened in July 2009, Cindy York, the hospital’s director of radiology, had to make some decisions.

“Much of the equipment we had was older and outdated, and we decided not build a darkroom because of the cost and additional considerations of maintaining the quality control with a darkroom,” she says.

Instead, a preliminary decision was made to purchase a second CR system that would serve as a backup in case the first system went down. But just before pitching that proposal to her CEO, she conducted some research on DR and decided that was the way to go. The question was what kind of system to go with.

York was concerned about maintaining efficiency—and quality. But she also was concerned about cost, since her 20-bed hospital is fairly small. As a result, she went with a portable, cassette-sized wireless DR detector (DRX-1, Carestream Health).

“Our patient turnaround time has been halved,” she says. “We can get a patient in and out in less time than it takes to get registered. They walk in, we shoot the exam, and we’re already positioned for the next patient by the time the images come up on the screen.”

What’s particularly important to York is that she believes her facility is now able to market itself as a facility that can provide DR technology—but which they were able to acquire at the price of CR technology. “In time, our patients will see this as a huge value,” she says. “They’ll be able to get a level of care they would normally have to drive an hour to get. That’s a big advantage.”

Kathy Hood, director of radiology at AnMed Health in Anderson, S.C., had a facility that had CR units she was looking to replace when she first saw the DRX-1 at the Radiological Society of North America (RSNA) annual meeting in 2008. “I was impressed, but a little gun-shy because it was so new,” she says.

But a “test drive” quelled those fears, with Carestream allowing AnMed to test the system in-house for two months. Her radiologic technologists liked the unit, both for its ease of use and the image quality it produced, says Hood. And with her facility reducing capital expenditures, she says cost was an important factor in deciding to go with the DRX-1.  “We can buy several of these without having to outlay the capital for a single DR room,” she says.

AnMed has installed three units at its north campus, and although she says the “jury is still out on the DRX-1” she, along with her RTs, are impressed enough with the product that she’s ordered two more for their south campus.

To Bill Colwell, director of diagnostic imaging for the Memorial Health System in Marietta, Ohio, the affordable path towards DR means taking a piecemeal approach.

While Memorial Health has both CR and DR, the objective over the long-term is to migrate to all DR. Yet, the plan for the system’s six outlying locations that are currently all analog is to add CR, he says.

There are a couple of factors at work in this approach, says Colwell. First is the goal to get completely move away from analog world. Second is a desire to become more efficient, which means transitioning to DR as fast—and as cost-efficiently—as possible.

Right now, Memorial Health’s main facility—Marietta Memorial Hospital—is using an IDC 2200 DR system (Imaging Dynamics) and recently installed a Shimadzu DR mobile x-ray system.  Adding the Shimadzu system, says Colwell, was particularly cost effective because its price tag “wasn’t backbreaking” and came with a three-year service agreement that basically covered everything from service to parts. “The money we’ll save on that service agreement has allowed us to use resources in other areas,” Colwell says.

The mobile unit itself has “been fantastic,” Colwell says. “It’s allowed us to be much more efficient and to go into certain areas of the hospital like the ER and the ICU and get images done in a fraction of the time.”

As for completing the transition to DR, Colwell says he’s giving it three to five years and hopes DR prices will come down. But he is confident that whatever investment his facility makes in DR will eventually pay off in efficiency gains.

For Bill Broaddus, director of radiology at Central Baptist Hospital in Lexington, Ky., the idea of making his staff more productive, while improving patient care, was a major consideration in going with the Siemens Ysio DR system as his department’s latest foray into DR.

The Ysio features a wireless detector that transmits the x-ray study directly to a server. Broaddus says he saw the system on display at RSNA 2007 and his facility ended up being the first in the U.S. to install the system a year later, in November 2008.

While not inexpensive, Broaddus says the DR system has more than justified the expense. “I haven’t done any time management studies,” he says, “but over the last several years, we haven’t had to add any staff [in diagnostic radiology] because the equipment makes the existing staff more productive.” The Ysio in particular, he says, allows much faster throughput than the hospital’s other DR rooms.