Digital X-rays are coming: Here’s what to expect
By Brian Duggan, MSN, RN
Senior Consultant, Information Technology Aggregation
Premier
Charlotte, NC
Digital radiography is a technology that displays radiological studies on a computer screen for interpretation purposes. Another term often used to mean the same thing is computerized radiography.
The technology for digital radiography is not new. Magnetic resonance imaging (MRI) and computed tomography (CT) studies are generated by a computer. MRI and CT films are simply printouts of the digital images in the computer. These images are quite detailed, but take very little memory for computers to store. Although radiologists frequently use films, they are usually comfortable using a computer terminal to view those types of images.
What is new in this field is the use of digital images for other types of images, such as ultrasound, and traditional X-rays, such as chest X-rays. For traditional X-rays, films are passed through a scanner that converts the film to a digital picture. Once digitized, studies can be stored, e-mailed, sent through a network, and even manipulated.
Hospitals go filmless’
This technology has allowed 10 to 12 hospitals throughout the country to go completely "filmless." Celebration Hospital, in Orlando, FL, was one of the early adopters of digital radiography. Its doctors can go to any computer terminal and call up lab work, radiological images, and the radiologist interpretation. The facility does not even have a traditional "file room," since images can be sent anywhere electronically. Rooms for radiologists now have computer screens in the place of view boxes.
Cost of systems depends greatly on what is purchased. A luminous digitizer is $55,000. This converts films to digital images. All the components for digitizing and transmitting images starts at $160,000, and a complete computed radiography budget is about $1.5 million.
As a result of this trend, rural hospitals linked with a major medical center will often send out their films digitally for interpretation when there is not adequate coverage in their own facilities.
Another trend has been the outsourcing of many studies to vendors that provide low-cost radiology physician assistants who can read the bulk of the most commonly ordered X-rays. An X-ray is taken, sent electronically to the vendor, and a result returns within minutes. The cost savings and efficiency of this type of process will force health care facilities to rethink their approach to providing a full range of radiological services in every facility.
X-rays can be viewed anywhere
Emergency departments will benefit greatly as this technology is expanded. Patients will be identified as soon as they arrive in the ED by any number of methods, including fingerprints or electronic cards that they carry. This will automatically link to the patient record and provide clinicians immediate access to previously stored radiology images.
X-rays taken during their ED visit can be sent electronically to radiologists at any time for rapid interpretation. Images can be shared between facilities, which reduces unnecessary repeat studies. Some outsourcing vendors will even store images for access through the Internet. This reduces the capital costs for individual facilities to purchase storage and retrieval systems.
The future of digital radiography will bring access to images to any location. Portable wireless devices will allow interpretations from anywhere. As costs drop, the need for full radiologist coverage will be decreased, and outsourcing will become more common. All of this will lead to better service to patients at a lower cost.
[Editor’s note: Premier is a joint venture of 230 independent not-for-profit health systems in 50 states. Duggan can be contacted at Premier, 2320 Cascade Pointe Boulevard, Charlotte, NC 28208. Telephone: (704) 733-5753. Fax: (704) 357-1469. E-mail: [email protected].]
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