Toll Free 1.866.429.9729

Digital Idol (Part 2 of 2)

THE VOTES:

Despite these advances, CR is not in immediate danger of being voted out of the hospital. "A lot of our clients love the idea of being all DR, but overwhelmingly we see that coexistence is absolutely necessary because of the need for portability and flexibility, particularly in the OR and trauma areas," Maier said. April Hammarsten, central region radiology supervisor at Sharp Rees-Stealy, whose institution uses Fujifilm systems, is one such customer. "Ideally, we'll have one of each type at any site," Hammarsten said. If forced to choose, however, she would select a DR unit and maintain a carbon reader and cassette option for extended work if needed.

Grady would vote the other way, choosing to keep CR or hybrid systems in place. Celebration tried DR in two of its sites but removed the units when quality did not match that of the CR systems. The impact on efficiency has been minimal. Celebration is located about 2 miles from the Walt Disney World Resort in Orlando and handles about 55,000 emergency department visits annually. "Turnaround is extremely important. We are using a new product that is almost a CR/DR hybrid - a single plate reader with a very fast image print time - and I can usually see images in 10 seconds or less," Grady said.

"DR costs more up front, but I think the maintenance of CR ends up costing more."

She acknowledges that DR can increase productivity but also suggests that the difference can be reduced with smart planning. By placing the hybrid type units directly in control rooms next to the exposure panels, Celebration has been able to maximize productivity. "By the time the technologist has positioned the patient and dropped the plate, they are able to see the image before they go out to reposition the patient - the tech can only go so fast," Grady said.

Analysis of 388,000 radiographic exams completed in a 6 week time period showed that the average time for a CR scan at Celebration from start to finish was 8 minutes, a turnaround comparable to that for DR as measured by Hill, Martin, and Walker. Throw in the high cost of DR and Grady predicts that CR, particularly hybrid units such as the one she uses, will be around for a very long time.

Hill is not quite as optimistic regarding the future of CR. "DR is definitely the way of the future. I think we are going to see CR become an obsolete modality within the next 3 or 4 years," Hill said. Though many don't agree it will occur that quickly, DR does have its proponents who believe that the biggest obstacle to its domination is its expense.

"DR is still fairly pricey. Most technologists and managers will say they would like to go completely DR, but due to the expense, most institutions are evolving in steps," said Martin, who notes that is the approach Cabell Huntington Hospital has taken. Martin thinks it's more a question of return on investment. "I think most facilities and institutions that currently have CR definitely want to make sure they realize the return on investment they've put into it. In 5 to 10 years, CR will still be around, though most places are in the process of phasing CR out," Martin said.

Those who have compared the long term cost of the two systems believe they are comparable and that perhaps DR offers a better deal in the long run. The ability to handle a greater volume of patients means more revenue generation and greater efficiency. DR devices often require less space than CR units, and the extra room can be used to install more units or fulfill other needs, such as physician and staff offices. "DR gives you more throughput with less real estate in your department, which is a big issue. We are always looking for extra space to grow into," Martin said.

Some departments may also be able to reduce personnel costs, either through the elimination of technologist positions, leaving them unfilled or replacing them with a lesser paid employee, such as an imaging assistant. This position would then get patients in and out and handle any paperwork while the technologist remains in a designated exam room and focuses on shooting images. "If you can utilize an imaging assistant to take the place of a technologist, you can cut the salary budget in half," Hammarsten said.

The elimination of cassettes not only deletes the consumables costs (Hill estimates this expense at $2,000 to $5,000 per cassette; Hammarsten pays about $1,800 for 14 to 17 units) but also results in less related expense for workers' compensation and less time off for technologists suffering from repetitive motion injuries. "DR costs more up front, but I think the maintenance of CR ends up costing more," Hammarsten said.

THE RESULTS:

With DR and CR expected to share the stage for some time to come, technologists can make themselves more marketable by learning both methods, although nearly everyone concurs that they are not in danger of being sent home early without this experience. "Hospitals want to know your experience, but either way, they will train you. I've hired techs who have never worked with CR," Grady said.

Generally, the basic radiographic principles are the same and are learned in school. Older technologists accustomed to film are therefore not at too great a disadvantage unless they are extremely intimidated by computers. Most importantly, technologists need to be open to learning a new system. There is a learning curve as systems move from conventional film to digital and from CR to DR, but it need not be intensive or complicated. "The training is so simple that you can take techs coming directly from film and train them in a DR environment and they will be successful. Even older techs who are computer illiterate will eventually catch up," Hammarsten said.

Many of today's systems strive to maintain as user friendly an interface as possible. Hill notes that the techs at Kaiser Fair Oaks were trained on a new DR system with just one 48 hour in service. "If you do go to a new facility that has equipment you are not familiar with, there is usually a training process. In general, you'll train on the technology that will be applicable to what you are doing," Hill said.

"Being comfortable with the computer and understanding x-ray principles will position a tech very well for CR as well as DR," Maier said. Naturally, the more you can do, the easier it may be to gain employment, but no one has suggested that technologists need to know everything nor do they need to specialize.

"To a certain extent, you always want to try to find the highest quality of professional that you can, but the way the market is right now for technologists, we feel very fortunate to be able to hire them with CR experience. DR experience is a plus," Martin said.

So just like on American Idol, for digital radiographic technology and technologists, the instrument doesn't matter so much as the ability to perform and win over the audience.

For more information visit http://www.awalshimaging.com
COPYRIGHT 2008 A Walsh Imaging, Inc.

Link To This Article

DIGITAL IDOL (PART 2 OF 2)

URL

http://www.awalshimaging.com/article04.htm

HTML

<a href="http://www.awalshimaging.com/article04.htm">Digital Idol (Part 2 of 2)</a>: Part 2 of a 2 part series detailing x-ray technicians take on Computed Radiography versus Direct Radiography.