From the March 2019 issue of DOTmed HealthCare Business News magazine
By Cris Bennett
In the radiology marketplace, pediatric facilities are looking to get the maximum return on their imaging investment without sacrificing patient outcomes and patient radiation dose.
Adding to the complexity are requirements of Medicaid programs, insurance companies, and governing bodies like the Joint Commission and the American College of Radiology. In addition, patient satisfaction is a big key in today’s market to obtaining the largest reimbursement amount possible.
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Pediatric facilities typically go for the best of breed when it comes to imaging purchases. Facilities that already have a 1.5T MR may purchase a 3.0T MR both for its research capabilities and for advanced imaging features such as larger gradient fields, faster scan times, and cardiac imaging. Many facilities are opting for the detachable table, which allows easy transfer from the patient room to the MR suite. Also, facilities are choosing to purchase high-channel-count systems to take advantage of larger channel coils and advanced coils that allow for higher signal-to-noise and possibly faster scan times.
In CT, facilities are purchasing 128–256 slice systems to take advantage of the faster scan times, lower patient dose, enhanced stroke protocols, and coronary imaging. All these purchasing decisions affect patient outcomes, revenue, and, most importantly, patient satisfaction.
In general, radiography facilities are focusing on radiation dose, patient safety, and comfort. The challenges in pediatric radiography include choosing the right protocol and having technical knowledge to allow for the shortest scan time achievable. The digital detector has aided the radiology department in reducing the radiation dose for pediatric patients.
Historically, vendors have not made radiography systems for pediatric patients. However, they have made modifications to accommodate pediatric exams. These accommodations include smaller panel sizes and panels that can fit into incubator bucky trays that can also be used in orthopedics.
We are also seeing software advancements that include gridless imaging with scatter correction that can be used on older and larger pediatric patients. Multiple vendors offer immobilization devices that allow the child to be still for the few seconds needed for the exposure. Use of these immobilization devices not only reduces time in the department but lessens the extra radiation dose that is given during repeat exams.