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Tips for imaging departments making the jump from CR to DR

por Gus Iversen, Editor in Chief | July 27, 2020
From the July 2020 issue of HealthCare Business News magazine

Managing the exposures used is also important and should be set up properly at implementation of the DR system. These can be changed over time but should be set to a technique that makes sense for the body part being imaged.

Making sure the techs understand the differences between CR and DR will also be vital when implementing a DR system. Education should be done with the team prior to a new DR system being installed. This will help establish a basic understanding before the chosen vendor comes in for applications training on the new unit.

HCB News: What kind of feedback, positive and negative, do you hear most often from imaging departments that are introducing DR technology?

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EE: There is an abundance of positives and I think we’ve addressed many of them already. Some of the negatives that you hear about across the industry include dose creep, lack of collimation, and improper shielding placement.

Dose creep is when techs use more radiation than necessary to decrease image noise. This is why it’s so important to have a quality monitoring program in place. Collimating the X-ray beam to the area of interest before exposure is very important in digital imaging. DR receptors are more sensitive to low levels of radiation, and the resulting digital image might demonstrate reduced image contrast because of excess scatter radiation striking the receptor. Shielding placed in the FOV can also be a problem. This could cause increased dose, which could cause the area of interest to be overexposed or obscured. At AdventHealth we’ve chosen to eliminate the use of patient shielding during X-ray and CT exams.

HCB News: Are there any tips you can share to ensure DR technology is being used optimally going forward, from the actual implementation?
EE: There will always be opportunities for improvement, even with a DR system. Three things that can be “easily” monitored are: quality, productivity, and dose. I say “easily” because the data is readily available, but it’s not always easy to manage the improvement cycle.

Quality monitoring can include: exposure index management, repeat/reject analysis, and image critique. These factors are important to ensure the radiologist have all information needed to perform their interpretation. Having a digital imaging system can help increase productivity with proper training and support. The time it takes to process an image goes from minutes to seconds. The techs have several indicators letting them know if an image is acceptable by the standards set in their department. There are four components that can affect dose; exposure/technique, AEC, collimation, and shielding.


Bob Winters

Cost consideration

July 30, 2020 10:47

Interesting process that makes sense. What I would like to have clarified is the cost of capital expense and maintenance of DR verses the cost to continue maintaining the CR. System in spite of the reduced reimbursement reduction. I am believing the real reduction in cost may only be FTE utilization because of improved speed but DR systems are less cost effective overall

Bob Winters

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