For community hospitals, portable imaging systems boost efficiency.

When newborns have trouble breathing, there’s not a second to lose. To expedite the process of getting these patients’ critical images into the hands of their ordering physicians, the new St Francis Medical Center in Colorado Springs, Colo, opened with a dedicated portable DR detector in its neonatal intensive care unit (NICU).

The machine, a CXDI-60G flat-panel detector from Canon Medical Systems, Irvine, Calif, allows physicians to see an image even before the radiology technologist leaves the room. The technologist loads the plate into a tray built into the incubator or warmer and takes the image. Within seconds, the image displays, and physicians can make determinations about line placement or other treatment needs.

Recently, Mary Tanner, RTR, used the unit to take images of a premature baby in respiratory distress.

“Within a minute—literally 60 seconds—the [physicians] were able to decide, ‘This is what we have to do with the baby,'” she said. “They were able to intubate the patient and then take another image right away.”

Not only does the quick turnaround of today’s portables positively affect patient care, but it also significantly boosts staff productivity. Traditional portables required techs to haul heavy cassettes to a central reader to be developed—a lengthy process that delayed results. Today’s portable options eliminate these steps, which means techs spend less time riding elevators between floors and more time capturing images.

“I’m easily saving 20 minutes per image,” Tanner said.

The Right Fit

The combined benefits of improved patient care and staff productivity were the impetus behind the decision to use DR portables throughout the hospital, according to Aaron Hackman, RTR, CT, imaging manager for St Francis Medical Center. The 156-bed hospital, which opened in August, uses three other portable DR units in areas such as the emergency department—but the NICU presented a unique challenge.

The NICU incubators and warmers required a 10- x 12-inch detector, a size that wasn’t yet available. At the time, Canon was working on a detector with these dimensions and agreed to get the first unit to St Francis Medical Center before the product’s scheduled unveiling at RSNA 2008.

“The biggest hurdle that we ran into was simply modifying the existing warmers and NICU beds to be compatible,” Hackman said. His team worked with the hospital’s biomed department to modify the trays of the NICU warmers and incubators to work with the new portable unit. This modification allows technologists to slip the detector in and out of the tray, and even retake images, without disturbing the sterile field. And by keeping the unit in the NICU, the savings on infection control are also significant.

The Canon detector was also an attractive option to Hackman because it allowed him to upgrade his existing AMX 4 from GE for around $100,000. An all-new digital unit likely would have cost as much as $250,000. “For us, it was a good buy,” he said.

Technically-savvy staff had no trouble learning the new system, and representatives from Canon presided over training sessions and were available to help those who were less comfortable with computers get up to speed. “It’s easy to use,” Hackman said. “The ability to get through exams is much quicker.”

The CR Alternative

While some community hospitals opt for portable DR units, others choose portable CR machines, which involve the use of cassettes. For Glenda Fabra, RTR, MHSA, PACS administrator for Henry Medical Center, Stockbridge, Ga, the Kodak Point-of-Care CR-ITX 560 system from Carestream Health, Rochester, NY, was the obvious choice for her department.

“It’s lightweight and easy to use,” she said, noting that a competing product she saw at RSNA seemed bulky and cumbersome.

The CR-ITX 560 combines Care-stream’s CR system with a portable x-ray system from Siemens. The system is easy to learn for staff, as the process of taking images with the portable CR is similar to that used with older portable systems—except for one crucial difference. Loading the cassette back into the portable machine allows the technologist to display the image within 45 seconds on the touch-screen monitor. For line placements, this is especially critical.

“On the portable, you can actually use the programming to tell [physicians] how much further they need to advance the line, or they can see if they’ve advanced it too far, or how much they have to pull it back,” Fabra said. “They can do the manipulation of that line and shoot another portable immediately.”

The hospital’s NICU staff and physicians quickly came to rely on this feature. “Our NICU physicians are ecstatic,” Fabra said. “If you go upstairs with an old portable, they will tell you to go downstairs and get the new portable. They don’t like the old portable because they can’t see the image immediately.”

Unlike traditional models, the portable CR from Carestream needs only one cassette. If a tech is taking 20 images, she does not have to lug around 20 cassettes—instead she can process each image as she goes. “You shoot, you process, you go on to the next patient,” Fabra said. “You don’t have to worry about the heavy load.”

Today, the 225-bed hospital has one CR-ITX 560 unit shared between the NICU, ICU, and CCU and an additional unit for the operating rooms. Ultimately, the hospital plans to replace all of its older portable units with the newer CR models. A third unit has been ordered for the use of the emergency department, for example.

“You know that you’ve purchased a good piece of equipment when you make the techs happy and the physicians happy,” Fabra said.

The Decision

When researching portable imaging systems, it’s important for hospitals to find the right fit for their staff. The best way to do this is to involve them in the choice—ideally by letting them try out the different options for themselves.

“If the company is willing to lend you a piece of equipment for a week and let you test it out, by all means, do so,” Fabra said. “Otherwise, do site visits. If you talk to the people who actually use it, you can get a better feel for [the product].”

Although tight budgets are often a concern for community hospitals, making the investment in a portable DR or CR system can boost staff efficiency and, ultimately, the bottom line. “This is a much better way to go no matter where you are,” Fabra said. “It’s more convenient, it’s more efficient, and your techs will most definitely be much happier.”

Ann H. Carlson is a contributing writer for Axis Imaging News.