Any savvy retailer will tell you that good customer service is the difference between succeeding in business and just scraping by. And although much of the medical field works with a “captive audience” of on-staff professionals, freestanding imaging centers are the industry’s retailers. For them, taking care of customers is the name of the game.
Achieving this goal has become more daunting in recent years. In addition to swiftly providing high-quality images and exceptional service, imaging centers must stay abreast of the latest technological advancements and how (and when) they’re being adopted as well as note their impact on the industry. The timing of when to offer new techniques-such as the digital acquisition and distribution of medical images-can make the difference between being selected by a client or being passed over.
“If physicians have a choice of imaging centers to use, undoubtedly they’ll prefer one that they feel shows efficiency when treating their patients,” says Steve Ura, CTO of A4 Health Systems (Cary, NC). “And perhaps even more importantly, [physicians want] one that gives them access to the record electronically.”
Whether or not to convert to digital systems is a complicated decision. When a hospital or medical center adopts an enterprise-wide PACS, the physicians, radiologists, and technologists often are simply along for the ride.
For imaging centers, however, converting to a digital environment is an internal process-one with little or no influence on the referring physicians, who make up much of their customer base. Although these centers must remain flexible and realize that every physician embraces innovation at a different pace, this divide places additional demands on these businesses, requiring them to produce images in any possible format.
“We would love to have the entire world operating filmless, digital, DICOM-standard data,” says Brent Backhaus, CTO of Virtual Radiologic Consultants (VRC of Minneapolis). “Unfortunately, it’s not a free upgrade to convert old modalities to digital, and it’s quite expensive to buy new modalities, so we understand the practicality of the world.”
In fact, the investment and financial commitment required to adopt a digital imaging system is the main barrier holding back the majority of practitioners. Because of the costs involved, many practices are opting to stick with film until the funding can be secured.
Imaging centers are aware of this situation and continue to be committed to serving this group of practitioners right alongside their digital clients.
“We have enabled all the different workflows,” Backhaus says. “Film digitizers are in place for customers who want to work with film, [and] we have secure connections [through which] customers send their DICOM data directly from a PACS. We try to make life as easy as possible [for them].”
VRC isn’t the only company helping to bridge the gap between film and digital imaging. Industry giants also are taking steps to make digital imaging attainable for businesses of all sizes by specifically tailoring systems with a variety of features appealing to smaller offices, including a less-hefty price tag. Eastman Kodak Co (Rochester, NY) produces one such example.
“We are proud of our Kodak DirectView PACS System 5,” says Michael Fiske, worldwide marketing manager of healthcare information systems in Kodak’s Health Imaging Group. “Imaging centers and orthopedic practices-both traditionally large users of film, who couldn’t necessarily afford to go all-digital-now have a realistic, cost-effective solution.”
The advent of smaller, more financially feasible PACS solutions makes converting to digital images a reality for many practitioners. Hence, freestanding imaging centers tend to be more comfortable encouraging their clients to undertake the process of converting to a digital environment. One ideal time to start this conversation is when customers inquire about improving their current processes and workflow.
“When customers call me [about digital imaging], I try to promote going to some sort of mini-PACS or light PACS,” says Larry W. Mickler, RT(R)(N), director of sales and technology integration at Ohio Imaging (Kent, Ohio). “You can do that at a low cost-probably lower than all the [costs associated with film].”
Moving Toward the Future
For many physicians, the conversion is happening whether they like it or not. Federal initiatives-such as President George W. Bush’s recent call for an interoperable health information technology infrastructure1-combined with compliance-related requirements, often demand upgrades be made to the practice’s internal network.
“We find that a lot of the doctors who want film and resist electronic images are making the transition anyway, because they’re being converted for insurance and verification [purposes],” says Hemant Maru, director of purchasing and operations for Doshi Diagnostic Imaging Centers (Hicksville, NY). “As part of that process, they’re getting computers and broadband, so we tell them that when they’re ready to receive images digitally, we’ll help.”
With many clients, a standing offer of assistance is the added bit of inspiration they need to make taking the leap slightly less intimidating. Even physicians interested in making a change become more eager if they can see for themselves the realm of possibilities that digital imaging offers.
“We try to show physicians the ease of using technology,” Mickler says. “One of the things we strive to do is build relationships, and with that, you give physicians what they want and try to guide them.”
Certainly, there’s no definitive approach to moving hesitant physicians and practices forward, but purporting the benefits of a digital system is unquestionably a solid first step.
Fortunately, the advantages of digital imaging are multifold and practically sell themselves. The biggest plus for many medical professionals is the faster access to images and ease of manipulation possible with digital imaging. Often, a quick peek at the available possibilities is enough to draw in a practitioner.
“[When] meeting with physicians and hospitals, I show [them] the images from one of our servers. I’m finding it’s pretty easy [for them to see the advantages],” Mickler says. “With one or two mouse clicks, you have windows and levels [for contrast and brightness], measuring tools and magnifiers, and you can flip angles.” He adds that after performing the demonstration and assuring physicians and administrators that support accompanies the technology, most are eager to make the change.
Many physicians also are won over by the fact that digital images are not confined to a single piece of film, but instead can be shared easily between several viewers simultaneously. This feature proves priceless in instances where multiple physicians are working on a single patient case, particularly when combined with the fastest distribution possible: image delivery via secure Internet connections. Once registered with their imaging center, physicians simply log on to access every image from a study as well as the report.
“We can distribute images to all referring physicians at once,” Maru says. “They can all access an image whenever they want it, at the same time, with no delays. Not only can this not be done with film, but with online distribution, it’s instantaneous.”
Instead of requiring all interested parties to gather around a single viewing box in a cramped room, the ability to distribute images online means any number of physicians can weigh in from different rooms, states, or even countries.
“If they have any questions, they can always call the [radiologist], and both physicians can look at the same images simultaneously,” Maru suggests. “For a referring physician, it’s as if the radiologist is in the same room with them, and that’s very good for the patient.”
Digital imaging not only improves a physician’s access to an image, but more often than not, it considerably abbreviates the imaging center’s processing time as well.
“The best selling point of digital images is the speed,” Mickler notes. “With hard-copy film, [reporting] usually takes a day or two. But with electronics, scheduling and reporting [happen] the same day.”
For those practitioners still hesitant to make the transition, approaching the technical changes in stages can be an ideal path. Though not as immediate as Web distribution, images delivered via CD or DVD share many of its other benefits and serve as an interim step toward abandoning film completely. Once the imaging center burns the study onto a CD or DVD, a physician can simply insert the disc into any computer with a compatible drive; the attached viewing program allows them to open, view, and adjust images instantly.
“DVDs and CDs are a good way to wean them off the film,” Maru says. “It gets them accustomed to viewing images on a monitor and using manipulation tools-instead of [looking at] film.”
Serving Those Who Serve the Patients
In the end, of course, the ultimate goal is making the customer happy and, in doing so, empowering physicians to better care for their patients.
“Some [physicians] don’t want to look at a computer, and others only want [images] on film because they don’t have Internet or broadband access, which takes longer to download images,” says Maru, quick to add the maxim of all prospering imaging centers: “We send films to all customers who want them.”
And although providing this depth of service does place some additional strains on the imaging center-including the need for a more robust infrastructure and increased bandwidth-centers are keen on doing whatever it takes to keep their customers happy.
“The bottom line is, we are here to provide service to the patients and referring physicians,” Mickler says. “Everything we do [is] geared toward that.”
Dana Hinesly is a contributing writer for Medical Imaging.
References
- The White House News & Policies. Executive Order 13335. April 27, 2004. Available at: www.whitehouse.gov/news/releases/2004/04/20040427-4.html . Accessed January 5, 2005.
