Governance, Mission, Growth

Move Over, DR: High-Volume CR Exceeds Expectations
Spotlight on Study: Radiologists’ Career Satisfaction May Depend on Workload
Professional-Looking Graphics for Medical Professionals

Move Over, DR: High-Volume CR Exceeds Expectations

by Cat Vasko

A new study by KLAS Enterprises, Orem, Utah, a research firm specializing in monitoring and reporting the performance of health care technology vendors, compares vendor performance in the area of high-volume computed radiography (CR) systems. The study surveys 158 provider organizations on their experiences with systems from Agfa Healthcare, Greenville, SC; Carestream Health Inc, Rochester, NY; Fujifilm Medical Systems, Stamford, Conn; Konica Minolta Medical Imaging, Wayne, NJ; and Philips Medical Systems, Andover, Mass.

“We’re reaching milestones in CR adoption, and folks are having to evaluate whether they want to transition to DR,” noted Jeff Boag, director of medical equipment research at KLAS. “A lot of sites have a mixed approach, and now they’re having to make that decision. Do they pony up the big money, double or triple their costs by going to the DR room, or do they stick with CR?”

The study looks at CR issues, including throughput, image quality, ease of use, system reliability, and cassette and plate quality. The results are surprising—providers who expected to upgrade to DR in 2008 or 2009 are finding themselves so satisfied with the performance of their CR systems and the attention they’ve received from their vendors that they are disinclined to make the investment in DR.

One factor, Boag notes, could be the adoption of PACS solutions; PACS vendors often have a CR strategy, and many ambulatory sites are just beginning to implement PACS for the first time.

“We found the adoption of CR was often associated with the adoption of a PACS solution,” Boag said. “A lot of the hospitals looked at CR as a transitional step, a way for them to cost-effectively justify going filmless without scrapping their analog equipment. A lot of these sites are 3 or 4 years into using CR and still cannot cost-justify adoption of DR, but I think their satisfaction with CR is also a factor.”

What makes CR so great? Reliability, for one thing. CR systems on the whole scored higher than the average for all medical imaging equipment in the KLAS database. Another major factor was vendor relationships. Konica Minolta, whose Xpress dual-bay CR unit received the most positive rating, scored well not only because of its low-maintenance, reliable technology, but because of the company’s strong performance in terms of service and support.

“A vendor’s level of relationship with the customer contributed highly to how well they scored,” Boag noted. “If you look at the function, modality to modality, they’re very similar. But if you look at factors like how invested the vendor was in the provider’s success, that differentiates the vendors from each other. We looked at many different factors, and none was as critical to satisfaction as the relationship with the vendor.”

Konica received the highest rankings in terms of long-term support. Konica also had the best service after warranty, though not by much.

“We did see some emerging trends where providers wanted to have the cassettes included in the warranty,” Boag said. “Plate quality frustrated providers in several ways. Many of them had issues with artifacts, because the overall durability was a transition for many of the providers to adjust to. They’re dealing with a different type of plate now that requires more care.”

But on the whole, vendors are committed to providing a high quality of product, and providers seem satisfied. Of the facilities that were only operating CR, many indicated no formal plans to adopt DR technology in the future, and several even plan to purchase single-plate CR readers to back up their high-volume devices.

“One of the surprises was how satisfied providers were with their CRs,” Boag said. “Many had initially planned to adopt DR in 2008 and 2009, and are reconsidering that adoption because of their success with CR.”

Spotlight on Study: Radiologists’ Career Satisfaction May Depend on Workload

A study in the July issue of Radiology examines what characteristics of radiologists, their practices, and their work environments affect professional satisfaction. On the whole, the study found, radiologists are very satisfied with their careers, but the mean satisfaction score for post-training professionally active radiologists has decreased since 1995.

“The biggest reasons reported by radiologists for increased enjoyment were mainly lifestyle and work hours, then income, and then new technology,” said Hanna Zafar, MD, MHS, a fellow in abdominal imaging at the Hospital of the University of Pennsylvania, Philadelphia, and the study’s lead author. “You have to be a bit of a techie to be interested in radiology, and if you think about it, over the last 15 years there’s been a real boom in the technology, with marked improvement in the speed and resolution of existing advanced technologies such as CT and MRI. There’s also been an increasing reliance on imaging for diagnostics.”

The study looked at data from the American College of Radiology (ACR) 2003 Survey of Radiologists, a nationally representative, stratified survey of 1,924 US radiologists. These data were compared with those from a similar 1995 survey in which roughly the same methodology was used.

Although 93% of those surveyed said they enjoyed their careers very much or somewhat, 41% said they enjoyed their careers less than they did 5 years ago (32% said they enjoyed them more). In 2003, medicolegal climate, workload, and reimbursement and/or financial pressures were the three most common reasons for decreased satisfaction; in the 1995 survey, the reasons were interference from managed care, government regulations, and increased administrative burden.

“There is a national trend, a larger trend of professional satisfaction decreasing over time, and that includes lawyers, teachers, and so on,” Zafar noted. “People suspect that it has to do with the increased workload. There are so many things we can conjecture. Patients have higher expectations. You have to see a higher volume of patients. We’re looking at larger volumes of data just for a single study on one patient, which can be very taxing.”

The study also revealed some surprising truths about radiologist career satisfaction. Among them: radiologists in academic environments are more satisfied than their colleagues in private practice, despite earning significantly less money.

“The enhanced current satisfaction in academic non-government practices found at regression analysis probably does not reflect differences in workload,” the study states. “We believe, instead, that this finding reflects the satisfaction in academic work—such as teaching, research, and working with junior colleagues. Regression analysis of the 1995 survey data also revealed higher satisfaction in academic practices.”

Another interesting finding is that, all other factors being equal, female radiologists are more satisfied than their male counterparts. “Whatever the explanation is, this may be regarded as a positive finding and probably should be emphasized given that relatively few women enter the field of radiology,” the authors noted.

Specialty type was found to have no significant impact on satisfaction, though radiologists specializing in breast imaging reported somewhat more satisfaction than their peers elsewhere in the field. Again, the authors remark on such a counter-

intuitive result. “Failure to diagnose breast cancer is by far the most common reason for malpractice suits against radiologists and medicolegal climate was the leading reported cause of dissatisfaction,” the report observes.

But the most obvious of the analysis’ findings is that increased workloads have dampened radiologists’ enthusiasm for their work.

“The data show that all other things equal, satisfaction was low among those radiologists who desired a decreased workload,” Zafar said. “In other words, among those radiologists with low satisfaction, there was a definite association with the perception of feeling overworked to such an extreme that they would be willing to work less and accept less money. It all has to do with perception, but there’s a definite trend of radiologists who work long hours having a lower level of satisfaction. There’s a point at which people are willing to work less and make less money in order to be happier.”

Professional-Looking Graphics for Medical Professionals

SmartDraw releases the newest version of its health care graphics creation software

by Renee Diiulio

Hand-drawn documents belong on a refrigerator or in a frame, not in presentations or hanging on office walls (unless in a frame). A professional image requires professional images, but for the average computer user, these can take too long to create. Seeing the writing on the wall, software companies have stepped in with tools designed to help users create the graphics they need to display information.

The latest health care version of SmartDraw features 1,000 templates for time lines, work schedules, and forms., San Diego, launches a new release of the health care version of its SmartDraw software this month. The automated program permits users to select templates and graphics to create the documents they need in minutes rather than hours.

“Typical graphics programs provide you with a blank screen and expect you to draw. With the SmartDraw Healthcare Edition, you select the exact template you need from more than 100 different types. You simply input your information or data,” said Paul Stannard, CEO of, in a release.

Templates include medical device diagrams, patient education handouts, anatomical diagrams, case management timelines, work schedules, forms, compliance documents, medical process flowcharts, medical facility management diagrams, and graphics for diseases and disorders. According to a company spokesperson, the new release features more than 1,000 templates and 20,000 graphics. The library includes Lippincott illustrations and Netter images from Elsevier; photos can also be imported.

Flowcharting, design elements, and charts are created through simple processes, including graphics that incorporate images to display data (the company has trademarked these “Chartoons”).

Users include radiologists, physicians, hospital administrators, hospital IT staff, nurses, medical students, and educators. A company spokesperson notes that there are more than 10 million current users. Their feedback was collected to direct development of the latest release.

Stannard suggests that the system requires no user manual and has virtually no learning curve. Modifications are just as easy: “one step—click to modify,” said Stannard. The completed documents can be converted into PDFs or inserted into other programs, such as Microsoft Word, Microsoft Excel, and Microsoft PowerPoint.

A trial version can be found online (, and free telephone support is available through the company.