East Texas Medical Center, Fujifilm continue their long working relationship with transition to DR

One of the hottest topics in today’s medical imaging community is the transition from computed radiography (CR) to digital radiography (DR). Many providers were already making the change without the influence of any legislation, but once President Obama signed the Consolidated Appropriations Act of 2016—which included provisions that will lower reimbursements associated with CR-based x-rays over time—interest in moving to DR grew by a significant margin.

East Texas Medical Center (ETMC) in Tyler, Texas, is currently upgrading from CR to DR, and Imaging Director and MRI Safety Officer Bill Tobin said the industry appears ready for this major change.

“Timing is good and in line with our already active plans to switch over to DR,” Tobin said. “It’s better patient care, it’s reduced radiation for the patient, and it’s in the best interest of the patient.”

A seamless transition

During this period of change for ETMC, Fujifilm has been there to help every step of the way. As Tobin explained, the medical center’s relationship with Fujifilm dates back to more than a decade ago, when it first selected the company’s PACS solution after a lengthy search.

Installing Fujifilm’s PACS made an immediate impact on ETMC, but perhaps even more impressive is the impact Fujifilm seemed to have on the entire community.

“Somewhere within that timeframe, the entire city of Tyler seemed to convert from film to electronic imaging,” Tobin said. “The radiologists were probably integral in the entire city staying with Fuji as well. Tyler is a Fujifilm town. Physicians don’t want to learn one PACS system and then go across town and learn a completely different system.”

The employees at ETMC have been gradually scaling up to DR for more than a year now. They installed Fujifilm’s FDR D-EVO II digital x-ray detectors in 2015 and brought in Fujifilm’s FDR Go portable x-ray systems soon after. Off-site facilities are being upgraded over time, and Tobin said his team’s familiarity with Fujifilm has helped make the transition remarkably painless.

“Since we’re able to use the existing Fujifilm workstations and our same x-ray equipment as we roll out DR, there’s no training—or if there is training, it’s minimal,” Tobin said. “So my team here has been using this CR equipment, and when the DR comes in, people have little to do as far as getting up to speed; they hit the ground running. It’s all the same computer platform.”

Jackie McGlynn, ETMC radiology QI coordinator, said she’s been impressed by how intuitive Fujifilm’s FDR Go digital portable x-ray systems are, especially for anyone with prior experience using the company’s other solutions.

“I think that even I could go with the Go and take a portable x-ray, and I haven’t taken portables in probably 15 years,” McGlynn said. “But I know the system well enough that I could use it, because I deal with the Fujifilm FDX Console all of the time. That makes it wonderful, and our technologists really like it.”

McGlynn said some radiologists or technologists may be unsure about moving to DR, but she always views changes in technology as a positive.

“I’ve been an x-ray technologist since 1971, and when I first started, there was hand dipping in the tank,” McGlynn said. “You just had to be close with your exposure factors. Then you would go in to a dark room and manually develop the film by immersing it in chemicals (developer) and judging your image quality by eye. Every step in improvement since 1971 has been for the better of the patient and the technologist.”

A change that benefits patients and providers

Even though its transition from CR to DR is still ongoing, ETMC is already reaping the many benefits of Fujifilm’s DR solutions. For example, Tobin reflected on how much faster images can be captured now, and how that has resulted in a more patient-centered approach to care.

“With CR, the technologists would take a cassette with the patient already in the room,” Tobin said. “They’d have to go in, place the cassette in the table under the patient, step in the booth, make the exposure, retrieve the cassette, then leave the patient room to get to the reader, feed the cassette into the reader, and select various computer functions so they could send it to PACS. With DR, they put the plate in the table and it wirelessly transfers the image in seconds to that computer for them, so the tech can stay in the room and stay with the patient to ease their fears.”

Tobin estimates that this saves at least 3 minutes per image with every patient, and that is especially critical in ETMC’s trauma rooms, which have been fully updated to DR.

McGlynn agreed with Tobin, saying she has been able to witness the improvement for trauma patients firsthand.

“I think the DR has made our trauma surgeons very happy,” McGlynn said. “My favorite thing is that it’s less radiation for the patient. We get a lot of young people in the trauma room who have had accidents, so you’re saving these young people radiation over their lifetime.”

Tobin said he’s had team members come to him in awe of the reduced radiation dose. It’s sending as much as 60 to 70 percent less radiation to patients, which also has an impact on the technologists. But, Tobin explained, Fujifilm is potentially saving patients and technologists from radiation in other important way as well.

“It’s not only saving dose to the patient by reducing dose during that x-ray,” Tobin said. “It may also be preventing people from having follow-up CTs, because the image itself is that much better.”

McGlynn is quick to list some of her other favorite features of Fujifilm’s DR solutions. She loves the FDR Go’s Virtual Grid processing, for instance, which saves technologists from carrying a grid with them all the time and may reduce dose by up to 50% compared to a traditional grid. She also loves how technologists can copy an image and manipulate it without leaving the floor, and the technology that allows users to magnify images to full screen by simply double tapping the area. In addition, Fujifilm earns its reputation for having the very best image quality; it’s so consistent, McGlynn said, that whenever someone asks for her recommendation about imaging equipment, she immediately suggests Fujifilm.

“I personally think you can’t get any better. I’ve liked Fujifilm from the word ‘go,’” she said.

As ETMC gets closer to completing its transition to DR, the positive impact of Fujifilm’s solutions is sure to grow even stronger. Provisions within the Consolidated Appropriations Act of 2016 may be pushing some facilities to upgrade a little earlier than expected, but as Tobin, McGlynn, and the other employees at ETMC have learned, the transition doesn’t have to be intimidating or difficult. It can, in fact, be seamless and valuable.