Digital radiography is one of the fastest-growing technologies in medical imaging. Between 2000 and 2003, the growth rate of filmless radiography doubled, according to Frost & Sullivan's 2004 Digital Radiography World Market Report.
Most radiology departments recognize the benefits of digital radiography: a 30% to 40% improvement in technologist productivity, more efficient room utilization, elimination of film and related film costs, and greater satisfaction among referring physicians and patients.
But some organizations lack experience in managing large, multifaceted projects like these, which require buy-in from key stakeholders outside radiology. The outcome of the transition -- whether positive or negative -- has repercussions throughout the hospital.
Guiding the process of going digital
Several key factors enable an organization's success in going digital:
Thinking strategically -- In making the case for digital radiography, radiology administrators need to position the technology in the context of their organization's overall strategic plan. Rather than benefiting radiology alone, the initiative should be positioned to improve the entire organization.
Enlisting support enterprise-wide -- Stakeholders from key areas, especially IT, need to be involved early in the implementation process because digital radiography and PACS have far-reaching impact in the day-to-day workings of an institution. Gaining their support will help radiology departments realize cost-savings and productivity improvements, as well as potentially lower length of stay and improve other hospital-wide indicators.
Learning from others' experiences -- Before implementing digital radiography, organizations should conduct visits to sites that have already made the transition. Attending training seminars on the subject and joining organizations like the American Healthcare Radiology Administrators (AHRA) and the Society for Computer Applications in Radiology (SCAR) to network with peers will also be helpful.
By learning from those who have already gone digital, radiology departments can make better decisions when evaluating and purchasing digital radiography solutions, whether they are new to managing large-scale purchasing projects or are more experienced departments that need to validate their decisions.
Hospitals report that the following steps can help ensure a smooth transition to digital radiography:
Getting down to basics
The first step is understanding how digital radiography works. Digital radiographic images are recorded electronically on a digital receptor rather than film. The digital image can then be viewed on a display screen, printed on film, or transferred to a picture archive and communications system, or PACS.
For most organizations, the move to digital imaging is driven by the desire to leverage a PACS. Digital images can be recorded either through cassette-based computed radiography (CR) technology or direct radiography (DR) systems. CR captures the digital image on a receptor housed in a cassette. DR involves the direct capture of a digital image through a detector and digital display system.
Digital radiography provides many valuable benefits, including quicker, easier, and more reliable management of images. By moving to a filmless environment, hospitals can transmit images over information networks and electronically archive them.
Assessing imaging needs
The next step is to assess imaging needs, while emphasizing the importance of strategic planning. A good starting point for hospitals is to assess current and anticipated film-based routine radiography, as well as to determine their goals for going digital. Evaluating how they stack up against competitors is also important.
In addition, hospitals need to compare the benefits of CR and DR, and decide which technology best meets their needs. A cost-effective alternative for higher volume facilities, DR increases productivity for both the technologist and the imaging room as a whole. CR is a less expensive alternative that does not offer the same productivity benefits as DR, since the technologist must still handle cassettes. A good system for lower volume facilities, CR offers certain specialized views that can supplement DR, such as nonbucky imaging in the trauma room, ICU, or OR.
Gathering information
The next step is to develop a standard request for information (RFI) that outlines the organization's equipment needs. Through the RFI, the hospital will secure a cost estimate of the entire purchase, which is needed to budget for capital equipment and to get management approval. In making the case to senior management, the proposal must demonstrate why digital radiography is right for the entire institution and directly related to its strategic plan.
Then the organization needs to create an evaluation team to attend site visits; assist with the needs assessment, RFI, and request for proposal (RFP); and make the final vendor recommendation to senior management. Through the RFI, the organization creates a shortlist of vendors to help it reach its digital imaging goals.
The next step is to invite these vendors to submit more detailed information in a formal RFP. Using a systematic evaluation process, the evaluation team will assess each vendor using a set of criteria and a weighting system based on factors most important to the organization. Once the vendor is selected, the final contract negotiation should be handled by the organization's purchasing department.
Implementation and celebrating success
The final step is to prepare and execute a successful implementation. The planning for delivery and installation should begin immediately after the contract is signed. Developing a working time line agreed upon by the organization and vendor will be helpful in planning construction and delivery.
The change from analog to digital should not come as a surprise to staff members. During the entire process, they should be informed of the process and the reasons why it is occurring, emphasizing the benefits. Once implementation is completed, the radiology department can celebrate its success with stakeholders both inside and outside the organization.
Contributed by Philips Medical Systems
August 10, 2005
The above is an excerpt from "Digital Radiography: An Administrator's Guide" from Philips Medical Systems of Andover, MA. The guide covers in detail the step-by-step process of going digital, along with in-depth case studies and a pro forma model to determine the financial break-even point. For a complete copy of the 44-page guide, just click here.
Copyright © 2005 Philips Medical Systems
