In the past three years, portable wireless digital X-ray imaging devices have played an active role in the imaging market. Digital imaging devices have matured after many developmental obstacles, and have been freed from the cumbersome and difficult to use situation, becoming a lightweight device that fully meets the requirements of portable imaging. Can these new devices come into play? What kind of strategy do we need to develop to implement this investment? Some industry pioneers shared their experiences.
"Since digitalization has become the industry leader, portable wireless digital X-ray imaging equipment has made significant advances in X-rays," said Mary-Theresa Shore, director of radiation clinical operations at Boston General Hospital (MGH) and master of science management. . In fact, Brigham and Women's Hospital, a member of the Boston Health Care Partner System, recently revised the procurement specifications for X-ray imaging equipment, requiring all newly purchased equipment to use portable wireless digital X-ray imaging.
The reason why the hospital is willing to accept this technology is determined by the basic characteristics of X-ray imaging technology - imaging quality and efficiency.
Eighty-five percent of portable research at the Massachusetts General Hospital is for thoracic examinations. The chest structure consists of bones, lungs, and soft tissues. The structure is complex and difficult to interpret. Another factor is that the diameter of the rule is becoming more and more precise, and the multi-striped network may be intricate. "Foos et al., published in the September 2010 issue of Clinical Contrast, showed that providing edge-enhanced views improves the accuracy of diagnosis by radiologists and intensive care physicians, can determine the location of blood vessels, textures, and common indications. Portable chest X-rays were obtained through intensive care equipment," said Florian J. Fintelmann, a radiologist at the Massachusetts General Hospital.
Michael Delvecchio, radiology director and radiologist at Brigham and Women's Hospital, points out that improved image quality is critical for portable imaging technology. Previously at Brigham and Women's Hospital, preoperative X-ray examination of surgical patients required a fixed digital X-ray imaging device. However, subsequent follow-up studies of patients used computerized X-ray imaging equipment. “The image quality is not as clear. It is very difficult to compare pre-operative digital X-ray imaging with post-operative computerized X-ray imaging,†said Charles David Healy, radiology director and radiologist, Brigham and Women's Hospital. Point out.
“Portable digital X-ray imaging standardizes image quality and eliminates the difference between actual survey results and image quality,†he continued.
Efficiency relationshipIn portable wireless mode, the relationship between image quality and efficiency is clearly visible. In the traditional computerized X-ray mode, technicians need to constantly move around and prepare a cassette for each patient to get the results. Most of the inspections take a few minutes to complete. However, since the technician needs to return to the departmental exposure cassette, the radiologist and the referral doctor will have 20 to 30 minutes of waiting time before getting the image. Shore pointed out that in wireless mode, imaging can be transmitted directly to the image archiving and communication system via the detector, and the doctor can view the images within 4 to 5 minutes.
The second efficiency factor is the ability to immediately assess the imaging quality of a wireless device. In computer X-ray imaging mode, if the technician cuts out a part of the bone image, or the patient moves the body, and the problem is not discovered until the technician exposes the cassette in the department, then the technician will return to the clinic and ask the nurse to do it again. A check, and the nurse may not cooperate.
“Technicians use digital X-ray imaging equipment to see images on the bedside and be able to re-examine,†Shore said. In addition, people ignore the return trip to improve efficiency. Shore and her Massachusetts General Hospital found that technology could have unintended consequences. The hospital plans to complete the repetitive analysis to ensure that the technology can perform the necessary repetitive inspections and get better images. “Technicians know that the second inspection will double the amount of radiation, but we still plan to monitor this,†she said.
Details and manipulationOne of the problems with the first generation of portable wireless digital X-ray imaging equipment was that it was difficult to manipulate. Digital X-ray equipment is very cumbersome, and some equipment tires are not enough and run out.
The latest equipment is easy to handle, interrupt, rotate and place. Shore said: "Our room is not big, but it does a lot of work. Our goal is to get in and out quickly, without any problems for the patient." The equipment is very satisfactory. But no matter how good the model is displayed at the trade show, early users suggested a comprehensive control test in the hospital to understand the operation of the equipment and see if the system can adapt to the needs of various wards.
Another problem with the relationship is the placement problem. The portable wireless digital X-ray imaging device used by Brigham and Women's Hospital has a parking area of ​​approximately 12 square feet. “We work closely with the team of doctors, especially the thoracic surgeons, to convince them that we are the main members of the group,†Healy said. The lobbying work was very productive, they won the designated placement room for the portable device, and the placement room was equipped with a power supply that could be connected to the chest. The portable system is safe to place in the room and is immune to the impact of stretchers, carts and other mobile devices.
Previously, Brigham and Women's Hospital limited the number of portable digital X-ray devices used in the emergency department and found that the device was able to maintain normal operation for a long time and had a long service life. However, the device moves only 50 feet at a time. The process of letting a device travel through a crowded elevator to a busy outpatient building is like a cross-country adventure. "We may not realize that this type of use can last for a long time."
Another problem with portable wireless digital X-ray equipment is the problem of ergonomics. Previous detectors weighed 10 to 12 pounds, were too bulky, and were not designed to be ergonomic. The new detector has been successfully slimmed down and weighs about 6 pounds. Some are equipped with a cassette of a computer X-ray device, and the cassette of the computer X-ray device can be directly transmitted to the digital X-ray detector. Some have added handles that are easy to carry. Technicians can carry a digital detector using digital X-ray equipment.
Although digital X-ray equipment is lighter, the Massachusetts General Hospital has to evaluate the ergonomic design of the equipment. “Our technicians completed 40 to 50 studies during the transition and we want to avoid overwork injuries,†Shore said. Currently, the model used by hospitals is to allow a technician to complete portable imaging. While nurses can assist with portable exams, Massachusetts General Hospital can try two technical modes of operation or have technical assistants assist portable technicians in their work.
In addition, check the connection problem of portable wireless digital X-ray equipment. "There is no device that can be used with it," Shore said. He works closely with the hospital's wireless team to ensure device connectivity and security, following the Health Insurance Portability and Accountability Act. The analysis was very productive and the team found some shortcomings in some buildings that required additional bandwidth.
Similarly, the Brigham and Women's Hospital team used its borrowed equipment to perform a comprehensive operational check on the hospital to assess operational and wireless connectivity. In addition, the connectivity of the hospital's graphical user interface to the radiology information system/picture archiving and communication system is also assessed. The workflow should be simplified. If the interface is too complex, or if the technician needs to use multiple programs to transfer the inspection results to the image archiving and communication system, the work of the technician will be affected.
Portable wireless digital X-ray equipment delivers high-quality images with increased efficiency. However, if the deployment is to be successful, a thorough assessment of the wireless infrastructure is required, along with ergonomics and repetitive research.
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