From the November 2015 issue of HealthCare Business News magazine
Advances in digital imaging with flat panel detector (FPD) systems have provided a wealth of benefits for the health care community including increased productivity, improved image quality, lower patient dose and overall ease of use. However, despite this progress, many end users are not able to effectively reduce patient dose, optimize image quality or reap all of the rewards of the innovative system features available to them. Feedback from radiology managers, end users and vendors has highlighted this problem as well as the need to examine current practices related not only to new system applications training, but also to those scenarios in which digital, FPD technology has been in place for some time.
Key Training and Competency Challenges
Computed radiography (CR) and digital radiography (DR) dose creep continues to be a challenge in all imaging departments, regardless of size, workflow or level of technologist experience. DR and CR dose creep occurs when technologists lean toward overexposure of the radiograph because the image can be corrected, so to speak, by way of window level functionality. In contrast, underexposed images appear noisy and grainy, regardless of attempts to optimize them using software tools. These software tools can help the end user but can also be a crutch when technologists fail to use lead markers at point-of-care to label lateralities for studies, and do not practice proper collimation of the X-ray beam.
Other obstacles related to user competency present in the medical imaging market today occur when multiple vendors’ systems are installed and the technologist must understand and be proficient with several types of user interfaces and protocols. In these cases, the end users are not familiar with all aspects of a given user interface, including system shortcuts or unique features. Furthermore, not enough niche studies that utilize advanced options, such as tomosynthesis, long-length imaging or stitching, or digital subtraction, are done on a regular basis to provide the technologist the experience or repetition to recall exact exam protocols and system functionality.
In response to dwindling budgets and the pressure to increase productivity, a number of departments use multimodality technologists to float from CT, MRI and X-ray to accommodate exam volumes during any given shift. Although this is an excellent use of resources, the downfall is that these technologists often do not spend enough time in one given modality to master the skill of optimizing exposure factors in digital imaging.
