New digital images improve X-ray use at BMH

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By John Barnhart

Bedford Memorial's radiology department's switch to digital X-rays is providing a number of advantages, according to hospital officials.

Don Updike, the hospital's director of imaging services, said that a major advantage is that a digital image can be enhanced for interpretation.

“That's a huge plus for our radiologists,” he said.

The enhancement allows the radiologist to look at various layers in the same X-ray. They can configure it to get the best view of what they need to look at. Updike said that it would have been necessary to take multiple conventional X-rays to achieve the same effect, exposing the patient to more radiation.

It also increases doctors' ability to compare a current X-ray with a an older one. An example, said Updike, is if a current X-ray shows cancer. If they have an older X-ray of the same part of the same patient, the radiologists can enhance the older one to see if they can find the tumor on that one. This information can help with treatment because it can show whether they are dealing with a fast-growing cancer.

Another advantage provided is something that just went on-line Monday. An X-ray can be transmitted to a radiology office outside the hospital. This makes it easier to do a consultation as two radiologists can look at the same X-ray at the same time without having to be in the same room. Updike said that a radiology office will have radiologists with different areas of expertise.

When a patient is referred to a specialist, the specialist can simply pull them up on a computer. Previously, the patient had to have copies made and these had to be physically sent to the specialist's office. It's also good when doctors have X-rayed someone who lives out of town. The X-rays can be transmitted to a medical facility in the patient's home town.

There's a big advantage for the hospital too.

“We have thousands of cubic feet of X-ray film,”said Updike.

Updike said that the hospital must keep all X-rays for 10 years. If the X-ray was taken of a person under 18, the hospital has to keep them until the patient turns 19, and for a minimum of five years. Storing X-rays digitally is easier, and the X-rays are easier to locate if needed.

“This will be so much more manageable,” said Updike.

Processing X-ray film left liquid waste with heavy metals in it. The liquid waste had to be processed in order to remove the heavy metals before it could be dumped into the city sewer system. Even then, there would still be trace amounts. Now, there is no liquid waste at all.

Eliminating film makes X-rays faster. Updike said it took 90 seconds to process an X-ray film and in most cases took four films.

Updike said planning for the new system began in 2006 and the hospital started producing digital images this August. Being able to transmit the images involved a lot of network connectivity tests. Bedford Memorial is operated jointly by Centra Health and Carilion. Both hospital systems have multiple firewalls on their networks and part of the work involved getting these to interface correctly.

Each technologist must have a password in order to view an image. The system leaves an audit trail so hospital officials can check to see who has been looking at a particular X-ray. Updike said that even a person with computer savvy won't be able to walk in the office and pull up an X-ray.

When X-rays are transmitted to a medical office, they are encrypted for a specific address, “So there is no way they will end up at Joe the Plumber's house,” said Updike.

Updike said that it cost more than $500 million to get this system installed but, in addition to providing for better patient care, it will save money.

Faster processing time means that the department will be more efficient. No film processing effluent to pre-treat before it goes in the sewer also saves money.

It is also part of the electronic medical records system. Along with making the actual images part of a patient's medical records, it means that the hospital's imaging department is now essentially a paperless office.

In addition to the cost of buying paper, the imaging department's paper is expensive to dispose. The paper produced contained patient data and was, therefore, sensitive, and the hospital hired a secure company to shred it.

“Information security is a big deal at this facility,” said Updike.