Engineering to Meet Patients’ Needs: A Conversation With Stephen Neushul, iCRco CEO

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Stephen NeushulWith reimbursement increasingly linked to patient satisfaction, as well as a growing consumer influence in health-care spending, making a positive patient experience possible is a priority for radiology groups and hospitals. Stephen Neushul, CEO of iCRco, a developer of CR, DR, and mammography systems (as well as complementary software), sat down with ImagingBiz.com to discuss how engineering, workflow, ergonomics, and dose-reduction capabilities intersect to improve the patient experience in imaging’s oldest modality.

ImagingBiz: Radiography is the oldest imaging modality and the one that touches the most patients. How do you envision it continuing to evolve?

Neushul: Radiographic technology had very primitive beginnings. In the beginning, it took a very long time to expose a film to get a very low-resolution exposure (something like 50 DPI), and you’d burn the patient in the process. Today, our systems can achieve 500 DPI, about 10 line pairs per millimeter, so we’ve already gone from very low image quality to high-resolution radiography.

As time goes by, our sensors are going to keep getting better, our machines are going to get more precise, and we’ll see more information within radiographic images. We saw that evolution when we went from film to digital imaging—the digital form is more convenient, and now it’s even better than film at visualizing the data, so the modality is evolving, as we speak.

At iCRco, we’re working on a very high-resolution digital-imaging solution for mammography, which is one way I see radiography evolving. In addition, CT is an advanced, digital form of radiography, so I see our new cone-beam CT system taking radiography into the third dimension. It has the potential to exceed the resolution of standard CT at 20% of the dose.

ImagingBiz: How can radiographic technology be engineered to meet the needs of patients?

Neushul: One of the key issues is ergonomics. We have spent a lot of time assessing our designs, based on how a customer will use our product. Our CR cassettes are thinner and lighter than any other manufacturer’s cassettes. On our new portable line of CR products, we made the cassette thinner so that it could easily fit under patients without moving them.

When you think about the design of an imaging solution, you want the smallest footprint with the fastest throughput; particularly with a cassette-based CR solution, you want a very fast cycle time, so you don’t have to wait for a machine. Of course, with flat-panel DR you want the fast cycle as well, but at some point, a faster cycle provides no additional benefit because of other ergonomic factors, such as positioning of the patient.

You always have to think about the end user and the process. Our new dual-bay mammography CR system can actually process two images at one time, to match the functionality and the workflow of DR. The unit is small enough to position right next to the patient, so the unit has good ergonomics and functionality.

We examine how the technologist interacts with the machine and how the patient interacts with the machine. We’ve redesigned our mammography cassette 10 times to get the plate as close to the chest wall as possible, even though our first design exceeded the requirements for this specification. We keep tweaking our devices to exceed what is required by the standards.

The other design feature that we have pushed to new lows is the size of our machines. Our units can go on a cart and roll right up to the patient. In a hospital or clinic, you want to be able to move things easily to where they’re most needed.

ImagingBiz: How do reliability and durability come into play in meeting patients’ needs?

Neushul: Having a machine that works every day—you don’t have to think about it, it just does its job—is the pinnacle of performance. You want a system that is robust and that doesn’t bend the plates (in the case of CR), so that it works every day and the quality of the images doesn’t degrade over time. With a CR solution, if your plate is being damaged every time you take an image, between the first day and last day you have a quality problem you can’t track—the quality of the image goes down, but you don’t notice it.

We have machines that have done 750,000 cycles without degradation; our systems stay consistently good. Of course, all machines can break down once in a while, but if you can guarantee consistent quality over a long time period, that’s the most important thing.