Patient-friendly Imaging: Digital Workflow at Marshfield Family Clinic

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On any given day, Mickie Burrell, medical assistant at the Marshfield Family Clinic in Missouri, has her hands full, as do her fellow staff members. “We see 80 to 100 patients a day, so time is of the essence for us,” she says. Like many primary-care facilities, the clinic has a wide scope of practice. She adds, “We do everything here, so at the end of the day, giving our physicians the best possible workflow is what matters.”

Toward that end, in the spring of 2012, the clinic replaced its analog radiography system with a Fusion DCR system from iCRco and implemented the company’s Clarity PACS to manage the digital images. Fusion DCR combines the image-capture capabilities of a DR system with a cassette-based CR workflow to provide DR-quality images at a lower cost. “Before the Fusion, we were producing films that we would put through a scanner to make digital,” Burrell says. “Now, everything is digital. In the amount of time it used to take us to develop and scan the film, the physician can already be in the exam room, discussing the image with the patient.”

Workflow and Support

For Burrell and her coworkers, the workflow for the Fusion system is similar to that of analog radiography. “Our technique is the same, but the way the system processes the images is different,” she notes. “You take the image and can see it immediately to confirm that you got a good shot.” The workflow is so intuitive, in fact, that little training was needed to get the clinic up and running with the new system, Burrell reports. “The system is so easy to use that training didn’t take much time,” she says. “Once we were trained and had started seeing patients, the iCRco team stayed to make sure we were getting the most out of the system.”

The Fusion is now the only system in use at the clinic. Its versatility—both 14x17-inch and 10x12-inch cassettes can be used—makes it a workhorse for the clinic’s variety of patients and conditions: “We have no need for another system,” Burrell says. In addition, the system’s compact footprint and digital workflow have freed a room in the clinic that previously housed the scanner used to convert film to digital images, she notes.

The clinic often sees repeat patients, and the Clarity PACS makes it easy for Burrell and colleagues to differentiate between prior exams: “The system keeps the images separated, so you don’t have to thumb through all of the patient’s past radiographs to find the chest radiograph you are looking for,” she says. Digitally managing images is also useful when the clinic needs to refer patients to specialists, Burrell adds. “Films are harder to keep up with, to store, and to share,” she says. “Now, if a patient needs to take images from here to an appointment with a specialist, we can just put those on a disc.”

Patient Care

Burrell estimates that between one-third and half of the clinic’s patients receive imaging using the Fusion system, which makes its contribution to the patient-care process of paramount importance. “The speed of the system really helps with patient care,” she says. “If the quality of the image is bad, we don’t have to go back and process the film while the patient waits, then make him or her come back in so we can retake it.”

Further, she says, the design of the Fusion system makes imaging easier and more comfortable for certain patients and clinical scenarios. “You have the option of doing the image with the patient standing up,” Burrell notes, “which isn’t an option on a lot of the older systems. People come here for broken ribs, and we also see a lot of elderly patients. In the past, you had to put those people on a hard table when they were already hurting. This way, you can just walk them in there and snap their pictures.”

The clinic’s new digital workflow makes rapid transmission of patients’ images to their exam rooms possible; there, the clinic’s physicians can discuss the findings with them in real time. “People like to see where the problem is and to know for themselves whether it is improving,” Burrell says. “When they see the problem, they can take more control over getting better.”

Perhaps most important, the image quality created by the system’s digital detector is excellent, Burrell notes. “I was skeptical at first, but the images are amazingly better than the images we got from our old system,” she says. “You have to experience for yourself how easy it is to produce images that are so much better. It’s amazing.”

Cat Vasko is editor