Sponsored Content | Case Study | Computed Radiography (CR) | November 01, 2016 | Sponsored by Fujifilm

Decoding the Consolidated Appropriations Act of 2016

How new CMS legislation will impact healthcare providers and what one center is doing to prepare

The FDR Go’s user-friendly platform helps to make the technologist’s job easier and improves the patient’s experience.

Beginning Jan. 1, 2017, the Centers for Medicare and Medicaid Services (CMS) will begin enforcement of the Consolidated Appropriations Act of 2016, a piece of legislation that incentivizes healthcare providers to transition imaging departments to digital radiography (DR). 

“[CMS will] reduce Medicare reimbursements for film X-rays by 20 percent in 2017 and for computed radiography (CR) by 7 percent in 2018. In 2022, it will be cut by 10 percent for outpatient classified exams,” said Robert Fabrizio, director of strategic marketing for digital radiography and women’s health at FUJIFILM Medical Systems U.S.A., Inc.

The legislation will affect at least half of hospitals in the United States, due to their continued use of CR, and many more private practices and outpatient facilities that still use analog film. “Revenue from exams that are performed under the HOPP billing codes, such as outpatient and ER patients that don’t stay overnight, will be impacted by this legislation,” Fabrizio explained. “Hospitals and, more specifically, outpatient and private practices, will be financially impacted, especially if they have a high concentration of Medicare patients.” 

The Benefits of DR

The main motivation for the new legislation is in reducing the costs of Medicare funding, however to healthcare providers there can be many benefits beyond simply preventing reimbursement reductions. 

“There are many benefits in upgrading to DR, such as new equipment reliability, patient safety in dose reduction, productivity in treating patients faster and more efficiently, better image quality and more positive patient experiences,” said Fabrizio.

This was the experience of East Texas Medical Center (ETMC), a 534-bed, level 1 trauma center in Tyler, Texas, that recently upgraded its CR systems to newer Fujifilm DR solutions in order to achieve dose reduction and departmental efficiencies for patients and physicians.

According to William Tobin, radiology director at ETMC, the hospital has seen as much as a 50 percent reduction in dose, which was especially important within the center’s trauma bays, where many of the patients they treat are younger.

Because DR images are captured immediately, the center was able to increase efficiency, which is especially critical in the emergency room, allowing physicians to salvage vital minutes. Instead of having to move a CR cassette from one area of the department to another in between exposures to process the image, technologists can simply move the DR detector within the trauma stretcher itself, directly moving it the length of the patient to shoot multiple exposures during the exam, saving significant time. 

“We saved about three minutes per image by converting to DR,” Tobin explained. “In the trauma setting, those three minutes are crucial.”

Utilizing DR has also improved patient care in the outpatient setting. Since DR images are acquired immediately, “the technologist can have more eye contact and more face time with the patient versus being behind a wall removing and processing a cassette after each exposure,” Tobin explained.

The Conversion Process

While the benefits of DR are apparent, many healthcare providers are still unsure about the feasibility of the upgrade in both cost and functionality. However, there are several cost-efficient options that can make the transition to DR relatively painless. For instance, Fujifilm worked closely with ETMC to ensure that the DR systems were phased in using small steps at first, creating less stress on the institution’s budget.

In addition, Fujifilm offers a variety of rooms, detectors and mobile solutions. The company can retrofit any third-party room to convert it from CR to DR, allowing healthcare providers to leverage the remaining life of existing X-ray rooms, which lowers cost compared to investing in a complete new room. Later on when those rooms are ready to be replaced, the detectors can be used with any newer equipment they choose to purchase down the line. 

Because the user acquisition workstation that powers Fujifilm CR remains largely the same when converting to Fujifilm DR, there is very minimal cost associated with it because little-to-no training of technologists is needed. Technologists are up to speed and running on the new DR in no time. With Fujifilm, radiologists are even able to keep many CR features, including the PACS hot key functionality that so many physicians find they can’t live without. “Departments should assess their environment strategically and, in some cases, may be able to reallocate some of their CR to inpatient uses or areas that have very low patient volume and upgrade areas in most need,” said Fabrizio.

ETMC has converted its outpatient center, Private Outpatient Building, trauma bays and trauma area in the emergency department, and the imaging center at the center’s South Broadway Suite. Last month, ETMC Tyler (Tobin’s facility) took the final step in transitioning from CR to DR. This included the addition of two more FDR Go portables and retrofitting five radiology rooms (four in main radiology and one in ER West). There are five additional ETMC facilities that have chosen Fujifilm as their partner in the DR conversion and are awaiting budgetary approvals.

What’s Next?

The conversion to DR is a process that most healthcare providers will have to undertake in order to prevent reimbursement reductions with the new CMS legislation. Although this transition can seem like a daunting task, selecting a vendor that supports department needs allows use of existing workstations and provides a long-term commitment that will facilitate a smooth transition and ensure that healthcare providers are receiving reimbursements and seeing the benefits of DR as soon as possible.

Related Content

This is a lung X-ray reviewed automatically by artificial intelligence (AI) to identify a collapsed lung (pneumothorax) in the color coded area. This AI app from Lunit is awaiting final FDA review and in planned to be integrated into several vendors' mobile digital radiography (DR) systems. Fujifilm showed this software integrated as a work-in-progress into its mobile X-ray system at RSNA 2019. GE Healthcare has its own version of this software for its mobile r=ray systems that gained FDA in 2019.   #RSNA #

This is a lung X-ray reviewed automatically by artificial intelligence (AI) to identify a collapsed lung (pneumothorax) in the color coded area. This AI app from Lunit is awaiting final FDA review and in planned to be integrated into several vendors' mobile digital radiography (DR) systems. Fujifilm showed this software integrated as a work-in-progress into its mobile X-ray system at RSNA 2019. GE Healthcare has its own version of this software for its mobile r=ray systems that gained FDA in 2019.

Feature | RSNA | January 20, 2020 | Dave Fornell, Editor
Here are images of some of the newest new medical imaging technologies displayed on the expo floor at the ...
Gadolinium based contrast dye in brain MRI

Gadolinium contrast agents (GBCAs) are partly retained in the brain, raising safety concerns, as seen in this MRI.

News | Contrast Media | January 17, 2020
January 17, 2020 — Bracco Diagnostics Inc., the U.
Carestream’s X-ray digital tomosynthesis functionality creates three-dimensional datasets from digital radiography (DR) that can be scrolled through similar to computed tomography (CT) imaging. It received 510(k) clearance from the U.S. Food and Drug Administration (FDA) in January 2020. Digital tomosynthesis uses a single sweep of X-ray exposures and streamlines operator workflow by separating the process of DT exposure acquisition from image volume formation.
News | Digital Radiography (DR) | January 15, 2020
January 15, 2020 — Carestream’s X-ray digital tomosynthesis (DT) functionality, which creates three-dimensional datas
Imaging Technology News (ITN) has been acquired by Wainscot Media
News | Imaging Technology News - ITN | January 14, 2020
January 14, 2020 — Park Ridge, N.J.-based publisher Wainscot Medi...
Videos | RSNA | January 13, 2020
ITN Editor Dave Fornell takes a tour of some of the most innovative new medical imaging technologies displayed on the
Partners of Collaborative Imaging experience billing collection improvements of over 25 percent while reducing operating costs by 30 percent

Image courtesy of Philips Healthcare

News | Radiology Business | January 08, 2020
January 8, 2020 — The $18 billion radiology industry continues to face a growing threat of consolidation, resulting i
Sponsored Content | Videos | Digital Radiography (DR) | January 06, 2020
An experienced technologist and two Agfa executives talk about what distinguishes the new Agfa 100s.
Sponsored Content | Videos | Ultrasound Imaging | January 06, 2020
The Arietta 850SE provides facilities with numerous features and functionality to get the most out of a system.
Sponsored Content | Videos | Computed Tomography (CT) | January 06, 2020
Hitachi announced the FDA clearance of its newest CT – Scenaria View – at RSNA2019.
The use of augmented and virtual reality in radiology was the subject of two articles and part of the HIMSS 2019 trends article in the top 25 list. Augmented reality is being looked at as a way to better train radiologists, allow surgeons to use medical imaging in true 3-D to better plan surgeries, and it can allow patients to better understand their conditions compared to use of traditional 2-D medical images. Photo by Dave Fornell.

The use of augmented and virtual reality in radiology was the subject of two articles and part of the HIMSS 2019 trends article in the top 25 list. Augmented reality is being looked at as a way to better train radiologists, allow surgeons to use medical imaging in true 3-D to better plan surgeries, and it can allow patients to better understand their conditions compared to use of traditional 2-D medical images. Photo by Dave Fornell.

Feature | Radiology Imaging | January 03, 2020 | Dave Fornell, Editor
January 3, 2020 — Here is the top 25 radiology articles on the Imaging Technology News (ITN) website from 2019 based