The sign outside the Women’s Center for Radiology in Orlando, Florida, announces the arrival of 3D mammography. Susan Curry, M.D., founder and medical director, wants to get the message out to women in Central Florida about 3D mammography and the difference it can make in the early detection of breast cancer.

Figure 1: The most important measure of a teleradiology provider was to have highly qualified radiologists reading studies.
Figure 3: Clients look to receive regular feedback and analysis of turn around time, as shown here for strokes.
Figure 3: Clients look to receive regular feedback and analysis of turn around time, as shown here for strokes.
Figure 3: Clients look to receive regular feedback and analysis of turn around time, as shown here for strokes.

While determining how to best measure quality in a teleradiology operation is more of an art, rather than a science, I want to propose the following equation:  TQ = fn (CV + QA% + TAT + QoS). In this equation, teleradiology quality is a function of the credentials of the reader (CV), the miss rate (QA%), the turnaround time for studies (TAT) and the overall quality of service (QoS) delivered.

With the need to transport images and make imaging studies readily available to referring physicians, WCGH got into the picture archiving and communications system (PACS) game relatively early, implementing its first system in 2003. When it contacted Infinitt North America (then SmartPACS) at that time, no one knew it would be the start of a technology partnership that would support them into the next decade or that its PACS would become the hub of its clinical IT platform.

“The time we save is priceless,” said Thomas G. Frazier, M.D., medical director of the Comprehensive Breast Center at the Bryn Mawr Hospital, referring to their use of the KUBTEC XPERT 40 specimen radiography system in the operating room. A nationally recognized surgical oncologist specializing in breast cancer, he performed the first immediate breast reconstruction surgery in the Philadelphia area. He uses the XPERT 40 at Bryn Mawr Hospital, “at least four or five times a week, maybe more, in the operating room alone!”

Cerner is one of several vendors offering a CPOE solution. PowerOrders is part of its PowerChart electronic medical record.
McKesson offers Horizon Expert Orders CPOE .

Although computerized physician order entry (CPOE) systems have been around for a few years, only a few vendors really embraced the market with robust offerings and only a few healthcare providers showed interest in adopting them — until the 2009 passage of the American Reinvestment and Recovery Act (ARRA). After that, the landscape changed considerably, as many providers wanted to take advantage of reimbursements available in meeting meaningful use (MU) requirements and the rate of adoption grew significantly.

Desert Radiologists is a high-efficiency practice in Las Vegas, Nev., that performs 1.25 million exams per year with a staff of 45 radiologists. Yet the practice operated with an outdated and overloaded picture archiving and communications system (PACS) that had no common worklist, no flexibility and could no longer handle its daily imaging volume. Additionally, as Desert Radiologists’ imaging volume continued to increase, its existing storage solution could not keep up. That system was a vendor-neutral archive with on-site SAN/NAS units. However, sending data to the vendor-neutral archive created two PACS and increased the complexity of managing and purging the data.

Bard Access Systems vascular access ports
Setup for measurements at 9, 12, 16 and 20 MeV electron energies.
Bard Access Systems low-profile titanium port model 0605490 dose profile at 6 MeV on film.
Polar diagram showing intensity variation from X-rays produced at specific angles
Bard Access Systems Rosenblatt port model 0654970 dose profile at 20 MeV on film.
Beam attenuation and scattering results around each Bard Access Systems vascular access port at various electron energies having identical treatment geometry.
This equation provides the calculation used for all attenuation and scatter measurements.

New research shows the effects of electron beams on implanted vascular access ports composed of plastic, determining how they impair the fluence of radiation around them.

One of the most important recent advances in radiation oncology has been the integration of 4-D treatment planning tools into the clinic. 4-D treatment tools have enabled the radiation oncologist to better plan and account for the tumor motion in a specific patient.

Magnetic resonance imaging (MRI) is safe, profoundly safe, provided we follow industry best practices. Unfortunately, the rates of reported MRI accidents are nearly five times what they were just five years ago, according to data from the U.S. Food and Drug Administration (FDA)[1] — an apparent indication that we, as an industry, aren’t following best practices.

With healthcare professionals thinking about the effects of ionizing radiation on the population at large, there is particular concern about its use for imaging children. That there is reason for concern was underscored by the release of new study results earlier this year, which indicated computed tomography (CT) exams of children in hospital emergency departments increased substantially from 1995 to 2008.  While CT still may be the best imaging choice in certain cases, there is continued emphasis on using other modalities whenever possible. As a result, magnetic resonance imaging (MRI) is being used more and more,
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