TechNation is focused on radiography equipment for this Roundtable article. Several knowledgeable individuals were invited to participate and share their insights with readers. Participating are FUJIFILM Healthcare Americas Corporation Director of Strategic Marketing, Diagnostic Imaging Rob Fabrizio, entech Director of Capital Refresh John Garrett, Carestream Health General Manager of Global Services and Solutions Jatin “JT” Thakkar and Banner Imaging Casa Grande Practice Manager Misti Wright.
Q: What are some of the newest features in radiography that facilities should consider when buying new?
Fabrizio: Many of the new features across radiography equipment include technologies that empower clinicians to achieve lower dose, maximize workflow efficiency and capture high-quality images. It’s important that facilities look to invest in radiography equipment that provides these features as they greatly contribute to enhancing the patient’s experience.
Garrett: There are a number of artificial intelligence options for better imaging results, specifically in studies that were previously difficult to achieve diagnostic quality images. There are various options that can increase throughput and improve workflow.
Thakkar: It is important to select equipment that can support future advances – otherwise your imaging equipment might become obsolete too quickly. The biggest software advances – that have the greatest potential for diagnostic imaging – are leveraging AI. For example, Carestream is using AI to improve the patient experience. Our Smart Noise Cancellation (SNC) enables health care facilities to lower radiation dose without a loss in image quality. We are also applying AI to enhance the user experience. Our Smart DR Workflow features help radiologic technologists capture exams more efficiently, expediting workflow and delivering repeatable results.
Wright: Data sharing, more of the population is technology savvy, the need for data sharing is increasing for health care providers and the patients. New features that can improve image quality, technologist’s workflow and increase productivity.
Q: What are some approaches/strategies health care facilities can use to maintain and repair its radiography devices?
Fabrizio: Facilities should start by purchasing reputable equipment, putting their trust in well-established companies and equipment with a solid reputation for uptime reliability, durability and performance. As technologies are advancing in reliability, comprehensive service contracts are becoming more affordable. Many times, the OEM can provide the best option for service. For example, OEMs — like Fujifilm — provide factory trained services and support, and they have direct access to the latest engineering changes, parts and documentation. Fujifilm offers technology upgrade options that can bring down the total cost of ownership through service bundled packages that allow very affordable lease and/or financing options that are all inclusive of full coverage — including software updates, maintenance, drop protection and more. These services also include remote monitoring and diagnostics along with factory-trained engineers and overnight parts availability. Remote monitoring can help detect issues before they happen, for scheduled maintenance, to avoid downtimes, load software and patches and even identify parts for service to bring with them before they get to the site.
Garrett: Create a service strategy prior to purchase. Ensure that training is available to in-house personnel. Understand all of the costs involved in maintaining the equipment. Look for workflow issues that will increase wear on equipment when comparing vendors. Once purchased, understand how the equipment is used at its specific location and the environment which it operates within. Ensure that preventive maintenance is done per manufacturer specification and any anomalies are addressed immediately. Build a solid relationship with the operators and encourage open and frequent dialog about anything that seems to not work correctly for early identification and correction of problems.
Thakkar: The three essential areas are preventive maintenance, service response and availability, and software and cybersecurity updates.
Preventive Maintenance: It is critical to up-time and patient care that health care facilities understand the preventive maintenance requirements for their imaging devices. These services help keep equipment running at peak performance, in compliance of all regulatory and safety standards, and within the operating standards determined by the manufacturer. Facilities should ensure that only factory-trained and authorized certified service personnel perform work on the equipment; and provide the facility with a record of maintenance performed to meet compliance requirements.
Service Response and Availability: Facilities should also ensure they have an agreed service level with their service provider, with a contract/agreement that contains a committed response time. Knowing this expectation will help the health care facility manage the impact that downtime could have on patient care. Service contracts often provide the facility with a level of priority to help ensure that troubleshooting and repairs are done as quickly as possible.
Software & Cybersecurity Updates: Health care facilities should ensure that their software and cybersecurity protections remain current and able to protect their network and patient data now and in the future. These updates typically are included in service agreements and often can be implemented using remote service technologies.
Wright: Currently our process, preventative maintenance is critical. Proper use of authorized manufacturer-approved cleaners and disinfectants are important.
Q: What should one look for in A service provider?
Fabrizio: There are a lot of players in the DR space today. Deciding which vendor to partner with can be overwhelming. My advice to health care facilities is to partner with a radiology service provider who has an exceptional reputation, robust experience in the space and, most importantly, check that the vendor is factory trained and certified to repair and maintain the equipment they will service.
Garrett: In the current environment, a big consideration are staffing levels, availability and staff experience. There is a considerable issue everyone seems to be facing with staffing within the medical field. Another, often overlooked, item is service reports. Do they meet the needs of the hospital for documentation and maintaining deemed status? Are they delivered in a timely manner? Do they allow for an accurate service history to be assembled? Do they have access to all the parts needed to minimize downtime? This includes understanding the supply chain they use.
Thakkar: Look for a provider who is delivering solutions that advance your strategic goals. For example, are they delivering new features that enhance the experience for your patients or for your radiology team? Do their solutions help improve clinical outcomes or lower your costs? Also look for a provider who offers a wide-ranging portfolio of products, including solutions that meet diverse budgetary needs.
Wright: Inquire about back-up units, is this available during downtime of equipment? Ability of remote services, may be able to identify the issue and get a head start on parts and reduce downtime.
Q: What type of training can in-house biomeds complete to better service imaging devices?
Fabrizio: OEMs like Fujifilm offer certified training side-by-side with their own field service engineers. Fujifilm’s customers have two distinct advantages to help them grow their level of expertise with their equipment and success – including industry-leading equipment and industry-leading instruction. In addition to offering hands on/in-person training with customers, Fujifilm also offers product training courses that help users reduce downtime, maintain compliance and support their facility’s goal to provide exceptional health care experiences.
Garrett: Obviously general modality imaging courses (X-ray, CT, MRI, etc.) and equipment specific training. Participation in local HTM groups, such as AZHTM, allows for training opportunities to keep up-to-date on technology. Further training at conferences, as well as the networking opportunities, build more resources that improve the ability to service equipment.
Thakkar: In addition to key operator training that enables some on-site adjustments, in-house biomeds should be familiar with the manufacturer’s recommended preventive maintenance schedule and which components must be cleaned, verified and quality tested. For in-house biomeds who are their facility’s first line of support – ask your equipment manufacturer about training on basic service needs and diagnostic tools.
Q: What advice would you give a biomed involved in purchasing a facility’s radiography devices?
Fabrizio: It’s critical to stick with a trusted supplier that has proven experience and is here for the long haul. At a time when many companies are scaling back, Fujifilm has been continuing to grow its portfolio and expertise. It’s also important to ask, “What use cases do I need DR equipment for now, or what cases are going elsewhere and what plans for growth do we see in the foreseeable future?” and then purchase accordingly.
Garrett: Ask people in your industry network about service histories of the equipment that is being considered. Understand how your hospital uses the equipment and be able to speak to how that might be expected to impact the longevity, uptime and overall cost of ownership for the equipment. Watch out for old technology repackaged with a new name.
Thakkar: When purchasing new radiography devices, biomeds should check that the manufacturer offers comprehensive on-site services as well as remote diagnostics and support. Also, ask whether the solution is capable of being upgraded to incorporate new technologies like AI and cybersecurity improvements. This scalability is essential in order to have the solution provide value in the future as well as today. Additionally, understand the types of training available for you so you can meet the needs of your radiography department now and in the future.
Wright: Discussions/involvement of the modality leads and/or radiologist. They are performing and reading the exams. Their insights can assist with making correct purchases. Reliability of equipment. Can this equipment be upgraded?
Q: What else do you think TechNation readers need to know about radiography equipment?
Fabrizio: The radiography equipment market is dynamic with new software applications and technologies taking clinical workflows, exam speed, image quality and the patient experience to a whole new level. It’s important for health care providers and facilities to understand the modern technology that is available to better serve both their clinicians and patients. I recommend professionals that work in the space attend radiology and imaging focused tradeshows, like the RSNA and AHRA conferences to witness the latest and greatest DR advancements firsthand.
Garrett: The specific use and environment should be a major consideration when purchasing medical imaging equipment. There are cases of a unit being purchased based on price that can’t handle patient volume or is not suited for the specific studies that are most often performed at a location. This leads to more downtime, a higher cost of ownership, shortened life of the equipment and poor patient satisfaction. The relationship with those that operate the equipment daily is crucial to best outcomes. It is important that you work as a team to maintain the equipment and understand what is being demanded. Understanding the person operating the equipment and what the facility wants accomplished by the equipment can tell you what needs the most attention during service.
Thakkar: Don’t overlook the importance of standardization. Often, radiologic technologists move among different pieces of equipment within a facility or network of facilities. Having a consistent user interface for mobile and/or room-based imaging systems not only reduces the training required, but also enhances productivity and ease of use.
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