For many small and medium sized practices a new digital x-ray system solution is the single largest purchase they will make. Before making a decision and selecting the company that will provide you with that solution, there are several questions you should ask first:

1. Does your company have experience with digital x-ray?
   Many x-ray providers have been around for many years supplying film and chemicals to their customers, but have little to no experience with digital x-ray options such as CR and especially DR. You don’t want your x-ray installer learning about DR or CR at your expense!
2. Will your company be fully involved in the pre and post-installation project management?
   Make sure the digital x-ray company you contract with will coordinate with your contractor, architect, electrician, IT staff and radiation physicist both before and after the installation. Lack of planning can result in delays and cost over runs.
3. What kind of technical support does your company offer?
   Does your x-ray provider have a dedicated support staff ready to answer your call when you run into trouble or need a little bit of re-training? Picking a company that doesn’t have people waiting at the ready means that you’re the one who will be waiting instead. Many companies simply wash their hands of the situation by passing you off to the manufacturer where you’ll sit on hold waiting for a support representative who doesn’t know your specific situation or needs.
4. Does your company offer multiple options for x-ray equipment?
   X-ray rooms are not one size-fits-all affairs. Each practice has different needs based on the types of shots being taken, the number of patients being x-rayed, the size and shape of the x-ray room and more. An x-ray company that only offers one or two options for both the x-ray equipment and the digital CR or DR may not be able to offer you the best solution for your specific circumstances.

The post 4 Things to Look for in a Digital X-Ray Provider appeared first on Dicomsolutions.com Blog.

Features

There are many standard and optional features for DR systems. Knowing what’s available makes selecting the right DR system easier and more cost-effective. The features vary based on make and model, but some of the most common ones are listed below.

• DR Panel Type: CCD, Cesium, GadOx or Selenium are the most common available.
• Tethered or Wireless: Most DRs are tethered with a cable to generator or operator workstation, however in recent years more and more wireless models have come on the market.
• Image Quality: DRs generally have excellent image quality with some variation between the models and manufacturers.
• DICOM Store Compatibility: This option allows the DR to send images to viewing workstations, PACS servers and other destinations based on DICOM standards.
• Multi-destination: This allows the DR to send to multiple destinations. (Example: daytime reading radiologist or nighttime reading radiologist)
• Auto-send: When an x-ray study is completed it can be automatically sent to a destination.
• DICOM Print Compatibility: If physical films are required, a DR can print directly to a digital DICOM film printer. These printers must be purchased separately.
• Modality Worklist Compatibility: This feature allows a DR system to connect to a RIS, EMR or HIS generated modality worklist. Note that in order for this feature to work modality worklist has be enabled and active on an electronic medical record system.
• CD/DVD Burning: A common method of distributing DR images is on a CD or a DVD. Often these include burned-in viewing software.
• Quality Control Software: This allows the technologist or doctor to fine tune the quality of the image, add markers or notes, and more before finalizing the image for interpretation.
• Touch Screen or Mouse/Keyboard Controls: DR systems often give the option of a touch screen or mouse and keyboard control. It is mostly a matter of workspace size, user preference and price.
• Mini-PACS and/or built-in Web Viewer: Generally designed for smaller providers, this works as an “all-in-one” option for storage and web viewing. It is not widely available from all manufacturers, but can be very cost effective in certain circumstances.

How DR Fits in Your Practice

What DR system you should buy varies between practices. Below we’ll take a look at some common scenarios for different types of practices.

General Medicine

With general medicine practices such as urgent cares, family practices, orthopedists and other healthcare operations that take x-rays of a wide variety of body parts it’s important to make sure that the DR you select has the ability to work with both an x-ray table and a wall stand. For this you have two options 1 panel that can be moved from table to wall stand or 2 panels both the wall stand the table.

• One DR Panel Option: It is important to make sure that you select a DR panel that can be quickly and easily removed from either the wall stand or table and then replaced in the other. CCDs are often too large and bulky to make this feasible, so it is best to take a look at Cesium, GadOx or Selenium. Also, look for models that have handles because a dropped and broken panel means downtime. Wireless DR panels, although more expensive, are worth looking at as well.
• Two DR Panel Option: When using two DR panels you can select from the full array of DR options because the panel won’t be removed from the wall stand or x-ray table regularly. The drawback with this option is that it will cost more because you’re buying two panels instead of one.

Chiropractic

Most of the shots taken in chiropractic environments are done standing or sitting in front of a wall stand. The DR panel can stay fixed in the wall stand for the majority of the time. If this is the case, then there is little need to make sure that a panel has handles or is easily accessible and panels can be evaluated based on quality and price.

Mobile X-Ray

Until recently DR panels were difficult to use in mobile x-ray because of the size of the panels and the cost associated with them. Tethered panels can be wired directly into portable x-ray machines and controlled from a tablet PC also mounted on the x-ray machine. This can be a huge benefit to mobile x-ray providers because there is no going back and forth between the patient and the CR reader in the vehicle. It is important to make sure that the panel is light-weight and has a handle. CCD panels are generally not a good option for this. It is best to look for panels that conform to standard cassette sizes such as 14 x 17 and 10 x 12.

The post Digital Radiography: Features and How DR Fits in Your Practice appeared first on Dicomsolutions.com Blog.

When your body is perfectly aligned, or has good posture, the weight and the force of gravity is distributed evenly throughout your body. Proper alignment includes your head sitting on top of your body, not protruding forward, your ears should line up with your shoulders; your shoulders are back inline with your torso and your body weight is balanced over both your spine and the joints of your lower extremities.

The biggest toll that modern life has put on our posture is the growing amount of people working in offices, at desks and on computers. Throughout the day our body moves into an arc, following the center of interest, usually a computer. Our bodies fall out of alignment, putting stress on the muscles, straining the neck, shoulders and lower back in particular. In the short run, this tires muscles and ligaments, causing pain and soreness. In the long run, besides chronic pain in the neck and back, poor posture can cause limited range of motion, decreased lung capacity, increased bowel issues and permanent damage to the curvature of the spine.

Sit Up Straight

There are simple things that you can do to improve your posture, while you’re standing or sitting and even while you sleep. A mattress with firm support of your lumber and spine will help you get a good night’s sleep as well as help to keep your body supported while you sleep. When working at a desk, make sure that it is at elbow height and that the computer is 15˚ below eye level. You can use a foot rest to take pressure off of your back, raising your legs slightly above your hips. Take breaks frequently to get up and walk around and stretch.

Maintaining a healthy weight and exercising regularly will also help you to retain good posture. Excess weight, especially in the middle, puts stress on the spine and weakens stomach muscles. Strengthening your abdominal muscles helps to take stress off of your spine and lower back as well as helping to hold your spine in the proper position. Lastly, pay close attention to your body if you fall or injure yourself. You need to allow your body to heal, without undue strain. If you do not allow proper healing, the injury can be made worse, healing can be prolonged or other parts of your body can be affected by overcompensation.

Good posture should be a priority for everyone. Those with good posture feel more energy, less stress and are less prone to injury. With Americans more focused on healthy living and being physically fit – posture should definitely be integrated into any health plan.

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Sizes

Currently, there are three common sizes of the radiographic areas for DR panels:

• 10 x 12 inch
• 14 x 17 inch
• 17 x17 inch

The actual size and weight of the DR panels can vary widely. Some have handles or protective covers built into the panel that can require retro-fits to the standard wall stand or table bucky. For some panels the handle, protective covers and grids are optional or removable.

CCD

CCD technology comes in two variants, the single, large CCD and the multi-CCD array panels.

Single-CCD: This technology uses a GOS or CsI scintillator that converts the x-ray energy into visible light that is then bent using a prism where a picture of the image is then taken by a single, large charge coupled device (CCD), similar to what’s in a digital camera.

• Advantages: Very short processing time, seconds to image preview and a high-dynamic range. Image Quality is very good.
• Disadvantages: Panels are large and bulky. Higher cost than some other technologies. Becoming obsolete as newer technologies can beat it on price and size.

CCD Array: CCD array technology is similar to the single CCD except it has 200 individual CCDs arranged on the iside of the panel that capture 200 individual images that are then digitally stitched together before being displayed on the operator’s workstation.

• Advantages: Very short processing time. Low cost. Panels are smaller than single-CCD panels.
• Disadvantages: Can take more dose than other DR options. Image quality is not optimal.

Indirect Flat Panel Detector (Non-CCD)

Indirect Flat Panel Detectors work in much the same way as CCD panels in that x-ray energy is converted to visible light that is then captured and processed into a viewable image. However, these panels have a scintillator made of either Cesium Iodide (CsI) or Gadolinium Oxysulfide. These scintillators release the visible light that is converted to a digital signal and read by an area of Thin Film Transistors (TFTs) instead of charge coupled devices.

To fully understand these types of panels it is important to make point out the differences between the scintillators:

Cesium Iodide (CsI)

• Advantages: Excellent image quality. Lower x-ray dosage required. Excellent choice for skeletal radiography.
• Disadvantages: Often requires a retro-fit for placement in existing x-ray equipment. More difficult to move panel from wall stand to table. Higher cost.

Gadolinium Oxysulfide

• Advantages: Lower cost. Higher image quality than CR. Good for skeletal and soft tissue images.
• Disadvantages: Requires 10% more radiation dose than CsI panel for the same image quality.

Direct Flat Panel Detector

This type of panel differs from either CCD or Indirect FPDs because the x-ray energy is not converted visible light and then read by TFTs or CCDs. Instead, the x-ray energy is absorbed directed by a sensitive material and then read by a TFT. These types of panels are often referred to as Selenium panels.

• Advantages: Excellent image quality. Often lower cost than Cesium Iodide. Many models can fit in existing x-ray tables and wall stands. Chest x-rays, soft tissue. Cassette-size is more versatile than other DR options.
• Disadvantages: Relatively higher cost.

Wireless

Several manufactures now make DR panels that are wireless. The quality of the images can be just as high as tethered panels and are far more flexible in terms of use. They are often standard cassette size and fit easily within existing cassette trays. These panels are battery powered.

• Advantages: No cables. Flexible usage.
• Disadvantages: High cost. Potential for dropping. Battery life.

The post Digital Radiography: The Different DR Types appeared first on Dicomsolutions.com Blog.

Digital radiography, or DR, is the next step in the evolution of medical x-ray technology. First CR technology replaced traditional film and now CR is being replaced by DR technology. Where CR required cassettes that had to be scanned by a CR reader, DR allows x-ray radiation to be shot directly onto a panel containing x-ray sensors. The panel containing the detector is connected directly to a PC that allows the image to be processed and pre-viewed by the x-ray technician in seconds.

There are several broad types of DR readily available today including CCD, indirect flat panel detector and direct flat panel detector. Within these broad DR types there are also several options to choose from depending on the intended usage.

In general though, DR systems enjoy several benefits including immediate image preview, higher image quality and contrast resolution and potentially lower dosage compared with CR and traditional film.

How Does DR Work?

On its most basic level, the way that DR works is fairly straight-forward. Conventional x-rays are shot through a patient and are then detected by sensors in the DR panel that is placed in either a table or a wall stand. Those sensors then send that radiation information directly to an operator workstation where software processes the information and displays the resulting image. The entire process can take less than a few seconds.

Using your DR with Existing X-Ray Equipment

For the vast majority of the DR panels mentioned above it is possible to continue to use your existing x-ray equipment. Some panels will file directly into existing cassette trays and buckys and others will require retrofitting the tray or the entire bucky. The grid will need to be replaced for almost all DR panels.

Also, some DRs will be connected directly to your existing generator. This is not generally an issue if you have an experienced x-ray/DR engineer performing the installation.

The post Digital Radiography: An Overview appeared first on Dicomsolutions.com Blog.

Sleep

The easiest thing that you can control is how you treat your body. A good night’s sleep is the place to start. Most adults need between six and eight hours of sleep each night. Sleep rejuvenates your body and mind, without a restful night’s slumber you will feel lethargic and unmotivated. The best ways to promote sleep are keeping to a bedtime routine, having a light snack that includes complex carbohydrates – a piece of whole wheat toast for example and disconnecting from all electronics. Phones, computers and televisions stimulate our minds and can make it difficult to fall asleep.

Eat

You want to make sure that you are eating a healthy, well-balanced diet. The food that we eat fuels our bodies, giving us energy and enhancing our mood. Diets high in fat can actually cause more depression and anxiety. Filling up on vegetables and fruits, whole grains and lean protein will help power you through the day – and with a better attitude.

Exercise

Exercise isn’t just good for your body; it’s good for relieving stress. Physical movement can release tension and anxiety that you have pent up inside. Exercise also causing the release of endorphins into your brain which helps to improve your mood. If you choose an activity that you really enjoy, you will get the additional benefit of having fun – another great stress reliever.

Attitude

One’s attitude has a great impact on how they deal with stress. Stress is unavoidable and there is only so much that we can do to lessen the stress around us. If you choose to have the attitude that some things you do not control, while other things you do, you can spend your energy on those items you can change and resolve yourself to the stressors that you do not control like the weather or traffic. Adding happiness and joy into each day can also help to change your attitude about your life. Start a gratitude journal, listen to music that relaxes or energizes you and laugh – laugh a lot.

Mind and Spirit

Our world is loud and filled with noise of every kind. Finding quiet in some form can be very healing to the effects of stress. Meditation has grown in popularity along with instances of stress. Meditation and breathing exercises can help you to relax, get some quiet in your life and allow you to escape, even momentarily, from the chaos of life. Other things like reading, aromatherapy or massage can also help you to de-stress.

The post Dicom Inside Health: Top 5 Natural Ways to Relieve Stress appeared first on Dicomsolutions.com Blog.

Text of regulations

(http://www.cdph.ca.gov/services/DPOPP/regs/Documents/DPH-08-015FinalRegText6.29.12.doc)

California Code of Regulations, Title 17, Public Health

§ 30305.1. Quality Assurance General Provisions

§ 30308.1. Quality Assurance for Radiographic Installations (Other Than

Mammography, Dental, and Veterinary Medicine)

§ 30311.1. Quality Assurance for Dental Radiography

Questions and Answers

1.  Where can I learn how to perform quality assurance testing and find additional information?

Additional information can be found on the Conference Radiation Control

Program Directors website at http://www.crcpd.org/Pubs/QAs.aspx.

For radiographic machines: http://www.crcpd.org/Pubs/QC-Docs/QC-Vol3-web.pdf

For podiatric facilities: http://www.crcpd.org/Pubs/QC-Docs/QC-Vol2-Web.pdf

For dental facilities:  http://www.crcpd.org/Pubs/QC-Docs/QC-Vol1-Web.pdf

2.  Our clinic uses only digital radiography/computed radiography in our X-ray department. Are there new Q.A. requirements for users who do not process film to record their radiographic images?

No. These regulations apply only to users who chemically process film to record their radiographic images.

3.  We process our films manually. Do these regulations apply to us?

Yes. Section 30305.1 applies to all users who chemically process film using either manual or automatic processing. Section 30308.1 applies to users who develop clinical radiographs for diagnostic purposes with automatic film processors for other than mammographic, dental, or veterinary use. Section

30311.1 applies to users who manually, or with automatic film processors, process intra-oral films for dental radiography of human beings.

47. How will dental image density, contrast, sharpness and overall quality be measured?

These will be measured by a visual check; the density may also be measured with a densitometer.

48. What type of documentation will be required to demonstrate compliance?

The inspector will review documentation showing that the required tests were performed and at the right frequency, problems were identified, corrective actions were implemented, and assessment of the effectiveness of corrective action was made to evaluate compliance.

49. Section 30308.1(a)(1) requires that each processor used to develop clinical radiographs be adjusted and maintained to meet the manufacturer’s processing specifications for the highest speed radiographic film used clinically. We process our mammography films in only one processor. Must all of our processors meet the processing specifications for mammography film even though they are not used for processing mammography film?

Each processor must be adjusted and maintained to meet the manufacturer’s processing specifications for the highest speed radiographic film used clinically that is processed in that processor.

The post Quality Assurance for X-ray in California – Frequently Asked Questions appeared first on Dicomsolutions.com Blog.

Quick Facts Breakdown-
Empirical evidence has proven that High Frequency Generators;

• Produce Superior Image Quality
• Can use up to 40% Less Dose
• Have Superior Patient Penetrating Properties
• Produce Less Re-Takes and Double Exposures
• Rapidly Increase X-Ray Room Patient Through-put
• Have a Faster ROI

Practical Implications-

Here is a comparison of techniques for the same exam, taken at the same film speed for High Frequency vs. Standard Frequency;

• AP Lumbar exam on a 32CM Patient, 200 Film Speed High Frequency System =
  kVP 84, mAs 100
• AP Lumbar exam on a 32CM Patient, 200 Film Speed Standard Frequency System=
  kVP 100, mAs 250

Standard Frequency                                       High Frequency
                         

With High Frequency Generators the X-Ray room becomes much easier to use with less mathematics involved and high patient through-put, allowing for a faster return on your investment.   This is mostly due to the fact that High Frequency Generators utilize Digital Operator Consoles as opposed to the physical dials that are used with Standard Frequency generators to set the proper technique for each exam.  With a High Frequency system, the operator simply chooses the exam type (ie AP lumbar) from a list of options, inputs the patients CM thickness and presses expose.  With a Standard Frequency system the operator will have to set the proper kVp, mA, and Time setting for each exam.  If the operator is not very well versed with X-Ray physics and image quality diagnosis, this results in many re-take exams and a much slower through-put of the patients in the X-Ray room.

Short Technical Explanation-

Standard Freq. KVP Waveform                                    High Freq. KVP Waveform

The above graphs show the evidence of why these two generator types first got their names.  The term “frequency” comes from the amount of times per second that the KVP waveform goes up and down.  This is important because useful Medical Imaging X-rays only happen when each of these waveforms are at the peak of the line.  As you can see, the High Frequency Generator’s waveform spends much more time at the top of the crest, thus producing more efficient and better looking X-ray images!

For all the above reasons High Frequency Imaging is a far superior technology and method of acquiring diagnostic images.  Dicom Solutions is ready to help you move into the Digital Age with your X-Ray equipment. 

Contact a sales associate today at 1-800-377-2617 for more information.

The post A Simplified Comparison of High Frequency vs. Standard Frequency X-Ray Generators appeared first on Dicomsolutions.com Blog.

Are you considering purchasing a new x-ray system for your medical office and overwhelmed with all the options and technology? Below is a great list to help get you started with asking the right questions in order to make your purchasing decision a little easier. Before talking to an X-Ray vendor you should answer the following questions about your situation in order to get a better idea of what may be the best solution for you:

1. What kind of Chiropractic practice is this equipment for (ie. Blair, NUCCA, Full spine)?
2. Are there any specific shots that your practice will need to take? For example Base Posterior, Stereoscopic, Vertex, Nasium, Full spine?
3. How many x-rays do you currently do per day and how many do you anticipate doing per day in the near future?
4. Do you have an existing x-ray room with equipment that needs to be replaced?
5. If the X-Ray equipment is for an existing x-ray room, what size is the current room?
6. If you do not have an existing x-ray room and are planning to build one, is it new construction or a remodel of an existing suite?
7. What is the available power in the building?
8. Are you interested in a CR System or a DR system?
9. Will you need a PACS, mini-PACS or off-site storage?

Not sure how to answer these questions? The experts at Dicom Solutions can help walk you through any questions that you may have in order to help you find the best solution. Check out what they can offer you for x-ray system solutions by calling 1-800-377-2617

The post X-Ray Checklist: Questions to Ask Before you Buy appeared first on Dicomsolutions.com Blog.

Studies such as these can help urgent care facilities staff and train to best suit the needs of the patients. For example 34% of all x-rays performed were chest x-rays. With this knowledge urgent health care clinics could increase the training of their staff in performing and reading results of chest and pulmonary x-rays. The expectations of the radiology staff could have more emphasis on the specific procedures performed at their clinic. Since the study researched the slowest and busiest days of the week, urgent care centers can also use this to assist in scheduling and staffing. Monday and Fridays are the busiest days of the week for radiology, while Sundays are the slowest.

The more information that practitioners and health care facility managers have, the better armed they are to provide the type of care that their patients require. Choosing the appropriate urgent care x-ray and radiology equipment as well as a team that is trained and properly staffed will help improve quality patient care.

The analysis concluded that x-ray utilization was not based on age or gender. The busiest days were Mondays and Friday, while Sunday was the slowest day of the week for x-ray procedures. More than one third of x-rays performed were chest x-rays. A minute amount of x-rays were given to those complaining of sinusitis, yet it was the second most common complaint found in the study of urgent care centers.

This study was conducted by a national teleradiology provider; the analysis included 7,675 X-ray studies from 56 facilities located in seven states.

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