June 1st, 2006 - Imaging Economics

Mobile Imaging Company Provides Services to Rural Nursing Homes in Texas—Thanks to a Scion and Starbucks
Advanced Imaging Services Inc (AIS), a San Antonio-based imaging company, is bringing new meaning to the phrase "mobile x-ray"—with a little help from Starbucks and a fleet of more-than-fully loaded Scions. No, the company is not promoting the double espresso; AIS' radiologic technologists (RTs) quickly transmit digital images using wireless portals like those offered for free or via paid monthly pass at Starbucks, FedEx Kinko's, and even a Dairy Queen or two.

And that is only the last step in a 21st-century workflow designed to minimize the time between physically scanning a patient and receiving a report back from a radiologist. The AIS system, which was designed by Dicom Solutions Inc, Aliso Viejo, Calif, optimizes efficiency by using the latest imaging technology coupled with today's free Internet services—from the wireless hotspots that are popping up around the country to free navigational tools like Google Earth.

AIS President Phil Rathbun started his mobile imaging business in 1993. "The old way that it was done," he said, "was the x-ray tech would go into the nursing home, shoot x-rays with film, and then fight the traffic all the way back to the office. The images would all be processed, then they'd be scanned digitally and sent off from there."

His system today is a little different. Yes, the RT still drives to the site, which is generally a nursing home in rural Texas. However, the vehicle is a Scion xB that is equipped with a DC-to-AC inverter and loaded with a mobile CR system from Kodak Orex, an accompanying laptop, an ImageGrid IG700 server from Candelis, and a GPS navigator.

"We offer heart echocardiograms, ultrasound, bone-density testing, and x-ray," Rathbun said, explaining how AIS eventually edged out competing mobile x-ray services: "As our business changed, we were able to move rapidly from rural hospitals—which eventually will get their own ultrasound machine and technicians and everything—into the nursing facilities."

After scanning the patient on site, the RT loads the images onto the laptop in the Scion and drives to the nearest wireless hotspot. From there, data is transmitted from the server to a radiologist via a virtual private network that is compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

"We just move to the local Starbucks, where we have an [Internet] account, and we send right there from the café while we're having a latte," Rathbun said. He laughed and added, "Everybody in Starbucks is probably thinking, ‘Man, the Internet is getting kind of slow all of a sudden,' as we're blowing these 20-megabyte x-rays through the system."

Before, Rathbun emphasized, his RTs spent the bulk of their time fighting traffic as they moved from company headquarters to sites in rural areas and back.

Chad Hutchison of Dicom Solutions, who installed Rathbun's system, said, "The amazing part of this whole story is the time. One, they have a GPS tracking system to know where their vans are at all times. Two, they call ahead so the patient is ready. And three, they transmit these images back as fast as they can, and the images are sent immediately to a radiologist in Florida to be read so the report comes back in a timely manner."

Rathbun estimated that the new workflow has made his turnaround time on images 75% faster. He also noted that it saves his business money. "Now, I don't have as many chemicals, I don't have as much in my processing rooms, we don't use as much gas, and I don't have as much film," he said. "Even though the up-front costs were high, the technology has paid for itself."