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Expansion of computed radiography brings key benefits in Australia

Project at Queensland Health's 130 facilities makes it first state service with digital x-ray at all of its facilities

BY TANYA OLIVER, DCR(R), AND LAWRENCE SIM, PH.D. | May 1, 2009
Ms. Oliver is a radiographic advisor and Dr. Sim is a scientific advisor at the clinical and statewide services division of Queensland Health in Brisbane, Australia.

Queensland Health provides public health services across a highly decentralized population base in the state of Queensland. This includes the provision of medical imaging services to 130 facilities. Successive projects to introduce digital image acquisition at these sites began in 2006. The latest of these, the j.net project, was completed in July 2008 and involved installation of computed radiography at 86 sites.

The project's completion made Queensland Health (QH) the first state health service in Australia to provide digital acquisition of general radiographic examinations at all of its medical imaging facilities.

A significant proportion of sites that have medical imaging services provided by QH offer only general radiography (87 sites). Licensed x-ray operators carry out all diagnostic image acquisition work at 77 of these facilities.

Licensed operators are employed at geographically remote locations that lack radiographers. They are licensed to perform a limited range of x-ray examinations and have access to a radiographer within the same district on a supervisory basis. Medical imaging is not their primary role in the health service facility. Many licensed operators are nurses, though the role may also be taken on by a member of the operational or medical staff.

Imaging facilities at remote rural sites typically consist of a single room with fixed or mobile x-ray equipment. When j.net commenced in July 2007, 73 of these sites were using wet film processors.

FIRST STEPS

The aim of the j.net project was to establish a minimum level of digital image capture and processing equipment at all sites. An accurate register of existing equipment was established as a first step. This involved collating survey data from previous projects and following up by telephone to confirm the information.

Existing QH contracts held by Fujifilm Australia and Carestream Health allowed the procurement of the required computed radiography equipment:

• single CR reader;
• “dry” film printer;
• workstation with CD/DVD burning capability.

The same make and model of equipment was installed within each district to assist with training and support.

In addition to the digital acquisition and processing equipment, the following accessory items were provided: antiscatter grids, foam positioning aids, x-ray-compatible patient trolleys, textbooks, and lead aprons.

A site survey tool was developed to identify preinstallation requirements, such as physical space, site access, equipment storage capacity, availability of power and air-conditioning, and availability of data network points on the local area network (LAN). Training requirements were determined by assessing the number of operators and days available for training.

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