Analog to digital: echo lab shares lessons learned the hard way

Digital imaging is finding its way into more and more echocardiography laboratories, and the transition may hit white water if the lab hasn't prepared well in advance.

Children's Hospital of Michigan in Detroit, one of the country's leading centers for pediatric echocardiography, performs more than 4000 studies each year. It shot the transition rapids late last year, undergoing a successful transformation from an analog lab that conducted all studies on videotape to a fully digital operation.

The wisest move Children's made to ensure a fast and smooth transition was to resolve physical plant issues like wiring and power well before vendor Agilent arrived for the kickoff meeting, said Dr. Richard A. Humes, echo lab director and pediatric cardiologist.

"Arranging for contractors to come in to rewire power or install data drops can take weeks in a big system like ours, but at the time of the kickoff we were completely ready from a wiring and power standpoint," Humes said.

It was helpful to obtain the physical dimensions of the server and jukebox so space could be designed properly, he said.

Children's also learned that network integration questions need to be asked well in advance of installation:

?Will the system run on a subnet or its own LAN?
?Will the system run on the overall hospital network?
?What performance issues will arise from the configuration?

"A fairly close relationship between the hospital information systems department and the technical staff in the echo lab helps," Humes said.

Humes found it useful to arrange a trial run prior to the installation.

"A trial is one of the most helpful tips I can offer," he said. "We began a trial of digital storage several months before the system was installed, which gave us the chance to see how much we needed in terms of loops, sweeps, and so on."

It also offered a chance for the lab to solidify its protocol and be reassured it was collecting adequate information.

"There is serious fear among sonographers that going fully digital means they will miss something that would otherwise have been stored on a continuously running videotape," Humes said. "The trial run gave us the confidence to devise a protocol that wasn't missing anything."