The Rise of Mobile X-Ray Technology

November 9, 2012
Whitney L. Jackson

Mobile X-ray technology is increasing in popularity as demand grows to get technologists out of fixed X-ray rooms. Here’s a look at its benefits and challenges.

Across the health care industry, mobile X-ray technology is increasing in popularity, and demand for equipment that brings technologists out of fixed X-ray rooms has spiked.

The biggest factor driving the uptick in use, industry experts say, is the need for better bedside imaging, most of which has already moved to digital from computed radiography or analog. Traditionally, obtaining quality images for the sickest patients - those most often located in intensive care units - has been not only time-consuming, but also logistically difficult.

However, based on the findings of a recent report from the health care research firm KLAS, the convenience of taking images at the bedside is now leading to additional advancements in the power management and wireless capabilities of this mobile technology.

“With these new mobile X-ray units, the near-instant access to the images at the patient side has providers asking for more,” wrote Kurt Ising, the report’s author. “Mobility and image quality are key enablers for this trend, while wireless connectivity and battery life are areas where most vendors can improve.”

KLAS analysts also found mobile X-ray vendors have seen a significant rise in the use of their equipment this year, especially in the most acute care settings, such as the emergency department, ICUs, and operating rooms. For example, EDs have augmented their mobile X-ray use by 100 percent in some instances, and ICUs and ORs report up to 89 percent and 60 percent jumps in utilization, respectively.

Increased Use and Its Benefits

Some industry experts credit the usage increase to the expanding variety of mobile, digital X-ray equipment available. And, the push driving that trend is consumer demand for change.

“I think this is one of those situations where there was a way people did things in mobile imaging for so long that people started to believe there was no other way of doing it,” said Helen Titus, X-ray solutions marketing director for Carestream. “Now, radiologists and technologists have challenged vendors to come up with very innovative ways of changing how people do bedside imaging.”

Caresteam, which already has one mobile X-ray product on the market, the DRX-Mobile Retrofit, recently introduced the DRX-Revolution. This wireless, digital X-ray system is the first machine to have a fully collapsible column, the company said. In its completely-retracted state, the machine stands only four feet tall, making maneuverability around the hospital easier, Titus said. With two touchscreen displays - one on the body of the machine and one that hovers over the patient - the DRX-Revolution also lets the technologist make adjustments at any time.

But it isn’t just the call for change to the equipment itself that is fueling the desire for mobile and wireless technology. It’s the main benefit it brings to the patient, the radiologist, and the technologist: time savings.

“This type of technology is as much about the benefit to the radiologists as it is to the clinician,” said Jie Xue, mobile X-ray and fluro general manager for GE Healthcare, manufacturer of the Optima XR220amx. “The immediate feedback of the digital technology allows doctors to see images on the screen instantaneously. They can see images in about 10 seconds and move on to the next patient without delay where before with CR and analog machines, precious minutes would be lost waiting for the image to be retrieved.”

This speed and accuracy can be very help in many situations, such as running a peripherally-inserted central catheter (PICC) line for a patient in the ICU. But the advantages of this technology also extend to the technologists who are responsible for taking the images, he said.

Susan Moody, a radiologic technologist and clinical manager of portable and OR imaging at the University of Rochester Medical Center (URMC), agreed. URMC recently purchased five Carestream DRX-Revolutions. Technologists no longer have to take cassettes to be developed in a dark room and then wait for them to be read by a radiologist, she said. And, with wireless technology, they no longer have to watch out for the various cords that once tethered detectors to the X-ray machine.

“Wireless, digital X-ray technology makes our jobs a lot more efficient and a lot easier,” she said. “There’s less running between patients rooms, and if we get a bad image, we can retake it immediately.”

Mobile, digital technology also reduces the risk that patient images will become mislabeled or misplaced, said Greg Cefalo, digital radiography business manager, with Agfa Healthcare, vendor of the HealthCare DX-D 100. Such technology eliminates much of the likelihood for human error, he said.

“There have been plenty of times where accidents happen. The X-ray cassettes have been dropped and confused,” he said. “With wireless, mobile machines, technologists can go to the patient, pull his or her name off their barcoded wristband, and the machine captures who they are, automatically connects the images, and can send it back to your PACS before you even leave the patient’s room.”

Ultimately, this technology can reduce repeat scans and limit dose exposure, he said.

A third vendor model, the Shimadzu MobileDaRt Evolution Wireless, also promises time-saving benefits. This machine boasts a three-second display time of images taken at the bedside, making it easier for providers to intervene quickly in dire situations.

Challenges of Mobile, Digital Technology

Despite the improvements with this X-ray technology, complaints still exist about various equipment features. The two biggest concerns have been difficulties in maintaining connectivity between the hospital’s wireless network and the mobile X-ray machine and limited battery life.

According to David Waldman, MD, PhD, URMC imaging sciences chair, there is a growing concern within the industry that radiology departments could be over-taxing hospital wireless networks. No problems have yet been reported, but the ever-increasing size and volume of radiology data has many providers and vendors concerned.

GE Healthcare took steps to proactively address that concern with the Optima XR220amx, Xue said. This X-ray model introduced a hybrid detector platform - GE’s most recent wireless detector, FlashPad, and Ultra-wideband - that puts imaging data on a different wireless network.

“With hospitals networks getting crowded, we introduced a platform that won’t clutter precious networks or risk interference while maintaining a system compatible with existing WiFi infrastructure,” he said. “It creates a fully-integrated workflow.”

Battery life is also often cited as a concern. According to the KLAS report, many batteries fail completely within a year of system purchase. However, some manufacturers have also made strides in improving battery life, maximizing the amount of time technologists can spend rounding the hospitals and taking X-rays.

According to Xue, the Optima XR220amx detector battery is now able to charge while docked in the system, eliminating the need for another charger or excessive battery handling. Carestream’s Titus also said the company talked at great length with customers and designed a battery meant to last through their most lengthy mobile rounds, often five hours. The DRX-Revolution is also equipped with software that works like a gas gauge to alert technologists when the battery is running low.

As with many equipment purchases, though, the biggest concern in today’s economy is the cost associated with mobile, digital X-ray machines. Many facilities must choose between purchasing a new machine, buying a refurbished one, or retrofitting existing equipment, Cefalo said.

To retrofit a machine, a facility will likely pay about $80,000, he said. The average cost of a refurbished machine hovers between $100,000 and $120,000. And, that price tag is close to the cost of a new wireless, digital machine - between $145,000 and $180,000.

Given the benefits of this mobile technology, if cost concerns were removed, Walden said, every hospital would replace their existing equipment. “Everyone wants to go with digital and wireless,” he said. “But it’s a question of whether they can afford it and when they’ll go to it.”

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