“Summer in the City – back of my neck getting dark and gritty,” yes as the season is heating up so is the continuing push and influx of direct radiography (DR) equipment into the imaging landscape. Forced obsolescence of analog radiography (i.e. film-screen) and CR imaging receptor technology by way of CMS reimbursement reductions that began in January is fueling the mass exodus. The reductions also support the invasion of DR flat-panel equipment into the “New Frontier of Imaging.”

This imaging technology receptor evolution is the theme for this edition of “Bridging the Gap.” Joining us are two very experienced professionals Director of Radiology Jennifer Hughes and Imaging Engineer Roger Jones.

The “imaging receptor” transformation can be traced back through the years via various technology circles and their resulting timelines. Now, the onslaught of DR technology being infused as the “standard” for all radiographed procedures enters us into yet another. When posing this conceptual thought to Hughes and Jones their comments were very similar in response – the quality of acquiring the “best” radiographic images without the “quantity” of exposures is still a mind-boggling breakthrough in not only a patient process flow perspective but an awesome “groundbreaking” advance toward reducing dose to the patient.

All new advances, however, can come with new challenges from equipment service and financial budgeting perspectives. This holds true for the “DR wave” of new flat-panel equipment flooding the imaging department landscape. The first, and foremost, abyss that must be leaped over is the hefty capital acquisition cost of this technology and tethered to it are “new” impact costs related to service, software updating and IT integration – yikes! Hughes’ immediate comment regarding these added costs, “I can’t, if at all, recoup these costs from our patient imaged billing. Yes, my profit margins will shrink to fund these new incurred expenses and the only offset that may help is if patient volumes increase as a result of this technology and improves process efficiencies and flows.”

Let’s talk a little more about these “new service costs hurdles” that Hughes and her peers are scrambling to neutralize on their budgets. This concern was posed to Jones who quickly pointed out two very ominous cost factors. The first being the general replacement cost of a DR flat panel detector which ranges from $60K to $90K, the second is that in order to “cover” or “insure” the unforeseen cost of a flat panel detector the only offering from original equipment manufacturers’ today is that of a expensive full-service agreement.

Hughes added that “with analog or CR” imaging equipment, the service costs are relatively low, but with DR flat panels in the equation those service and maintenance costs go up by a factor of 10 or more!

Jones said that DR flat panels are mostly maintenance free. They do not have moving parts which should result in less service labor hours, reduced reliance on the need for replacement parts and a higher level of equipment reliability – i.e. “Really Good Uptime!”

History shows us that as technology advances, change and adaptation can be the hardest portion of that curve. This phenomenon is demonstrated over and over in all that we encounter and as painful as it may seem in the beginning, we relish and prosper via those advances that soon become our common state of functionality. Rock on DR!