Hologic Selenia helps the Breast Center of Greensboro be the first to go digital in the Triad area

In December of 2006, the Breast Center of Greensboro Imaging, located in Greensboro, North Carolina, completed its transition to a completely digital workflow, with the installation of their third Selenia digital mammography unit.

"The Breast Center of Greensboro Imaging," says Preston Allen, MBA, the Executive Director of the Breast Center, "has long been the leader in providing service and technology to the women of the Triad [Greensboro, Winston-Salem, and High Point ] area, and our new Selenia systems allow us to continue that leadership role."

The Digital Decision

According to Dr. Elizabeth Brown, Medical Director at the Breast Center, one of the most important factors in considering the move to digital was the publication of the results of the Digital Mammographic Imaging Screening Trial (DMIST)

"DMIST showed that digital mammograms were much better for younger women, and others who tend to have denser breast tissue," she says. "Because of the large number of younger women in our area, the DMIST merely confirmed our decision to move forward with digital. Once we understood the needs of the market in our area," Allen continues, "we knew that it was time to pursue digital mammography."

Patient Centered Care

For the Breast Center of Greensboro, the change to a digital workflow was one of the final steps in a transition begun over two years earlier, when the Center set out to redesign the entire patient experience of the Center. "We wanted to completely remake our Breast Center to be totally patient focused," Dr. Brown says, "this gave us the opportunity to completely take it apart and put it back together again, exactly the way we thought it should be."

Immediate Impact

The impact of the installation of the Breast Center's first Selenia was felt almost immediately, with a significant increase in the number of women coming to the Center for mammograms. As each of the three Selenia units was installed, the number of patients grew also. In January, the first full month of operating all three systems, the Breast Center saw 38% more patients, compared to the same period one year earlier.

There were several reasons for this impressive spike in patient volume. The first was that the Center conducted an aggressive media campaign to announce the arrival of digital. "Our marketing blitz announcing the new technology really generated a lot of buzz," Allen says.

The second was that the Center had begun offering extended service hours on the exact same day as the first Selenia was being installed. Allen says, "We were doing the install at the same time we were growing the business, and there was no impact on our ability to serve our new patients."

The third reason for the exceptional growth in the practice: the patients themselves. The women of the Triad area are educated, and have researched the technologies available to them.

"I have a lot of patients that have done their homework," says Dr. Brown. "I am impressed with the number of patients that come in knowing about digital and coming here specifically because we have digital."

"They like the idea of digital mammograms," Allen says, "they know that it is going to give them a better exam, and that the quality is better."

According to Lead Technologist Diane Ball (RT)(R)(M), patients have found the new Selenia systems quite comfortable compared to the previous analog units. "The FAST paddles with the Selenia are great," Ball says, "Several patients have actually commented that they feel much more comfortable with the new units, and that the compression especially is much better, and not as intimidating for them."

"We have seen number of new patients, more than we had seen before, because of the digital technology," Allen states, "There was a whole lot of unmet need out there; we can now begin to fulfill that need."

Financial Rewards of Digital

Combine the increased capacity resulting from the installation of the Selenia technology, with the extended hours of operation at the Center, and the higher insurance reimbursement rates for digital mammography, and the Breast Center has seen substantial financial growth as well. "We have gone from an 'okay' financial position, to a really impressive, almost unbelievable financial position," Allen says, "Thanks in large part to the digital technology."

Medical Impact of Digital

With an average patient throughput of anywhere from 85 to 115 women per day, The Breast Center once already has seen a one-day high mark of 139 women. Of those numbers, fully one third of the women are there for diagnostic exams. "That number, when you think about it, represents a significant number of diagnostic procedures," Allen says.

"More patients," says Dr. Brown, "means more screenings, which will inevitably lead to a higher percentage of diagnostic procedures, which ultimately means that we will discover more cancers."

Cindy Strable, Administrative Director for the Breast Center, says that the patient centered environment is more than just a catch phrase. "It is one of our greatest strengths." Strable says, "We are very aware of the patient's experience here, and we work to ease any anxiety the women are feeling." This is especially important for women who come to the Center for diagnostic procedures. "The radiologist meets with the women immediately after the procedure and if a biopsy is needed, we can usually do it the same day. We can get the pathology report the next day, and if a surgical appointment is needed, we can schedule that within forty-eight hours."

According to Dr. Brown, the combination of the Selenia image quality and the Hologic MultiCare stereotactic biopsy table makes diagnostic procedures much easier to perform. "Needle localizations are very quick, and very efficient," she says, "the Selenia's full resolution image provides plenty of magnification for most procedures."

The Hologic Solution

When the Center was initially looking to make the transition to a digital environment, they considered several different vendors in the field, and made site visits to view each system at work in the clinical setting. When the research was concluded, the decision was made to go with Hologic.

One of the reasons for this was that Hologic was able to offer a complete package of solutions for the Center's transition. "The clear differentiation between Hologic and the other vendors," Allen says, "is that Hologic came onto the scene with a complete turn-key solution to our needs. Hologic had the Selenia. They had the workstations, both for the radiologists and the technologists. They had the R2 CAD technology, and they had the archiving system." Hologic's Mammography Image Management Solution (MIMS) allows The Breast Center of Greensboro proprietary control of their digital mammography images.

The Breast Center of Greensboro Imaging is partnered with the Moses Cone Medical Center, which already had an archiving system in place. "There was a question," says Allen, "of whether to go with them and store on their PACS system." However, there was an issue of system compatibility, as well as compression conflicts. "We had made such an aggressive pursuit of digital technology, that to have tried to integrate into the Moses Cone PACS would have presented such a significant impediment as to have made any further pursuit not worthwhile."

The Hologic dedicated MIMS system was the perfect system for image storage. Allen says, "With the MIMS, we can access a broad range of images, at a 4-to-1 compression ratio, compared to the PACS, which only gives us a 2.5-to-1 ratio." Cost benefit of the MIMS was also significant. Because of the compression algorithms used in the PACS, the Hologic MIMS archiving system represented almost half the cost of making the PACS at Moses Cone work for the Center.

Working with Hologic

According to Allen, a transition of the sort undertaken by the Breast Center of Greensboro Imaging could not have happened as smoothly as it did without the help and support of a vendor who was dedicated to making everything work.

"Hologic was always right there, and was always willing to listen," Allen says. "They answered every question, and they were able to offer us different solution ideas based on each of the different scenarios we were considering at the time."

"Their responsiveness was impressive," Strable says.

Ultimately," Allen concludes, "Hologic was head and shoulders above the other vendors. Product, responsiveness, delivery of equipment - they did everything to meet our desired timeline."