In 2004, Vancouver Radiologists, of Vancouver, WA, made a dramatic change in how they perform mammograms. They decided to take the practice digital, eliminating their old film screen system entirely. "We did the switch over almost all at once," said Dr. Gary Sahlstrom, Lead Radiologist at Vancouver Radiologists, adding, "Digital technology has changed everything."

Digital Made Financial Sense

The decision to affect a major technology changeover does not happen over night. Vancouver Radiologists conducted careful research into the viability of becoming totally digital. "Would it make sense financially? That was our big concern," Dr. Sahlstrom said.

Jason Koller, the IT Director at Vancouver Radiologists, was asked to do a pro forma review of the various digital mammography systems available. After an intensive two-month search, Koller came back with his findings: digital was the way to go, and the best system on the market for their purposes was the Hologic Selenia System.

"We looked at four different systems" Koller explained. "Selenia provided the best image quality, with a larger image plate, which saves space in terms of electronic storage." Digital mammography can also translate into increased reimbursements from insurance providers, in some cases, twice as much as for an analog mammogram. Combined with savings from having one less tech and freeing up one extra room where the film processor used to be, Selenia offered Vancouver Radiologists solid ROI numbers. Selenia made perfect sense.

Digital Increases Connectivity

By June of 2004, Vancouver Radiologists was completely online, with two Selenia systems onsite, and one off site at the Vancouver Clinic at the Columbia Technology Center. As Dr. Sahlstrom explained, one of the great improvements of the digital practice is the ease with which the doctors can connect with each other for consultations. "We practice from one location, but we can now be in as many different places as we need to be." The new Selenia systems allow the Vancouver Clinic to send digital mammography images back to Vancouver Radiologists, where a radiologist can read the image and send an assessment decision back to the clinic much faster. "I can see the image on the workstation as soon as the technologist sends it," says Dr. Sahlstrom, "and we can talk on the phone and I can say, 'do this view...do that view' and it is practically done."

Because the Selenia system allows doctors to view images simultaneously, surgeons often call the clinic to discuss the images they are seeing. "They ask me 'What is this showing?' and I can tell them because we each have the image right in front of us."

The Selenia Difference

Since the practice has gone digital, there has been no looking back. And according to Kathy Zeazas, Mammography Manager at Vancouver Radiologists, she never wants to go back. "I wouldn't trade it for anything else, and I would never go back to analog. Digital is fantastic...and Selenia is the best I have seen."

One important difference is the quality of the images. "With Selenia, the images are so much sharper." Zeazas said. The Selenia system utilizes an exclusive HTC crosshatch grid for its images, as opposed to a linear grid used on other systems. "They are just easier to look at and to read," Zeazas said, and then added, "If you are having a mammography done digitally, you are basically getting a better exam, simply because the radiologists can see a lot more."

Exclusive to the Selenia system is the high-resolution, soft copy workstation that allows doctors to read and interpret the images in the greatest possible detail. "The images are spectacular," said Dr. Sahlstrom, "just spectacular. These images give me more confidence in my interpretations. I take less time to make a decision about an image, which is better for me and the patient."

According to Dr. Laurie Anne Cleland, radiologist with Vancouver Radiologists, "The difference has been night and day with the new digital systems. The quality of the images is great, and we are seeing more things."

Dr. Sahlstrom agrees that the new digital mammograms are showing much more than the old film systems. "We are no longer staring at a film image, trying to decide what is there. Digital is so clear. There have been calcifications that we have been able to see only on the digital system, because there is such high resolution of detail."

A High Volume Practice

Being able to see more and read faster has allowed the practice to improve patient throughput. "We are a high-volume practice - reading over 120 mammograms a day," Dr. Cleland explained. Being able to read quickly makes a big difference in the daily operation of the practice. "With the Selenia system, we have significantly shortened our decision cycle, which means more patients can come through the clinic faster."

Digital and the Patient

Vancouver Radiologists has a long history of serious commitment to its patients, and they feel that the new digital systems have gone a long way in helping them meet that commitment. "Going digital was the next logical step in improving patient care and service," Kathy Zeazas said.

Technologists at Vancouver Radiologists have found that because they never have to leave a patient to process film, they have seen a perceptible decrease in the level of patient anxiety.

The nervousness and tension that was caused by the wait has been eliminated. "Patients are very happy that they do not have to wait, they can just get dressed and go. And because we know immediately if an image is useable, the women have no problems when we tell them we have to do repeat images."

Ease of Use

The doctors and the technologists at Vancouver Radiologists have found the Selenia system very easy to learn, and that ease of use has been integral to the success the practice has been having with it. "This system is so user friendly," said Dr. Cleland. "We are a high volume practice, and we can't waste time learning new equipment. We needed to be up and running as soon as possible." She said that even if a doctor could not attend the on-site training provided by Hologic, the system was so intuitive; it could be easily learned just by working with it.

Partnership in Technology

Vancouver Radiologists appreciates that Hologic is using their practice as a control site for system software upgrades. "If I see something that would make my job easier, or make the system more functional, I can make the suggestion to Hologic, and those suggestions are incorporated into the next upgrade," said Dr. Cleland. "I can't tell you how important it is to be able to mold the technology to our needs." Dr. Sahlstrom added, "Ultimately, digital is better for our practice, and our patients."

For additional information on Vancouver Radiologists go to www.vanrad.com