Digital on the Move: Woman's Hospital of Baton Rouge

Bringing digital mammography technology to outlying areas

Last year, the mobile digital mammography van operated by Woman's Hospital in Baton Rouge, LA performed 5,000 mammograms. Without that service, three quarters of the women currently being screened by the service would go without mammograms. That's the estimate given by Woman's Hospital's Director of Imaging Services, Cynthia Rabalais, RT, who coordinates the mobile program.

While Woman's mobile mammography program has been serving Baton Rouge and the surrounding parishes since 1996, the digital incarnation of the program began making the rounds a decade later. In 2005 the hospital committed to changing their three campus and satellite screening sites to digital, but converting the mobile program required a little extra ingenuity and a lot of foresight.

"We just took the bull by the horns and decided that we weren't willing to stop serving the 5,000 women that depended on us," Cynthia recalled. "It took us about a year to plan, to work with the coach manufacturer and with Hologic and no one had a whole lot of experience about all of that."

Location, Location, Location

The switch to digital presented a few challenges to the mobile van crew's established routine. In years past, the crew would drive a small van to a remote site, take the analog equipment out of the van, and set it up in the building that would host the screening. With digital, there was no such portability. "We did our due diligence about that and visited some coach manufacturers. The only place at that time that was doing mobile digital was in Seattle at Swedish Hospital. I did a site visit there," Cynthia said.

After the coach design was established, Cynthia tackled the logistics of delivering a much larger unit to the screening sites. "We were in some very small places, like a community health clinic that had a total of 8 parking slots. Well, you bring this big thing in and you need 10 parking spots to set up. So we had to re-analyze where the coach would go.

"We also had to establish where we could have a mobile connection because we are registering the patients onboard and wanted to take advantage of the advantages of being digital, that we could not do in an analog world." After about two weeks of working out routines and transmission issues, the link between the mobile unit and the hospital's PACS worked effortlessly. The van's technologist and driver work in tandem to register patients and order tests. Once the image is acquired on the van's SeleniaT, R2 Image Checker is overlaid on the image and saved on a laptop containing the hospital's PACS software. "When we get back home we put the laptop into the hospital's network and all those images are dumped into the PACS and we're ready to read," she concluded.

Sometimes the smallest issues pose the biggest concerns. "For me, the greatest challenge has been learning how to operate the coach. Driving it - it's like having a teenager; every time they leave I tell them '"don't speed, don't go over too many bumps, don't scratch it, don't dent it.'" Cynthia said with a laugh.