As one of your practice’s most expensive capital investments, your digital radiography (DR) unit should be a consistent source of revenue long after you’ve made the purchase. But there are a many factors to consider when buying a DR system, and overlooking just one of them could wipe out your return on investment, not to mention negatively affect your patient care.
You may already know that the detector panel is the most expensive component of a DR system, and a low-quality panel may produce distorted images and be unreliable. But beyond the panel, the potential day-to-day pitfalls present the highest risk to impeding daily workflow. The most common problems with DR relate to:
- Technical Support
- Compatibility with existing practice management software
- Ease of Use
- Inconsistencies across patients of various species and size
- Automatic Updates
Unreliable Technical Support
If your DR system malfunctions or if you’re unable to navigate the user interface, you should be able to pick up the phone, call tech support, and get the problem resolved quickly. Otherwise, patient care may suffer, along with lost revenue while your DR is out of commission.
Another issue is the first-hand experience of the technical support personnel with their products. In the best case, the company has partnered with the same, reputable panel and/or software manufacturers for many years through several models/versions, and in some cases, has even had a hand in the development of these products. This level of experience provides assurance and a comfort level you deserve. In the worst case, distributors are simply resellers, with little to no interest in the technical support that you and your patients deserve.
In any case, know the company you’re partnering with, and the extent of their relationship with the manufacturer of both the hardware and software. It will most assuredly save you headache down the road.
Many DR units are not designed to be compatible with all operating systems (Windows, Mac, Linux) and practice management software (PMS). If your DR unit cannot integrate with your current digital systems, it will stifle your workflow, cause disorganization, and can quickly lead to buyer’s remorse.
Integration is a term often thrown around casually, but you could quickly find that advertised integration is nothing more than a completely isolated system that only integrates insofar as it is used in the same building as your receptionist! Of utmost importance is bilateral integration with your existing practice management software (whether it’s Cornerstone, Infinity, or AVImark), PACS system (whether on-site or cloud-based), and teleradiology service. This is the benchmark for integration; anything less should simply be unacceptable.
Confusing User Interface
Needless to say, the vast majority of the DR market is the human medical sector, and so the majority of software/user interface development is geared towards that application. Some DR manufacturers have not properly adapted their units to the needs of veterinary clinics, either due to lack of resources or expertise. This leads to more cumbersome workflows that take time away from your patients. Beyond expanding your caseload, your DR system should make it easy to send X-rays to radiologists and other specialists either from the Cloud or directly from the DR unit.
If you’re going to a conference, you should be able to pull up the X-ray images on your tablet, iPad, smartphone, or computer station. Even more importantly you need the ability to share the images with clients in the exam room so they have a visual representation of their pet’s health, and the tremendous value of the digital radiographic procedure. Numerous complicated toolbars and sub-windows just get in the way of the take-home message: that you were able to quickly and accurately make a radiologic assessment of their pet’s health. And so you should be able to, with a press of a button, share the case via email to not only your clients but to colleagues and specialists.
Low Image Quality
Any sales rep can show you post-processed radiographs that look like the Sistine Chapel, but what you really need to know is how the images will look on a daily basis. Most DR systems can produce a decent image when an animal weighs 15 to 50 pounds, but some may struggle when a patient’s weight falls outside of that spectrum. This is because small animals and exotics usually have a lot of bone and virtually no target organs or soft-tissue, and larger animals have a lot of mass to shoot through. There are terms such as spatial resolution and dynamic range that you should get more familiar with, but live image acquisitions on demonstration day should convince you of the image quality.
But don’t just shoot the typical 35 lb dog. It would be embarrassing if the image quality on the perfect patient wasn’t presentable. Insist on demo x-ray imaging of smaller cats and larger dogs so that you can see consistency in image quality. Also take note of any modifications the rep may have to make in order for that image to look perfect. The more advanced DR systems have smart algorithms to adjust for the wide variety of exposure levels with the ability to segment and independently adjust the contrast layers to display a finely-tuned image every time. Some of the older (or less sophisticated) systems require manual tuning that puts your consistency at risk to variations in technique among the multiple technicians in your clinic that take radiographs on a daily basis. One quick, but illustrative test is to magnify the images, especially of small patients/body parts. Inferior systems easily show image degradation when zoomed.
You should also ask your sales rep to put you in touch with veterinarians who are currently using the same DR system. Ask them if they’re satisfied with the image quality and performance of the unit, across a range of patients, and compare a few of their X-rays to the images that the sales rep showed you.
Automatic Updates, Yes or No?
A DR system is a long-term investment, and within that time, technology will definitely progress. You absolutely need the ability to update your software quickly, easily, and when necessary. Like everything else discussed here, there is a wide variety of methods/functionality among DR companies to address this.
In the worst case, there are no updates. Just short of that, though, are updates with little-to-no notification or documentation, sent on a thumb drive only on a client’s request, or when there is a support issue. This is an unacceptable approach as it puts the burden on you. This requires technician staff to remember that they have to do this in the first place, understand the procedure to download and execute the update, and verify proper installation. Your technical staff should have higher priorities!
In the best case, there are automatic updates that are installed behind the scenes, outside of working hours, with notifications and release notes informing and educating you of updates. These require virtually no technician effort and no down-time.
No veterinarian wants to invest in a DR unit only to find out later that they overpaid for underperformance. Be informed beyond the superficial topics. Ask about the panel, the manufacturer, the extent of the distributor’s partnership with them. Ask if automatic updates come standard with the system. Find out if tech support is available 24 hours a day, and ask if an engineer will come out to your practice if tech support is unable to resolve a problem.
You’ll find that the answers to these questions will be very different from one company to the next. A low upfront price tag might be attractive, but the quality of the panel, the reliability of tech support, and the overall efficiency of the system are ultimately going to determine your return on investment (ROI).
If you need help finding the right DR unit for your practice, or to learn about Sound’s® digital radiography systems, call 800-268-5354.