Totally Digital...With a Favorable ROI

Early in 2005, The Women’s Center for Radiology, in Orlando, FL, shut down their screen-film mammography systems and switched over to an entirely digital screening environment. They replaced their six analog systems with four Selenia digital mammography systems from Hologic. “We had been a beta site for another manufacturer,” said founder and medical director Susan Curry, M.D. “We knew that digital was the way we needed to go, and Hologic was far and away the superior technology.”
Of course, in any transition to a new technology, benefits need to be weighed against projected costs. Initial startup costs for a digital system can be steep, especially when compared to analog. Dr. Curry said, “We always want to provide the best studies possible for our patients, and digital would give that to us. But could we afford it?”
The Women’s Center, unsure of the impact digital would have on the practice, decided to make the transition gradually, with the installation of one Selenia system at their main location in 2004. They wanted to work with the new system for a while before making a decision to move forward with the purchase of additional systems.
It didn’t take long, however, to realize the potential that digital imagery held for the Center. “Once we worked with it,” said administrative director Vicki Belmont, “we knew we had to get the other systems right away. Two and a half months later, two additional Selenia units were installed, one at our main site and one at a satellite office, with a fourth system planned at the main office.”
Making Money with Digital
The Women’s Center was excited to have the other Selenia systems up and running since it had become apparent to them that going digital was having a significant impact on their practice.
The Center discovered that despite their concerns regarding the initial startup costs, two factors combined to make the digital upgrades very attractive: lower recall rates and higher reimbursements.
“Our recall rate has dropped 50 percent,” said Dr. Curry. For a center that normally performs over 50,000 studies annually, that reduction represents a sizable improvement in workflow.
“Before digital we had eight technologists imaging 50,000 patients per year on six analog machines and 10 percent of those were recalls,” Belmont said. “Now we have four Selenia digital mammography systems and can do 50,000 studies with two fewer technologists and with a reduced recall rate. We are able to see more new patients and provide mammography service to more women. And because the insurance companies reimburse more for a complete mammogram than for recall studies, there is a net gain in reimbursement and less anxiety for the patient.”
Vicki Belmont explained the numbers: “Insurance companies reimburse more for digital mammography than analog mammography and although the motivation to switch to digital mammography was because of higher quality mammograms, the reimbursement has made the transition equal to an increase in income.”
“In addition, the move to digital eliminated the need for film, processing chemicals, cassettes and the added personnel to maintain the processor and supplies. There was a savings almost immediately after the transition. We’ve reduced our film costs by over 95 percent; that represents savings of tens of thousands of dollars, just by eliminating the need for film and processing.”
The combination of more efficient workflow, lower film costs and higher reimbursements has allowed the Women’s Center for Radiology to show a return on their investment on the new systems. “We were able to increase our income after our first year of being totally digital,” said Belmont.
Incredible Images, Incredible Technology
According to Dr. Curry, the impressive improvements in workflow are the direct result of the quality of the Selenia technology. “The images are incredible,” she said. “They are high resolution and are available immediately. We know right away if we need to do additional studies or not.”
“We’ve reduced our waiting time significantly,” added Belmont. “From the time the patient walks in the door to the time she leaves is now less than 30 minutes. With analog two hour wait times were not unusual.”
Cindy Swinehart, RT(R)(M), lead technologist at the Center, says the Selenia systems have changed the way she does her job. “We love the new systems,” she said. “We have patients scheduled every 15 minutes, but because the technology is so easy, and the image is available right away, we usually finish in less time.”
Unlike the other major digital mammography systems, Hologic uses one detector to image all patients, and their detector is large enough to accommodate almost every breast size. Now instead of switching film cassettes and paddles, the site only needs to switch paddles. “With analog, the time it took for routine screenings was double what it takes with Selenia,” said Swinehart, “and the patients are all pleasantly surprised that the compression with the Hologic FAST paddle is so much more comfortable.”
What It’s Really All About – Better Patient Care
Dr. Curry is quick to point out that the improvements in workflow and the substantial financial savings would mean little if the technology did not improve the way the Center delivered healthcare to women.
“With Selenia,” Dr. Curry said, “the image is so clear, and the resolution so exceptional that we know we deliver better care with digital. The workstation allows us to magnify views and manipulate the image right there in front of us.” These improvements have allowed Dr. Curry to see cancers earlier than was possible with the analog systems.
“We have found cancers as small as one millimeter,” Dr. Curry said. “Being able to detect cancers that small means the patient now has totally different treatment options; significantly different than if the cancer had been found at a later stage.
“When we can find a cancer that small and that early,” she explained, “treatment can be noninvasive. That means the woman does not have to have aggressive surgery; she does not have to have lymph nodes removed; she does not have to have chemo; she does not have to lose her hair; and she does not have to feel ill during treatment.”
Hologic: a Partner in the Process
The transition from analog to digital was smooth, in large part, because of the support of the manufacturer, Hologic. “They’ve been great,” Dr. Curry said, “always available, with a wonderful support team.”
For the same reason the site went to Selenia, Dr. Curry says, the site installed a new Hologic MultiCare Platinum biopsy table. “The image quality of the Hologic systems is superior.”
The Women’s Center of Radiology has seen incredible returns from the purchase of the Selenia systems as well as better care for their patients. Dr. Curry says that she hopes that other clinics and hospitals will look at the numbers more carefully and take a closer look at upgrading their mammography equipment in the near future.
“As more facilities see that having digital mammography systems can be successful financially,” said Dr. Curry, “more facilities will be able to provide better care to more and more women.”