A frank discussion on the concerns vs advantages of digital mammography

A conversation gaining increased attention in radiology circles is whether to eliminate traditional mammography ¬– meaning conventional film, chemicals, processors, folders, filing, etc. ¬¬– in favor of transitioning to a 100 percent digital mammography PACS environment. While changes to the ‘typical’ way of doing things can cause temporary challenges, evaluating the cost savings and efficiency improvements that can be gained make a strong business case for making the shift. Tyler Harris, NovaRad Corporation’s Vice President, Clinical Solutions addresses the issues.

In any business it is prudent to evaluate and weigh both sides of a decision to ensure that it is clinically and financially advantageous when compared to leaving things status quo. When I am onsite at clinics and women's centers, I hear most often the following issues:

Is the image quality of digital comparable to film?

Because resolution and degradation is of utmost concern when dealing with microcalcifications and other pathology and etiology, there are FDA-approved standards that must be met for monitors and software to ensure high quality, accurate images.

In side-by-side comparisons of film and digital images, the image quality of digital studies has proven to be as good or even better than film. In its study "Digital vs. Film Mammography in the Digital Mammographic Imaging Screening Trial", http://www.cancer.gov/newscenter/DMISTQandA, the National Cancer Institute reported that women who will gain the greatest advantages from screenings completed with a digital system include those under 50, those with very dense breast tissue and perimenopausal women.

Further advantages provided by digital mammography include the elimination of artifacts and providing better visualization of the skin, retromamillary region, nipple and dense parenchymal areas. Contrast has also been shown to be much better with digital compared to film for fatty tissue and high density areas. When combined with the tools and features offered in digital systems, including advanced hanging protocols, advanced workflow for reading, step-by-step walk through, CAD markers and overreads, a digital system is delivering the added benefit of making reading more efficient, which is helping deliver a higher standard of patient care.

Our facility has made a major capital investment in film processing equipment.

After factoring in the expenses for purchasing, processing, maintaining and storing film, there is only a small margin of cost recovery per patient. Price sensitivity is what is impacting the industry and causing providers to look for ways to cut costs and increase margins per exam.

When comparing the costs of film to digital it is simple to show in real bottom line savings. It is not just eliminating the film costs, it is also time saving for FTEs by eliminating QC for film chemistry, film quality and modalities. Even with the low reimbursement for mammography, typically, most facilities that have installed mammography PACS realize ROI in less than a year, and in many cases in as little as six months.

Digital systems also offer space-saving benefits. Archiving mammography studies with a digital system is more convenient and saves space compared to traditional film. Digital images are stored on a server archive, making them easily accessible for repeat analysis, running additional reports or sharing studies online. 

Electronic file storage can also improve productivity. Typically, studies can be retrieved in less than 30 seconds. This is a tremendous time saver compared to physically locating jackets in a storage room, and then pulling and hanging films.

Overall, the tangible cost savings and intangible space savings to be gained clearly demonstrate the advantages to going digital. The question then shouldn't be 'if' the shift from film to digital should be made, but 'when'. The sooner the better is proving to be the best business case for facilities that want to gain the competitive edge.

Biography

Tyler Harris is Vice President, Clinical Solutions at NovaRad Corporation. In this position, he leverages his years of clinical in-hospital experience to help hospitals, clinics and imaging centers improve workflow procedures, productivity and patient care. Prior to joining NovaRad, Harris worked as a licensed radiology technologist.