There are many different imaging modalities in health care. X-ray is the oldest if not the most used imaging modality. ICE Magazine reached out to some imaging leaders to find out more about X-ray, including recent advancements and how it can save a hospital money.
Participants in the article are:
- Todd Anderson, Imaging Manager, Children’s Hospital Los Angeles;
- Rebecca Clinger B.S., R.T. (R) (CT), Supervisor of Radiology and the Harrington Heart and Vascular Institute at University Hospitals Conneaut and Geneva Medical Centers;
- Jill Jones, CRA, RT(R)(CT), Medical Imaging Manger, Banner Imaging; and
- Jacqui Rose, System Director of Radiology, UC Health
Q: H​ow has the role of X-ray changed over the past 5 years at your facility?
Anderson: We have become completely digital with fully automated machines.
Clinger: Although the role of our X-ray department has not changed greatly in the past 5 years, our X-ray departments have changed in a number of ways over the last 5 years – both technologically and in staffing. Our role, as a department, remains to support our ordering physicians and their patients with their imaging needs. As a department, we’ve seen the addition of AI on some of our equipment and also used as a “first look” for our radiologists, the removal of all CR equipment, the addition of DR systems, and an increasing need for multi-modality technologists.
Jones: In the last 5 years of X-ray in my current facility, the role has evolved into a larger volume of ambulatory outpatients. Physician offices and smaller urgent care clinics are unable to staff their X-ray departments therefore moving that volume to outpatient imaging centers.
Rose: Since COVID, we have seen many changes in X-ray. From difficult to recruit and fill positions to very high sign-on bonuses and wages to lack of capital to replace equipment. This makes the management of all resources much more difficult. We are looking for more creative ways to recruit and retain while lengthening the life of our equipment and the services to keep it running longer.Â
Q: What are the must-have features a radiology department needs​ ​in its X-ray devices?
Anderson: In my opinion a dose tracking software is something every X-ray device should have built in.
Clinger: The X-ray equipment has to be user friendly, durable, reliable, interface with PACS and RIS easily, provide quality images and acquire the images quickly. These are all very important features that all imaging equipment should have. With increasing volumes, we need to be able to move our patients through our department quickly, all while providing them great patient care and quality diagnostic imaging.
Jones: With the volume of outpatient imaging clinics increasing, it is important that X-ray devices can see patients that are wheelchair bound. X-ray equipment that does not have the removable plates for imaging create an obstacle when trying to perform X-rays on patients that are in a wheelchair or bedridden. This also is a factor when trying to perform specialized imaging such as weightbearing feet and ankles on patients.
Rose: The must-have features for X-ray devices are more like characteristics. They must be cost effective, versatile, stabile and have a long life.
Q: How can X-rays help a health care facility save money?
Anderson: Used as a diagnostic tool it can avoid a good amount of clinical work-up and intervention.
Clinger: X-rays can save a health care facility money by providing quality diagnostic imaging at a much lower cost than other advanced imaging modalities. X-rays can also play a vital role in getting some advanced imaging exams pre-authorized through the patient’s insurance carrier, thus ensuring payment. Radiographers are usually paid less than multi-modality and/or CT or MRI technologists, so salaries are usually lower, saving the facility money in that aspect.
Jones: X-ray can help a health care facility save money by providing the basic X-ray on patients before they are referred for an MRI, CT or additional imaging. Performing the initial X-ray on these patients often results in the patients not needing additional imaging or advanced testing which costs the facility more money in the long term.
Rose:Â By creating a workflow that optimizes every piece of equipment and staff, we can certainly save time and money. Creating a manageable service process and workflow is also needed to prevent unplanned downtime and expenses.
Q: What safety measures should every X-ray department implement?
Anderson: Dose management protocol and easy access to a lift team or equipment.
Clinger: Safety measures in X-ray departments might look slightly different than they have in the past. We still implement time, distance, and shielding for staff, but we no longer shield our patients for their exams. All our technologists take the pledge to Image Wisely and Image Gently annually, to show their commitment to safe imaging of our adult and pediatric patients. We run our repeat rates and share with the technologists, for awareness, and expect a 9% or less repeat rate. Having specific protocols for adult and pediatric populations are also key to safe imaging.
Jones: Every X-ray department should implement safety measures that keep the patients and the technologist safe for every procedure. Verifying patient pregnancy, having lift assistance tools, and the room set up for patient movement ensures that patient safety will be met with every patient.
Rose:Â Every Imaging department must develop a culture of safety which goes much farther than a program. It is inherent in everything that we do to always keep our patients and our teammates safe.
Q: What is the future of X-ray in health care over the next 5 to 10 years?
Anderson: I believe radiology will always be a important diagnostic tool, and I feel that AI will advance our field in ways that are yet undiscovered, ie. remote technologist
Clinger: AI is going to be increasingly important in the next 5 to 10 years. With radiologist shortages throughout the country, having an extra set of “eyes” on our images is imperative. Technology will also continue to improve image quality, decrease image acquisition time, increase detection of pathology, and decrease the radiation dose to the patient.
Jones: The future of X-ray over the next 5-10 years, I believe, will still be very ambulatory based with high volumes. The shortage of X-ray staff is what will hinder facilities from being able to accommodate the needs of the public and the providers.
Rose:Â X-ray is the basis for all imaging services and our teammates coming into the field are feeders for other modalities. It is important to develop relationships that enable us to maintain a steady stream of new talent to go into X-ray and keep them in the system. The potential is there to impact the radiographers pay to be consistent with other modalities to enable them to continue in the modality.Â
Q: What else should ICE Magazine readers know about X-ray?
Anderson: It is a very rewarding field with lots of opportunity for advancement and room to expand your skill set.
Clinger: Radiographers are currently in high demand and there are many opportunities to grow in the profession. The imaging world is always changing and it’s important to be able to adapt to those changes. Every patient is different and has different needs. We have to be able to think quickly to make their experience in our department as enjoyable as possible.
Jones: X-ray is the first stepping stone for many patients when they have an issue. With the evolution of technology, less dose is required to obtain what is needed for these patients to begin their imaging and healing journey.
Rose: Although X-ray is the basis, it is critical to the foundation of all imaging departments and should be seen and treated as such. Without a solid foundation, every department will suffer. We, as imaging leaders, must recognize and work toward elevating our X-ray team to help maintain that solid foundation.
This month’s article was sponsored by XRA America. For more information on this company, visit
x-rayamerica.com.
X-ray America LLC
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