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Technology requirements and selection

Equipment selection, what you will do now and later

Technology is changing rapidly. The investments that are made in research and systems for the video gaming and video businesses are contributing significantly to the medical imaging industry. These advents and the numbers in which they are produced are bringing the cost of systems for remote reading down. When buying a system for remote reading it is important that you buy that which meets your needs at that point in time, however, understand and consider what your needs will be as you progress through the technical and economic life of that system and how it will match what you know about your changing needs through that period.

Typically, computer systems in medicine can be depreciated over a 5 year time period. Systems at this price level and use pattern can be depreciated over a 3 year cycle with 0-10% residual or salvage value depending upon your preference.

Since most remote reading is the interpretation of processed images the computational power that you might need in a environment where computation from raw data is done is not required. Systems that have 2-4 gigahertz dual or quad core processors serve the need nicely. Larger memories, RAM enhance the speed at which data is moved. 2 gigabytes or greater is desired and a very lost cost incremental investment for its benefit. Disk storage space is getting less expensive everyday so even though you may not be storing large amounts of data plan for the future and look at ~500 Gig Bytes or a Terra Byte if that is available. The added cost is very low.

In the computer one of the most critical components is the video card. A video card designed for use in medical imaging, that matches the requirements of the displays used is critical. If you go on the cheap and buy a commercial grade card your monitors will not perform up to their specifications and the result will be a sub clinical quality image with poor diagnostic yield. Be prepared to pay ~ $1,000 for a single head card and ~$2,000 for a dual head card. If you chose to have a 3 display system with 1 of those displays being used as an administrative display note that a second card of commercial quality will be needed to drive that display. Often a card that comes with the computer system is satisfactory for this task.

Displays are the key element to superb image interpretation. Depending on your intended clinical use you may select a display that ranges from 3-5 Mega pixels. Note that if you are doing digital mammography the FDA mandates 5 Mega pixels displays for this use. The data yield of the new digital mammo units require a display of this resolution to properly display the acquired data. For conventional general x ray, CT, MRI and various other modality viewing 2-3 Mega pixel units are well versed to support the task.

Displays today have a useful life of 3-5 years depending upon frequency of use and use patterns. In considering their technical and economic life it is best to align them with the life cycle of the computer and plan accordingly for replacement at the 3 or 5 year interval or if a remarkable new imaging technology is presented to the field dictating extensive capability beyond your present system.

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In doing so you have a sound investment. Ongoing support, the ability to upgrade and mean time between failure are all extremely important to your decision. If your system is not working you are not serving patients and losing revenues and possibility compromising relationships. Look for providers that can offer local service or a “hot swap” program to minimize downtime. System problems will eventually happen and you need to plan for it. Lost productivity translates to lost revenues and perhaps contracts if it is frequent.

Data transmission system, technology, high speed data, interface to front end systems and compatibility – I.E., My Connection

One of the most overlooked devices in system configuration is those devices that get the Internet to your computer. Just like the video card to the display the hardware interface to the Internet is of paramount importance. To manage the movement of very large files you need speed and to maintain that speed from the Internet to the computer you need a device designed for this need for speed. Stress this point to your network consultant and be sure that a specialized device that fulfills this major data movement requirement is included and system tests to the specified performance. Limited data transfer speed translates to limited productivity. Do not be swayed by low price business office environment devices. You wouldn’t buy a Parachute at Walmart.

Installation and considerations, make it work, be comfortable

Every person has different preferences in the way systems are set up in their use surrounding. The best rule of thumb is plan to be comfortable and don’t be cluttered. Recall the command post concept on setting up displays and clear the clutter from cables and other desk items that can interfere with work and if snagged by accident can create a costly down time. Some radiologists prefer to stand to read and others like the idea of either standing or sitting. There are furnishings that allow both from industry manufacturers. By all means buy the best chair to maintain posture and avoid back problems. Furnishings are an investment to success, your back and your eyes.

On going technical support, stay calibrated and in the lead

More governing bodies and professional associations are requiring ongoing testing and compliance to established standards. Payers are also supporting this movement to assure best quality of service and minimizing risk of recourse from misdiagnosis. While most hardware in a system remain stable through life displays are in a constant state of change as they age. This suggests the need for periodic calibration to assure known consistency day to day. Many to most display manufacturers offer simple to sophisticated calibration systems. They range from manual to automatic systems. They can be locally controlled or through a network whichever best suits your need and you abilities. They are nominal in cost given their features and the value they provide. We highly recommend the acquisition of a calibration system.

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