Finding a PACS that Supports Mammography Modalities; It’s Not As Easy As You Think

Encompass Medical CenterEditor’s Note:  Encompass Medical Group recently installed a CARESTREAM Vue PACS to serve its eight locations in the greater Kansas City area.  Susan Stidham, Director of Ancillary Services at Encompass Medical Group shares her thoughts on PACS support for breast imaging modalities and how it impacted their PACS selection in the guest blog post below. 

Our medical group has six imaging centers (located within our 8 primary care physician offices)  and conducts 12,000 screening and diagnostic mammography exams a year—about one-fifth of our total workflow. When our staff evaluated suppliers for a new PACS, we were shocked to discover how hard it is to find a PACS that supports an efficient mammography workflow.

Some PACS do not support all breast imaging modalities. Demonstrations revealed that others could not display breast exams in full resolution or required five minutes or more to display each exam. The good news is that we found a PACS platform that delivers all the mammography reading capabilities we need:

  • Reading of all breast imaging modalities, including FFDM, CR, MR and general and vascular ultrasound
  • Rapid delivery of full-resolution images to ensure a streamlined reading workflow
  • Specialized mammography reading features and tools including a prelabeled keypad with the most commonly used commands (save, finish exam, mark as read, go to next workflow, turn CAD on/off, etc.) and a programmable mouse. These features facilitate fast, efficient reading for on-site and off-site radiologists.

Our new PACS–CARESTREAM Vue PACS–met our budget requirements and is flexible and scalable enough to serve us for many years. If your staff doesn’t initially find a PACS that meets CARESTREAM Vue PACSall your mammography  needs, keep looking. The PACS of your dreams is out there—you just have to find it.

Does your current PACS address your mammography workflow?

If you are replacing your PACS, have you had a difficult time finding a new PACS that streamlines mammography reading?

Annual National Interdisciplinary Breast Center Conference Stresses “Self-Care” and Continued Education

Julia, Weidman, Marketing Manager, Women's Health & Healthcare Information Solutions, Carestream

The 22nd Annual National Interdisciplinary Breast Center Conference sponsored by the National Consortium of Breast Centers opened yesterday in Las Vegas.

A global audience of nearly 1,000 attendees will participate in more than 120 sessions from 78 world-class presenters focused on the clinical, imaging, administrative and nursing concerns associated with breast health and breast center management.

The celebrity keynote was given by Kelly Corrigan. The New York Times best-selling author talked frankly and engagingly about her battle with breast cancer, and what compelled her to author her book “The Middle Place.”  Ms. Corrigan spoke about the strong bonds she developed with the caregivers who helped her navigate her journey – “the magic we”, and encouraged attendees to “perform the role nobly”.

Elizabeth Clark PhD, ACSW, MPH, executive director of the National Association of Social Workers, delivered the professional keynote “Words that Heal, Words that Harm.”  Ms. Clark raised attendees’ awareness of the context of the words they use, and how powerfully those words impact patients.  Ms. Clark also spoke about the importance of creating communities of hope for cancer patients and the need for caregivers to practice “self-care” to avoid burnout.

Visitors to the Carestream booth shared feedback that this year’s conference featured a nice blend of technology and experience sharing:

“We hear from the best and brightest in the field at this meeting.The multidisciplinary study tracks and discussions about emerging technologies are real learning experiences,” said Bonnie Rush RT (R) (M) (QM) from Breast Imaging Specialists.

Deb Wright, President and CEO of Inner Images was a judge for the poster session:

“Tech-wise there was a lot of molecular imaging. And I was glad to see papers on outreach programs for survivors.”

Dr. Lazlo Tabar commented, “This year’s NCBC has a very interesting program, very comprehensive both for physicians, technologists and nurses.” Dr Tabar also spoke about the sessions he and and Louise Miller RT (R) (M) will hold for technologists focusing on the proper positioning of the breast in screening:

“The radiology technologist is a very important part of the diagnostic team.  They are responsible for proper positioning.”

We’re sure the technologists here at the conference will line up early to get a seat!

Other hot topics like healthcare reform, breast density issues, risk assessment and geonomics and tomosynthesis will be covered throughout the conference, which ends on Wednesday. You can follow the conversation from the conference on Twitter using the hashtag #NCOBC.

 

Mammography Scheduling Portal Helps Improve Screening Attendance in Denmark

With 200,000 women aged 50-69 years,  a free mammogram every second year and 750 patient appointments each day, the mammography screening program in Denmark’s Capital Region is the largest in the country. It also boasts a 75 percent screening attendance rate.

Key to balancing the demands of scheduling, hospital resources and patient satisfaction? Empowering women to book mammography appointments online at a convenient time and location with the CARESTREAM Vue RIS Portal.

How It Works

  1. Women are sent a letter, questionnaire and leaflet explaining how to access the RIS Portal with a unique, password-protected, secure ID number.
  2. Once in the Portal, the patient navigates through a simple process to modify appointment time, day or location as many times as they like for up to three months. At the same time, the Portal seamlessly communicates with the hospital RIS to book.
  3. A summary screen displays date, time and address details to print for future reference.
  4. Patients can also cancel their appointment for the current screening round or altogether, giving them complete freedom of choice.
  5. The portal allows patients to include comments. Consequently, the hospital can track why some women are choosing not to attend their screening appointments.

This patient-centric solution makes it easier for women to coordinate  busy lives with hospital appointments because they no longer are required to phone the hospital between 8 a.m. and 3 p.m. For Denmark’s health system it means secretarial staff can find a more efficient use for the time they spent writing to non attenders, re-booking and dealing with cancellations.  For radiologists and technologists, it means  one system harmonizes  clinical tools and reports with a scheduling system that encourages quality care in a timely fashion.

Chief Physician Ilse Vejborg, Head of the Mammography Screening Programme, sat down with us at Righospitalet, the main hospital for the capital region of Denmark, to discuss how Vue RIS has become the most used web site in the region and plans for continued improvements.

Come see the CARESTREAM Vue RIS at ECR2012 in Vienna, March 1-5.

What should we do with dense women?

Anne Richards, Carestream Health

Anne Richards, Clinical Development Manager, Women’s Healthcare, Carestream Health

Women with dense glandular breast tissue present a challenge—and one with high stakes.

Their tissue type is capable of hiding small abnormalities, they have a documented increased risk of breast cancer, and should they have a tumor it is more likely to have certain aggressive characteristics (as reported recently in the Journal of the National Cancer Institute).

As radiologists, you’re aware of these facts. But what about the women whose mammograms you interpret?

My recent post about breast density focused on the Governor of California’s decision to veto legislation that mandates that we inform “dense” women following their mammograms of their breast type and the implications, including the possible benefit of additional screening.

Similar legislation has passed or is pending in several U.S. states, but this veto highlights the importance of radiologists voluntarily providing this information.

Informing a woman of her breast density presents another dilemma. How useful is that information without recommendations on what to do next? What’s more, the medical community has yet to establish a protocol for them, including what modality should be used for follow-up.

For example, trials indicate that ultrasound combined with mammography provides increased detection in dense breast tissue. So should asymptomatic women with dense breasts be screened will full ultrasound in addition to their annual mammogram? Will insurance companies pay for the radiologist’s additional time? Can and should technologists be trained to do this screening instead?

In my opinion, we should not wait for mandates from the government to address this issue. Insurance companies, radiologists, and physicians need to work together to develop a standard of care for women with dense breast tissue. It’s a new horizon for our field—but one that will lead to brighter futures for the patients we treat.

What steps is your practice taking to notify women about the risks associated with dense breast tissue?

Bill Veto Fuels Breast Density Discussion

Anne Richards, Carestream Health

Anne Richards, Clinical Development Manager, Women’s Healthcare

California Governor Jerry Brown recently vetoed bill SB 791 that would have mandated medical providers to notify women if they have dense breast tissue.  Brown stated he was not comfortable with language in the proposal that required women be told they might benefit from more screening.  This legislative move has fueled more discussion about density as an independent risk factor, the challenge dense tissue poses to radiologists interpreting images and patient right to more information about their breast health.

Breast density is an important topic, but this discussion is far from a new one. In fact, the Connecticut General Assembly passed their act in 2009 and several other sates have similar legislation pending.

This past summer at the Society of Breast Imaging (SBI) Postgraduate Course, I sat down with Gerald Kolb, Mātakina International’s VP of Business Development, who shared his thoughts on personalized screening and volumetric breast density assessments:


How is your imaging department or center educating and informing patients about breast density? 

Highland Hospital’s Breast Imaging Center Event Stresses Importance of Mammography

Jennifer Dodd, Carestream Health

Jennifer Dodd, Marketing Analyst, Carestream Health

Hospitals across the country are hosting events this month to raise awareness about the importance of early detection of breast cancer.  Last week I had the opportunity to attend the 18th annual breast cancer education event hosted by Highland Hospital’s Breast Imaging Center here in Rochester.  This event supports the Imaging Center’s mission of providing comprehensive breast care to the community while also reinforcing that annual mammograms remain the best way to fight breast cancer.

Despite the effort to raise awareness for the importance of annual breast screening, Avice O’Connell, M.D., Director of the Highland Breast Imaging Center, shared that 1 in 3 women still don’t get a regular mammogram.  She identified the three most common reasons for this decision, which physicians need to proactively address with their patients:

  1. I’m too young:  18% of breast cancer cases are in women under the age of 50, so it continues to be best practice to advocate for annual mammograms beginning at age 40.
  2. I don’t have a family history of cancer:  75% of women diagnosed with breast cancer are the first person in their family to have cancer.
  3. I don’t have enough time:  Annual mammograms are a commitment to yourself and your loved ones.  The amount of time it takes to be screened is minimal compared to the time lost if breast cancer is diagnosed too late.

O’Connell challenged event attendees to share what we learned to support breast screening.  For physicians this means educating patients about the importance of mammograms.

Like many hospitals across the country, the Highland Breast Imaging Center has been offering free mammograms for the past seven years during Breast Cancer Awareness Month and has served close to a thousand women who may not have been screened otherwise.

This year Highland is also one of more than 130 hospitals participating in this year’s Pink Glove Dance Competition.  Staff and physicians from each hospital submitted a video, and the facility receiving the most votes will receive a donation in their name to the breast cancer charity of their choice.  I placed my vote to support this hospital’s mission!  Check out their fun video below or vote at the link above.

How are you educating patients about the importance of regular breast screening? 

Is film-screen mammography a technology of the past?

Anne Richards, Carestream HealthUsed correctly and regularly, studies have proven that screening is a key tool in the early detection of breast cancer.  Early detection enhances a woman’s chances for survival.

Film-screen mammography has a deep heritage and long been the gold standard for breast cancer screening.  While more than 77% of mammograms in the U.S. are captured digitally, many of the statistics about the benefits of mammography are from studies that used film.

Even with recent developments in other technologies, film-screen mammography remains a great tool for detecting breast cancer in its earliest stages. Plus, it offers practitioners a financially viable option for effective screening. Outside of the U.S., the numbers skew even greater for film-based mammography over other technologies.

Manufacturers such as Carestream—the world leader in breast imaging—continue to invest in the development of film-screen mammography through ongoing research and new product development like our New MIN-R 2000 Plus Film. Today’s products yield better resolution, greater contrast and finer details than ever before. We’re dedicated to further improving the capabilities of film-screen mammography as a screening and diagnostic tool.

Whatever technology you use—film-screen, computed radiography or full-field digital—the most important thing is to do it right. That means adhering to the manufacturer’s recommendations and following proper quality control procedures, ensuring that your system is within compliance, etc.

And keep in mind that the technology you choose for capture is only one part of the imaging chain. The technologist plays a key role in proper positioning, compression, and quality control. Likewise, the radiologist is critical in interpreting the results. It’s how you put it all together that you deliver the greatest benefit to your patients.

How long do you think film will have a place in early breast cancer detection?

Mammography Screening Matters: Response to British Medical Journal

Guest Post: Laszlo Tabar, M.D., F.A.C.R.(Hon), Emeritus Professor of Radiology, Uppsala School of Medicine, Sweden

Editor’s Note:  Dr. Tabar recently published a study pointing to the long-term benefits of mammography screening.  You can see these results discussed in a previous Ask Anne post.

I am sure you have been disturbed by the media report questioning the value of mammography screening, based on a “publication” in BMJ, therefore I would like to give you a very simple and easily understandable way of looking at the issue. You are one of the experts in your area, so it is important to be able to argue properly.

 A report in the current issue of the British Medical Journal claims that there is no evidence that mammography screening has played a direct role in breast cancer mortality reductions in countries in which screening has been implemented. Lead author Phillipe Autier and his colleagues compared breast cancer mortality trends in three pairs of adjacent countries (Sweden vs. Norway; Northern Ireland vs. Republic of Ireland; and Belgium vs. Netherlands), with each comparison including a country that introduced mammography screening some years earlier than the other. Comparing breast cancer death rates between 1989-2006, the authors observed similar trends in the reduction of breast cancer deaths in each country pair. They conclude that mortality trends are more likely to be influenced by improvements in therapy than the effect of mammography screening.

 One should rely on people’s common sense – and try to ask relevant questions:

Read more of this post

15th Annual Mammography Course Offers Education in Breast Imaging

I recently talked with Dr. Michael Linver, X-Ray Associates of New Mexico, about the upcoming 15th Annual Mammography Course in Santa Fe, NM, August 8-12.

I’ve spoken before about the importance of continued education and this breast imaging event gives attendees hands on screening opportunity. During the workshop radiologists will evaluate 100 mammography studies on dedicated workstations, allowing attendees to rate themselves throughout the event.  Discussions will also include the use of Ultrasound, Tomosynthesis and Breast MRI.

Will you be there?  Have you attended previously? We’d love to hear about your experience!

Proof that Regular Mammography Screening Works

Anne Richards, Carestream Health There’s been a lot debate in recent years over at what age screening mammography should begin, and how often it should be repeated. Now, 29 years after researchers began a study of 130,000 women in Sweden, they’ve reported in an article published in Radiology that regular mammograms reduce breast cancer deaths. What’s more, the number of lives saved goes up with each year of screening.

And that, my friends, should end the debate over the value of screening mammography.

While this long-running study does not deal with what is the ideal frequency, it does scientifically prove that regular screening works.

If you’ve been involved in mammography for as long as I have you’ve seen the steady and continuous progress that’s taken place in this field.

Remember when we first had a film dedicated to mammography?

How about a printer optimized specifically for and dedicated to digital mammographic images?

Over the 29 years of the Swedish study, the technology we have used to screen women for breast cancer has certainly gotten better. Carestream and other manufacturers have devoted significant R&D to technological advances such as the shift from wet to dry processing and the development of digital image acquisition. We may take these technological advances for granted, but we’re now able to find more types of breast cancer at an earlier stage. We’re detecting them at smaller and smaller sizes. And we’re having a positive impact on mortality rates

At the same time, we’ve made great strides in workflow, training and techniques. Let’s not forget the importance of our patients: by getting regular mammograms, they’re giving their radiologists the historical perspective that can lead to the identification of subtle changes from year to year.

At the end of the day—this day—mammography is still the best tool at our disposal to find the most cancers. I, for one, am glad it’s a tool we can depend on.

What milestone in mammographic imaging has had the most impact on your professional life?

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