Everything Old is Not New Again...

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In 1895 Wilhelm Roentgen discovered the x-ray while working with a cathode-ray tube in his laboratory in Wuerzburg University in Germany. He called this mysterious ray 'x-radiation' because he didn't know what it was. This mysterious radiation could pass through most substances that absorb visible light. From this discovery, Roentgen discovered that this ray could pass through human skin, but not bones nor metal objects. Though one of his first successful images was of his wife, Bertha's hand, his interest was not for medical application; instead, he wished to use it for commercial applications. It wasn't until February 1896 when John Hall-Edwards in Birmingham, England that an x-ray image was used in a surgical operation.

From these early images to today, medical imaging has become a crucial element in the modern healthcare system. Modern radiology provides today's physicians with a fast and accurate diagnosis to facilitate the improvement in health outcomes and quality of life for the patients. However, this 'fast and accurate diagnosis' is often dependent on the equipment used to take the x-ray. A major factor in the 'fast and accurate diagnosis' is age and the modernity of technology of the equipment used in our healthcare facilities today.

On a recent trip to my local emergency room with a family member, this issue of the age of the equipment became a topic of conversation. First, let me state for the record, that the staff at this local hospital are EXCELLENT! Seriously, I have visited this emergency room on three occasions, and the care, competence, and overall quality of the doctors, nurses, technologists, administrative staff, and medical staff exceeded my expectations. However, on this particular visit, my family member needed an x-ray, and when the technologist came around with a portable x-ray unit, he advised us that an x-ray from one of the facility's x-ray rooms would be best because that particular portable was the "older one" and the image quality was lacking. When I asked why he said 'older,' he responded that the usual portable he makes his rounds with was down, but that one too was at least ten years old. In retrospect, I probably should have asked more about the "why," but my concerns were for my family member.

As the family member of a patient, I greatly appreciate the technologist's advice, but I wonder about the hospital administration's decision to depend on ten plus-year-old medical equipment. Let's face the facts; radiological equipment has a definitive life cycle and trying to stretch that life cycle will result in unavoidable breakdowns and the decrease or loss of image quality. When this equipment breaks down, it causes delays in the diagnosis and treatment of the patient (it took an additional 75 minutes to get my family member's x-ray.) With the rise of full-service urgent cares, shouldn't the administration of the facility be concerned with patient satisfaction?

Today's imaging equipment is a combination of advanced electrical and mechanical engineering, years worth of research, and functional design. Months, not years, usually marks the timeline of progress in the medical imaging industry. Better digital radiography (DR) panels, higher-density pixel monitors, and artificial intelligence/machine learning software have led to higher resolution images and more precise diagnosis. These improved images can assist a physician in recognizing small anomalies in the patient's x-ray and ultimately lead to more accurate and more timely patient diagnoses. Faster start-up times and faster image processing times lead can be a lifesaver in an emergency room. More universally, newer equipment reduces the intensity, length of exposure, and radiation absorption by the patient and the technologists. As with anything other manufactured product, newer designs often take into accounts the lessons learned from previous models. Whether it be a telescopic arm on a portable for better visibility for the technologists or an improved table maximum weight of 600lbs to accommodate bariatric patients, state of the art equipment is better equipped for today's busy healthcare facilities.

While today's patients aren't likely to look at a machines date of manufacture, they do have a reasonable expectation of being diagnosed accurately and expeditiously. Today's healthcare marketplace is becoming increasingly competitive (see my blog post on Amazon entering the healthcare industry), and as a result, patients now have more options and are demanding the best care possible.

Which would you choose?

An oncology radiologist to examine a mass with a film x-ray on a lightbox?

Or the same physician examining the same mass with a brand new digital x-ray on an 8-megapixel full-color monitor supported by a hard drive loaded with Artificial Intelligence and Machine Learning.

I know which one I would choose.