Valley Medical Center (VMC) is a 303-bed acute care hospital and clinic network established more than 63 years ago. It is the oldest and largest public district hospital in the State of Washington, VMC proudly serves over 600,000 residents in South King County. VMC is a thriving medical center and the largest nonprofit healthcare provider between Seattle and Tacoma. VMC is also South King County's only disaster recovery facility and offers advanced emergency care in its Level III Trauma Center. In 2011, VMC announced the formation of a strategic alliance with UW Medicine. Now in 2018, UW Medicine currently includes: Harborview Medical Center, UW Medical Center, Northwest Hospital & Medical Center, UW Neighborhood Clinics, UW Physicians, UW School of Medicine and Airlift Northwest.
Even at that time, VMC has been forward thinking when it comes to diagnostic imaging. About 10-15 years ago they were going through a big upgrade of their diagnostic imaging equipment throughout their hospital and clinics they chose to go with X-ray systems with fixed digital DR detectors, and at the time they were very cutting edge and versatile. However, the challenge with these systems was that they had fixed detectors. To overcome this, they were using CR cassettes for tabletop work, stretcher chest, AP feet, and cross-table exams in those rooms.
Leading up to 2018, VMC had some decisions to make. With the Omnibus Bill soon to go into effect, VMC had to get rid of their CR before 2018 otherwise they would be subjected to a reimbursement penalty from Medicare. They needed to retrofit 6 rooms with new Digital DR detectors and so they began the process. They met with 10 + vendors who all presented their best offerings, but in the end, they selected us, Core Medical Imaging, for two main reasons: Our technology was the best and our service proposal was the most cost-effective. Our proposal was to set each workspace up with a Canon tablet and a paired Canon 10’ series detector and the result was: 7 Canon 710 detectors, 1 Canon 810 detector (8”x11”), and 8 Canon DR tablets.
For them, the Canon products offered the best combination of image quality, reliability, design, flexibility, and technology. The 10’ series are the lightest detectors on the market (710 (14”x17”) model is 5.1 lbs.) and has a full carbon fiber frame to enhance durability. There are embossed handles with curved edges to improve ergonomics in mobile and emergency environments. It features an IPX 7 rating meaning it can withstand a drop in water up to 1 m. for 30 minutes. There are a lot more features to this system and you can learn about them here. The Canon tablet is a powerful system that has all the standard Canon NE features but with an additional built-in barcode scanner and most importantly a contrast resolution of 3,000 to 1 for image clarity and accuracy. With the detector in AID mode, the detector and the tablet sync to each other which provides the flexibility to take X-ray images where ever there is an X-ray source.
At VMC, each room to be upgraded was slightly different with different existing X-ray equipment, existing detectors, and different intended use for the new Canon DR detectors. For example, they have adjacent ER room’s that share a central workstation. Both rooms had systems with fixed detectors and they needed 2 710’s and 1 810 to be used between both rooms for all tabletop, stretcher, AP feet, and cross-table exams. This also gave them the flexibility to use the tablet and the 3 detectors with a mobile machine in the ER as well. Ever since they started using the new Canon 10’ series detectors in the ER with a portable grid cap they are really starting to prefer the Canon image quality. With their existing portable in the ER they often find themselves using the Canon detectors and tablet with their portable rather than their existing DR.
Over the course of two weeks, we installed 8 Canon 10’ series detectors in 6 different workspaces. We had 3 detectors for their ER, 1 in their rad department, 1 to be used across two RF rooms, and 2 detectors across three rooms in their outpatient center. Some of the challenges we faced were the dynamics of the room itself. In their Rad department, we set them up with 1 detector across 2 RF rooms for all of their wall bucky exams in each room. For this to work, we needed to install additional wireless repeaters in each room. These repeaters function to extend the signal output from the detector to the tablet to ensure proper connection and transmission of images.
In addition, the standard X-ray rooms in the outpatient center were retrofitted completely meaning the detector was set up to be functional in all three workspaces: table, wall bucky, and tabletop. To make all this work, we had to take in account the grids and the photo timers in the room. The result was that we had to replace the existing grids and photo timers in these systems, to prevent noise and transmission issues. The challenge was that issues such as the grids and photo timers are issues we can anticipate but we can only diagnose them and solve them during the install. Overall, it was a collaborative effort between our staff and VMC BioMed to ensure a smooth installation.
The second reason VMC chose to go with us at Core was our approach to Service. Rather than set them up with a regular service contract, we provided costs for the replacement parts and explained to them that the only components of this configuration that could have issues would be the Canon detector itself and the Canon tablet.
So, what did we do: we gave them an additional detector and tablet as back up. With the idea, that if a tablet has an issue they can switch out the tablet with an extra and work on the problematic tablet without interrupting workflow. For a detector, the main issue is dropping the detector. It made the most sense to just set them up with a very cost-effective drop coverage program for all their detectors. If they drop a detector, then they can easily swap that out with a replacement.
Lastly, the last part of our service proposal was Canon training for their internal BioMed. They have since completed the training so now going forward, VMC has all the Digital DR equipment they need, they have the drop coverage on all their detectors, and they have an internally trained BioMed service engineer who can handle end user issues and complete regular PM’s to maintain the equipment.
Overall, this was a very exciting project for Core. We have worked with other University of Washington affiliated hospitals and we are glad to be working with another facility that offers great patient care. This is our first multi-detector project with the new Canon 10’ series detectors and VMC is our first customer with this new approach to service. When things are brand new, there are always things you learn after the fact. We now have experience with the Canon 10’ series and Canon tablets in a large hospital environment with multiple rooms with different existing equipment configurations and we feel very confident that we can provide this set up for our other customers.