Digital tech transforms radiology training in BC

Moving from traditional film to a digital imaging system – dubbed eFilm – has been a massive undertaking for B.C. hospitals.

But it has had happy consequences for the Province’s radiology departments and British Columbia Institute of Technology (BCIT) students, according to a program head at the school.

Transmission of patient radiographic digital images to external destinations for consultation and interpretation has been occurring for some time in B.C. However, it’s only by the end of this year that the province will have nearly all hospitals using eFilm, said Mary Filippelli, program head, medical radiography at Burnaby-based BCIT.

“The technology is at least 10 to 12 years old,” said Filipelli. “The use of eFilm started at a Vancouver hospital that had been reading film for the remote Queen Charlotte Islands’ facilities, off the coast of B.C.”

The Island hospital, she said, had an x-ray technologist, but not a full-time radiologist. Having digital x-rays sent to Vancouver for analysis was more convenient and cost-effective than employing a visiting specialist.

“They have been doing it for years,” she said.

Filippelli’s specialty, medical radiography, is the art and science of capturing images with x-radiation. Digital film enables connections by either a central PACS (server) system or an alternative that can communicate and share patient information over the Internet.

B.C. hospitals recognized they had to go digital for many reasons, she said. One key reason was storage.

“Previously all x-ray images were hard copy, stored in envelopes, and took up massive storage space,” said Filippelli. “It is so expensive to store them that city hospitals have to rent space off site, because legally records must be stored for seven years.”

In late April, the Canadian Medical Association Journal (CMAJ) reported that because provinces are extending their time limits for filing malpractice suits – in Saskatchewan, for example, from two years post-treatment to 15 – physicians would need more storage space for patient records.

“Doctors will need storage space, digitalization, and time spent to manage those files,” said Marcus Davies of the Saskatchewan Medical Association. “They have to ensure a proper chain of custody on every file.”

Many factors have pushed eFilm into play, but the cost to implement a digital system could be an impediment to private clinics, Filippelli said.

“We’re talking hundreds of thousands of dollars,” she said. “Return on investment would have to be factored out into the initial investment, the volume of patients, and the size of the hospital. There are a lot of factors.

“‘How long will it take to pay for itself?’ I don’t know,” Filippelli said. “That’s one of the reasons private clinics aren’t going digital. I haven’t heard of any (private clinics) in the Vancouver area (that have done so).”

Through BCIT’s medical radiography-training program, the school has gone one step further in using digital technology, according to Filippelli. Since it has radiography clinical training sites throughout the province, they have implemented a digital link that will enable student produced patient exams to be sent to BCIT for instructor evaluation.

“The images are stripped of all patient demographics and identified only by student name and sequence number,” she said. “This enables our program to remain cohesive and ensure consistency of training.”

The students embrace new technology with gusto, however, BCIT’s biggest challenge is getting all the clinical staff to “buy in” to this direction of student education, according to Filipelli.

“In a recent conversation with a radiology resident,” she said, “he mentioned that his ‘perfect’ job would be to receive, interpret and report patient images via the Internet on his sailboat.”

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