RADIOLOGY ENTERPRISES increasingly are embarking on the journey toward a digital environment, even if that journey has taken them no farther than the preliminary discussion stage. Regardless of where along that path a hospital or freestanding imaging center happens to be, the fundamental challenge ever remains the matter of how best to produce, process, and distribute digital images.

One very viable solutionin concert with or absent a PACS implementationis computed radiography (CR). Suitable for use by enterprises large and small, CR proves to be a cost-efficient, easily deployed replacement modality for analog screen-film radiography. Consequently (and we at Agfa never hesitate to point this out), CR makes an excellent first, middle, or final step in converting to an all-electronic theater of operations.

That is a much-repeated refrain in this latest Intelligence Report sponsored by Agfa, beginning with the voice of Katherine P. Andriole, PhD, who describes the efforts of her enterprisethe hospitals belonging to the University of California, San Francisco (UCSF)to eliminate reliance on film. Andriole's argument for CR hinges on the notion that hospitals and imaging centers will find it impossible to become totally digital until they provide a digital answer for projection radiography, which typically constitutes the bulk of imaging work performed at most facilities.

Once an enterprise decides that CR is needed, the next decision is where to deploy first. For San Jose Medical Center, a level II regional trauma facility about an hour's drive south of UCSF, the choice of best place to put CR was obvious: the super-busy emergency department. William Morse, RT, director of diagnostic imaging, enthuses that CR in the ER immediately put an end to the problem of films never being available when staff needed them the most.

Farther south, in San Diego, decision-makers at the Naval Medical Center elected to start their CR deployment in the intensive care unit. For good reason, too: it is difficult to obtain good, diagnostic-quality images on the first try when exposing ICU patients, as retakes cause considerable damage to a radiology department's productivity, throughput, and cost-effectiveness. With CR, ICU retakes occur much less frequently, since images of marginal quality due to exposure techniques often can be improved during processing.

A key to any successful CR implementation is a network of imagers as created in Chicago by Rush-Presbyterian-St Luke's Medical Center. The imager network is the critical piece in the CR solution to distributed radiology, for it is the mechanism by which CR images reach the eyes that need to see them. Kiley Rodgers, RT, PACS/IT administrator, reports that a well-structured CR imager network can pare an enterprise's costs on the one hand while improving its ability to deliver quality care on the other.

It is our hope that readers will find this 18th Agfa Intelligence Report useful.

Ray Russell is Imaging Business and Marketing Director, Agfa Healthcare, Greenville, SC.