Tomorrow's Technology Today: The Migration to Wide-Angle Breast Tomosynthesis

Trihealth is a large hospital system that is in Cincinnati, OH, and we serve all of the patients in the tri-state area, Indiana, Kentucky and Ohio. We are located in Montgomery, Bethesda North Hospital and also downtown Cincinnati with our Good Samaritan Hospital and we have multiple other facilities throughout the region. One of the things we're most proud of is how much access to care we have for our breast patients in the Community. So we have 10 locations where we provide breast services and seven of those are screening locations and that includes 3 that also provide diagnostic services and surgical appointments for comprehensive care. In 2008, we made a transition from analog to digital mammography, and like a lot of people in the market. At the time, we had one vendor several years ago. We decided it was time when we, when we had the ability and the funding and the capital to add additional equipment and to upgrade our 2D units to 3D. We thought it was time to take start taking a look at other vendors. So I think the strong vendor in the community at the time. Had a stronghold, they they were really the premier vendor so when it became time for us to start looking, we wanted to look at some other options and see if there were other people out there that would better serve our needs. From a service standpoint, a pricing standpoint and just a a technical ability. So we were looking at other vendors and because of our relationship with Siemens and other modalities, we thought it was time to take a look in addition to the fact that they had been recently approved for 3D only through the FDA and we were looking for better service agreements and and better support from the vendor that we chose and then ultimately the technology with the 50 degree angle really impressed our radiologist and and that's what pushed us over the edge. And help us decide to make a switch. So we chose the mamam at Revelation, particularly for its 50 degree angle. The technology in the image quality was just superior to what we have been using in in other things that we saw within the market. Feedback from our staff about the mammal revelation is is gaining popularity. So to be honest it's very different from the other vendor that we use, so there's a learning curve. I like to compare it to Apple operating system versus another operating system. If people have been using Apple for a long time, they're very used to it's very user friendly and other operating system might provide just as much or better quality. But it's just a. Learning curve to learn how to use something else, but our patient feedback with the compression and the ability to breathe through the exam has been very positive and our technologists are are really coming around to really love the the revelation. So we now have 7 mamam at revelations and we have 12 of our other vendor in our installation base. So when we made the decision to transition, I think we were at a really good place having just transitioned our pack system from a dedicated mammography workstation to one where we could read multiple modalities. So one of the concerns we would have had went away with that. Our biggest concern was really just the different look of the images between vendors for our radiologist because now we were in a situation where they were going to be moving back and forth between looking at maybe 1 vendors images for five patients, and then another vendors for three. And that different look, but has not proven to be an issue and they transition to that that workflow very well. The transition for the technologist was a little. It was a little bit rough in the beginning because it is very, very different technology. But the one thing that I like to to promote all the time is Siemens has been excellent with follow-up care. I mean, I've been doing this for a very long time and we bring in people for applications. You get a couple days of applications and they're out the door. The support for the installation of this equipment. Was phenomenal. Follow-up, they come in and they they do the applications training and then a week later they come back and follow up. And then there's even more follow up and they've been incredibly available for new technologists. When we hire new technologists, they come in and help us train the new technologist. Just service that that I've never seen before. From a workflow standpoint, I think we actually went into this expecting that we were going to have need more time to perform screening mammograms on this new unit because the the scan time is just a little bit longer, but that is not proven to be a factor at all. It's it's really been pretty equivalent. We actually bumped our time spots from 20 minutes down to 15 minutes. I recognize a lot of that is because of our internal processes and support with with tech AIDS, but no, we have not had any concerns at all. With the additional scan time. From a patient comfort perspective, we do have patient satisfaction surveys and we receive those results and comments each month. We do have comments from patients stating that their mammogram was more comfortable. I have actually heard the patients tell me that their mammogram was much more comfortable. I myself had my first mammogram on the Siemens revelations this year and I found it to be more comfortable, not as much compression it was, it was. It was a good experience. We try to focus all of our screening patients on the revelation because the callback rate is lower than it is on our other vendors equipment. We really appreciate as a system, the lower callback rate because it's better care for our patients. People don't understand how anxiety provoking mammography is for patients, even when they're just coming in for their screening. So when they get that phone call that says we saw something, we need you to come back in for additional imaging they've already been to Google. They think they have breast cancer. They're very, very anxious, so the fewer patients we have to actually call back for additional imaging and we can get it all done in one shot, the better. Having a partnership with your vendor is is really important. They can make or break your day if your equipment goes down and you can't take care of patients your whole day shot and you've also you know ruined the day for patients. So having a partnership with the vendor that you can trust, that's going to be reliable on the front end and isn't going to disappear once the installation has occurred. From a financial perspective, a capital perspective and a patient care perspective. It's really important to have a good relationship with the vendor. The implementation to Siemens for us wasn't very difficult. We decided to try it. We knew we had several pieces of equipment that needed to be replaced in the in the very near future, but we got a new van, a new mobile mammography van, and this was our opportunity to really put Siemens on the van, give it a good try before we had to make additional purchases for our big center. It very well I'm I'm not going to say we didn't have hiccups that we had to work. True, because it was certainly our first installation. Working with our pack system and our IT department and honestly putting it on a van where you have transmission rates that are coming across wide differences was a little bit challenging, but Siemens was extremely willing and able to be there and provide solutions to get us through that process. So much so that we decided to continue purchasing the revelation. Seaman service has been excellent to work with. They've been very responsive. We have a local engineer that works very closely with our hospital engineers and if he can't talk our hospital engineers through it. He's on site in a very timely manner. We've had very little downtime with the revelations and it's usually been related to an upgrade, which is a good thing. Some of the reasons that we really wanted to look for another vendor is because we were. We were kind of tired. Of price gouging and service issues, and we had a lot of pieces of equipment and when you have a lot of equipment and a lot of it is software based, there's a lot of software upgrades that are necessary and every time we needed a software upgrade, you know across our system of of 1920 units. That's a lot of money and we weren't getting a lot of collaboration with that vendor, so that really helped us help drive us towards seeing what else was out there. When it comes down to making a decision about what equipment you're going to install and what vendor you're going to work with, there's a lot of factors that come into play. Certainly cost certainly service and relationships, but also technology. At the end of the day, we want the best technology for our patients, so the real selling point. I mean obviously the price was there, the partnership was there, but the real selling point was the superior image quality of the images. Knowing that we could. Improve the cancer detection rate and lower the callback rate was the ultimate decision. So for us our radiologists approval was was what helped us make our final decision. In our practice, we made the decision to try to push all of our patients that were here for screening mammograms to the MAMAM at Revelation Rooms because we still have a blend of vendors in our breast center. It really only made sense to try to put our screening patients in the rooms where we're going to get more information. We're going to reduce their callback rate. We can do diagnostic in those rooms, but with a with a split vendor situation, we really feel like the importances on getting those screening patients into those manamat revelation rooms.

2107 62 52 63 74 61 84 Tomorrow's Technology Today: The Migration to Wide-Angle Breast Tomosynthesis Manager's Perspective Jacqui Appel Manager 10506A TriHealth - Mary Jo Cropper Center for Breast Imaging Cincinnati, OH / USA TriHealth Thomas Center Bethesda North Hospital MARY JO CROPPER FAMILY CENTER FOR BREAST CARE Medical From analog to digital mammography. From 2D FFDM to 3D DBT. From 2D FFDM SIEMENS Healthineers SIEM Healthine Looking for anotlier vendor. Feedback from staff and patients. MAMMOMAT Revelation Transition from one system to another. Workflow challenges. Mammography BETSY BLAZIC STOP Op Pa Patient satisfaction. Mary Jo Cropper Family Center for Breast Care Callback rate. Mary Jo Cropper Fa Center for Breast C Siemens Healthineers as a partner. The implementation of the new system. or choosing on for the test pen and choosing AIDET contact and smile Siemens Healthineers' service. mm Conclusion. C Siemens Healthcare GmbH, 2021 The statements by Siemens Healthineers' customers described herein are based on results that were achieved in the customer's unique setting. Because there is no "typical" hospital or laboratory and many variables exist (e.g ., hospital size, samples mix, case mix, level of IT and/or automation adoption) there can be no guarantee that other customers will achieve the same results.