‘It all happens out there, in clinics and hospitals. This is where you find the people who are responding to patients’ needs, and who tell us what they need so we can develop products to help,’ he said. ‘We like to get out there, to talk to these people, to see what they are doing, how they have solved problems and the challenges they continue to face in their work.’
Minnigh explained that there are common issues for every radiology operation, but there are also specific solutions to these shared problems, approaches that are unique, and often sometimes specific to a region or a culture.
In August 2014, at the annual meeting of Association for Medical Imaging Management, he shared what he calls a radiology travelogue in a presentation entitled ‘Patient Care Over There: What We Can Learn from Radiology Practices Around the Globe’. Examples of clinical practices were drawn from visits in the United Kingdom, Chile, Brazil, Germany, France and Russia, all illustrated in true travelogue form with snapshots. ‘I’m not a clinical expert, so I am not going to tell people this is what they should or shouldn’t do,’ said Minnigh. ‘Yet there are distinct differences in radiology practice that provoke ideas, that may speak to health care providers about how they might do things differently.’
At the highest level, people everywhere want to help the patient, he pointed out. ‘They all have a shared concern and try to use the least amount of radiation exposure. Some are more meticulous about how they manage dose.’ As an example he cites visits to German radiology clinics where he found a greater concern for what is called scatter radiation, or second-hand dose. Where it is common in North America to use mobile X-ray units in the emergency department, in Germany emergency patients who are able to move are taken to the protected area of the radiology department for the X-ray exam. Trauma patients not able to be moved are directed to a dedicated CT scanner rather than undergoing an X-ray.
The travelogue then moved to South America for a fresh look at another shared problem of patient scheduling to maximise the use of imaging equipment. Noting that it can take three times as long for a patient to undress and dress again during an exam than it does to actually shoot an X-ray, Minnigh said, ‘This clinic asked the question: What if we create three dressing rooms? If we add three times the capacity for patients to change, can we then make the X-ray unit three times more productive?’
‘This is exactly what they did in Argentina to make the fullest use of their digital radiology room,’ he said. ‘The dressing rooms cost very little to build compared to the cost of an X-ray machine and the space required,’ Some people might call this a mass-production approach, he acknowledges, but he counters that clinics are confronting a growing demand for radiology services. In many Western countries, this demand is coming from the increasing medical needs among an aging population, many of whom are over 65 and typically require 15 times greater service on average than people just 45-55 years of age.
Beyond imaging equipment, clinics need to consider that, as this senior population swells, the number of younger people available as employees will shrink, requiring fewer people to do even more by being more productive. ‘Rather than be overwhelmed, the challenge to radiology operations is to prepare for a potential increase in business in a way that assures the same safety and quality of service,’ Minnigh advised, adding that the benchmark he shared from Argentina is a way of teasing this question.