With outpatient digital x-ray install, Mercy St. Louis takes another step toward digital future

When four-state Mercy broke ground on a four-story, 120,000-square-foot virtual-care center on a patch of green in Chesterfield, Mo., last spring, the blueprint represented a bold and visionary step into American healthcare’s digital future, as the center may be the first of its kind anywhere in the world. The organization estimates that the center will manage more than three million telehealth visits in the first five years following its scheduled 2015 opening.

While observers wait to see how the plan plays out, a willingness to move forward is already in evidence at departments throughout the Mercy system. It finds expression in the enthusiasm of director-level leaders like Kevin Huskey, director of outpatient imaging services for Mercy St. Louis, who are committed to making the patient a central part of Mercy’s digital future.

A 30-year veteran of the department who rose through the technologist ranks, Huskey supervises 40 technologists and oversees operations at some 13 offsite imaging facilities.  “Customer satisfaction is a big driving factor for us,” he says. “We are always looking at ways to improve our customer service, maybe try to go one step further than our competition is going.”

Huskey discovered his passion for outpatient care while working at the main hospital. “Balancing the needs of outpatients with those of inpatients, not to mention ER and ICU patients, I came to appreciate that outpatients deserve the same level of high-priority care as patients with more emergent needs,” he says. “These facilities are designed to achieve that balance.”

He provides the example of Mercy Hospital St. Louis’s recent purchase and installation of new digital radiology (DR) systems for three of the outpatient sites plus a spine center on the campus of the main hospital. The buy was spurred by the opening of two new suites, part of Mercy’s multi-year initiative to put care sites closer to patients’ homes.

Huskey found himself settling quickly on a U-arm system that came with a built-in pediatric package for dose management. “After all of these years, our radiologists trust my judgment on x-ray rooms,” Huskey notes. Price sensitivity played a significant role in his selecting a DR system marketed by Garner, N.C.-based Viztek, but feedback from many of his technologists sealed the deal.

“I’m a tech who was trained 30 years ago, so I predominantly did everything on a table,” he says. “As an administrator, I didn’t embrace this new technology right away, but the techs were raving about their ease of use with this equipment. Especially in the outpatient setting, where most patients are ambulatory and can easily cooperate on the levels that we need to do different types of exams, it enables the techs to complete exams quickly and comfortably for the patient.”

Dose matters

Huskey clearly enjoys looking back to see how far Mercy’s imaging services have come—in more ways than one. “When we first moved imaging services away from the main campus 12 or 13 years ago, we were film-based,” he recalls. “So while the satellite offices were great for both patients and staff, the situation wasn’t great for the referring physicians. There were frequent delays, as we had films couriered from the site back to the hospital to be read. Turnaround times on radiology reports were not good.” 

Digital radiography changed all of that, Huskey says. Radiologists stationed in Mercy Hospital St. Louis can view images remotely and in real time while patients are still in imaging rooms. Care can be expedited for the patients, and so can reports to referring physicians.

Another thing that has changed is patient awareness of radiation dose. “Over the last three or four years, dose has become a real issue for the public,” Huskey says. “We have become more conscious about dose ourselves. One of the features that drew us to Viztek was their Pediatric Imaging Package software.”

The dose-conscious capabilities he’s referring to function as a double-check system for technologists. The software receives demographic and other patient data fed into the system, then prompts techs to select options for reducing radiation dose without sacrificing image quality. This functionality is built into Viztek’s Ultra U-Arm DR system, the system selected by Mercy St. Louis.

Mercy’s radiologists have been as satisfied with the system as the technologists, referring physicians and patients. “They were happy with image quality when they first used the system,” Huskey reports, “and have continued to get positive feedback as we have added new U-arms.”

Keeping the care in healthcare

He may have moved from the proverbial tiled areas of the health system to the carpeted ones, but Huskey still likes to talk shop. Asked how the new DR solution’s cesium iodide detectors perform compared to the detectors he used in the past, he says the differences are more subtle nuances than major differences.

“There’s a natural dose reduction that comes with the cesium iodide detectors as compared to the Gadox [gadolinium sulfoxylate] detectors,” he says. “The Gadox detectors are more durable, but that’s pretty much it.” As for the price differential—cesium detectors generally cost a little more—the payoff is that cesium “provides natural dose reduction and so doesn’t require as much technique on the part of the technologist.”

“The digital world has really enhanced patient care as well as physician satisfaction,” Huskey concludes. “At the same time, the market has become very competitive, and we need to stay on top of that. I like the increased challenges of succeeding in outpatient medicine today, as well as the improved ability to care for patients. That is front and foremost in any decision that I make and in what I do to encourage the staff, reminding them why we’re here at Mercy: To take care of people.”