The Importance of Ongoing CT Applications Training

The Importance of Ongoing CT Applications Training | blog article by Catalina Imaging

Since the development of Computerized Tomography (CT) in 1972, CT has always been a software-driven imaging modality. 

Medical imaging equipment manufacturers such as GE, Siemens, Philips, Hitachi, and Toshiba/Canon have all developed vendor-specific software platforms along with manufacture specific terminology and technology which must be mastered in order to operate the systems effectively and safely for both the patient and operator.

The difference in the vendor-specific terminology is confusing to most newer CT Technologists, as well as the difference in software and hardware.

The issues arise with the way CT Imaging Technologists are trained to use the systems. Most technologists are trained by other technologists at the facility. Most were trained by someone else who had a varying degree of knowledge regarding proper system operation. 

This “Shoulder to Shoulder” style of training leads to incomplete training and a technologist who knows barely enough to get by. Training of this style can be a liability to the patient and the facility. 

Often times, the technologist doing the training will withhold information about a specific system operation so that they are perceived by management to be the “expert” and are of more value to a facility. This can hinder any exam from the basic to the more advanced procedures, frustrating many radiologists. This can lead to a catastrophe in an ‘on-call” situation when the ER has to wait for another technologist to come in because the one who is there is not well trained. 

Some of the lucky few technologists are chosen by a facility to attend the manufactures training facility. This initial training is then followed by a week or two of onsite training.

Onsite training is meant to adapt the system to the customer’s facility and assure proper system function and acceptable image quality with the radiologist.

The same technologist who went to the training academy should also be attending the subsequent weeks of OEM training to further their knowledge of system operation. 

Training which should include not only scan protocol building and basic patient scanning but the advanced procedures and software applications applicable to the system purchased by the facility. 

This could include Cardiac Angiography and Function Analysis, Digital Subtraction Software, Brain Perfusion and Dual Energy imaging techniques and CT Fluoroscopy to mention a few. 

Since some of the advanced applications require additional training, manufacturers sometimes provide a course at their training facility. However not all clinical applications can be taught effectively at a training facility without actual patients to scan, for example CT Flouro, CT Angiography, Cardiac, Brain Perfusion, and Dual Energy.

For onsite training, patients are required for the exams and may be in very limited supply. Often times, facility budget and time constraints leave the staff as a group of “Button Pushers”, and not well trained. Staff duties should be delegated so as to allow for the full training experience. If not, then the outcome is that not everyone is trained to the same level of expertise.

Staff will leave one facility for a better position, better pay, better hours, better training or a better location, taking the knowledge, and sometimes the training materials given to them for the site, with them. This can also leave a facility with a system that is not being utilized to its fullest potential.

Staff technologists who are well trained are happier on the job. They have the respect of their peers, administration, staff physicians, and patients. 

By contrast, those with a lack of training are often classified as button pushers, doing nothing but the most routine scanning having to call in a more experienced technologist to complete the challenging studies, CTA, Cardiac CTA, Perfusion. 

This leads to a delay in diagnosis and service to a patient. Technologists often get into the same rut at a facility because the equipment is used past its prime and often not replaced with state of the art systems that have more capability, lower patient exposure, and better image quality with advanced imaging protocols. 

These are the staff who leave a facility, for better working conditions, training and pay. Proper applications training will lead to a happier and more productive staff with less turnover, especially with older systems and an untrained staff.

There are many pros to ongoing applications training, some of which are more notable than others. A well-educated staff leads to more complete exams for the reading radiologist and reduces the chance that a patient will be recalled to evaluate a hepatic filling defect or to obtain a proper early arterial phase in a tri-phasic study to evaluate for metastatic disease, or a delay image for contrast filling defect not seen by the Technologist who should review images prior to completing an exam. 

This leads to an overall lower cost to the facility. Clinical Applications can review the staff’s operational workflow and offer recommendations for workflow enhancement so that the staff is working smarter and not harder. 

Clinical Applications can assure your staff is operating with best clinical practices, assist your reading radiologist with issues regarding image quality, patient exposure, contrast timing, and the development of new imaging protocols and techniques which make diagnosis more accurate. An Applications Specialists can act as a lesion between the CT staff, management, and the Radiologist ensuring an effective educational experience for all your staff.

I recommend that an imaging department budget include clinical applications on-site support at a minimum of every two years. This continuing support is necessary, not only for the CT technologists, but for the physicians and patients as well. 

This can be even more critical in a short term lease of imaging equipment, especially when the equipment is different from what the staff is currently using. 

Clinical applications support can train your staff answering all their questions regarding system operation, assist with building scanning protocols, train them with the latest imaging software upgrades and suggest workflow modifications to enhance department productivity and patient experience.

Clinical applications support can handle issues with the radiologist regarding missed contrast timing, image quality, and system artifacts which affect their experience with the system. 

This can improve transition time to a new system if the leased mobile is from the same OEM as a new system is installed, even though the software may be different or has more enhanced upgrades. At times you need a service engineer, at times your need applications support. They go hand in hand.

Here at Catalina Imaging, our goal is to create an experience that goes beyond your expectations, and applications support is just another way we can enhance that experience. Please feel free to contact us and see what we can do for you.

Learn more about Bob Phillips

Bob Phillips | Education and Training Director

Meet Catalina Imaging’s Robert M. Phillips, RT, R CT
Who is Catalina Imaging’s new Education and Training Director? Read on.

Robert “Bob” M. Phillips, RT, R CT, joins the Catalina Imaging family as our new Education and Training Director. Bob brings with him a wealth of experience spanning 40 years in the Radiologic Technology (RT) and Computed Tomography (CT) industries.

Bob’s Career at a Glance:
● 18 years as a Clinical Applications Specialist
● Clinical CT Class Instructor on Toshiba America Medical Systems, Canon Medical Systems, and Mobile CT Imaging
● 5 years as a Lead CT/MRI Technologist in Computerized Diagnostic Imaging Centers
● 5 years as a Radiology Department Manager at Moreno Valley Community Hospital

Education and Certifications
Bob graduated with an Associate in Arts Degree in Radiologic Technology from Orange Coast College in Santa Ana, California, in 1980. He is a certified member of the American Registry Of Radiologic Technologists (#183641, until March 2021) and the California Department of Public Health (CRT #RHB00045250, until December 2020).

Career in Detail
As a Clinical Applications Specialist (CT) from January 2001 to August 2020, Bob worked in various hospitals, clinics, outpatient imaging centers, and veterinary facilities in the US, Alaska, Hawaii, and Guam.

He gave clinical instruction on Toshiba/Canon Asteon 4, Aquilion 16/32/64, Prime CT, Lightning CT, Aquilion One, and Aquilion Genesis CT Systems in all phases and aspects of CT imaging. This covered basic routine scanning, cardiac CT angiography, brain perfusion imaging, CTA subtraction, dual energy, and post-processing techniques.

Bob was also instrumental in resolving issues like unacceptable image quality, patient dose-related issues, CT artifact troubleshooting and resolution, and contrast timing in CT angiography. He spearheaded the mapping out of protocols for any CT examination. Bob also taught and trained staff in all aspects of CT imaging including systems operation, protocol building, CT file management and archiving, contrast bolus timing, raw data reconstruction, multiplanar reconstruction (MPR), 3D, dual energy, brain perfusion, and cardiac calcium scoring.

As a Class Instructor at the Toshiba/Canon Training Academy (specifically the Toshiba/Canon Institute of Advanced CT Imaging), Bob instructed and mentored technologists from across the country on the effective use and implementation of Toshiba/Canon CT systems.

This included delivering didactic and hands-on instruction according to Toshiba/Canon policy and procedures and using Toshiba / Canon training materials. “I always received great reviews from the technologists with whom I served,” Bob recalls.

As a Lead CT/MRI Technologist for Computerized Diagnostic Imaging Systems, Bob led and managed staff schedules in both CT and MRI. He also performed staff training in CT with a new Siemens CT System in their outpatient center. Bob even branched out to the Riverside Community Hospital, maintaining staff schedules for shift and call CT.

As a Radiology Department Manager at the Moreno Valley Community Hospital (now Moreno Valley Medical Center), Bob was responsible for the day-to-day operations of the Radiology Department. They serviced the 150-bed community hospital as well as its free, standing outpatient office where radiology services were also provided.

A warm welcome
Catalina Imaging is happy to have Bob Phillips on board. His presence in the organization ensures the continuous improvement and learning of our staff which will, in turn, be felt by the clients who trust only Catalina Imaging for their mobile CT rental needs.

Welcome to the family, Bob!

You can reach Bob by calling Catalina Imaging (916) 652-9501, or by calling him directly (714) 422-6621.

After COVID-19, Radiology to Rethink Revenue Cycle Management

After COVID-19, Radiology to Rethink Revenue Cycle Management | blog article by Catalina Imaging

With no end in sight of the pandemic, some radiology clinics need to rethink their practices to better their revenue cycle management and improve their services to stay afloat. 


COVID-19 has far-reaching effects more than anyone ever expected. A report, conducted by lead author Richard Sharpe Jr., MD, MBA, a radiologist with the Mayo Clinic, and colleagues about the impact of COVID-19 on radiology, stated, “Some groups may prove unable to survive the COVID-19 pandemic, potentially fueling trends either toward consolidation into larger radiology groups or toward increased employment by hospitals.” 


In the first six months of the pandemic, records show a steady decrease in the revenues of many radiology practices. For some, the percentage of this decline reached up to 80%. Most affected by this situation are the smaller private practices whose revenues are dependent on examination interpretation. 


Some cost-cutting measures were already adopted by others in the industry, including salary diminution, time off, and reduction of benefits. While these actions worked to keep practices afloat, experts do not consider this viable solution in the long term. They predict that smaller practices will be likely consolidated with larger groups that offer a broader practice model. 


The industry remains hopeful as lockdowns are lifted, and communities are reopened, but just like for any other industry, a consistent decrease in revenue remains imminent for some. 


According to an Urban Institute estimate, about 10 million people will lose their healthcare coverage from a COVID-19-related job loss. People who previously relied on employer-sponsored health cards are projected to switch to healthcare coverage through other family members as dependent or enroll in Medicaid. Radiology practices will most likely see a rise in Medicaid and self-paying patients.  


The COVID-19 pandemic continues to batter a lot of industries. Those who cannot transform and reinvent themselves are at a higher risk of losing the battle. 


For radiology practices, one point must be highlighted: Patient care is a top priority. Practitioners must deliver client-focused patient care and ensure hassle-free visits to attract more self-paying patients. An over-all pleasant medical procedure will boost the confidence of patients in smaller radiology practices. Hiring highly-qualified staff also guarantees the quality of healthcare provided. 


Another highly suggested way for radiology practices to survive is to adopt new technologies and better processes to offset lost revenue opportunities. Investing in technology, streamlining workforces, improving bill cycles are a great start.

Getting a partner to optimize billing and introduce automation is a thing to consider as well. Howard Pingston, Regional VP of Business Development in Radiology with Zotec Partners, stated that “Radiology groups will not only face an increase in bad debt but also potentially an 8 to 11 percent reduction in reimbursement in 2021, depending on the CMS final ruling. Now more than ever, radiology practices need an RCM partner that is truly equipped to help them identify revenue opportunities and provide full transparency throughout the process in order to weather this storm in the near term and succeed in the long term.” 


The availability of convenient payment options is also a plus factor. Online payment and special discounts are also appreciated by people who are struggling in this time of pandemic and economic recession. 


The answer to the problem faced by radiology practices requires a multi-pronged approach. It is a combination of technological, financial, and personal solutions.  COVID-19 is a difficult enemy that everyone wants to get rid of. While the battle is far from over, it pays to prepare and soldier on constantly. 

Use of A.I. in Radiology Showing Positive Benefits to the Community

A Glimpse into the Future: How AI Technology Will Affect Radiology | blog article by Catalina Imaging

Yale New Haven Health System (YNHHS) has implemented an AI-powered system to optimize radiology practice in real-time collaboration and data organization.

Historically, radiology has had a crucial and active role in the evolution of healthcare. Radiology’s role in the current COVID-19 crisis is undoubtedly critical for its prevention and cure for the patients. 

The healthcare system worldwide, including radiologists, is facing a never before experienced exhaustion and financial constraints since the virus has spread. Nobody was ever truly ready for it.

Now, more than ever, radiology should adapt to the ever-changing world and technological advancements to avoid specialist burnouts and backlogs. 

A new age has dawned at Yale New Haven Health System as it fully embraces and AI-powered technology called PowerScribe Workflow Orchestration and PowerConnect Communicator to improve efficiency and promote safe practices in the facility.

Yale School of Medicine’s Dr. Irena Tocino, MD, FACR, professor of radiology and biomedical imaging and vice-chair of imaging informatics shared how the AI-based system has improved their workflow and efficiency, “Studies are analyzed first by the AI model. Positive results are automatically prioritized on the appropriate worklist, while negative results move down the list for later review. Having this solution in place helped YNHHS navigate the challenges because of the pandemic – from an influx of COVID-19 patients to the swift transition to remote reading.”

“YNHHS has transformed their reading room experience, keeping colleagues connected, more efficient, and safer in a virtual paradigm, while prioritizing patient care.”

The technology in place has forged a new path in helping the medical frontliners work smarter, not harder — allowing them to focus on analyzing efforts rather than organizing data. Real-time, remote collaborations optimized data analysis, making way for efficient application of healthcare. 

In these trying times, the PowerScribe Workflow Orchestration and PowerConnect Communicator is a promising technology that can unload the burden of the already burnout healthcare system if properly implemented.