BLOG: How Clinical Versatility Helps Small Town and Rural Patients

The clinical needs of those who live in rural America and small communities are both simple and complex. A physician may have to explain a patient’s back pain; uncover heart disease; or perform advanced surgery. Ultrasound can help do all three.

CentraState Medical Center, a community hospital in Freehold, N.J.,leverages ultrasoundforrobotic surgery．centrstate的机器人手术协调员罗莉·查韦斯(Lori Chavez, r.n.)形容这种模式“太棒了……我看到它拯救了世界。”查韦斯说，如果没有超声波，外科医生将很难区分癌变组织和健康组织。他和外科医生一起在中央州立医院的手术室工作。

The ultrasound unit there is currently dedicated to robotic surgery, but that could change. Its use to support interventional radiology, she said, is being “looked at.” With dozens of compatible probes, theArietta 70can be used to conduct fundamental as well as advanced exams, saidTom Oko, executive director of marketing for ultrasound and surgery at Hitachi Healthcare Americas, which provides the ultrasound system.

Providing an Edge

Even as it is currently applied at CentraState Medical Center, the Arietta 70 gives the community hospital an advantage over nearby competitors. Some have turned to robotic surgery, according to Chavez, but none — to her knowledge — has used ultrasound the way CentraState has for the last several years. The surgery console there presents ultrasound images and an optical view of the operating field side-by-side.

Using the gripper at the end of the robot arm,the probecan be maneuvered around a patient’s kidney, for example, to identify the location and extent of the tumor. (CentraState first applied the Hitachi ultrasound system for this purpose — to assist in doing partial nephrectomies, Chavez noted.) Locating the margins between tumor and healthy tissue allows complete removal of the cancer, while protecting healthy tissue from excision.

Supporting Different Surgeries

Hitachi offers a wide range of surgical probes — ones not only for robotic kidney but open or minimally invasive surgeries of the liver or brain, for example. “Hitachi has many very specialized probes based on the shape of the (surgical) access point,” said Oko. One of these is designed for “burr-hole” neurosurgery, in which the probe is small enough to fit into a hole drilled in the patient’s skull.

他说，日立所有的手术探针都可以消毒，这意味着它们可以安全地直接放在人体组织上。在共享服务中使用高端超声的潜力为Arietta 70增加了另一个维度。

如果附近的医疗中心不能提供先进的医疗设备，农村人或居住在美国小社区的人可能不得不开车数小时前往大型城市医疗机构。这关系到的不仅仅是便利。“不是每个人都能去那些设施，”Oko说。

And being clinically versatile can be essential to the survival of rural facilities, which must keep revenues up and costs down, noted John Walsh, marketing manager surgery ultrasound at Hitachi Healthcare Americas. Rural and community medical centers have to get the biggest bang possible from their investments in equipment.

“Sometimes procedures are pretty advanced but infrequently done. Coupled with that (these facilities) may have a limited budget,” Walsh said. “So they have to be assured that the equipment they buy can do those advanced procedures and they can do other (routine) things as well.”

Where X-ray Fits

Clinical versatility may require X-ray as well as ultrasound. Physicians at a rural facility may, for example, need to visualize a broken bone in one patient and perform X-ray fluoroscopy on another. Agfa HealthCare designed its DR 800 to handle both possibilities — even under challenging circumstances.

The system’s 180-degree tilting table allows wheelchair foot-on-table imaging, for example, as it supports a wide range of fluoroscopic imaging procedures, including shunt angiography to intravenous pyelography. Agfa’s MUSICA digital image processing, which is embedded in the system, allows digital X-ray processing and radiation dose optimization.

An urban center might use the DR800 to handle patients who otherwise can’t be scheduled on a dedicated radiography or fluoroscopy device. But a rural or community medical center might depend entirely on the DR800 to do both radiography and fluoroscopy.

Doing Basic and Advanced Apps

In a shared service configuration, applications of the Arietta 70 may range from general radiology or OB/GYN exams to a vascular or cardiology study — or to support surgery. This kind of clinical flexibility can make the difference between success and failure for rural and small community providers.

“They really need to get the most out of their investments as possible,” said Hitachi executive Walsh. “So the ultrasound systems need to do a lot relative to the investment.”

Greg Freiherr is a contributing editor to Imaging Technology News. Over the past three decades, he has served as business and technology editor for publications in medical imaging, as well as consulted for vendors, professional organizations, academia, and financial institutions.

Editor’s Note: This blog is the third in a series on Rural Healthcare in America. The first blog,Rural Imaging Requires Affordable And Versatile Equipment, can be foundhere．The second blog,Clinical Demands in Rural America Call for Advanced Imaging, can be foundhere．The next in this four-part series will look at how advanced diagnostic imaging can boost rural health．

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Rural Imaging Requires Affordable And Versatile Equipment

Clinical Demands in Rural America Call for Advanced Imaging

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