For Kate Sweeney, clinical manager of the department of vascular and interventional radiology (VIR) for The Cleveland Clinic (Cleveland, OH ) managing workflow might be described as a juggling act. Her Codonics Horizon Ci multi-medical media dry imager helps keep all those balls in the air - so to speak - and has a significant impact ensuring the wheels of imaging move efficiently forward as she supervises a department in various stages of a digital evolution.

VIR's move to digital was part of a trend to upgrade the angiography department, consistent with the cutting-edge technology already in place in MRI, CT and Fluoroscopy. "While some of our newer angiographic systems were digital DICOM compatible, several other systems' output were still analog. We installed analog-to-DICOM interfaces, allowing all of the department's imaging to be centralized to a single Horizon imager," Sweeney commented. "This has enabled VIR to meet the image quality, throughput and budget objectives while satisfying the needs of our physicians."

A High-Volume Department

Located on the main hospital campus, The Cleveland Clinic's VIR is an extremely high-volume department committed to delivering a superior quality of care to patients throughout the Cleveland area and beyond. It is comprised of four abdominal and two neurological rooms, which together perform 30 to 40 procedures daily, totaling over 800 abdominal and 175 to 200 neurological procedures each month. The department is serviced by 15 physicians, 16 nurses and 19 technologists plus support staff.

VIR relies on Horizon to produce the 14 by 17-inch films used to maintain a hard copy archive for all six rooms. In five rooms, doctors read from these films primarily for angiography procedures, while in the sixth room reading is done on an advanced workstation used primarily for neurological imaging.

"The ability to handle the high throughput in this sizeable department - printing a minimum of 125 films per day - speaks volumes about Horizon's performance," Sweeney commented. "I was amazed by the speed of the Horizon Ci and the ability of this compact imager to keep my department on schedule, not to mention Horizon's ability to print multiple formats simultaneously from three separate media trays. Images are high quality, the output is extremely fast and Horizon can connect to multiple modalities as well as an unlimited number of acquisition devices on our network."

VIR purchased the dry imager in 2002 when the nuclear imaging department's darkroom closed, forcing Sweeney to transition from wet film processing to a more modern, hard copy solution. "We didn't think we could get the image quality we were used to from our wet imager, but were pleasantly shocked with Horizon's results," Sweeney exclaimed. She also wanted it to integrate seamlessly with the hospital network noting that "only Horizon fit the bill."

Head and Shoulders Above the Competition

Everyone involved in the purchasing decision agreed that Horizon stood head and shoulders above the competition. "Doctors were unanimous that Codonics' high-quality film output is superb for diagnostic reading," said Sweeney, pointing out the dry imager relies on advanced direct thermal and dye-diffusion technologies to print both high-resolution grayscale and vibrant color with 16.7 million hues per dot. The result is laser-quality output at a significantly reduced price.

Setting it apart in the marketplace, the innovative Codonics Horizon prints not only to film but also to durable DirectVista photographic-quality paper media, which costs 30 percent less than similar sized standard film. Both Horizon DirectVista Paper and DirectVista Film are available in a full range of sizes including 8 by 10-inch, 11 by 14-inch and 14 by 17-inch with film available in both blue and clear base. ChromaVista Color and DirectVista Grayscale Paper are available in A- and A4-size as well. "The price of film is also excellent compared to other dry imagers from major manufacturers," Sweeney said.

Once the dry imager was in place, many of the department's abdominal radiology specialists were no longer content with just black-and-white film. They discovered the convenience and impact of including A-size (letter) paper output in charts for referring physician use or as an invaluable teaching tool. With the department's recent acquisition of new 3-D angiography capabilities, color output on paper was extremely useful. "Given this, we see the need for color printing increasing significantly," Sweeney added.

Catering to a Broad Range of Demands

For The Cleveland Clinic's challenging digital imaging environment, imagers printing only film no longer meet diagnostic imaging requirements. Output on film or paper and digital interpretation on monitors are essential tools for today's healthcare enterprise. "The versatility of Horizon has not only aided in our efforts to reduce costs while maintaining the department's quality, but Horizon has helped us grow our referral base with the best looking images and selections of media in our market," said Sweeney. Horizon is also frequently used by CT and MRI in a nearby department as well as by VIR's in-house referring physicians, who rely on the dry imager to create their own study copies.

As angiography's technology evolves, Sweeney feels strongly the department's color printing will expand and, as the department migrates into a full digital environment, Sweeney believes Horizon will continue to be in high demand. "To accommodate the growth resulting from the efficiencies of our full digital environment, I have budgeted for an additional Horizon to be installed in 2005," said Sweeney.

"The ability to handle the high throughput in this sizeable department - printing a minimum of 125 films per day - speaks volumes about Horizon's performance." Kate Sweeney, clinical manager of the department of vascular and interventional radiology (VIR) for The Cleveland Clinic