The Harley Street PET/CT Clinic faced a unique set of challenges when it came to publishing and distributing the results of patient exams. The dedicated PET/CT imaging center of HCA International's Harley Street Clinic, a renowned cancer care center in the heart of London, needed a reliable system for burning studies to CD at the same pace as patients were scanned. Though the clinic interfaces with a top-of-the- line PACS, transmitting images and reports instantly to those clinicians who choose to access the system, many UK patients still expect to leave an imaging center with a disc or films in-hand.

"A lot of our referring physicians now use the Web to directly access our PACS," explains Kaye Bonython, PACS Program Manager for HCA International. "But a lot of them also don't. Many are frightened of the technology. We knew as an organization when we started this process that PACS is wonderful, but it's only wonderful if the person at the other end can use it. Here in the UK, some doctors don't even have a PC in their offices."

Harley Street, the nexus of high-end healthcare in one of the world's busiest capital cities, creates a particularly unique environment for patients and providers alike. "A lot of patients come here for their imaging services, and then they walk around the corner to see the referring physician, who might be on the premises or a few doors down," says Kaye. "This is an area where every building is full of consultants. So the idea is, you're seeing the consultant at 2:00; let's do your imaging at 1:30 and you walk out of here with your CD to deliver to him or her."

Kaye characterizes this "takeout" approach to imaging as a major difference between the cultures of U.S. and UK health care. "In the private sector, every patient has always been given a packet with a film in it," she says. "Then they probably put it in a drawer and never see it again, but they were always given something to take home."

For that reason, the ability to produce CDs and DVDs efficiently was a must for the Harley Street PET /CT Clinic. But the rarefied environment led to space constraints as well as turnaround time limitations. "CD robots are not cheap to purchase, and in London we are physically very constrained on space," says Kaye. "For years we'd been grappling with these less-than-ideal robots. We really needed a better option."

Initially, the clinic used the CD /DVD burners provided by its PACS vendor, but soon Kaye discovered they were insufficient to meet the clinic's needs. "I don't think our PACS vendor understood how important that aspect of the service was for us," she recalls. "The burners they gave us couldn' t keep up with the speed of printing, and they were breaking a lot because we were putting them under tremendous pressure."

Kaye happened upon a demonstration of the Codonics Virtua XR Medical Disc Publisher at the November 2007 Radiological Society of North America (RSNA) meeting. Shortly afterward, in March 2008, the Harley Street PET/CT Clinic implemented the system in place of its previous CD burner. "It was so much more easy to configure," Kaye says. " You could burn CDs and DVDs from the same burner, and the burn time was a fraction of what we were used to."

The Virtua XR Medical Disc Publisher is capable of burning up to 60 CDs or 30 DVDs an hour*- a rate more than sufficient to match the Harley Street PET/CT Clinic's throughput. " They're incredibly reliable," Kaye says. "They work at the pace we want and don't create delays. This is now our preferred burner, and we've implemented it at two of our other London clinics."

HCA International operates a total of twelve clinics in the London area, which makes customization of CDs and DVDs particularly crucial. "Each site has its own logo," says Kaye. "They're all individually branded. A CD burner like this one, where the CD comes out with the right logo on it, is great for us on multiple levels. It becomes a marketing tool for that site as well."

Kaye explains that the CDs and DVDs also come complete with the Codonics viewer, preventing complications on the referring physician side of the equation. And because some of the clinic's referring physicians still work without a computer, the option exists to print the radiologist's report to paper directly from the voice recognition system. "Reports are sent from the speech recognition application twice: once into our HIS, and once into our PACS," Kaye says. "Then, if the patient's going offsite to someone who won't avail themselves of the technology, we print to paper, customizing the report for the referring physician depending on what they like to use. Many people leave here with the printed report plus the CD." The clinic recently implemented Codonics' Horizon SF Imager to print color images from their 3D workstations. In addition to color, the imager also prints on low-cost grayscale paper and diagnostic blue and clear film.

Today Kaye says the Codonics family of printers and CD publishers are HCA International's default choice for its clinics. "All new sites are having these installed as standard," she says. "We've got four more installations coming up, and now, if we have to replace a burner we automatically go to Codonics.

As an organization, we need to focus on flexibility and catering to all needs, and speed and reliability are absolutely mandatory. This product has ticked all the boxes for us."

* Burn speeds based on a typical clinical study. Not all features available on all models. Specifications subject to change.

This model/configuration of Virtua is not available for purchase or use in the United States.

Kaye Bonython,
PACS Program Manager for
HCA International