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Clinic strives for patient ease, comfort in new imaging space
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MONROE - The technologists of Monroe Clinic's medical imaging department go to great lengths to care for patients ... literally. They have put in countless miles rolling equipment back and forth across the skywalk between the hospital and clinic buildings.

Monroe Clinic's medical imaging department performs thousands of highly advanced diagnostic procedures annually, putting them on par with larger urban hospitals. Few areas of medicine have changed as rapidly as medical imaging and current hospital facility, built when X-rays were high-tech, is no longer ideal.

Once the Northwest Addition opens in early 2012, the department will finally have a space that enhances its capabilities. Located on the lower level, adjacent to the emergency department and cardiac clinic, medical imaging will be fully integrated into the flow of care.

"The workflow will be greatly improved for both patients and us," said Alessandro Rossi, MD, a radiologist at Monroe Clinic. "We already provide a high level of services and the new space will be more convenient. It will be easier for us to communicate with patients. It eliminates a lot of the hassle and wasted steps."

Women coming to Monroe Clinic for mammograms will notice the biggest improvements, Dr. Rossi said. The new women's imaging center will house two digital mammography suites with private dressing/waiting rooms. If an abnormality is discovered on a mammogram, ultrasound units are nearby for follow-up testing. Radiologists will be able to discuss results quickly and comfortably in adjacent consulting rooms. Presently, mammography patients must walk from the clinic to the hospital if they need an ultrasound.

The digital mammography units use less radiation than traditional film. Digital images can be stored and transmitted electronically, making the images more accessible to the medical team. The machines can be upgraded to perform digital tomosynthesis, which is a three-dimensional breast scan. Early studies have shown digital tomosynthesis can better detect tumors and substantially lower the rate of false positives. Available in Europe and Canada, the technology is awaiting FDA approval. Monroe Clinic is ready when the approval comes, said Rhonda Roenneburg, director of medical imaging and cardiology services.

"When we put together the wish list for the new facility, adaptability and room to grow were among the top considerations," she said. "We will have shell space for new technology that may not even exist at this time. The new building is designed to take us through the next 30 years and no doubt there are technologies that will emerge that we haven't even imagined yet."

Some "shell space" has been set aside to add a second computed tomography (CT) scanner. Right now, technologists perform 500-600 CT scans a month. There are plans to add a cutting-edge nuclear medicine/CT scanner that will provide a more complete anatomical picture for radiologists to analyze. Monroe Clinic's current 64-slice CT scanner will be upgraded with new software to reduce patient radiation exposure to its lowest possible dose. With new technology and expanded space, including a private injection room, both patient comfort and workflow will be improved, according to Roenneburg.

Magnetic resonance imaging (MRI) is another critical tool of medical imaging. Approximately 250 MRI tests are conducted monthly at Monroe Clinic.

The MRI is located in a permanently parked mobile unit attached to the back of the hospital, which has made it impossible for staff to perform sedated procedures. So children and some adults, particularly those with claustrophobia, have been sent to other locations for the test. When the Northwest Addition opens, a new MRI unit will be integrated into the department and sedated procedures will be offered. The unit's upgraded hardware and software will enable technologists to perform heart and breast scans.

The consolidated medical imaging department will also include labs for cardiac catheterization, angioplasty and fluoroscopy, all conveniently close to the cardiac clinic. Nuclear medicine will be located in this area as well as two general radiology rooms containing X-ray equipment.

During the planning process, Monroe Clinic has been careful to match equipment investments to demand. That's why positron emission tomography-computed tomography (PET/CT) scans will continue to be performed in a mobile unit, which will be parked adjacent to medical imaging. This is a highly specialized scan, used primarily to help determine staging and treatment for patients diagnosed with cancer. Because demand is limited, Monroe Clinic is sharing the unit with other regional facilities rather than installing one, Dr. Rossi said. In the new building, the mobile unit will be physically attached so patients won't need to walk outside as they do now.

"In the current facility, we have done a lot to provide same-day access even with less-than-optimal space," Roenneburg said. "If a physician wants a test, we can usually get the patient in the same day. "

And we're the only provider in the area that accepts self-referral for breast exams and mammograms. So we're already committed to providing the best care and access. Starting in 2012, we'll be able to do much more."