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  • Millisecond Opinion

  • Seated in front of four monitors, Dr. Mack Bandler of Medford Radiological Group can access a patient's images and records in an instant and consult with colleagues from across the world.
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  • Seated in front of four monitors, Dr. Mack Bandler of Medford Radiological Group can access a patient's images and records in an instant and consult with colleagues from across the world.
    When he began practice in the Rogue Valley 23 years ago as a diagnostic radiologist, he consulted individual X-ray films that were developed with chemicals.
    "Virtually all imaging has become computerized or digital," says Bandler. "The digitalization of radiology has really transformed our profession in a very positive way. It's increased our efficiency and accuracy."
    For trauma patients, a medical staff's instant access to digital images can be lifesaving.
    "In some of these things, minutes are precious," says Bandler. "It has enabled the physicians to be part of the imaging early on and to make decisions at the earliest possible moments."
    In the case of a patient with a brain hemorrhage, for example, a neurosurgeon can view an image at home and direct hospital staff to have an operating room ready to go in the five or 10 minutes he may need to get there. The images would also be available to Bandler, the emergency room physician and other specialists, all of whom can view computer screens from widely scattered locations.
    On any given day, Bandler may work at a different site in the valley. He can be at his company office, one of three locations at Rogue Valley Medical Center, Ashland Community Hospital, Providence Medford Medical Center or Oregon Advanced Imaging. All have a similar setup.
    Two of his monitors are high-resolution, medical-grade machines that cost up to $15,000 for a double-image version or $10,000 for a single-image model with a display of about 14 by 24 inches. On these monitors he views such medical images as X-rays, CT scans, ultrasounds, PET scans, MRIs and digital mammograms. A third high-end, commercial-grade computer feeds Bandler a patient's medical information and previous imaging work. A big, red exclamation mark on computer records indicates when attention is urgent.
    "We are virtually paperless. There's really no paperwork on my desk other than work pads," says Bandler.
    The fourth monitor, also commercial grade, provides images for comparison studies and access to the Internet for educational resources and medical literature, says Bandler.
    "We tend to keep it a little separate so that we can protect the rest of our network from the dangers of the Internet," he says.
    "In the past we would have been limited to working on-site with another radiologist," he says. "I can easily get three or four radiologists to look at any of the items I'm working on."
    Digitalization has expanded staff size and changed the way people work, says Bandler. Information technicians and supervisors manage the computer systems that keep the images flowing.
    "The technologists are more efficient," says Bandler. "They spend time scanning patients, what they are really trained for, rather than clerical things like hanging film."
    Older images are digitized to allow for comparison at places such as RVMC's Women's Imaging Center, which has converted to digital mammography.
    "We have women coming in and their prior mammograms are on film," says Bandler. "We like to compare a couple years back. When patients are scheduled, clerical staff gets older mammograms and has them scanned in (the system)."
    After 6 p.m., one radiologist is on duty to interpret images from local hospitals, but it's a function that can be performed from home when pagers sound. In the very late hours, a contract with the Nighthawk radiology group allows American-trained technicians located in either ZÃ1/4rich, Switzerland, or Sydney, Australia, to read the images and send back interpretations nearly instantaneously over the Internet.
    "It's just become the new paradigm," says Bandler. "A patient came in (recently) with a hemorrhage into the brain. There was no delay. We knew immediately — me, the ER doctor, the neurosurgeon — that decisions could be made very quickly."
    Tony Boom is a freelance writer living in Ashland. Reach him at tboom8929@charter.net.
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