curvebm, Author at CurveBeam

When Billing CT Scans, a Little Effort Goes a Long Way

It should come as no surprise that providing a patient’s clinical history can help verify and interpret results from a CT scan. Including as much information as possible when submitting an imaging order seems like an obvious practice, and yet researchers from the University of Chicago Medical Center found that many physicians needed a reminder. Led by Dr. Saad Ali, the team was able to show that the effort physicians put into writing clinical history reports has benefits not only for the patient, but for the doctor’s own hospital or clinic as well. Interventions implemented by Ali’s team led to payments and reimbursements arriving on average 21 days earlier.

To obtain these results, Ali’s team took a look at their own emergency department and analyzed 1,000 requests for head CT scans. They began by simply analyzing the practices that were common in the department at the time. Not only did poor histories complicate the radiology department’s efforts to interpret results, but they also negatively impacted the hospital’s ability to get reimbursed.

According to their findings, inadequate histories can lead to confusion for the coders and billers. With a high rate of inaccurate billings, the denied claims begin to pile up significantly. Seeing this, the researchers were determined to find a way to rectify the situation. There had been plenty of studies that found poor history practices to impact image interpretation and billing, and yet bad habits still persist.

The team put together a program they called an “intervention.” This primarily involved educating the emergency staff about how to write high quality histories. PowerPoint presentations were displayed in the department with helpful tips reinforcing the concepts outlined in the lectures. After this program, not only did image requisitions for CT scans receive higher scores, but payments and reimbursements arrived a full 21 days earlier on average than they had before Ali and his team stepped in.

Any medical practice can always use some improvements. For some, this might mean improving clinical histories, for others it may just mean ensuring that necessary equipment is on hand to properly care for patients. At CurveBeam, we are constantly pushing ourselves to find new ways to provide our customers with the best in weight-bearing CT technology. Just as our customers seek to provide the best care they can to their patients, we work hard to provide them with the equipment they need to do so. To learn more about CurveBeam, visit our About page.

CurveBeam Goes to Europe: ECR 2018

The European Congress of Radiology (ECR) is the annual meeting of the European Society of Radiology (ESR). The next ECR congress will be held from February 28 – March 4, 2018, in Vienna, Austria, and CurveBeam is excited and honored to be among those participating this year.

Founded in 2005, by merging the European Congress of Radiology (ECR) and the European Association of Radiology (EAR), the European Society of Radiology (ESR) is an apolitical, non-profit organization dedicated to strengthening and unifying European radiology. With more than 75,500 members worldwide, it is the largest radiological society in the world.

The Society works closely with radiological societies across Europe while establishing relationships with major international organizations from other related fields. It also monitors developments on the EU level, with a significant influence in radiology research and practice. The mission of ESR is to serve the healthcare needs of the general public by supporting scientific research, education, and training, while constantly striving to improve the quality of radiological practice.

CurveBeam, founded in 2009, is an innovator and industry leader in weight-bearing CT. A study performed in 2012 in Finland, concluded that “Cone-beam CT technology with new design and flexible gantry movements allows both supine and weight-bearing imaging of the lower extremities, with a reasonable radiation dose and excellent image quality. Weight-bearing CT of joints can provide important new clinical information in musculoskeletal radiology.”¹ It was the first major study to demonstrate the viability of weight-bearing CT.

CurveBeam will be exhibiting several of their products in Booth X1/110. Medical professionals can learn about pedCAT, InReach, and the currently investigational, LineUP.

The pedCAT’s bilateral, weight-bearing 3D views of the foot and ankle give specialists the information they need to create comprehensive treatment plans. Its compact size and ultra-low dose CT imagine boasts a scan time of one minute. InReach is the most compact extremity cone beam CT scanner, and it images the hand, wrist, forearm, elbow and the lower extremities. In the early stages of development is the LineUp, a bilateral, Weight-Bearing CT device for imaging of the knee and lower extremities, designed with patient comfort in mind. LineUp is easy to operate and offers quick scans of less than 30 seconds each, producing 3D Reconstructions, Multi-Planar slices, and X-Ray views.

CurveBeam can’t wait to network with medical professionals and other imaging specialists in Vienna. It won’t be our only connection to Europe, however. CurveBeam has had the good fortune of partnering with The UK’s Standing CT, who has created a mobile solution for patients to utilize pedCAT.

CurveBeam looks forward to showcasing its exceptional products and talking with you about the imaging needs of your orthopedic or podiatric practice. We are eager to introduce you to our exceptional imaging products: pedCAT, InReach, and LineUp.

Learn more about CurveBeam here!

¹Department of Diagnostic Radiology, Medical Imaging Centre of Southwest Finland, Turku University Hospital, Kiinamyllynkatu 4, Turku FI-20520, Finland. Address correspondence to E. K. J. Tuominen (esa.tuominen@iki.fi)

Takeaways from the 2018 OrthoForum Annual Meeting

The 2018 OrthoForum Annual Meeting concluded this past weekend in Orlando, and the agenda was once again packed with useful sessions for orthopedic executives.

During the popular CEO breakout sessions, executives shared some timeless principles that are worth pausing and reflecting on. Here are two of the key takeaways we picked up:

1. Approach internal and external communication with continuous improvement

There was a strong, consistent message that orthopedic executives and surgeons will need to increasingly work together as a unified group in reforming healthcare delivery. Foster communication with other orthopedists and care providers embrace opportunities to collaborate with healthcare systems, not just compete with them. Now is the time to act rather than taking a wait-and-see approach. Be involved, participate in discussions and be open to change.

Internal communication is important as well. Several administrators shared how their operations suffer from “leakage” when surgeons don’t follow practice guidelines for utilization of in-house ancillary services. Instead, they tend to stick to old habits, including outsourcing services, even if they capture less revenues and end-up with studies of inferior value. Repeatedly communicate the true value and enhanced quality of ancillary services to minimize leakage.

2. Customer Service really does matter

Speakers suggested implementing training to offer better to best in Customer Service. Healthcare has become more competitive and consumers are shopping around. How patients feel they are treated matters now more than ever. Train, monitor and measure customer/patient satisfaction and respond to all comments by acknowledging them, showing appreciation for feedback and addressing any concerns with a goal to improve perceptions. Incentivize your staff to buy-in to this goal.

Differentiating your practice with customer service delivers the most impact. It’s what patients and the general public understand more than anything else. People remember how you made them feel. Reinforce positive and engaging staff attitudes, and keep patient-treatment paramount.

CurveBeam is a proud sponsor of the OrthoForum Annual Meeting.

CurveBeam Sponsors The OrthoForum’s Annual Meeting

CurveBeam is proud to be a returning sponsor of The OrthoForum’s Annual Meeting February 15-17, 2018 at The Ritz-Carlton in Orlando, Florida. The event will bring together orthopedic practices from all over the United States.

This year’s agenda will focus on practical ways new physician owners can become productive board and committee members and will include instruction on the factors and skills needed to successfully contribute to effective practice management. Highlights of the event include a presentation from keynote speaker Andrew Hayek, the CEO of Surgical Care Affiliates and Optum Health, focusing on the delivery of orthopedic care in a value based payment environment.

Ross Bernstein, a nationally known business speaker, will present information on developing peak performers based on his extensive research with professional athletes, and OrthoForum will showcase new initiatives that are creating practice management support programs for compliance and physician recruiting.

CurveBeam will have information about its imaging solutions on display.

The pedCAT system was created with orthopedic and podiatric clinics in mind, and is a compact, ultra-low dose CT imaging system. Since the device was designed for busy practices, the pedCAT can scan in less than one minute. The system is also self-shielded and has a compact footprint of about 4’ x 5’. The pedCAT has the largest field of view available in orthopedic CBCT imaging, which permits true weight-bearing positioning.

The InReach system can perform hand, wrist, forearm, elbow and lower extremity scanning in less than 20 seconds. The InReach is the most compact system on the market, with a footprint of about 2’ x 3’. The system is self-shielded and is also PACS/DICOM compatible, just like the PedCAT.

We at CurveBeam are very excited to attend this event this year as a Sponsor, and we look forward to meeting Ortho practices from all over the country. For more information on the event, you can visit the event website, or email questions directly to Lauren Chastain at lchastain@theorthoforum.com.

See you soon!

Curvebeam Corporate Webcast: Standing CT—Zooming in on the Problem with Dr. Selene Parekh

Mark your calendars for an upcoming FOOTInnovate lecture with Dr. Selene Parekh. Titled, “Standing CT—Zooming in on the Problem”, the lecture will detail Dr. Parekh’s own experience with incorporating weight bearing CT imaging into his own clinical practice. Be sure to register at Foot Innovate, and join your colleagues for what’s sure to be an informative evening on Wednesday, February 28, at 8:00 PM EST.

Dr. Selene Parekh, M.D. is an orthopedic surgeon and expert on sports injuries. He currently serves as Professor of Orthopaedic Surgery at the North Carolina Orthopaedic Clinic at Duke University. Prior to his time at Duke, Dr. Parekh was a foot and ankle surgeon at the University of North Carolina (UNC), where he not only taught medical students and residents, but he also consulted in foot and ankle cases for the athletic department. He treats athletes at various levels in his current practice.

After earning an MBA in Health Care Management as well as an MD from Boston University, Dr. Parekh completed both his surgery internship and his orthopedic surgery residency at the Hospital of the University of Pennsylvania. While in residency, he was honored with multiple awards for his research in the field, and most recently was awarded the Ranawat Award by the Eastern Orthopaedic Association.

Dr. Parekh prides himself in learning about his patients to understand their specific needs and their overall functioning. He considers himself conservative in his surgical approach, and believes in maximizing non-surgery methods, only operating when necessary.

More popularly known as the “Fantasy Doctor,” Dr. Parekh has combined his passion for sports medicine with his love of fantasy football, utilizing his impressive skills to accurately predict how injuries will affect a player’s career and in turn, impact the Fantasy football league and its teams. He has even written two foundational research papers using Fantasy football data to track the epidemiology and outcomes of tendon and ligament ruptures in the NFL.

Orthopedic Cone Beam CT: A Primer for Radiologists

In the past five years, cone beam CT technology has been incorporated into an increasing number of orthopedic clinics and hospital orthopedic departments. When a radiologist reviews a CT volume captured from an orthopedic cone beam CT device, he or she will likely observe that trabecular bony detail is comparable to or even superior to those acquired from a conventional medical CT system.

What a radiologist may not realize is that filters and kernels applied during reconstruction are set to accentuate hard tissue and bone, and are not changeable. Therefore, soft tissue windowing is limited. A radiologist may also not realize that the effective dose of cone beam CT scans is typically significantly lower than a scan of the same body part on the low dose settings of a conventional medical CT.

CurveBeam has put together an introductory primer for radiologists that details the differences between cone beam and traditional CT volumes.

Enter your email address below to email a copy to yourself.

How Weight Bearing CT Technology Improves Patient Outcomes

The medical industry has relied on CT scanning for years. The traditional machine has patients lie down, preventing medical staff from seeing how weight has an effect on bones, particularly those in the feet. The pedCAT changes that.

Avoiding False Negatives by Dodging Potential Pitfalls

It would seem radiography reigns supreme when it comes to initial fracture detection. And yet, some researchers from the University of Washington’s Department of Radiology believe that relying on a single x-ray image can lead to a false negative. In their article Radiographic Pitfalls in Lower Extremity Trauma, authors Alice Ha, Jack Porrino, and Felix Chew examine the possible reasons for a missed diagnosis and measures that can be taken to avoid these inaccuracies. While the article lists a variety of pitfalls that can trip up radiologists, these can generally be broken down into three groups.

The first group relates to technological hitches. Detecting a fracture relies on having a variety of views, proper positioning, and technically sound equipment. While severe fractures may be identified from various viewpoints, others may only be detected when viewed from a specific angle, and fractures that go unnoticed can lead to more severe issues down the road. Additionally, the introduction of digital radiography has led to a belief that insufficient tube current can display an underexposed radiograph. To avoid false negative conclusions, there must be a thorough set of technical checks in place.

The second group that Ha, Porrino, and Chew focus on arise from physiological complications. Nondisplaced fractures, for instance, are often impossible to spot using a basic radiograph as the lack of displacement makes the bone appear intact, especially if weight bearing scans are not a part of the process. Utilizing a CT scan or an MRI can help avoid these errors, particularly in the lower extremities where there’s a higher possibility of missed fractures. And, according to the authors, fractures in places where hardware or artificial replacements have been installed can be all but invisible to radiographs, and thereby require a more comprehensive scan.

The third group of pitfalls highlighted in the article are attributed to human error. This can include everything from eliminating that one vital viewing angle during the imaging process, to simple faulty reasoning. A radiologist may identify a fracture, for example, but fail to realize the fracture is atypical for its location, and mis- or under- diagnose treatment for a more far-reaching issue. There is also the fact that many normal anatomic variations, such as sesamoid bones with multiple parts, can be mistaken for fractures. Other options must be implemented to account for human error.

At CurveBeam, we strive to erase potential pitfalls. Whether it’s allowing doctors to examine fractures through a weight bearing CT scan using our pedCAT technology, or giving a comprehensive look at a patient’s lower extremities with CurveBeam’s forthcoming LineUP, our products reduce false negative occurrences to ensure patients are getting the care they need.

To learn more about how CurveBeam products help to avoid radiographic pitfalls, visit http://www.curvebeam.com/ today!

In Lecture, Dr. De Cesar Netto Calls WBCT an Essential Diagnostic Tool

The field of foot and ankle pathology has seen recent technological advancements that allow specialists to diagnose and treat ailments with far greater accuracy and effectiveness than was previously possible. Dr. Cesar de Cesar Netto, a board member of the Weight-Bearing CT (WBCT) International Study Group, recently outlined in a lecture on FOOTInnovate the leap we have made by moving from traditional X-Ray scans to the modern weight-bearing CT scans, such as the pedCAT developed by CurveBeam.

“Comparing the X-Ray with weight-bearing CT technology is like comparing a game of FIFA on the Sega [Genesis] with the PS4. “There’s no comparison,” De Cesar Netto says. “You’re seeing the same team, the same game. The concept is the same but the visualization is completely different.”

The pedCAT uses is cone-beam CT technology, which means that a cone shaped X-Ray beam is used to gather volumetric data from all sides of the foot or ankle in just a single rotation. What makes this technology particularly significant, according to De Cesar Netto, is the ability to see how the bones and tendons in the foot interact differently when weight is placed on them. Not only that, but cone-beam CT scans only put out around 3.8 micro Sieverts of radiation, compared to the 25 micro Sieverts of a traditional CT scan.

In his lecture, De Cesar Netto lists standardization as one of the central goals of the WBCT Study Group. By establishing automatic alignment parameters, doctors will be able to more easily detect anomalies in the scans. To show this he walks the audience through several case studies.

The first involves a 54-year-old patient who is suffering from a bad ankle sprain. Through the use of WBCT scan software that provides 3D biometrics, De Cesar Netto shows how it is possible to use alignment analysis to determine where the patient’s talus is compared with where is should be if all bones in the foot were properly aligned. The second and third case studies, involving patients suffering from progressively flattening feet, also used WBCT imaging to show issues with the ligaments and inflamed tendons contributing to the problem.

By utilizing WBCT scans and CurveBeam’s latest software tools, De Cesar Netto says doctors can implement more effective solutions through complete analysis than if they simply relied on conjecture based on traditional X-Rays. The more complete the picture, the better the treatment.

De Cesar Netto is anticipatory of CurveBeam’s LineUP system, which will provide doctors with a bilateral data set image of the foot, ankle, and knee at the same time, allowing them to have a complete picture of deformity in the lower extremities, leading to a better evaluation.

CurveBeam is constantly seeking to move the field forward and provide doctors with the tools they need to care for their patients. It’s why Dr. De Cesar Netto mentions in his lecture that he believes CurveBeam is one of the best available options on the market. View Dr. De Cesar Netto’s webinar on FOOTInnovate here. Membership is required to access the webinar, but is free for foot and ankle specialists.

Examining the Added Value of Preoperative CT for Determining Cartilage Degeneration in Patients with Osteochondral Lesions of the Talar Dome

Osteochondral lesions of the talar dome (OLTs) involve the articular cartilage and subchondral bone. These lesions can cause deep ankle pain as well as impaired daily activities and sports activities. Surgical treatments are conducted as repair or replacement strategies to achieve biological healing of the OLT. The surgical procedure depends on the size, location, and stability of the lesion, as well as the extent of cartilage damage and the condition of the subchondral bone.

The usefulness of magnetic resonance imaging (MRI) has been reported to interpret the condition of the lesion ahead of a surgical procedure. It is not a perfect solution, however. An MRI might over- or underestimate the staging of OLT owing to bone edema and thinning of the articular cartilage. Computed tomography (CT) can provide more precise information than MRI on the subchondral bone, such as bone sclerosis, absorption, and cystic lesion.

To evaluate the unique features of the CT findings that relate to the condition of the articular cartilage in OLT, a study was conducted by the Department of Orthopaedic Surgery at Hiroshima University’s Graduate School of Biomedical Sciences in Hiroshima, Japan. The lead researcher on this study was Tomoyuki Nakasa, MD, PhD. The findings were published in the American Journal of Sports Medicine. Thirty ankles in 29 patients who had OLT with an osteochondral fragment were retrospectively reviewed to find out the extent to which CT image prediction of the histological findings on OLT will be useful to determine the most appropriate therapeutic strategy.

The osteochondral fragment of 19 ankles could be preserved by fixation or drilling at surgery. This was the preservation group. In the remaining 11 ankles, the osteochondral fragment was removed. This was the excision group. Preoperative CT findings were compared between the two groups to determine the relationship between the CT and histological findings. Biopsies of the osteochondral fragment from 13 ankles were also performed.

The area of lesion in the preservation group was significantly larger than that in the excision group. The CT images of the lesion showed the rate of absorption of the subchondral bone plate (SBP) in the preservation group to be lower than that in the excision group. The lesion bed absorption was higher in the preservation group than in the excision group. All cases in the excision group showed bed sclerosis, compared with 42.1% in the preservation group. The specimens with disruption of the SBP exhibited cartilage degeneration and abundant chondrocyte cloning. OLT with absorption of the SBP on CT showed severe cartilage degeneration, while the remaining SBP on CT showed low-grade cartilage degeneration.

In conclusion, while the condition of the SBP affects cartilage degeneration, CT findings provide important information for the determination of surgical treatment.

CurveBeam designs and manufactures Cone Beam CT imaging equipment for the orthopedic and podiatric specialties. Learn about CurveBeam’s Cone Beam CT systems here!