Digitalizing healthcare

Imaging in a heartbeat

Expert knowledge travels fast in Swiss hospitals

Santina Russo
Published on August 12, 2020

At a leading hospital in Lucerne, Switzerland, radiology specialists are virtually connected with technologists and patients within a network of affiliated hospitals. Thanks to the new software for remote scanning assistance, knowledge transfer is fast, easy, and cost-effective. An additional benefit is that patients have a shorter waiting time for their scan appointments – which has turned out to be especially useful in these times of the COVID-19 pandemic.

<p>“We are going to do a Turbo-Flash scan now,” says the female voice over the microphone. “Yes, go ahead,” confirms Jürgen Fornaro, MD, Head of CT Imaging at Lucerne Cantonal Hospital, one of Switzerland’s largest medical centers. He is sitting in front of a monitor showing a camera image of his patient lying in the CT scanner, and the display of the CT scanner workplace. A moment later the first results of the pre-test for the upcoming heart CT scan, appear on the screen. “The scan range is very good, you can proceed,” Fornaro advises the radiology technologist. For him, there is nothing unusual about a specialized heart CT scan that is detailed enough even to visualize coronary arteries measuring just 1 mm in diameter. </p>
A patient is scanned in a CT scanner.
<p>Although the heart CT scan is made kilometers away from Lucerne, the radiologists and technologists can cooperate as usual using syngo Virtual Cockpit.</p>
A patient is scanned in a CT scanner.
<p>What is unusual, however, is the fact that the radiologist is located kilometers away from the CT scanner and the actual patient. Fornaro is based at the Lucerne hospital that serves central Switzerland, whereas the radiology technologist is with the patient at an associated regional hospital in the town of Sursee, some 30 kilometers from Lucerne. The connection is possible thanks to syngo Virtual Cockpit, a software that lets experts advise and control imaging procedures like CT and MRI remotely. Using syngo Virtual Cockpit, radiologists and technologists can cooperate as usual — with the added benefit that the system allows them to work together regardless of their location.</p>
<p>Straight away, the next check is carried out in Sursee, supervised by the specialist in Lucerne. It is a test bolus, meaning a quick scan using only a small portion of the contrast agent. This helps CT expert Fornaro to optimize the timing of the heart scan in order to get the ideal contrast. The whole process, from the tests and inspections of the results to the communication between the two sites, takes place via <i>syngo</i> Virtual Cockpit. “The software makes it easy for specialists to share their knowledge,” explains Justus Roos, MD, Head of Radiology at the Lucerne Cantonal Hospital. <br><br>“We can guarantee the same excellent quality within our radiology network, without having to send medical experts to our remote sites. ”His department provides services not only at the main hospital but also at a radiology facility located in the center of Lucerne, at two regional hospitals affiliated to the center, and at three more collaborating hospitals in different districts of Switzerland. Overall, it is the largest radiology network in Switzerland, responsible for a catchment area of 800,000 inhabitants.</p>

Justus Roos, MD, Head of Radiology at the Lucerne Cantonal Hospital

<p>As a consequence, patients receive scan appointments a lot faster. Before the implementation of syngo Virtual Cockpit, patients had to wait up to three months for elective, non-urgent heart scans. “We have managed to reduce this general waiting period to one month,” says Roos. The time-saving benefit has actually increased and become more noticeable in the current COVID-19 crisis. Given that hospitals were focused on dealing with the coronavirus threat in the last few months, most of the non-urgent, elective imaging exams had to be postponed. “Now thanks to syngo Virtual Cockpit, we are catching up with the many rescheduled heart examinations as it allows us to optimally exploit the imaging capacities at all available sites,” Roos explains.<br><br>In addition, patients appreciate the fact that they don’t have to travel to the central hospital for specialized examinations. “In Switzerland, healthcare is traditionally very localized with regional hospitals providing medical care for residents of the area they serve,” Roos explains. “We strive to maintain this high level of accessibility.” On the other hand, patients who urgently need an advanced examination can be flexibly relocated to a site with free scanner capacity.</p>
J&uuml;rgen Fornaro, MD looks at a heart CT scan on a screen.
<p>As the first healthcare facility to implement a remote solution for CT imaging in Switzerland, the Lucerne Cantonal Hospital is doing pioneering work. The system will soon also be extended to magnetic resonance imaging, initially for certain examinations requiring expert knowledge, such as prostate or breast MRI. Further extension to include other types of examinations, as well as the integration of other hospitals in the radiology network are under consideration. “Employing such digital advancements will help us to operate sustainably in a productive and cost-effective way,” says Roos.<br><br>Another, rather unanticipated advantage lies in the associated training effect. As departmental head Roos observes, supervision by the specialists in Lucerne enhances competence at the remote sites: “By now, our technologists can almost perform the examinations by themselves.” This relieves the specialists further – a useful effect that has developed automatically and at no additional cost.”<br><br>In Sursee everything is now set for the heart CT scan. The actual scan takes less than a few heartbeats. After that, the software computes the images of the patient’s heart and blood vessels. The resulting 3D images are razor-sharp and show no indication of an abnormality – good news to pass on to the patient.</p>

By Santina Russo
Santina Russo is a freelance science and medical journalist based in Zurich, Switzerland.