Three Keys to Quality Bone Density Reporting

This posting is the last of a 3-part series about bone density reporting and how BoneStation can make a difference compared to common practices. Part 1 focused on costs reduction and part 2 on time savings.  In this article we discuss three specific areas that BoneStation addresses in regards to quality:

  • The Report – components that comprise a good bone density report
  • Review process – facilitating a sound interpretation
  • Workflow – improving communications between staff

The Report
The International Society for Clinical Densitometry defines the minimum requirements for a bone density report.  Some items that should appear on a report include: patient demographics, BMD values for each site measured, DXA manufacturer/model, and significant change.

BoneStation automates report creation.  Manual data entry is eliminated.  BoneStation extracts all appropriate DXA data and places the data in a report.  In addition, changes in BMD and determination of significant change are automated.  A final bone density assessment is even suggested.

The Review Process
While DXA bone density scan images should not be used for diagnostic purposes, they are instrumental in determining the consistency of serial measurements.  Is the patient positioned properly?  Are the regions of interest (ROIs) consistent with prior scans?  What is the technical quality of the scans?

BoneStation’s review process is designed to highlight key aspects for interpretation.  Prior scans are easily visible. ROIs may be viewed both visually and numerically.  Technical quality of scans must be specified and may also appear on the report.

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Workflow
In most situations, the technologist and reading physicians are in different locations.  Scans are not typically read in real time either.  Improved communications among bone density staff can lead to increased quality.

  • BoneStation allows technologists to pass information to reading physicians via “scan comments”, which are entered on the DXA and appear in BoneStation.
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  • BoneStation may be configured to “validate” patient information for consistency.  Is data missing, is patient demographic info consistent, etc.  For example, if a female patient is 62 years old and is designated as pre-menopausal, BoneStation is able to provide a warning that this information may not be valid.
  • When a reanalysis is required, BoneStation facilitates communications between the reading physician and technologist.  The reason for reanalysis is described to the technologist.  The scan is also tracked as awaiting reanalysis – so staff will not lose track of it.
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Summary
BoneStation is designed specifically for DXA based bone densitometry.  It increases efficiency and quality simultaneously.  Much of the mundane handling of bone density scans is automated. It facilitates a review process designed for bone density, and enables easy communication among bone density staff.

BoneStation has produced more than a half million reports and has proven to be reliable solution for BMD reporting.  Customers such as Mass General Hospital, Swedish Medical Group, Emory and others enjoy higher throughput and quality at lower cost.

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Speedy Bone Density Reporting with BoneStation

This posting is part 2 of a 3-part series highlighting how BoneStation can reduce costs, save time, and improve quality in BMD reporting.  In the previous blog, we emphasized the cost savings aspect. Here we focus on the time aspect, or the speed of reporting.

Bone Densitometry using DXA has been around for a while. As we all know, a particularity of BMD scans is that they output images (spine, hip, etc) as well as numerical values (BMD, BMC, T-score, Z-score, etc…).

In today’s digital world, still many practices waste precious time in error-prone manual steps when reviewing DXA studies. These steps include: writing down numbers on paper, calculating BMD changes with calculator, retrieving historical scans from PACS, using post-its to ask technologists for reanalysis of a scan, using dictation, using the FRAX website, etc…

BoneStation resolves these issues, thereby offering the opportunity to save time at several points of the workflow:

  • Data (BMD, T-score, etc..) is extracted directly and instantaneously from the DXA scans
  • No need for human reading, dictation or transcription
  • Current and prior scans (images and numbers) show up side by side allowing for instantaneous comparisons
    • no need to pull charts, or to retrieve historical images and data on PACS
  • BMD changes are computed instantaneously and show up in the report
  • BMD changes are instantaneously compared to the stored least significant changes
  • FRAX is calculated automatically according to ISCD recommendations
  • Request for reanalysis is built in BoneStation for quick and traceable communication with the technologist

Even today we occasionally observe situations where readers do not compare scans with priors and do not calculate changes in BMD.  The International Society of Clinical Densitometry (ISCD) recommends these as important elements of a bone density report.  Perhaps it takes too long to provide this information in a report.  However, BoneStation makes it easy.

This BoneStation video illustrates how quickly a reading physician can review a spine and hip DXA study, including FRAX.  An actual review, with prior scans, can often take under one minute with BoneStation.  With the narrative in the accompanying video, it takes about a minute and half to review a spine/hip.

We hope that this brief blog helps you think through your bone densitometry process. 

Sylvie Bokshorn

BoneStation has produced more than a quarter million reports and has proven to be reliable solution for BMD reporting.  Customers such as MGH, Swedish Medical Group, Emory and others enjoy higher throughput and quality at lower cost.