Interventional Radiology Clinic
Whittier Imaging Vein Care
– A letter from Chip Truwit, MD, FACR, Chief of Radiology
My mission is very simple: to transform HCMC Radiology into the premiere radiology group in the Twin Cities and the Upper Midwest.
By recruiting outstanding, patient-centered radiologists, overseeing the installation of state-of-the-art imaging equipment, and leading the technical and nursing staff to expect excellence of themselves and the radiologists, I would like to believe we have achieved that goal. With that backdrop, we are now in the 'Good to Great' phase of our journey. For our group, that translates into constantly working to exceed expectations – of our patients, of our colleagues, and of ourselves. And, it means we 'practice what we teach' to our outstanding trainees, Minnesota's future radiologists.
In addition to our radiologists, physician assistants and radiology practitioner assistants, the department includes over 120 radiology technologists and nurses. Our technologists are licensed, accredited and among the best in their fields. They understand completely that they are here to help, and they are incredibly committed to your well-being and comfort.
Here in Radiology, we are incredibly fortunate to have a team of exceptionally well trained nurses. They have been selected from the ranks of intensive care nurses. They are also committed to keeping you safe and as pain-free as possible during your procedures.
In short, everyone in the department – from the front desk clerk to the radiologist interpreting your images – is an ambassador on behalf of HCMC. "Centered Around You" means that we all seek to ensure that your experience is a positive one. If you need guidance to your next appointment, please ask. If you wish to speak with a radiologist about your imaging study, before or after, please ask. We try to speak in non-medial jargon as much as possible. If we use language that is unclear, please interrupt us and ask us to try again. Finally, please feel free to share your experience with us. Of course, we love the positive feedback, but equally important, we need to hear if we drop the ball.
From my 12 years service in the US Army Medical Corps, I learned firsthand what exceptionalism means. Likewise, I learned that with this comes responsibility. While nowhere is this specified in my job description, my commitment is to public sector care and to that end, as Chief of Radiology at HCMC, I am committed to ensuring that for those suffering acute trauma, HCMC is, and remains, the destination hospital in the region.
Obviously, that means hiring the very best people, installing the best equipment at the best price, and holding the group accountable to a standard of exceptional service. What's perhaps not so obvious is that we've been at this for a long time. For a radiology department, while all of the above are incredibly important, no decisions are more important than which CT scanners and which computer system (x-ray images are now all on computers) one deploys. These two innovations are among the most important advances in medicine ever. While the CT scanner literally meant survival of accident victims that previously would have died, the computer systems (and it's more important counterpart, the internet) meant a revolution in health care that is still underway.
Earlier I spoke about the CT scanners. Let me explain about our PACS (Picture Archiving and Communication System). In 2003, the performance of our earlier system became so unreliable that it had effectively become of little use to us. After a lengthy process, we selected what is known as the iSite system. At that time, we believed it be the industry leader, and we needed to ensure we installed a best of breed system.
The rewards were immediate and were palpable. This was a transformative moment not only for HCMC Radiology, but for HCMC at large. Not only were the radiologists performing at their best, but HCMC's corps of physicians and allied professionals were now able to see the images from anywhere in the medical complex, as well as from their computers at home.
This meant that CT scans could be seen from anywhere in the complex – almost immediately – especially in the Emergency Department and in the ICUs. Not surprisingly, it wasn't long before our most innovative moment came along: HCMC Radiology, in conjunction with our colleagues in Information Services, initiated Minnesota's first state-wide, and soon, region-wide network of image sharing. Immediately, the care of trauma patients in outlying hospitals about to be transferred to HCMC were to realize the benefits. Virtual private networks were set up with dozens of hospitals whereby the CT scans from those hospitals could be sent from the CT consoles directly to HCMC's iSite computers for viewing by our radiologists – all of whom are exceptionally schooled in the imaging of trauma. Unbeknownst to most of our citizens, for Minnesota this single moment was as important a public health initiative as it gets. What immunization has done for public health, this network has done – and is continuing to do - for trauma care in the state of Minnesota and beyond.
Today, this network has grown to over 60 hospitals and clinics throughout the midwest. Moreover, our network is now used for far more than for trauma: Minnesota's citizens suffering from acute stroke, acute aortic dissection, and other acute situations all benefit from this network. In short, despite being an unaligned hospital (like those of the Mayo system, the Allina system, the Fairview system, and the VA system, HCMC was over a decade ahead of its time at fulfilling its mission to the citizens of Minnesota – all because of our commitment to mission, our commitment to patients, our commitment to innovation and our commitment to exceptionalism. At HCMC, we promise to lean forward and to continually travel the journey from Good to Great.
Radiology equipment includes many different modalities: by their common names, CatScans, MRIs and ultrasounds are among the most well known. Additionally, there are traditional x-ray machines, DEXA, nuclear medicine, PET scanners, and "Cath labs". Of these, MRI and ultrasound do not even use x-rays; instead, they use radio waves (MRI) and sound waves (US). The others take advantage of the x-ray. We want to assure you that we we always use the least amount of radiation (ALARA: As Low As Reasonably Achievable) whenever we do use the x-ray equipment.
As you can imagine, Radiology equipment is very expensive. As such, we spend a good deal of time thinking about how best to spend the resources we have. We want to ensure that all of our patients are imaged appropriately, using the most-up-to-date equipment. With a few exceptions, we have chosen to work largely with equipment from Philips Healthcare, and we believe everyone has benefitted greatly from that decision. Philips has exceptionally advanced imaging equipment and is a leader at reducing radiation dose – both to patients and to the radiologist in the "cath lab".
Our primary CT scanners are outfitted with iDose4, the industry leader in dose reduction. HCMC has set the standard in our community with its 256-slice CT scanner, the iCT. While we use that machine for all types of CT scans, it is exceptional in its application at cardiac CT scanning. This scanner, like the air hockey you played as a child, has eliminated many mechanical parts and "spins" within a nearly microscopic cushion of air that all but eliminates friction and allows for extremely high rotation speeds that the scans can literally "freeze" the motion of the heart. The scan is obtained so fast, that each spin occurs in milliseconds, but a fraction of a second! In combination with iDose4, HCMC's patients can expect that their scan meets or, more likely, exceeds the standard of care for cardiac CT angiography.
Likewise, our MR scanners offer significant advantages over competitor systems. We do not use gimmicky "open-sided" MRI that are forced to compromise on image quality. We seek to image once and to do it right. Both at HCMC and Whittier, our satellite outpatient facility, we have large bore scanners that significantly eliminate claustrophobia. We offer audio-visual sets that allow you to listen to music or watch a movie. Of course, MR scans no longer take an hour; with our scanners, most exams are completed within just 20-25 minutes.
And, were that not enough, our scanners offer exceptionally advanced imaging techniques that allow for sophisticated imaging of the brain, spine, breast, prostate, bones and joints, liver and heart. Our MR scans set the standard in this region, be it if we are performing a study on your unborn child (fetal imaging), the "stiffness" of your liver (MR elastography), your hip (before surgery or, with OMAR, our new orthopedic metal artifact reduction scanning, after you have had a hip replacement), your heart or that of your child (cardiac MRI), your breast or prostate (both of which are now standard of care in preoperative evaluation), and your blood vessels (brain, carotid, renal, aorta, etc.).
HCMC Radiology was the first to replace its analog bedside (portable) x-ray units with digital technology. What does that mean? It means better patient care. With our state-of-the-art digital "portables", HCMC Radiology's technologists no longer have to run x-ray cassettes back to the main department to be "developed". For several years, HCMC's patients and physicians have benefitted from this digital conversion: when a bedside exam is performed, on the ward, in the ICU, in the OR, or in the ED, the image is immediately processed and wirelessly sent to this Radiology computer system. Just seconds after the technologist says, "hold your breath please", the image is available for interpretation and viewing, and sharing with the patient and family.
– Chip Truwit, MD, FACR, Chief of Radiology