Boost efficiency and user confidence - Delta Medical Systems · 2020-03-05 · 2 White paper | Boost efficiency and user confidence in your radiology department with standardized

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Boost efficiency and user confidence in your radiology department with standardized MAX system operation

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2 White paper | Boost efficiency and user confidence in your radiology department with standardized MAX system operation

1. Executive Summary The way healthcare services are delivered is dynamically changing. Due to technological advances, there’s an ever-growing use of high technology – and the application fields in hospitals are also shifting. These are just a few of the trends that continue to transform the delivery of care. In the meantime, clinical institutions have to make sure they remain efficient as the development of new technologies and treatment alternatives outpace healthcare budgets. The implementation of efficient processes is one of the key success factors for clinical institutions if they want to stay competitive in the long run. Standardized system operation is one way to increase process efficiency, as it can make using various technologies easier and reduce training efforts. Read on to discover how a unified operating concept for systems in radiology departments offers great potential to enhance efficiency, staff satisfaction, and quality of care.

White paper | Boost efficiency and user confidence in your radiology department with standardized MAX system operation 3

2. Introduction Having access to healthcare services is seen as a fundamental right in many countries around the world. But the delivery of care is highly regulated with limited reimbursements, leading to tight and sensitive operating margins. Technological developments will continue to impact the delivery of healthcare. As new digital equipment becomes increasingly automated, it might be ex-pected that it would become easier to use. But because the new systems offer ever-more technical features and open up new clinical possibilities in both diagnostics and treatment, they are instead becoming more complex to operate. Medical equipment manufacturers address this issue by constantly working to simplify system operation. They focus on the user of the technology – and aim for systems that are convenient, efficient, and safe to use. There is a solution from Siemens Healthineers: the MAX family of X-ray systems, all of which share the same technical platform and focus on standardization. Based on a study performed with different MAX systems in several radiology departments, this white paper illustrates how a uniform operating concept can help institutions increase their process efficiency as well as enhance user performance and satisfaction.

Table of Contents The Challenge ................................................................... 4

Oppurtunities for Standardization ................................ 5

Benefits of a Uniform Operating Concept ..................... 6

Key Takeaways .................................................................. 14

References .......................................................................... 15


3. The Challenge

With new technologies seeming to emerge every day, the demand for highly qualified staff is increasing. However, staff who can handle these changing and sometimes complex technological requirements in addition to their other medical tasks can be difficult to find and retain. To resolve this dilemma, clinical institutions must continuously invest in user training so that their staff can operate the diverse interfaces correctly and efficiently at all times.

Process efficiency is essential in all industries, including healthcare. Reducing the total cost of care delivery is the primary concern of U.S. hospital managers – directly followed by integrating data that will streamline analytics for evidence-based decision-making, enhancing patient satisfaction, and offering value-based care.1

This paper explores the efficiency gains that result from standardizing the operating concept in X-ray systems. We also investigate its effect on staff performance and satisfaction.


4. Opportunities for Standardization

Research shows that the hospital industry cannot attain economic efficiency unless technical efficiency is achieved:2 and yet this is challenging due to the aforementioned shortage of trained staff as well as smoothly interfaced, cross-departmental processes. These challenges can be overcome by standardizing equipment, operating concepts, and overall processes. By engaging stakeholders to contribute to the common goal of providing the best possible patient care, standardizing system operation opens up many op-portunities, including more consistent quality of care, increased reproducibility, and improved measurability of medical services as a basis for process im-provements. This in turn lays the foundation for a competitive clinical institu-tion. Improved technical efficiency begins by actively involving hospital staff and enabling them to confidently handle even complex system operations, such as highly specialized technical applications that require multiple operating steps. A uniform operating concept can also help reduce training time, ensure safe system usage, and reduce unwarranted variability. Medical equipment manufacturers are blazing new trails that will enable efficient, high-quality workflows and unify operating patterns.

We should mention that there are concerns about standardization. These are expressed primarily by physicians and system users who fear that they will be restricted in their work and decision-making. In addition, some patients are worried that standardization will lead to less individualized care.3 As a solution to this problem you can standardize (e.g. your equipment, work-flow) according to the customer’s policy. Furthermore, you can apply patient group-specific standardization, giving the possibility to adapt to the special needs of certain patient groups (e.g. pediatrics) while keeping the benefits of standardization.


5. Benefits of a Uniform Operating Concept

Clinical investigation with the MAX family The MAX systems from Siemens Healthineers are an exemplary approach to a unified operating concept. They are designed for radiography and fluoroscopy, a highly technical discipline where the impact of technological change is dra-matic. The MAX family encompasses X-ray systems for varied uses, ranging from mobile and stationary X-ray and fluoroscopy to Twin Robotic X-ray. All MAX systems share the same user interface, the same automated image pro-cessing software, the same operating concept, and one family of detectors. This clinical investigation assessed the potential advantages of a uniform user inter-face. Six new installations of MAX systems were examined. The users’ experi-ences with system handling on the new MAX systems were compared with their prior experiences. The MAX Portfolio Efficiency Study, this descriptive field study, shows that shorter training time, increased user satisfaction, flexible staff scheduling, and an optimized learning curve are the most relevant bene-fits of a standardized user interface for system users.4

Experience the MAX effect and multiply your gains in standardization, savings, and satisfaction.


Reduced initial training time

In the consumer sector, users demand that new technical equipment – for ex-ample, a mobile phone – is intuitive enough to use without having to read the manual. In the healthcare industry, however, introducing new systems with unfamiliar operating concepts requires initial training by application special-ists and a learning phase for the users. During the initial training phase, patient throughput will be significantly re-duced because users must familiarize themselves with the new system and its functionalities. This is usually followed by a learning phase with higher, though still not optimal, performance. This learning process will eventually result in increased throughput and output. The study demonstrated that the initial training period – which significantly reduced the performance of both the staff and equipment involved – can be cut by at least one-third if users have prior knowledge of the MAX or a similar op-erating concept from Siemens Healthineers (for example, syngo). Depending on the level of experience with different systems that share the same operating concept, in some cases the training time was even halved.5

Initial training time for MAX systems


Ease of system familiarization6

Prior to the installation of the MAX systems, participants in the MAX Portfolio Efficiency Study were asked about their view of standardized system usage. All of those interviewed clearly stated a desire for more standardization in the technical equipment they use. They all wanted systems with a similar operating concept, expressing a desire for an easier learning curve with new applications, more flexible staff rotation between different systems, and reduced risk of op-erational mistakes. All participants with prior work experience on a different MAX system also expected to realize an advantage in integrating the new MAX system into their work routine. When introduced to the new systems, this user group perceived the MAX system as familiar. They also considered it to be more intuitive to use than did users without MAX experience – which directly corre-sponded to their confidence in operating the system independently in a short timeframe.

Do you think that the system experience (that you mentioned be-fore) has facilitated your work learning to use the new system?7


I feel confident that I will be able to independently operate the system very soon8

In addition, the user group with MAX experience expected their acclimatization with the new system to be easier and faster based on their prior knowledge. This expectation had a positive impact on the users’ overall attitude toward the new system – and ultimately on their training and familiarization with the new modality.


Efficiency gains after the learning phase – changing from CR cassette to digital The aforementioned learning curve on a new system has the potential to con-tribute to an optimized workflow, especially when the operating concept is al-ready known to the user. The following chart depicts the changeover time from a stationary CR system to a new stationary digital Ysio Max system. It illustrates the average time required for one radiography examination, in-cluding deviation time. After an initial short-term increase in the average exam-ination time per patient (which was expected because users have to become familiar with the larger number of advanced functionalities), the chart shows that making the transition to a digital system can bring great potential for effi-ciency gains. It also reveals that the deviation time when using the digital MAX system after just six weeks of use was far smaller than with the CR cassette system, even after years of experience. Some of the reasons include the clearly defined workflow process steps of Digital Radiography (DR) and the intuitive user interface of the MAX system. Conversely, the highly irregular CR cassette reading workflow can result in inefficient usage and time-consuming examina-tions.9

Please note: This is an example of the average examination time, including deviation time, for a chest X-ray acquired in a participating hospital.


Efficiency gains after the learning phase – changing from digital to a MAX system Shifting from a CR cassette system to a digital MAX system is not the only de-vice change that can lead to efficiency gains. The following chart shows that changing from a competitive stationary digital system to a digital Ysio Max system can have the same effect. Once again, the average time needed for one radiography examination was longer in the transitional phase, the result of users needing to familiarize them-selves with the new system. After this short-term increase, however, it took less time to perform one radiography examination with a MAX system than with the previously used digital system. In addition, the deviation time also decreased. Reasons for this include the clear, uniform operating concept and the intuitive user interface of the MAX systems.10


“The system operation enables me to have more time for the patient.”11

Please note: The chart above depicts answers from users who have prior experience with a MAX system.

Flexible staff scheduling No one radiology department is like any other. The six radiology sites that took part in the Siemens Healthineers efficiency study were very different. They in-cluded hospital radiology departments and radiology practices in hospitals. The number of beds ranged from 70 to 979 and the number of X-ray technicians from 6 to 30. Whether small or large, a radiology department or practice usually owns sev-eral systems. Complex systems are typically operated by one or two system experts. If these staff members are away on vacation or sick leave, however, staff scheduling can become a challenge because there may be no one else on the team who knows how to properly operate the system. Furthermore, some technologists may prefer a certain system and feel more comfortable operating it. A radiology department is usually divided into several subunits, including con-ventional radiology, computed tomography, magnetic resonance tomography, mammography, fluoroscopy, angiography, and sonography. Unlike other units, traditional radiology departments usually operate 24/7. Of the six radiology sites that took part in the investigation, the staff of the traditional radiology unit worked in shifts. In addition, each staff member was an expert on one mo-dality in the other units for emergency cases. Because it owns heterogeneous equipment with different operating concepts, however, this practice is prone to operational failures, interruptions, and the resulting process delays – which can lead to excessive wait times. A standard-ized workflow and operating concept across the various systems can help ad-dress this issue and increase flexibility of staff scheduling.


… A significant advantage here is that Mobilett Mira Max has the same interface as the Ysio Max – in any case, we use the syngo inter-face on all our Siemens Healthineers systems. Our team rotates between different workstations, and this uni-formity makes adapting to working on different devices easier. We only have to adjust in terms of what we are doing, and don’t have to worry about how to use particular functions, because we know exactly where every little button and feature is.

Gesa Peil, Senior Radiologic Technologist Johanna-Etienne-Krankenhaus, Neuss, Germany


6. Key Takeaways Although the intention is to improve care delivery, advances in technology are leading to an ever-increasing number of applications in hospitals, which may add to the overall complexity for staff. This makes establishing process efficiency an important factor in cost management.12 Standardizing the operat-ing concepts of medical systems offers a huge opportunity to minimize training and onboarding time, reduce interruptions and wait times, and make processes faster. It also allows staff to operate any equipment confidently and inde-pendently, which in turn enables flexible staff scheduling and increased patient safety. 1. Standardized operating concepts are very welcome If the only goal of standardizing processes is to reduce expenditures, the chang-es are not generally well received by staff. Standardized user interfaces and unified operating concepts, however, are welcomed and supported by users in the radiology department. They can result in an open attitude and positive ex-pectations when new systems are added at a later time, because the staff antic-ipates that the adaptation phase will be fast and easy. 2. Efficiency gains can be clearly defined Standardizing the operation of medical systems leads to efficiency gains, including reduced initial training time, ease of familiarization, and flexible staff rotation. It also means that the radiology department no longer needs to depend on a particular expert staff member to operate a specific system. A uniform operating concept also saves time and therefore costs when onboard-ing new team members. 3. Improved patient care due to reduced focus on equipment The users participating in the study were able to operate the new MAX systems independently and confidently within a very short time. Confident users who know exactly what buttons to press also minimize the risk of error, which in turn increases patient safety. Additionally, all users who were interviewed agreed that once they were used to the system, they also had more time for their patients – because they did not have to focus on the equipment. This means that standardization results not just in efficiency gains but also in more satis-fied staff and patients. This can ultimately lead to a higher level of patient care.


7. References/

Additional Resources 1. Premier Inc. (2017) C-Suite Survey: Health System Leaders Focused on Managing

Costs, Improved Use of Data in Period of Uncertainty. [online] Available at: https://www.premierinc.com/premier-inc-c-suite-survey-health-system-leaders-focused-managing-costs-improved-use-data-period-uncertainty/ (accessed July 4, 2017)

2. Rezapour et al. (2015). Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012. Medical Journal of the Islamic Republic of Iran, 29, 266. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4715383/ (accessed July 10, 2017)

3. Zarzuela et al. (2013) Defining Standardization in Healthcare. [online] Mohawk shared services. [online] Available at: https://www.mohawkssi.com/en/resourcesSection/resources/ResearchPaperDefiningStandardizationinHealthcarerevisedOct302013Final.pdf (accessed May 31, 2017)

4. Burmann, A (2017) Masters thesis: Eine Portfolioeffizienzanalyse der “Multiple Advances in X-Ray“ (MAX) – Röntgengerätelienie der Firma Siemens. Erlangen. Restricted.

5. Burmann, A (2017) Masters thesis: Eine Portfolioeffizienzanalyse der “Multiple Advances in X-Ray“ (MAX) – Röntgengerätelienie der Firma Siemens. Erlangen, pp. 35-37, restricted.


7. Burmann, A (2017) Masters thesis: Eine Portfolioeffizienzanalyse der “Multiple Advances in X-Ray“ (MAX) – Röntgengerätelienie der Firma Siemens. Erlangen, p. 40, restricted.





12. Bailey et al. (2012) Health system fitness: A proven approach to transformational cost reduction. [online] Strategy & Available at: https://www.strategyand.pwc.com/reports/health-system-fitness-proven-approach (accessed June 1, 2017)


The MAX family is not commercially available in all countries. Due to regulatory reasons its future avail-ability cannot be guaranteed. Please contact your local Siemens organization for further details.

The statements by Siemens’ customers described herein are based on results that were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption), there can be no guar-antee that other customers will achieve the same results. The speaker is separately engaged and paid by Siemens to provide product reference services.

On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products/services/features included in this paper are available through the Siemens sales or-ganization worldwide. Availability and packaging may vary by country and are subject to change with-out prior notice.

International version. Not for distribution or use in the U.S.

Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen Germany Phone: +49 9131 84-0 siemens-healthineers.com

The information in this document contains general descriptions of the technical options available and may not always apply in individual cases.

Siemens reserves the right to modify the design and specifications contained herein without prior notice. Please contact your local Siemens sales representa-tive for the most current information.

In the interest of complying with legal requirements concerning the environmental compatibility of our products (protection of natural resources and waste conservation), we may recycle certain components where legally permissible. For recycled components we use the same extensive quality assurance measures as for factory-new components.

Any technical data contained in this document may vary within defined tolerances. Original images always lose a certain amount of detail when reproduced.

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Boost efficiency and user confidence - Delta Medical Systems · 2020-03-05 · 2 White paper | Boost efficiency and user confidence in your radiology department with standardized