CHAPTER 2

• Fusion Technology
• PACS Administrator
• Radiography
• Vascular-Interventional Radiography
• Computer Tomography
• Nuclear Medicine
• NMAA
• Cardiovascular Interventional Technology
• Mammography
• Radiation Therapy
• Sonography
• Magnetic Resonance Imaging
• Bone Density
• Quality Management
• Radiology Assessment

Production of images using ionizing radiation.

• Radiologic Technologist person qualified to use x-rays to produce images of internal parts of the body.
• Performs various diagnostic exams. 
• Skeletal system chest & abdomen.
• Contrast studies; GI tract, GI tract, myelograms, anthrograms, etc. 
• Radiologists physician qualified to interpret x-rays.

• Minimally invasive procedures performed by using image quidance.
• Ex., CT, Fluoroscopy, and US.

• Sometimes called CAT Scan. 
• Uses x-ray equipment to obtain image data from different angles around the body then uses computer processing of the information to show a cross-section of body tissues and organs. 
• Starting salary between 61K-62K annually.

• Involves procedures that require the use of radioactive materials for diagnostic materials for diagnostic or therapeutic purposes. 
• The images are developed based on the detection of energy emitted from radioactive substance given to the patient, either intravenously or by mouth. 
• Usually involves images of the patients organs (liver, heart, or brain).

• Advance level NM tech filling in the gap in NM department from pre-testing assessment through prediction assessment allowing the NM Physician/Radiologist the freedom to commit to the final interpretation of tests while maintaining the hands-on approach to patient care without sacrificing quality.
• Starting salary 71K annually.

• Specialize in performing exams of the cardiovascular system. 
• These procedures involve the injection of contrast media into arteries or blood vessels. 
• Starting salary 65K annually.

• Specialize in performing examinations of the breast. 
• Mammography is a specific type of imaging that uses a low dose x-ray system for examine breasts. 
• A mammography exam, called a mammogram is used to and in the diagnosis of breast diseases in women. 
• Starting salary 60K annually.

• Radiation therapy is the use of controlled high-energy external or internal radiation used to destroy cancel cells so they can no longer continue to divide or multiply. 
• Radiation therapist is a person who administers radiation treatments to patients according to the prescriptions and instructions of Radiation Oncologists. 
• Starting salary 80K annually.

• Member of Oncology team who trains under qualified Physician.
• Design a treatment plan to best assist patient.
• Same idea as P.A. to a physician.

• Ultrasonography, commonly called sonography, sonogram, or ultrasound scan. 
• A diagnostic medical procedure that uses high frequency sound waves (ultrasound) to procedure dynamic visual images of organs, tissues, or blood flow inside the body.

Used to help diagnose breast lumps or other abnormalities.

• Done to help monitor/examine blood flow to organs & tissue throughout the body.
• Ex., Doppler study.

• AKA MRI
• MRI uses radiofrequency waves and a strong magnetic field rather than x-rays to provide remarkably clear and detailed pictures of internal organs and tissues.
• Starting salary 65K annually.

• Used to diagnose osteoporosis.
• Osteoporosis, is a disease in which bones become extremely porous, and are subject to fracture and heal slowly, usually in women following menopause. 
• Measurement of lower spine and hips are most commonly performed.
• Starting salary 55K annually.

• Includes room and workflow design, equipment selection, equipment purchase, installation oversight, acceptance testing, commissioning, quality control, on-going equipment maintenance and support, and disposal at the end of equipment useful life. 
• Most have RT to take ARRT Quality Management examination.
• Starting salary 80K annually.

• With Radiologist supervision, the RA performs patient management fluroscopy and many other radiology procedures. 
• The RA makes initial observations of images but not provide an official interpretation. 
• Starting salary 103K annually.
• 46K school cost.

• This technology combines organ function with organ anatomy.
• Old way, PET & SPECT is organ function.
• CT & MRI is organ anatomy
• New way, Fusion Technology combined, organ function and anatomy combinning all four, PET, SPECT, CT, and MRI.

• Picture, archiving and communication system.
• Require maintenance management and troubleshooting of a PACS system.
• Manages and implements storage of all digital images received.
• Starting salary 60K-70K annually.
• Plan and implement software upgrades.
• Supervise training on PACS for Radiologists, Technologists, and any other technical staff. 
• Must work well under pressure and able to handle multiple projects at once.
• Must manage department operating budget and be involved in purchase of PACS. 
• Excellent written and oral skills. 
• Must have strong people and communication skills.

• Hospitals, colleges, and universities. 
• Clinical instructor, didactic faculty member, clinical coordinator and program.
• Management 
• Director of Imaging Department. 
• Commercial Firms as sales rep selling equipment, film, processing chemicals, and related supplies. 
• Application Specialist, giving in-service training for new medical equipment.
• Jails/Prisons x-rays fluroscopy room.
• Assisting the medical examiner to determine cause of death.

• Ensures radioactive materials and radiation producing machinery are handled properly. 
• Many duties overseeing safe use of ionizing radiation, monitoring radiation exposure of all personnel, maintaining the dose reports, providing survelaince of labs that use radioactive materials, proper handling and disposed of contaminated radioactive materials, etc. 
• Ensure all personnel learn new techniques for exposure limits and radiation protection.

• All modalities are usually offered. 
• Radiography, Fluroscopy, CT, MRI, US, Mammo, NM, Interventional Studies, and Cardiac Studies.
• Hopitals are openend 24 hours/7 days a week.

Clinics can range from Radiography for orthopedic services to all modalities for a major outpatient health care setting.

• Primary function is diagnostic imaging.
• Most imaging centers are not open 24 hours a a day.

• Surgical procedure done outside the traditional hospital setting. 
• Technologists services are required.

• Mobile services provided increased access to care in remote areas. 
• Another option for Technologists as employment.

• 1970's terminally ill patients could chose the facility of their choice to be cared for. 
• On occasion a physician may order an x-ray patient. Usually done through a portable service to come to patients home.

• Alternative to a hospital setting to treat people suffering from psychiatric disorders. 
• Radiology department is on the premises.

• Is needed when another person is needed to help with physical or emotional need over an extended period of time. 
• Can be due to illness, injury, disability, terminal condition, or infirmity of old age. 
• Can be temporary, ongoing or long term care.

• Since hospital care costs have increased, patients are being discharged from the hospital stay very ill. 
• So home health care gives them the care still needed in their home.

• Wellness program designed to get people to live a healthy lifestyle. 
• By education information, activities,  or memberships to local health and fitness facilities. 
• Completing screenings and counseling. 
• Emphasis on prevention rather than medical intervention.

Is an application of clinical medicine where medical information is transferred through the phone or internet for purpose of counseling and sometimes remote medical procedures or examinations.

• ICD-9-CM used for coding and reporting diagnosis and procedures. 
• HMO's
• PPO's
• No Insurance
• COBRA
• Medicare
• Medicaid
• CHIP 
• Community Health Centers
• Self-Pay
• VA Benefits

• AKA Health Maintenance Organizations
• Provide complete and comprehensive health care for the cost of a premium each month and a co-pay for each visit.

• AKA Preferred Provider Organization
• If a physician is chosen "in-network" the patient will be responsible for their annual deductible and co-pay.
• If a physician is "not-in-network", then the patient will pay a higher amount, need to pay the doctor directly and file a claim and the PPO will reimburse later on.

No coverage for medical, dental, or vision care.

• AKA Consolidated Omnibus Budget Reconciliation Act
• Can be purchase for a variety reasons,
• Quit job and want continual coverage.
• Have ongoing health problems.
• Have a job that does not offer a health plan.
• Been declined from private insurance.

• Covers persons 65 years and older, permanently disabled workers and their dependents and persons with end-stage renal disease. 
• Part A, covers acute hospital care with home health services and requires person to pay a deductible for each benefit period for hospital.
• Part B, covers out patient care, doctors services, tests and preventative treatments. Home health services include limited and only medically necessary part-time care.

Federally funded and state administered program that provides medical care for families and dependents older adults, children, or disabled persons who qualify.

• AKA Children's Health Insurance Program
• Low cost insurance for children in families who earn too much income to qualify for Medicaid, but can't afford private insurance.

No cost or sliding scale based on a persons' income.

• Payment must be made in full at time of services. 
• Usually a discount of some sort is given for "cash patient" (20%).

If serves at least 24 months, benefits are given.

• 1st Party - Patient
• 2nd Party - Dr., hospital, clinic, etc. 
• 3rd Party - Insurance company. 
• 3 major types of reimbursements systems.
• 1. Free-for-Services
• 2. Espisode-of-Care Reimbursement
• 3. Global payment method.

• AKA Traditional Retrospective Payment
• A specific payment is made for each specific provider.

• Method which providers receive one lump sum for all services they provide related to a condition or disease. 
• One amount is set for all the care associated with the condition or illness.

3rd party makes one combined payment to cover the services of multiple providers who are treating a single episode of care over the course of a year.