Other issues affecting the industry today are poor reimbursement, the economy and the inability to get financing.

"Many of the clinics that were planning to add digital mammography in 2009 are now reevaluating their budgets or putting off the purchase for four to six months until they see what the economy will do," says Becky Lowe, Modality Manager for Women's Health at Block Imaging International, Inc. "It's a very uncertain time for free standing centers and small independent or rural hospitals who can't afford to take a risk."


A digital system runs in the neighborhood of $350,000 vs. $70,000 for an analog system, so financial constraint does play a major role for many in the decision to make a switch.

For those who want to go digital but can't, they can try the next best thing by using Computed Radiography, which is an inexpensive alternative and provides some of the benefits of using a digital system.

"This allows facilities to continue to use their existing screen-film cassettes, but with an imaging plate that acts as a digital adapter," says Hall. "Computed radiology produces something that's similar to screen film but it produces a digital image. You would take a standard screen film gantry and use digital plates instead of cassettes and take them to a reader or processor and the image will be read out as a digital image."

The price point on these systems is cheaper than a full digital system and the PACS system required to go along with it, but it doesn't offer the same workflow efficiencies that are often wanted.




The economy may be causing problems on the patient side as well. There is a rising fear in the health care industry over a decrease in women getting a mammogram, which may be attributed to the economy and tightening personal budgets.

Many people are losing jobs and health care coverage, or switching to health coverage with higher deductibles where they can't afford to pay the co-pay, so they are skipping their yearly screening.

"Most recently, screening numbers have been declining, an alarming trend that requires immediate action," Radtke says.

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