The company, based in Rochester, NY, is leveraging its strength in digital x-ray to expand into new sectors of the imaging market

When late last year the Rochester, NY-based Carestream Health announced its plans to develop a new 3D imaging system using cone beam computed technology (CBCT), some viewed the move as a departure from the company’s traditional focus on digital x-ray. That’s not the way Todd Minnigh sees it.

Minnigh, a radiology expert and Carestream’s worldwide director of Global Service Sales, calls the new system, currently being trialed under FDA guidelines, a “natural expansion for our portfolio.” More digital x-ray images are made using Carestream products than those from any other company, he notes; that powerful presence in a tried-and-true space gives them every reason to explore new opportunities. “We pride ourselves on taking fresh looks at established markets and trying to do things that haven’t been done before. We’re certainly moving in new directions, but we’re doing it by leveraging what we’ve already accomplished.”

That builder’s approach to progress—where the foundation is poured and the first floor is framed before upper levels begin to take shape—seems to be working. In recent months, the Carestream team introduced its “next generation” of DRX detectors, known as DRX Plus; entered the radiography/fluoroscopy (R/F) market with a pair of systems called DRX-Excel; and received FDA 510(k) clearance for its Touch ultrasound systems, which the company reverse-engineered using feedback from nurses.

When Carestream announced the release of its two Touch products (the Touch Prime ultrasound and the Touch Prime XE ultrasound) last June, Diana Nole, president of the company’s Digital Medical Solutions division, noted that the systems “build upon our proven expertise in digital x-ray.” The company created the technology from a “clean slate,” she said, and worked closely with its customers to give them what they wanted.

New Detectors, New Benefits

Those customers, of course, include not only the doctors and nurses who are the end users, but also those experts on the front lines of HTM. Ask Minnigh about any of Carestream’s latest offerings, and he’ll list all the features that make them easy to use or enhance image quality—but he’ll also point out what they offer for technicians. “We’re always thinking about the needs of biomeds when we design a new product,” he says. “We listen to their concerns in the same way we do the concerns of clinicians.”

Toward that end, Minnigh says, Carestream’s new R/F systems can be easily integrated with its popular DRX-1 detectors, which means upgrading to its DRX Plus line of devices is entirely optional. And for those facilities that do choose to go with the latest detectors, there are “many new things that biomeds will appreciate,” he says.

First on his list: the fact that the detectors can withstand serious abuse. “The main thing is intrusion protection,” Minnigh says. “They have the water resistance of a watertight watch.” In fact, the devices can be submerged in a meter of water for up to 30 minutes without failing (an IPX7-level rating for liquid resistance), essentially eliminating any chance of accidental breakage caused by proper disinfection techniques, patient fluids, emergency flooding, or even a spilled drink.

The new detectors are also both thinner and lighter than earlier models, he says, making them easier to handle and less likely to be dropped. And the detectors’ batteries, which get up to 340 exposures on a full charge, can be changed without a reboot. “You have 15 seconds of hot-swap time, so you can pull the old battery out and put the new one in” without shutting down, Minnigh says. “It saves time, but we also think it will reduce wear and tear.”

Other HTM-friendly features on Carestream’s new detectors include enhanced security and communication protocols, Minnigh says. Traditionally, for a detector to work wirelessly within a department, it would have to communicate with a dedicated access point either on the device itself or in the room where the detector was being used. Carestream’s detectors, through an optional configuration, “can communicate through a RADIUS server to an access point out in the hallway,” Minnigh says. IT security pros appreciate this fact because it gives them the ability to control access points. “And this helps them to limit the ways that someone might be able to hack into the system.”

The drawback, he concedes, is that if a network is anything less than robust, “the rapid communications back and forth between the console and the detector at the moment of exposure could cause issues.” Still, he says, most hospital networks can now handle such communications, and “the security-related advantages” may be worthwhile to some institutions.

Finally, Minnigh notes, the new detectors can be configured for use without any interface to x-ray equipment. Used in so-called “beam-detect” mode, the device is designed to detect an exposure and then shut itself off (which saves battery life). “In a typical wireless detector, the console is usually interfaced to the generator so that the detector knows the moment when the exposure is about to happen,” he explains. The new setup eliminates the need for cable connections, which in turn makes things easier for the folks in HTM. While this configuration is less battery-efficient, it makes for more simplified interfacing to equipment.

A Nice Touch

Similarly, Minnigh says, Carestream’s Touch line of ultrasound machines were designed with ease of use and safety in mind. Built without any knobs, the Touch machines include an etched all-glass interface that allows an ultrasound technologist to tell where the keys are without looking at the screen. “And because it’s just one piece of glass,” he notes, “it’s very easy to clean.”

The company’s popular DRX Revolution, the mobile digital x-ray system that Carestream literature describes as an “x-ray room on wheels,” is also well thought out. The unit incudes a fully automatic collapsible column that makes it easy to maneuver down tight hallways and around crowded bedsides. It also features built-in compartments for gloves, bags, and other clinical accessories. “All of our products are focused around solving the challenges that hospitals face,” Minnigh says. “And patient safety and infection control are both really high on that list.”

Repairs and Replacements

Given the cost pressures most hospitals face, the right of staff BMETs to repair equipment when it breaks or malfunctions is also a major issue. His company, Minnigh says, is aware of that concern, and so offers training to any department that has purchased a Carestream system either directly or through an authorized dealer. Training sessions are offered in Rochester, NY, at Carestream headquarters, and also in Italy and China, at what he calls “market-competitive” prices. In addition, he says, some organizations have internal “train the trainer” programs, where an OEM-trained staff person then instructs additional end users at the facility.

Institutions are permitted to do the servicing themselves, Minnigh stresses, but if they want to do “more than just external work,” they need to be certified by Carestream “to essentially get the keys to the equipment.” Those keys, he adds, include online access to the company’s technical bulletins and repair manuals.

In practice, Minnigh says, many facilities have their own biomeds do first call on all equipment service needs, and then supplement that through a contract with Carestream that covers parts and support, including technical support. Parts for contracted customers come directly from Carestream; for those without a contract, parts are available through Carestream or third-party dealers.

Industry surveys such as MD Buyline have consistently rated Carestream among the best OEMs in terms of customer service, and Minnigh says that ensuring HTM departments are satisfied with their products is always a top priority. “The service training that we provide is not just a business for us. We want to make sure that the facilities we work with are up as much as possible.”

Carestream measures the satisfaction of its customers on its own, using a system called the Net Promoter Score, or NPS. NPSs are calculated on a scale of 0 to 10 and are based on customers’ answers to a single question: “How likely is it that you would recommend [Carestream] to a friend or colleague?”

“It measures the likelihood that that customer would recommend your product to someone else who was interested in it,” Minnigh explains. “You know, ‘I have this Carestream thing, you should give it a try.’ ” When companies operate at that standard, he notes, “you do everything you can to make sure your customers are happy, and that they have every way to get back up if they should ever go down.” For Carestream, he adds, it all boils down to making great devices. “You want to give them the best-quality product you can possibly deliver.”

Which brings us back to that cone beam CT system. Carestream already offers CBCT for dental applications like endosseous implants and facial reconstruction. That system, Minnigh says, “scans very quickly and at a very low cost point compared to a regular CT.” The company’s new technology—should it eventually be approved by the FDA—will provide similar savings in efficiency (and quality) for orthopedic applications.

Minnigh won’t speculate if or when that approval might happen. What he will say, however, is that Carestream will continue to look at the market and attempt to create new imaging technologies that ultimately improve healthcare. “As long as there are new challenges ahead of us, we’ll keep coming up with ways to meet them.”

Chris Hayhurst is a contributing writer for 24×7. For more information, contact chief editor Jenny Lower at

Photo caption: The DRX-Excel Plus is Carestream’s first radiography/fluoroscopy system available in the United States.