Transition to an all-digital echocardiography laboratory: a large, multi-site private cardiology practice experience.

Acquisition, interpretation, and storage of digital echocardiographic images has many advantages over the standard videotape-based method. Archival, transmission, and comparative interpretation are all optimized with digital echocardiography. A study performed at one site can be immediately available for viewing and analysis at another site by means of standard data transfer technology. Echocardiograms can be interpreted in the context of prior studies, which are readily available for side-by-side comparison. The transition to an all-digital laboratory involves the commitment of persons at multiple levels in the cardiology practice, including administrators, information technology specialists, sonographers, and physicians. Quality of patient care, use of physicians' and sonographers' time, and long-term financial benefit are all areas where improvement may be realized with the use of digital echocardiography. We present our experience in the development of an all-digital echocardiography laboratory, and we conclude that digital echo-cardiography is practical and can be implemented readily in a clinical setting. We performed several correlative analyses during this transition to validate the consistency and accuracy of digital interpretation compared with those of analog methods. The transition process from analog (videotape) to digital, including full wide area network exchange, took approximately 8 months. As technology advances, issues surrounding storage, comparison, and acquisition formats will continue to develop. We hope that our experience will help others make the transition to the digital environment and benefit from the ease of image access, the ability to comparatively interpret echocardiograms, and the superior image quality afforded by this advancement.

Noninvasive approaches to peripheral vascular disease. What's new in evaluation and treatment?

Current availability of noninvasive evaluation and treatment methods for peripheral vascular disease is unprecedented. Understanding of vascular and molecular biology, physiology, and pathology has improved significantly, as have the technologic capabilities of ultrasonography, digital imaging, therapeutic angiogenesis, and other methods not even in existence a few decades ago. However, although science continues to advance rapidly on multiple fronts and, eventually, noninvasive methods will supersede current treatment options, for the immediate future, heavy emphasis should continue to be on preventive strategies.