With healthcare institutions incentivized to convert to digital radiography (DR) under the Consolidated Appropriations Act of 2016, many organizations have made the transition from computed radiography (CR) to DR. For the imaging staff at Androscoggin Valley Hospital (AVH), a small, rural 25-bed hospital in Berlin, N.H., it was not the cost-effectiveness, but time and resources that led to the conclusion to adopt digital. The final decision came when their 11-year-old CR system began needing new imaging plates and maintenance.
A Hybrid Solution
Recently named one of the top 100 critical access hospitals in the U.S. by iVantage Health Analytics, AVH may be a “small-town hospital” but it plays a key role in the health of patients in several towns in northern New Hampshire, as well as two prisons (one federal, the other state). Serving thousands of patients annually, the small institution maximizes its assets (people, technology, etc.) to serve a large number of patients. Wayne Couture, director of imaging and cardiopulmonary services at Androscoggin Valley Hospital, cites the secret to the small hospital’s success is finding ways to optimize care quality while maximizing budgetary resourcefulness.
When the time came to transition to DR, AVH conducted comprehensive research on DR vendors as it was important to get the most out of its investments. The hospital decided to remain with Fujifilm, its CR partner since 2004, and upgrade to two Fujifilm FDR D-EVO II detectors. A hybrid partner in CR and DR enabled the techs to use CR as a backup, as their existing Fujifilm FDX Console workstation integrates with both CR and DR.
“I didn’t necessarily have to throw away a capital asset that I purchased back in 2004 and still has some life in it,” said Couture. “The D-EVO II ended up providing a pathway forward, into full digital radiography, without my having to completely close the door on the older CR technology. It has been a perfect solution.”
Utilizing the new DR detectors on their console helped Couture’s team quickly learn DR, while avoiding the costs and time associated with installing and learning a new workstation.
Digital Upgrades Made a Big Difference
In a hospital the size of AVH, small upgrades mean big time-saving and quality improvements for Couture’s staff. One of the most promising features of DR is the memory that stores images inside of the detector — mobilizing technologists to freely use detectors on demand with a portable or bring it into another room to capture images. When the techs finish X-raying patients, they can upload images at a workstation, without special configuration or any invasive connections to those secondary X-ray systems.
On its memory capability, Couture stated, “It instantly became the perfect solution to everything I was trying to achieve. We’re now able to have DR in both our X-ray rooms as well as with our portable radiography. For us, this technology was the solution to many upgrade challenges.”
The Priority is Quality
For AVH, patient-focused outcomes have always been a top priority. Not only did the transition to DR benefit AVH’s staff, it also improved healthcare outcomes. With the D-EVO II, exams are improved due to less discomfort and decrease in radiation dose.
“We have actually reduced radiation by 40 percent compared with CR,” said Couture. “That’s more than I thought we could do.”
Along with increased patient comfort, the lighter weight of the D-EVO II detectors and tapered edges have made the exams easier for techs to position under patients.
Another time-saving measure for the hospital is the incorporation of Virtual Grid technology, which interprets and corrects the effects of scatter radiation and reduces dose all while completely eliminating the need for cumbersome grids.
“We were all blown away by the Virtual Grid feature,” Couture said. “The first time I saw an abdominal X-ray done without a grid, and with Virtual Grid applied, it was for a very large patient. The algorithm gets applied, and you can’t believe how this technology can clean up scatter the way it does. You can read about how this works, but until you see it actually happen — let’s just say, seeing is believing.”
Improved Care for More Patients
Since its upgrade to DR, AVH has been serving patients in its community faster and with more comfortable exams, while radiologists receive top-notch image quality in a user-friendly, mobile experience.
With decades of experience in imaging, Couture believes DR to be the most significant technological leap and AVH is capitalizing on DR’s features and quality to serve more patients.
“We’re planning to buy a third D-EVO II panel this summer,” Couture explained. “We’ll leave the larger room with a panel in each tray and have a dedicated panel in the smaller room.”
For the community hospital, saving time with DR technology is mission critical.
“I am still a working technologist myself, and when I am X-raying a cervical spine or shoulder, the accuracy and time savings I gain is amazing,” he said. “The instantaneous image display that DR provides for repositioning the patient” is such that “none of the staff ever wants to go back to the clunky CR processes again.”
Case study supplied by FUJIFILM Medical Systems U.S.A., Inc.
October 23, 2025 
