Bracco’s SmartInject Solutions | Powered by Outstanding IT Applications Support

Every minute of downtime in the CT suite means lost productivity, reduced revenue and a patient waiting for answers.

Kamran  Nasrullah, CIIP, and Siju Koshy, MBA, RT (R)(CT), CIIP, know this challenge well.  Nasrullah has worked in healthcare for approximately 13 years, first as a hospital PACS administrator, and now as a Senior Device IT Application Specialist at Bracco Diagnostics. Koshy is a registered CT technologist who spent nearly two decades as a PACS administrator and systems administrator before joining Bracco as an IT Application Specialist.

In the role of IT Application Specialist, “we wear many hats, from project managers, trainers, liaisons for customer service, and product consultants within Bracco,” said Nasrullah . However, supporting clinicians with service that goes the extra mile, is a top priority.

Nasrullah and Koshy strive to fulfill this mission every day, ensuring Bracco’s injectors and software are helping customers deliver the right contrast injection protocol for the selected exams. . “We make sure the customers are always taken care of,” said Koshy.



A Holistic Approach to CT Imaging with SmartInject Solutions

Nasrullah and Koshy support Bracco’s SmartInject Solutions which centers on NEXO® Contrast Management System, a server-based application intended for use as a data-management and visualization system.  NEXO® is able to read, store, share, compare and relate data, as well as graphically display information and injection programs coming from RIS, PACS, and multiple enabled EmpowerCTA® Injector Systems which provides users with record-lists, graphics, and key preforming indicator (KPI) reports.

These interconnected systems allow customers to collect critical information that supports data-driven decisions. “Everybody wants to capture information so they can start making meaningful sense out of it,” explained Nasrullah . “That’s the benefit of our smart injectors. You're tying contrast information to patient demographics and their medical records, and you’re doing all of this on an existing platform that clinicians are already familiar with.”

“NEXO® collects everything contrast-related so you can make the proper adjustments and operation changes within your department,” continued Koshy.


The SmartInject Solutions platform can be scaled to fit any size facility, allowing users to standardize protocols and manage multiple injectors from one console. With these interconnected systems, contrast imaging protocols and parameters can be shared with a third-party system like a dictation system. Receiving this type of contrast data within the dictation software reduces the burden of manually inputting that information into the radiologist’s report.

“We can automatically transfer the information into the dictation report. That's one step that can actually eliminate human error, and any kind of mistakes that would otherwise happen manually, and by eliminating clicks and extra steps, it makes it seamless for the radiologist,” said Koshy. 

Nasrullah concurred. “So, the radiologist is opening a blank dictation report that has all of the contrast information there; for instance, the contrast brand, the concentration, and the amount of contrast that was delivered.” 

With patient demographics and contrast injection parameters seamlessly and automatically populating into the Radiologist’s report, the SmartInjectCT® offers an opportunity to achieve the highest levels of clinical care.



A Simplified CT Workflow

The NEXO® Contrast Management System creates a secondary DICOM capture that contains all of the contrast injection information for each CT scan. Koshy said this is one of the biggest benefits of the system because it simplifies day-to-day CT operations and allows users to send an image to the PACS and remotely share comprehensive contrast information with the radiologist. 

“It's CliffsNotes of how the injection went. It gives everything from the patient identification, the CT scanner that was used, the contrast injected, plus all the details from the injector itself, such as the pressure, graphs, flow rates, all the minute details of what phases were utilized during the injection, plus any text notes that the technologist conveys to the radiologist. With this DICOM capture, the radiologist receives all this information automatically, removing any manual process,” said Koshy.

If the radiologist sees that images aren’t enhanced properly, they review the DICOM secondary capture to decide how to improve subsequent images, such as adjusting the contrast protocol or injection rate.



The protocol management feature indicates how users are injecting patients for specific studies, allowing managers and technologists to easily standardize protocols. This can be especially helpful for larger integrated health networks with multiple injectors installed in different CT rooms, across many facilities. 

“You're able to customize protocols and push them out to all of the networked injectors without going from site to site and having to touch each one. It saves a lot of time and money, when there is a need to update the protocols,” said Nasrullah.



Standardizing Protocols, Managing Compliance and Balancing Budgets

Nasrullah said many hospitals are establishing contrast committees that annually review contrast purchases and protocols to improve finances, safety, compliance, and standardization. A SmartInjectCT® informatics system can support this endeavor by simplifying this process. 

The NEXO® system delivers key performance indicators, including financial reports detailing contrast and disposable utilization. The protocol management solution allows users to assess CT operational data across a fleet of injectors, incorporating the type of study and the amount of contrast being used for a specific protocol. This information is extremely helpful for radiology administrators as they manage operational budgets and track contrast waste. Importantly, quick access to the data from the network of injectors during The Joint Commission review is helpful and supports the medication management guidelines. 

“If you’re using a smart injection solution, you're going to be ahead of the game because you're collecting that information and keeping if with the patient’s history. This places a facility ahead of the curve in these changing times of data collection,” explained Koshy.



A Phased Approach for a Smooth IT Deployment

Nasrullah and Koshy said their shared background in healthcare helped them establish a three-phase process that prevents any issues during the NEXO® deployment. “We make it as easy and seamless as possible because nobody wants to buy a product that's really difficult to deploy,” said  Nasrullah.



Phase one includes a kickoff call with all key stakeholders, including clinicians, the IT team and PACS administrators, to establish the relationship and answer preliminary questions. “There’s a lot of information that is shared on this call, and it’s delivered to a lot of people who will be involved during this part of the deployment,” said  Nasrullah This initial phase provides the IT application specialist with an opportunity to ensure that everyone feels comfortable with the deployment steps and understands that there will be support continually delivered by someone that respects the imaging department’s workflow and IT needs.


Next comes the installation and configuration phase, where the NEXO® application is installed. This involves the facility’s PACS administration team “to determine what the configuration process will be and how the customer wants it to be configured to meet their IT platform,” stated Nasrullah. 

Phase three is the “go live” stage, complete with a site visit to properly connect each device and conduct hands-on training. This includes communicating details to all stakeholders and making sure the right people know their Bracco IT applications specialist will be on site to completely support the installation, deployment, and training. 

“Go live day for us is like the championship game, so we have to make sure we're there and ready to go,” said Koshy.

Nasrullah feels that “communication with the customer is number one” when it comes to successfully deploying a smart IT solution in today’s imaging departments. Through weekly and biweekly calls with the key stakeholders, the IT application specialists keep their customers informed and aware of where they are through the entire deployment process, including when they can expect a “go live” day and time.

Keys to Successful IT Deployment

When installing the NEXO® Contrast Management System, Bracco’s IT application specialists deliver a “one-stop-shop” process to customers. They provide on-site, in-service training, in the “natural environment” where the technologist works each day. A new SmartInject application is best accepted when technologists feel supported by application specialists who understand the day-to-day departmental workflow, while prioritizing the patient’s safety and care during the application training.



Building the Customer’s Trust

A key part of the process is building trust with the customer to ensure the project’s long-term success.

“This is where Bracco's reputation comes in play,” said Nasrullah. “It’s also important to clearly define objectives and describe your specific background to the customer so they understand that they're not dealing with somebody who has no idea what they're doing. Our goal is to always build trust as quickly as we can.” 

It is critical to protect confidential data and deliver the cybersecurity that hospitals expect. “We make sure we're using the latest software and technologies to keep patient records secure in a world where data breaches are happening day in and day out,” said Koshy.

Post-deployment upgrades are treated with the same attention to detail. “We have yet to see any problems out in the field because we usually go above and beyond when it comes down to planning for those installs and upgrades,” said Nasrullah.

A Passion for Going Above and Beyond

Drawing from their personal experiences of working in the hospital setting and listening to their NEXO® customers, Koshy and Nasrullah worked together to develop a customer-focused, deployment process with the ultimate goal of delivering a seamless implementation plan that supports Bracco’s SmartInject Solutions. 

“We try to go above and beyond because we know that there is a patient on the table. We come from the hospital world, so we know what that means. We want to make sure that the customers are up and running with no downtime. If there are any issues, we are there to help them as best as we can,” said Koshy. 

“We both chose this field specifically because we are passionate about it. This is what we live and breathe day in and day out. This is not a job for us, this is our life,” said Nasrullah. “It's going above and beyond. We are always thinking outside of the box, not looking at it like a cookie cutter mold for deploying our IT solution.”



Even during the COVID-19 pandemic, this commitment to the customer did not change. 

“The first opportunity we had to go to a customer, we didn't even think twice. We got on a plane, went to the site, helped them out, got them up and running. That's how passionate we are about our field and that's how much we care for this specific product,” said Nasrullah.

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