Recommendations on Standards for the Design of Medical Diagnostic Equipment for Adults with Disabilities, Advisory Committee Final Report

7.3 Imaging System Accessibility Configuration Examples and Concerns

The overall goal of imaging system accessibility configurations is to offer technically feasible, relatively low cost solutions to improving accessibility of existing imaging equipment and thus meet recommended standards for diagnostic equipment accessibility. These accessibility configurations could possibly be considered as integral components of diagnostic imaging equipment, just as are other accessories under FDA regulations. As noted above, the concept of imaging system accessibility configurations arose initially from deliberations of the Diagnostic Imaging Subcommittee, and the Advisory Committee discussed this possibility at length. Making specific recommendations about the components of this new concept was beyond the scope of the Advisory Committee. Nonetheless, given the interest of some Advisory Committee members in this option, this section of the report provides background information and preliminary concepts about potential imaging system accessibility configurations.

Members of the Diagnostic Imaging Subcommittee suggested a number of possible imaging system accessibility configurations. Examples of potential configuration components include:

• Making architectural changes to sites where equipment is installed, such as embedding parts of the equipment into the floor (or raising the room floor). This would reduce the distance between the floor and the transfer surface.

• Installing ramps or scissor-lifts next to equipment to raise wheelchair users closer to the transfer surfaces.

• Installing adjustable/collapsible handgrips next to the transfer surface to provide patient transfer or positioning support.

• Using ceiling-mounted lifts to raise the patient onto the table if there is not sufficient space to accommodate a portable lift (e.g., because of inadequate room underneath the equipment’s base for a portable lift to be positioned).^MM

Three figures provide images of potential imaging system accessibility configurations:

Figure 7.3(a). Illustration of a concept (not to scale) for a detachable floor mounted support. The support could be made to be both height adjustable and detachable at floor level.
(SOURCE: GE Healthcare)

Figure 7.3(b). Illustration of a concept (not to scale) for a wheeled support. The wheels would lock and the base is sufficiently robust and sized for appropriate loadings. The support could be made to be height adjustable.
(SOURCE: GE Healthcare)

Figure 7.3(c). Illustration of the concept (not to scale) of various accessories deployed as part of an accessibility configuration. The first illustration shows a floor mounted support combined with a scissor lift. The following illustration shows the floor mounted support combined with the elevated platform.
(SOURCE: GE Healthcare)

Some committee members expressed concerns about various aspects of the imaging system accessibility configuration concept and examples. One issue involved the practical implications of some components of these suggested accessibility configurations. For example, a detachable handhold might not be readily available to patients (i.e., because they are detachable, the handhold might have been moved elsewhere). Technicians might not be trained adequately in the use of these accessibility aids. Lifts cannot be used independently. Embedding equipment into the floor of rooms in the imaging suite might be expensive and architecturally challenging. Therefore, some of the more “fixed” accessibility configurations might not appeal to some health care providers.

Committee members also raised concerns about potential safety issues. Having ramps built next to equipment – or scissor lifts – raised questions about safety for individuals using mobility aids and perhaps clinical personnel (e.g., because they could create tripping or falling hazards). These types of changes would require further study of risks to safety for patients and staff. In addition, these configurations would need to allow access for emergency personnel.

Again, the Advisory Committee urged the building of accessibility features into future equipment designs. But some Committee members, including certain representatives of equipment manufacturers and health care delivery systems (equipment purchasers), emphasized the reality that imaging equipment today represents a large capital outlay for health care facilities. This equipment generally is used for many years before being replaced with newer technologies. Some members of the Advisory Committee saw imaging system accessibility configurations as an option for “retrofitting” many existing systems to improve their accessibility within a relatively short time frame. Furthermore, accessibility accessories, ancillary equipment, and/or site features could be designed to have minimal impact on current imaging systems, thereby increasing the likelihood of adoption and thus the total number of accessible systems. Additionally given the costs and lengthy time involved for new equipment design, Committee representatives of imaging manufacturers indicated their belief that the imaging system accessibility configurations would provide a lower customer cost, timely strategy for improving accessibility to this equipment in the near term.

Notes

^MM These two lifting methods would be viewed as equivalent.