Chip Check—PIMS Can Help Manage Microchip Updates
Promote Check the Chip Day All Year Round
by Constance Hardesty, MSc
MRI and Microchips
There is some concern about susceptibility artifacts caused by microchips, particularly in scans of the neck and cranial thoracic regions of cats and small dogs. As more general practices offer MRI services, Trends asked neurologist Simon Platt, DACVIM Neurology, DECVN, FRCVS, RCVS & EBVS European Specialist in Veterinary Neurology, to clear up misperceptions and explain just what’s going on with microchips and MRI.
What do general practitioners and certified technicians need to know about susceptibility artifacts caused by microchips?
Microchips occasionally cause a problem when performing an MRI scan of the neck and cranial thoracic regions of cats and small dogs, with sagittal images most likely to be affected. They sometimes require removal due to their interference with a diagnostic image being acquired based on loss or distortion of local signal termed a susceptibility artifact.
Microchips themselves are not affected by the magnetic field and the chip number is not erased. In addition, susceptibility artifacts are less pronounced with low-field than with high-field systems.
What does an artifact caused by a microchip look like, and how can doctors recognize it? If a dark spot appears on an MRI image, is there a way to determine whether it is caused by a microchip?
Susceptibility artifacts due to the presence of a metallic object such as a microchip in the field of view creates areas of signal loss, with bright curved margins, surrounded by image distortion. The artifact may either obscure or mimic lesions, rendering some studies nondiagnostic.
Images in the dorsal plane, ventral to the chip, may be acceptable, as may transverse images immediately cranial and caudal to the chip. The characteristics of the artifact detailed here help to distinguish it from other causes of signal drop-out, but association can also be confirmed with the radiographs to localize the chip’s presence.
In your experience, are susceptibility artifacts caused by microchips common and problematic, or (given relatively low rates of microchipping) do they rarely occur, or (because of where microchips are typically located) are the artifacts irrelevant?
Susceptibility artifacts from microchips cannot be avoided, and many patients have these identity chips placed in the soft tissues of the neck. They will only distort local signal, so a microchip in the neck will only very infrequently affect interpretation of the brain and won’t affect interpretation of the thoracolumbar and lumbosacral vertebral column.
Even when interested in imaging the neck, many patients can still have a diagnostic study, depending on the region of interest and the potential to limit the effect with some technical adjustments.
It is becoming more common to see MRI machines in practices. For those practices: In preparing the patient, conducting a scan, or reading it, is there anything veterinarians or certified veterinary technicians can do to prevent microchips from interfering with the image?
Although removal of the microchip may be necessary in some cases, the artifact created by a microchip may be reduced by displacing the tissue around it using tape or a stay suture.
The effect of the susceptibility artifact may be minimized by some technique adjustments made to the image acquisition parameters, which include changing the slice direction, decreasing voxel size and/or field of view, decreasing the TE, increasing receiver bandwidth, or changing the frequency and phase encoding directions.
Microchip installed: Check. Registered: Check. Info updated regularly? Maybe not. The good news is, you can use your practice information management system (PIMS) to get the job done.
The best microchip in the world won’t do much good if pet owners don’t do their part. That’s one reason why AAHA and AVMA launched Check the Chip Day in 2013. It creates a moment for pet owners to make sure all their info is up to date in the microchip register. If you plan your marketing six months out, put this on your calendar: Check the Chip Day is August 15. Use it to celebrate pet owners who protect their pets all year long and encourage others to get updated.
But what about the clients who are new to your practice or whose contact information changes in April or December, long before or after Check the Chip Day?
Thanks to automation and communications tools built into your PIMS, you can reinforce the message with reminders that touch clients only when needed. Unlike “drip” campaigns that send out a stream of messages throughout the year, a check-the-chip reminder can be linked to specific events, like when new contact information is entered in the client record.
It’s a great idea “if the hospital uses the PIMS and sets it up correctly,” said Kelly Baltzell, founder and CEO of Beyond Indigo Pets. Unfortunately, many team members don’t know how to code the software to perform the function. And, with practices already in high gear, can you really ask anyone to take time out to learn new software tricks?
We’ve got it. Trends asked the makers of several widely used PIMS to explain how they would set up a year-round check-the-chip promotion. The key takeaway: A series of clicks is all you need to set up your system to automatically register microchips and send reminders to clients.
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You can use your PIMS to automatically remind clients to update their contact information in microchip registry databases.
Here you’ll find general tips which an experienced practice manager or system administrator can easily implement. Step-by-step instructions for NaVetor, IntraVet, Neo, Cornerstone, ezyVet and VetRadar are posted as a link in this article at trends.aaha.org. If instructions for your PIMS are not there, ask for help from your IT consultant or PIMS vendor.
Use Your Templates
There are several ways PIMS can help automate the task of keeping microchip information registered and up to date for pet owners.
To start, when you first implant the microchip, register its number with the microchip databases like Home Again or PetLink. Several PIMS integrate with at least one database so that when you register the microchip number, the information is sent directly to the database. To help clients keep track of important information, create a note that contains the microchip registration contact details. Link that note to the invoice or create a document that can be printed separately.
To be sure that microchips are checked annually, take advantage of PIMS templates. First, choose which type of visit(s) will serve as a good prompt for the microchip check. It might be the new pet, spay/neuter, annual wellness, or dental visit. You might also decide to scan the chip at irregular appointments, such as boarding or before an MRI is performed.
Once you’ve chosen the type of visit, simply add “check the chip” as a routine item or task to the visit template. Use the document or messaging section of the template to link a reminder message to the task.
What should the message say? Like the following sample message, keep it brief. Explain why clients need to maintain up-to-date contact information in the microchip registry. Provide simple, brief instructions to help clients verify and update their information with at least one registry. That’s it! Be sure to associate the reminder message with the check-the-chip task in the visit template. That way, the message will automatically accompany the invoice (print or email).
Similarly, in Cornerstone, you can create a zero-dollar product, then create a picklist template that includes the zero-value product as a billing trigger for certain appointment types. Link that to an automatic email reminder to be sent after the appointment.
Clients’ contact information can change throughout the year. So, it makes sense to set up automated reminders, separate from the check-the-chip tasks. These reminders prompt clients to review and update their microchip registration information even if they are not scheduled for a visit.
Various PIMS handle reminders differently, but most platforms allow you to set automated reminders for certain annual events, like the pet’s birthday.
Mel Heinz, software product manager, Patterson Veterinary Supply, recommends that reminders be sent annually based on when the microchip was first registered rather than after an annual exam. “That way,” he explained, “if the client misses an annual exam, the microchip reminder will still be sent.”
In NaVetor, for example, Heinz explained, integration with the Home Again and PetLink databases means clients can check and update their microchip information via their patient portal, and that information is then automatically sent to the microchip databases.
Write a note that will appear on the invoice, on a separate printed document, or in a follow-up email/text. The note should provide the client’s current microchip registration contact details and the URL they can use to update their information.
Give the client a good reason to go to the trouble to update their info. Here is a sample message you can use.
Success! Your pet’s microchip is in place and working! Next up: Make update your contact information with the microchip registry.
Currently, your contact information with [autofill this field with the name(s) of the microchip databases you use, e.g., Home Again] is: [autofill this field with information from the registry]
If that’s not right, correct it by going to [autofill this field with the URL for the appropriate microchip registry.]
Keep your contact info up to date so you can be reunited with your pet!
Let the client take it from there. A PIMS that is integrated with the microchip registries may make it easy for you to update client information, but you should never do that without the client’s express permission. You don’t know what may have prompted the change of contact info and whether the client wants the registry to reflect the new information.
If clients insist they aren’t able to update their information at home, refer them to their local public library. Most libraries have computers, Wi-Fi, and staff who help patrons use them.
Constance Hardesty, MSc, is an award-winning writer and editor.
Photo credits: PCH-Vector/iStock via Getty Images