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The Steps to becoming Certified for Research Imaging

Posted By Adeline Stone, Friday, April 12, 2013
Updated: Friday, April 12, 2013
The approach to becoming certified for clinical research imaging versus the protocols that you may be used to during the day to day clinic, may look a little daunting! The first step is to take a step back and say I KNOW I CAN! Doing a little research on how to perform research imaging either OCT’s, Photography, or cell counts is the first step to becoming certified. Breaking it down by first figuring out equipment and software, log in accounts, studies requirements for certification and finally obtaining images that will get you certified for your desired study.


Begin researching the certification requirements for equipment, or software versions of capture stations. Communicate with your research coordinator, or research manager to find out if a log in account needs to be requested for the study your clinic or physician is enrolled in. Once a log in account is established for you, start researching how to get your equipment certified. I also recommend spending some time learning the websites. Not all of them are the same to navigate. Finding the certification manuals for which imaging device that you are getting certified for, makes it much easier. I will print out all the manuals and have them handy when I am performing imaging, or tasks. Creating a centralized binder is very helpful when you have several individuals trying to get certified as well.

Some reading centers will require a verification file to be downloaded on your capture station. Before downloading make note of the serial number of the capture station, operating system, version of capture station software, and patches. Other reading centers will need you to provide calibration/schematic eyes to test that the equipment being used is adequate. Once the file or calibration image is sent off for verification, you will either be good to go, or possibly need to have an update. In the case of the Spokane Eye Clinic we did not have the patch that allowed for histograms to be viewed while taking images for Imagenet. We had to save our photos first and then we could see our histograms. After we enlisted the help of Tony Pugliese we were able to correct our settings for blue, hazel, and brown eyes. This was an entirely new process for us, and we have really made an improvement to how our photography looks. Here is the link to his article about how to control histograms and achieve a higher quality of imaging: Once you have the histograms and software version up to date, a sample fundus image will also need to be sent for review, in the correct format (TIFF, PNG, JPEG, etc..). Soon a certification notice is sent via e-mail through the reading center. Now it is time for the fun!

7 Fields Certification Photography
(Taken By Adeline Stone, COT)


During the slower clinic days we will dilate willing participants to sit through a session of photography for our certification. It makes a world of difference to just practice the protocol on a fellow co-worker who has great media, and cooperation. Following the protocol 7MD, which requires stereo pairs at 35 degrees, and anterior photos to document lens opacities. Make sure to also save in the correct file extensions, for the study you are trying to become certification you are seeking. After obtaining two right eyes, and two left eyes, burn to a disc to send in the mail, or upload through an online portal. You will also have to request certification through the website or reading center that is certifying you, or fill out a form requesting certification. We have found it best to overnight the discs with a tracking number through FED EX when you have to do it this route. This prevents delays on having to re-submit another CD when a second submission might have to be re-submitted.


Screen shot of Histogram during angiogram

(Taken By Adeline Stone, COT)


Once you receive confirmation that your images have been submitted, and then you either lucky to pass, or possibly need to redo another set of a left eye and right eye. Don’t get discouraged if you didn’t pass the first time! I found it very helpful to talk directly to the photographers of the reading center of what I was doing wrong. In my case it was a little bit of focusing issues due to my own accommodation and I needed to achieve more depth of field. I solved those issues by focusing with the monitor, which I have to do from time to time and lowering the gamma. The second submission was a pass! Even if you don’t get it during a second go, keep trying. Each time is good practice and will make you more efficient each time.

For FA certification it is not as easy to perform on co-worker that really doesn’t need to take the risk of an invasive procedure. I started by practicing on our clinical patients for the protocol required for our study. Once I had it down I used those images for my certification photos. I also like to communicate with the patient and doctor that I am following a protocol for certification and ask them if it is ok with them if I proceed with the certification series. Otherwise I don’t want to take extra photos on a patient that may difficulties with the lights from the photography. If you are lucky enough to get to practice on another willing participant that you work with, always get prior approval from your doctor. I was a participant; I signed a consent form, and also received a written order from a physician before just doing it. This was a great experience not only for my fellow photographer to get excellent photos, but as well for me to be the patient. I have much more empathy and understanding of how it feels, and looks like during an FA.

Photography Dream Team! From left to right Vicki COT, Sandy COT, Becky RN, BSN, -look she can inject without looking!

(Photos Taken By Adeline Stone, COT)


OCT certifications can have their own challenges such as trying to find pathology that will meet the requirements of the study. Once you have an excellent scan with the correct pathology requirements obtaining multiple scans that are consistent will be a requirement as well. Showing consistency between the sets of OCT’s from the normal eye to the eye with pathology will give better data. If there is a chance to obtain OCT’s during your regular clinic, be sure to scan patients under the required certification labeling practices. The other option is to rename patient information on those scans that are required to have macular pathology. Make these changes with care, as not to accidently remove important identifying information when you re-edit the OCT. Lastly exporting the correct file, either e2e or, not zipped or a zipped file will allow a successful upload or submission on a disc.

Once the leg work of obtaining the images in the correct format for the study is completed and your clinic site is ready for patients, continue to review and practice the steps for obtaining the images. The more practice for the protocols the more they become second nature, and beneficial for the studies. In conclusion, becoming involved in the process of following study specific protocols adds to the challenges to a busy clinical setting. It may seem at times to be a long process, but in the end rewarding to progressing imaging skills for the ophthalmic photographer.

Adeline Stone, COT, is employed at Spokane Eye Clinic as the Supervisor of Diagnostic Services. She has an Associate of Applied Science degree in Ophthalmic Medical Technology from Portland Community College. In her free time she enjoys the great outdoors with her husband in the Pacific Northwest by snowboarding, hiking and camping. Having obtained a Certificate in Culinary Arts, she also enjoys cooking, baking, canning and gardening.

Tags:  blog  certification  education  Ice Breakers  Meaningful Use  PDC  research  Tips 

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Comments on this post...

Tom Reeves CRA COT says...
Posted Sunday, May 26, 2013
Great post! I recently went through this process for two separate studies that are about to start. Your essay was very helpful in knowing what to expect. Thanks Adeline!
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Adeline M. Stone, COT CRA CDOS says...
Posted Wednesday, June 12, 2013
Hi Tom! Thanks very much! We have been doing research now for about 2 years, it is getting easier the more patients we enroll and also the more studies we become certified for. Best of luck for your continued research imaging and photography :)

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