CHARLESTON, WV -- A health care startup headquartered in Hurricane is reducing the cost of X-rays for patients who can't get to a doctor or hospital. It is also cutting the turnaround time for X-ray results from days to minutes. OnSite Digital Radiology Services began offering mobile X-ray services in the Charleston and Huntington markets last spring. Richard Pulcrano, president and chief executive officer, said OnSite is the first provider of mobile direct radiography technology in West Virginia. Pulcrano said the way X-rays are traditionally done in nursing homes and residences is to take the machine to the patient, get an image and then transport the image to a location where it is processed and reviewed. It is then sent to the health care provider who ordered it. OnSite Digital uses a combination of mobile digital imaging equipment and wireless communications to speed the process. The company has a fleet of vans in the region. Each is staffed with a radiological technologist and is equipped with portable digital imaging equipment, a global positioning system, or GPS, and wireless access to the Internet. Say a doctor gets called to a nursing home to see a patient and orders a chest X-ray. The nurse calls OnSite's central dispatch center. The dispatcher uses GPS to determine which OnSite Digital van is closest to the nursing home and tells the nurse how many minutes it will take for the van to get there. When the van arrives the technologist takes the imaging equipment to the patient, takes the X-ray and wirelessly transmits the image to Radiology Inc. in Huntington. At Radiology Inc., a board-certified radiologist reviews the image and provides an expert medical opinion of any normal or abnormal patient anatomy. This interpretation is then sent immediately to the attending physician and client. Pulcrano said, "Stat [without delay] images are usually available within 5 minutes and routine images within 15 minutes. The final report is automatically faxed directly to the facility or the physician. "If they want to look at images later, they can go into our secured website," he said. "They each have a user name and password so they can look at images that are specific to their patients." Providing services in a residence or nursing home eliminates the cost of moving the patient and the toll moving takes on the patient. Ann Calicott, a nurse practitioner with MD2U, is a big fan of OnSite Digital's services. Nurse practitioners like Calicott collaborate with physicians but can operate independently as clinical providers. "We see patients, order tests, order lab work," she said. MD2U makes house calls and provides primary medical care for people with chronic and acute illnesses. The company is based in Louisville, Ky. The company's Charleston office serves Kanawha, Putnam, Cabell and Lincoln counties. Calicott said some patients who have a physical limitation or can't drive find it impossible to keep follow-up appointments with their doctor or get to the hospital. "Medicare will pay for transport if the patient is going to the hospital for a procedure but not if they're going to the hospital just to see the heart doctor," she said. "Going by ambulance can cost more than $300 each way plus $9 a mile." Using OnSite Digital's service saves patient transportation costs and "with Rick's service, they have access to things they need. "This is the future," Calicott said. The West Virginia Health Care Authority issued a "certificate of need" to OnSite in August 2012. The certificate is essentially a license. Pulcrano said there was some opposition to issuing a certificate of need to OnSite. He said OnSite won an appeal to the state Office of Judges in January 2013 and is now awaiting the outcome of an appeal filed by a competitor in Kanawha Circuit Court. OnSite plans to expand its services statewide this year, Pulcrano said. OnSite is headquartered in the Prestige Professional Park in Hurricane. The company's website is at http://onsitedigitalradiology.com.