Mri Notes

Bringing mag realizeic resonance imaginativeness to Your fri balanceship infirmary A friendship infirmary washcloth story 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM knave 1 Bringing magnetic resonance imaging to Your biotic alliance infirmary CONTENTS Introduction . 1 reservation the blood line Case .. 2 The Business Plan 2 Reasons for Bringing magnetic resonance imaging to your hospital Financial Considerations .. 3 Selecting the Equipment . 8 comparability Te chnologies .. 8 Equipment Features 10 S auricula atriich Process .. 11 Managing the magnetic resonance imaging course of instruction . 12 Operations .. 12 Staffing.. 12 Siting . 13 securities industrying the Program .. 14 Conclusion .. 15 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM foliate 3 Bringing magnetic resonance imaging to Your federation Hospital 1 INTRODUCTION magnetic resonance imaging is 1 of todays smart festering imaging modalities, spurred in single off by rapid advanc es in engine room and important untried-fashi sensationd applications in unhurried c atomic f ar 18. Recent statistics oerly suggest that expanding Medic ar reimbursements and the growing demands of an informed and aging population for health care work are elevating magnetic resonance imaging utilisation to raw(a) levels.Is your confederation hospital delveing adding this expanding and often lucrative modality? This paper ordain serve well you answer that question. It enumerates at the channel and fiscal aspects of an magnetic resonance imaging course of instruction, reviews magnetic resonance imaging technologies and features, and arguees charge of an magnetic resonance imaging course of instruction. Over wholly, it gives how put oning an magnetic resonance imaging chopine depart enhance existing medical go and better meet alliance leases. 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM knave 1 Bringing magnetic resonance imaging to Your confederation Hospital 5 ProfitabilityPerforming a pre displaceoff of standard pecuniary analyses allow for help mildew the potential profitability of your proposed magnetic resonance imaging design. Generally, the monetary analyses should contend up the first atomic bend 23 years of your plan. The standard financial analyses are Breakeven abbreviation. A bumpeven analysis lead show how me real mental testinations must be carry by means ofed to cover magnetic resonance imaging design cost. The specialised breakeven testify is cypher by dividing the restore be ( much(prenominal) as equipment, space, personnel, maintenance, and utilities) by the honorariumment per exam minus the vari competent be (such as supplies, fees, and b fed up(p)ing be) per exam.It whitethorn solve out that your breakeven point is 1,000 exams, simply your market analysis indicates demand for only 700 exams. In this case, you whitethorn want to analyze maturation trends to situate when or w hether your magnetic resonance imaging program could break even in the future. You may alike want to waitress at restructuring your proposed program to get through it financially feasible. Return on investment (ROI). ROI is one of the close commons measures of profitability and target indicate whether consumption money on an magnetic resonance imaging program is a entire subroutine of your hospitals re line of descents. It is calculated by dividing net income by the cost of the investment.Net income tin tooshie be approximated by looking at the demand, payer mix, and exercise rate for various magnetic resonance imaging functions in your market and estimating your revenues. The investment shape involves non only the cost of the equipment under(a) each pay option, but as well as the costs of arcning the program (including the costs of staffing, trade, any studyed construction, and administration). disposed the round of variables contributing to the ROI calcul ation, changing the structure of your proposed magnetic resonance imaging program peck increase your dispel on your magnetic resonance imaging investment.Internal rate of output (IRR) and net present determine (NPV). IRR and NPV are commonly utilise to analyze whether a neat expenditure (such as the secure of magnetic resonance imaging equipment) go out yield the revenue wanted in the future they tramp similarly be used to train among various investment proposals (such as divers(prenominal) types of magnetic resonance imaging equipment or different financing options). Net present value is calculated by a mathematical suffice involving the estimated revenues and expenses of an investment. The calculation sens help determine whether the anticipated currency flow rates 04-201-XO-491_Bringing_MR5. xd 12/10/04 1005 AM rogue 5 6 A alliance Hospital uninfected Paper will cover the cost of capital and recover the costs of the investment. IRR (defined as the rate of inter est at which the incremental NPV of a proposal is zero) is some other way to look at the value of a capital expenditure by looking at the rate of buy the farm on the investment. If a calculation shows that the IRR is above the cost of capital, the proposed investment should be profitable. These deuce calculations help determine whether the investment is economicalally feasible for the hospital.Again, the information needed for these analyses can be obtained from equipment marketers, commercial databases, and outside suppliers. offer Options Hospitals can use a number of methods or creative hybrids from these methods to acquire both hardened and mobile magnetic resonance imaging. Deciding how you will pay for your magnetic resonance imaging system requires achieving the skilful repose between using addressable cash and accessing debt. utilize in stock(predicate) cash may practice sense if in that respect are few other capital projects on the horizon and cash flow f rom operations is strong.Using debt instruments, such as bonds, situate loans, or leases, however, may preserve uncommitted cash for other capital projects, deform a better financial restitution on the capital project, or lucidly make the project affordable by reducing the capital outlay to a monthly in operation(p) expense. Consider the undermentioned options Cash Purchase. The main advantage of a cash purchase is that your hospital would throw the equipment outright the equipment dos an as solidification on your balance sheet and no debt or indebtedness is get tod.Making the purchase, however, would necessitate the use of a probative amount of obtainable cash, which would thusly no longer be available to support other projects or for future financial take. Leasing. Leasing moves oftentimes of the stocking to your operational work out and minimizes credit requirements. In addition, it provides better twinned of revenues and expenses on a monthly basis. some types of leases allow you to build equity into the lease and purchase the magnetic resonance imaging equipment for a abject capital outlay at the end of your agreement. 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM page 6 Bringing MRI to Your club Hospital Bonds. Using bonds allows your hospital to raise significant capital to fund long-term and short-term projects through one debt issue. The bond offering can be made on a exempt basis, so the interest due on the principal is typically calculated at a very attractive rate. A bond offering may press six to nine months to execute, however, and may involve significant costs. More importantly, including assets that have economic and useful lives shorter than the term of the bond in a bond issue produces debt without any continuing benefit to your hospital there would be a mismatch between revenues and expenses.Bank Loans. If your hospital has an existing relationship with a blaspheme, it may be quickest and easiest to fund you r engine room acquisitions through a blaspheme line of credit. Given banks size and access to capital, they typically offer attractive pay rates for rise payout loans. Your hospital may be required to keep a compensating balance at your bank, however, and one engineering purchase may consume available credit lines that your hospital may need for other capital projects or working capital needs.Another drag outback to using a bank loan is that banks will only finance the technology acquisition itself they will not pay for the installation or the costs of professional military operate associated with the equipment. Your hospital may want to purchase MRI equipment freelancely to meet your own imaging needs. You could then lease access to the equipment part eon to other facilities at fees that could help pay for the purchase. Your hospital may also consider a shared out purchase of MRI equipment.Partnering with other local anaesthetic anesthetic hospitals or independent ima ging centers offers the advantages of sharing financial burdens and lucks, sequence acquiring the ability to provide MRI service. Frequently, the participating facilities form a league or modified liability gage to serve as the umbrella for the purchase, and the financial arrangements and responsibilities would be specified in the prescribed agreement. This arrangement reduces the costs and financial risk for each associate, while allowing each partner to provide MRI services. Co-funded MRI acquisitions may be either put purchases or leases. 04-201-XO-491_Bringing_MR5. xd 12/10/04 1005 AM knave 7 8 A Community Hospital White Paper SELECTING THE EQUIPMENT Rapid posements in MRI technology mean that your hospital will be faced with an array of equipment and features. Your call forion will depend on your business objectives and clinical requirements. Your goal is to select the equipment most permit and cost- legal for delivering the mellowed- timberland images you need toda y, while allowing for tender applications and upgrades in the future. Equipment sellers can help you potpourri through your options to acquire the capabilities you need without salaried for features you will not use.The sections below discuss some of the basic technologies and features available to you. Comparing Technologies Magnet Given the branch in the number of MRI applications and rapid advances in MRI technology, MRI may become your radioscopy departments workhorse. Therefore, your hospital should start with a solid, proven platform. era some applications still use a sub-1T magnet, a 1. 5T magnet is now the standard, because it can both handle current applications and conform to future applications and upgrades. A 3T magnet is available, but it represents truly innovative technology and ability be to a greater extent powerful than most hospitals need. quick vs. Fixed MRI As mention above, mobile MRI is housed in a specialized van and can right away be shared among ho spitals and healthcare facilities. Mobile MRI is frequently acquired when a hospital expects a small peck of exams, when the hospital wants to test an MRI program in the lead leasing or purchasing, or when the hospital does not have the financial resources to purchase fixed equipment. somewhat hospitals use mobile MRI to supplement overburdened fixed MRI equipment, provide capacity while postponement to purchase superfluous fixed equipment, slip by radiology services into other geographical areas, or maintain service during mental synthesis projects.A main drawback of mobile MRI is its availability the equipment may not be available when it is needed. Patients and referring physicians may have to wait for several(prenominal) days or even weeks for procedures. 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM Page 8 Bringing MRI to Your Community Hospital 9 Fixed MRI may be fixed interior the hospital or in a nearby grammatical construction. Because it is right at the hos pital, it is very convenient to use. Patients may be able to get their exams within a day, jot room doctors can get studies the akin day, and diagnoses can be made or confirmed very quickly.Physicians can use in-house equipment to confirm results and to make sure that seemly care is given and they can draw on the medical services provided by other departments in the hospital, if needed. Fixed MRI facilitates forbearing care. It is easier to move seriously ill, elderly, or emergency room diligents to an in-house MRI than to tape drive them to mobile or distant equipment. In-house and fixed facilities also tend to be much than than comfortable and attractive than mobile ones and patients can use other hospital services and facilities at the same time. render vs. unlikeable MRIApproximately 28% of MRI installations are of give way MRI (according to the IMV 2002/03 MRI Census Market Summary Report ). Open MRI is considered to a greater extent comfortable for patients, especia lly children, the elderly, the obese, and the claustrophobic, and may thus reduce the need for patient sedation and the number of incomplete exams. Until now, the enduringness of the magnet in most string out MRI systems has been comparatively weak (no more than 0. 7T), which has limited the pure tone of the images and has not back up a full range of applications. A refreshing class of MRI systems was introduced in the summer of 2004, called Open Bore MRI, with stronger 1. T magnets and the ability to offer 60% of exams with the patients head outside the magnet. These tender systems have the same image quality as shut MRI systems and are able to support as umteen applications. Closed MRI has traditionally used a stronger magnet, which has led to clearer images and has allowed closed MRI systems to support a broader range of applications and some(prenominal) new-fashioned proficient advances and upgrades. Some newer closed MRI equipment has been designed to be more comfort able for patients and to reduce the acoustic hoo-ha level by up to 97%. The technological advances in open MRI may reduce the differences in technological capabilities between open and closed MRI systems. *Results may vary. Data on file. 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM Page 9 10 A Community Hospital White Paper Equipment Features run into Quality Image quality is one of the primary MRI considerations. Factors affecting quality include strength of the magnet, high theater computer performance, sequence selections, and 3D postprocessing. Differences in image quality can be seen by comparing sample images produced by all the equipment being considered.Workflow and Productivity MRI benefits from a broad range of new productivity-enhancing tools that may allow you to serve more patients and make the silk hat use of your equipment and staff. groundbreaking scanners have the ability to do unseamed whole-body imaging with a single coil, eliminating the need to reconfig ure coils and reposition patients. These can cut scan time by as much as 50% to 75%. * Others allow simultaneous scanning of more limited anatomical areas with up to four integrate coils, delivering similar benefits.Both allow the user to select exams, not coils, and provide the highest acquisition step on it without image artifacts, while promoting patient comfort. This enhance workflow enables more patients to be seen during a day and often paves the way for manipulation of a greater patient volume and increased profits. Additionally, recent advances in MRI technologies allow the processing of MRI images during, kinda than following, the ex amination, which produces results faster. Others automatically position slices for reproducible, logical results.New developments also promote clinical dexterity by improving workflow and eliminating facsimile tasks. This includes reducing examination set-up time through single-mouse-click coil positioning. Another new technology elimina tes the need to reenter patient exam parameters by allowing existing images to be dragged and dropped onto the patient magnetic inclination and even to be transferred from images on telecommunicate or CDs. Some manufacturers provide a common interface across all modalities and applications, including MRI, to reduce learning curves and facilitate hold management. *Results may vary. Data on file. 4-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM Page 10 Bringing MRI to Your Community Hospital 11 Patient babys dummy Some new technologies make MRI procedures more comfortable for patients, which in turn makes clinical time more productive. These technologies may reduce noise level, eliminating the need for ear shelterion reduce scan time, which makes the procedure less stressful for patients allow for more comfortable horizontal loading or allow patients to keep their heads outside the bore, minimizing claustrophobia. Open MRI technology accommodates anxious, obese, or claustrophobic patients, particularly children.Search Process A multifunctional see team, including radiologists, engine drivers, administrators, and IT professionals, should be appointed to analyze the equipment options and make recommendations. The front should be driven by the goals of your program in monetary value of improve patient care and financial feasibility, the technological features specified by radiologists, and the procedure needs of referring physicians. The search process should include expound comparisons of the features and image quality of the equipment made by different vendors.Members of the team should visit localises where the equipment is used, question radiologists and technologists working with the equipment, and request and review a range of images made by the equipment. Some equipment vendors may allow a short-term trial of the equipment or special features sooner purchase. many a(prenominal) hospitals consider it important to purchase as much equipment as practicable from the same vendor. For smaller hospitals, where technologists may perform many different types of procedures, having one vendor makes cross-training on different modalities easier.The relationship with a single vendor may also contribute to the expeditious running of the radiology department and may expedite repairs and other needed services. At the end of the search process, the team should make recommendations on which specific equipment and features to purchase. The team may also set out a schedule for devising regular upgrades to the equipment or for purchasing supernumerary features or applications. 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM Page 11 12 A Community Hospital White Paper MANAGING THE MRI PROGRAMWhen bringing MRI to your community hospital, you will have to make decisions closely overall management of the program. training should cover four areas operations, staffing, siting, and marketing. Operations Patients and physicians both want the MRI program to run smoothly, efficiently, and in a timely manner. When implementing the program, the hospital will have to keep an affectionateness on the scheduling of patients for efficient utilization of equipment, patient throughput, patient comfort and education, efficient handling of paperwork and archiving of images, and timely communication.A Picture Archiving and parley System (PACS) has become a emergency in managing an MRI program. The hospital should envision on monitoring the operations of the program and should expect to make changes to increase operating strongness. For example, the hospital may find that it wants to extend hours of service or hire additive personnel to handle paperwork and scheduling. Staffing For a community hospital, an MRI program requires one or more radiologists, technologists, administrators, and possibly also technologist aides.There is currently a famine in the number of available radiology professionals, so it may be necessary to dev elop a recruiting program that sets out how the hospital supports and meets the needs of its employees. Radiology professionals will look for a competitive salary and benefits, devout working conditions, flexible and reasonable schedules and workloads, and opportunities for growth and development within the profession. They are particularly interested in keeping up with technological advances and in having opportunities to learn new modalities.During recruiting visits and interviews, most radiology professionals check whether a hospital has the latest technologies and equipment. Many radiologists look for the use of a nighthawk service at night or over weekends to make their workloads manageable. Nighthawks, who can be located anywhere in the world, are sent images digitally over the Internet for opposed reading. A PACS system facilitates the sharing of images betw een the hospital and the nighthawks. 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM Page 12Bringing MRI to Your Com munity Hospital 13 The hospital may also need to consider whether it will be able to pursue a number of the standard options for making sure that it has satisfactory staff Using temporary or short-term workers, provided by a healthcare staffing company or recruited from locum tenens services Sharing radiology professionals among joint think partners or local radiology practices Using creative scheduling, such as job-sharing or part-time arrangements Cross-training technologists on different modalitiesGiven the shortfall in available radiology professionals, a hospital will want to pay attention to retaining its staff. An effective retention program must be built into the staffing course of study for the MRI program. Retention strategies may include giving staff opportunities for career growth through learning new technologies and modalities, creating a supportive work environment, and following through on all the commitments made during the recruiting process. Siting Given the ph ysical requirements of fixed MRI equipment, administrators will have to decide where they want to site the program.Existing vs. New Space An MRIs powerful magnetic field limits the thinkable locations for the equipment. The magnet room must be built with specific construction materials and can insure only certain fixtures and additional equipment. An existing site within the hospital will need significant morphologic renovation to eliminate all ferric metals to ensure patient safety and protect your equipment. It is necessary to compare the costs of renovating and of building new space to help contain expenses associated with the program.Equipment vendors are a good source of information on the requirements of a magnet room and the work needed to create a safe and comfortable site for your MRI program. 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM Page 13 14 A Community Hospital White Paper Inside-the-Hospital vs. Freestanding Outpatient Facility MRI exams are frequently outp atient procedures. Locating your MRI program in an outpatient facility has the obvious advantages of reducing hospital crowding, enhancing throughput, and reducing the complications of hospital visits for ambulatory patients.Other outpatient facility siting benefits include flexibility in financing, through joint ventures and shared equipment, and larger physical space with the first step of expansion. However, if your primary goal is to meet in-patient imaging needs, an inside-the-hospital location is safer and easier, particularly for critically ill patients. Other advantages are the availability of the full range of on-site medical services and the proximity to in-house physicians and referring physicians with offices near the hospital.Marketing the Program A community hospital can best market its new MRI program by involving the community during the development of the program and by using specific marketing techniques. Community Involvement Many community hospitals have found that creating strong community involvement in the program leads to high patient volume. It may be effective to Draw local businesses and business associations, such as a Chamber of Commerce, into the training process and any necessary fundraisingCreate a hospital website that keeps the community informed intimately progress, educates potential future patients about your new services and the benefits of MRI, shows pictures of the new equipment, and links to the equipment vendors website for additional information babble out about the program and MRI to local community groups and at school programs cast off an open house and give tours of your new facilities Media Relations Given the strong everyday interest in healthcare issues, it may be possible to interest local newspapers, magazines, television, and radio stations into reporting on your new MRI program and its benefits.Distributing a press release describing your program, making hospital administrations and radiology profess ionals available for interviews, and hosting media events may be effective in publicizing your program. 04-201-XO-491_Bringing_MR5. qxd 12/10/04 1005 AM Page 14 Bringing MRI to Your Community Hospital 15 Marketing communication theory Some hospitals have found it effective to develop written materials that explain and broadcast their program and the new MRI technology.These materials can include brochures that educate patients and answer questions about MRI technology and benefits, brochures for referring physicians that describe the new imaging services, handouts with contact and procedural information, and yarn-dye advertisements for local media. Equipment manufacturers are a good source of cost-effective assistance in developing marketing communications. CONCLUSION MRI technology can provide legion(predicate) benefits to your hospital by enhancing the speed and true statement of diagnoses, facilitating earlier and more accurate preaching of medical conditions, and generatin g additional revenue.Making the decision to implement an MRI program involves analyzing the marketplace and the financial aspects of the program and planning for managing and marketing the program. A critical decision is which MRI equipment and applications will meet the needs of the hospital and the community. Many of the newest technologies provide significant benefits in terms of quality, efficiency, and patient comfort. Given the cost of the equipment, the hospital should compare various financing options, including direct purchase, leasing, and joint ventures.