The decisions are getting harder when we try and determine what our facility should invest in to provide the best patient care. 256 slice CTs, 3.0T MRIs, Digital Mammography, PACS Upgrade, EHR and so on …? We first try and determine our available budget or we are asked to submit a request for funds based upon current and future requirements, local competition and / or physician requirements. It is now necessary to take a long hard look at what is currently being utilized and determine how best to enhance capabilities. You probably begin to bring in vendors to discuss the capabilities of their new systems, as well as potential costs. If you are like many administrators, you immediately get a large blast of reality. You immediately know that you will be limited to one purchase or less and it's possible funding will not be available for several years. If you are experiencing growth, patient count is increasing, test procedures are on the increase, and available system time is becoming harder and harder to come by, then you know you will need to upgrade Radiology capacity.
You now are probably asking yourself why you are faced with this growth. The first thing you may remember is that those people called baby boomers are becoming elderly and generally with age, comes increased health care. Secondly, the Deficit Reduction Act (DRA) reduced reimbursements to imaging centers, putting a number of facilities out of business and moving those patients to fewer remaining facilities. And, of course our Government is becoming close to adding more than 47 million uninsured Americans on the rolls of public health insurance which is sure to increase radiology test requirements significantly everywhere in the country. Now that you are pretty much convinced you need to expand capacity, usually with a limited budget, just what do you do?
You first may want to take a close look at what you are utilizing today and determine what is adequate and what needs to be replaced. If you are using a 4-slice CT or less, if your MRI is 1.0T or less, if x-ray, R / F and mammography systems are analog output (film) instead of digital, then you have important issues to resolve. Now, if you have an available budget of around 3 Million dollars you should be able to purchase new replacement systems that will work very well – a 32 slice CT, a 1.5T short bore MRI, x-ray and R / F systems with DR and a digital mammography system.
Let's assume for a moment that you do not have a budget of 3 million dollars but you do require upgrades. Here's what you might consider: Upgrade the CT with a late model 16 slice CT, refurbished, installed and warranted for about $ 200,000. Also, bring in a late model 1.5T short bore MRI system for about $ 400,000. Purchase one new high volume CR system to convert x-rays for about $ 70,000. Add a refurbished fluoro DR system to the R / F room for about $ 45,000 (or a new one for $ 65,000). And finally, purchase a Mammo CR system for about $ 90,000. Now for just over $ 800,000 you have nearly the same results as if you had replaced and purchased new except you will saved approximately 2.2 million dollars.
How do I know this? We do this every day. We enable health care facilities to upgrade with high quality, high performance late model systems for a fraction of the cost of new. This business of diagnostic imaging is all about taking pictures, and as long as the pictures are high quality, very little emphasis should be focused on whether or not the system that took the pictures are new. Remember, once that new system has been operated once, it becomes a used piece of equipment!