While large medical hospitals, academic medical centers and health systems have traditionally been the earliest adopters for cutting-edge imaging technologies, community hospitals reap the benefits as the next level of adopters of imaging and IT to balance the needs of the community with delivering better patient care, controlling costs and increasing business and referrals.
It is clear that community hospitals are making an impact. There are about 4,900 U.S.-based community hospitals, according to the American Hospital Association (AHA). In 2007, these hospitals saw record profits, posting $43 billion in revenue compared to 2006—the largest single-year jump in margins in at least 15 years, according to AHA. Net revenue grew at 6.7 percent, while expenses grew 5.7 percent. In this article, we take a closer look at how smart technology investments are helping community hospitals to align business priorities, deliver quality care and keep a competitive edge.
CT expands service lines with more slices, lower dose
Early adopters are already reaping the benefits of the explosion of configurations and new software developments for the CT realm. But for community hospitals, the business-building benefits of buying the latest and greatest in CT technology isn’t a sure thing unless the referral base is onboard.
Step 1 is to know what types of physicians are ordering exams—as well as getting educated on exams that could offer further benefits. “It’s important to ping your referring physician base to get a good idea of what types of procedures are ordered to determine what kind of features in a new CT scanner to look for since it doesn’t make sense to go out and purchase the latest CT if you aren’t going to use it,” says Chris D’Angelo, director of imaging technology at Alamance Regional Medical Center in Burlington, N.C.
The 240-bed community hospital watches carefully the exam ordering patterns of its approximately 700 referring physician base. Based on the observations and feedback from the referral base, Alamance has expanded its service lines to include more cardiac procedures, such as coronary CT angiography (CCTA). The hospital, which performs about 110,000 imaging exams annually, has installed the Somatom Sensation 16 for bread-and-butter CT imaging, as well as the Somatom Sensation 64 and Somatom Emotion 64 CT systems—all from Siemens Medical Solutions. The most recent addition is the Sensation 64 for CCTA and all other vascular procedures.
Since installing the newest scanner, Alamance has seen procedure volume increase by a third more specialty exams, and the hospital has expanded its capabilities in the CT angiography realm. With a new cardiology group that has joined the organization, D’Angelo says this area is expected to be a big push for them. And what’s next on their wish list? A Siemens Definition Flash scanner, perhaps in 2010, for use in CCTA, due to the scanner’s speed and low-dose capabilities.
“We’re taking it step by step,” he says. “64 [slice CT] is a good choice for us as we enter the cardiac CTA market, but already we’re looking forward at 2010 and planning to expand our services.”
Alamance is not the only community hospital capitalizing on CT. The emergency department staff at St. Elizabeth’s Medical Center in Edgewood, Ky., has already seen an increase in the number of CT brain perfusion and CCTA procedures they are able to now perform thanks to the new Aquilion ONE volume CT from Toshiba America Medical Systems they installed six months ago.
“You have to have the best imaging and best radiologist reading it in order to get referring clinicians to listen,” says Jeff Dardinger, MD, director of the vascular imaging institute at St. Elizabeth’s. “Just adding the newest system is just background noise, since they are looking for something new that provides more value.”
New procedures that St. Elizabeth’s has added, which are replacing invasive procedures, include CT brain perfusion, CCTA, as well as dynamic CT imaging of the renal arteries—all the while attempting to deliver lower radiation dose to the patient.
He says since installing the system six months ago, “cardiac CT volume has increased and CT brain perfusion has taken off.” The hospital now performs approximately 40 to