Versatility and Affordability: The Imaging Requirements of Today’s Rural Facilities

David Rushing

If you’re going to operate a hospital outpatient imaging facility so distant to the nearest city that your location overlooks a sprawling cow pasture, you need to give patients a reason to make the drive. OGH Imaging in Grand Coteau, LA.—population 939—has been doing just that ever since opening its doors in 2005. The center was founded as a joint venture between several Southwest Louisiana physicians and 226-bed Opelousas General Hospital, which was the first healthcare facility in the entire region to install a digital mammography system. At the time, the closest such system was in Nashville, Tenn.

In fact, Opelousas General Health System also installed the first fixed MRI in their parish and currently has the only 3-Tesla MRI in the parish.

Today, recollections of those advances help light the way when OGH Imaging is mulling management decisions. “I reflect on our health system’s past history and attempt to use that as inspiration for the services we provide to our customers,” explains imaging director David Rushing, an MRI technologist by training who has spent the last 13 years of his 27-year imaging career with OGH Imaging.

The guiding idea then and now, Rushing says, is to demonstrate the center’s intention to rank second to none for nearly every manner of outpatient imaging.

“When OGH Imaging started, it was starving for patients,” Rushing says. He notes that the center has more than doubled its volume, from fewer than 50 patients per day when it started to more than 100 per day today.

“I really attribute our initial growth to the early decision on women’s imaging,” Rushing adds. “Women are typically the decision-makers when it comes to medical care. They would send their husbands and kids here after having a good experience themselves. However, true expansion in volume occurred only after adding the latest in MRI technology several years later.”

Because of that, today OGH Imaging is accredited by the American College of Radiology for mammography, MRI expertise and general imaging proficiency. It keeps four reading radiologists busy with images captured by 11 technologists credentialed in all major modalities. And the center continues its commitment to selecting state-of-the-art imaging technologies in order to serve its communities with, in Rushing’s words, “a better value, a better convenience and a better all-around experience of imaging.”

Up to the competitive challenge

It was to those ends that, two years ago, OGH Imaging added a second MRI suite and outfitted it with a Hitachi Echelon Oval MRI. Well-known in the industry for its 74-centimeter wide-bore, the Echelon Oval can accommodate patients up to 550 pounds. “We do grow them kind of big in South Louisiana,” Rushing says with a smile in his voice. “Having a machine that can comfortably accommodate a larger patient was important to us.”

A year later, in 2017, the center replaced its aging CT system with Hitachi’s Supria CT. This too has an extra-wide bore, along with advanced radiation dose minimization and artifact reduction. The CT selection “was really about finding a piece of equipment that would be up and running for us with minimal downtime,” Rushing recalls, “so we can serve our community without interruption.”

So it is that outpatient imaging shoppers in and around Greater Lafayette have more reasons than ever to make the drive to Grand Coteau.

For his part, Rushing is happy to have found a vendor he recognizes as a true partner. The excellence of the new MRI and CT equipment is mirrored by the attentiveness and know-how of Hitachi’s customer support, he says. In fact, he adds, it was the promise of superb service that made Hitachi a standout during the MRI selection process.

After seeing that promise fulfilled over the course of a full year, all OGH stakeholders and decision-makers agreed that the new CT would bear the Hitachi badge as well.

“For the bread-and-butter MR imaging that we do, Hitachi had everything we needed,” says Rushing. “The hospital that has joint-venture ownership with us has a 3-Tesla made by one of the ‘Big Three’ manufacturers, and our spine work looks better than theirs. Plus Hitachi’s price was fair. And it was clear they were willing to take care of their customers.”

Which helps the staff and physicians of OGH Imaging take better care of their patients.

“We have two competitors for MRI, including one in Lafayette that provides a very similar service to ours,” Rushing says. “Keep in mind that people have the perception they’ll get better care in the city than in a rural area. Our challenge is just to get that person to give us a shot.”

“As soon as new patients walk into our building, they can see we’re up to the challenge,” Rushing says. “Our front door is just 30 to 40 steps from our parking lot, our Hitachi MRI room is gorgeous, and there’s really no better imaging experience available in our area at any price.”

32 channels, 1 exciting clinical study

Rushing’s confidence in OGH Imaging’s capability to compete with any competitor, including imaging operations in academic settings, is backed up by the caliber of the radiologists who recommend its services. The center counts the University of Texas’s MD Anderson Cancer Center in Houston and St. Jude Children’s Research Hospital in Memphis, along with a nationally recognized neurologist in Louisiana, among the prestigious referrers who have encouraged patients to continue using OGH Imaging after seeing the quality of the center’s work.  

Meanwhile, OGH Imaging is the first and only Hitachi MRI site to participate in a national drug study that could impact the practice of hepatology across the country. Rushing says OGH’s participation was made possible by upgrading to Echelon Oval’s 32-channel coil capability. The go-ahead came just six months post-installation, ready-made for use with OGH’s investment in a high element count flexible body coil and making the center the second imaging operation in all the U.S. to get the upgrade.

“For this study, we’re imaging livers with shorter breath-hold times, higher resolution and more signal in the image,” Rushing says. “Especially for your elderly patients, you feel good about not making them try to hold their breath for too long. And the free-breathing stuff just looks much prettier too. The edge definition is sharp. The Echelon Oval just does exquisite abdominal imaging.”

And in another first, OGH Imaging is the only outpatient imaging center in Southwest Louisiana using an audiovisual system that lets MRI patients watch TV while they’re getting scanned, Rushing says. “Combined with the wide magnet and the comfortable room that we built for it, the entertainment helps the patient feel even more relaxed.” The result of the total room re-think has been a backout rate of less than 1 percent due to claustrophobia. The incidence of anxiety-stricken patients calling off MR exams “was never high here,” Rushing says, “and it just doesn’t happen at all anymore.”

As for image quality with the Supria CT, Rushing recalls expressing his skepticism over the How low can you go? approach to radiation dose reduction.

“That goal is fine in an academic setting,” he says. “But when you greatly reduce dose just for the sake of being able to talk about reduction, at some point, you sacrifice image quality.” He describes a day when he sat down with the Hitachi applications specialists to talk brass tacks on the matter. “I said, ‘Look, guys, give me better-than-ACR recommendations with low radiation dose, and let’s get images that are textbook quality.’ They immediately went to work, and they succeeded in getting us to where we wanted to be on both low radiation dose and high image quality.”

An inspiring epicenter of imaging excellence

What’s more, Rushing says, Hitachi’s service and support organization distinguished itself when it came to training OGH Imaging’s technologists, five of whom are cross-trained to operate both Echelon Oval MRI and Supria CT.

“With the busy daily workload that we have, getting these five techs trained and up to speed was important,” he says. “It wasn’t much of an issue for any of them to get comfortable and confident with both these technologies. And when they have had questions, the availability of Hitachi’s applications people—and their ability to answer any questions on the fly—has really been phenomenal.”

So impressed has Rushing been with Hitachi’s advanced-imaging products and overall presence that he has been recommending the company to like-minded rural imaging centers as well as larger imaging operators. It appears some have listened and acted on the tip, giving Rushing the satisfaction of knowing that OGH Imaging is lifting the quality of patient care for miles beyond its physical footprint in Grand Coteau.

“Since we put in our new magnet, I know of at least three others that have been installed in the state. One is going in within earshot of us,” he says. “So I know the technology is making a difference in this community, and other smaller healthcare organizations are gaining confidence in Hitachi as a company that can compete with any other vendor—including the Big Three—and not just from an image-quality standpoint. The versatility and affordability of the equipment, coupled with the service and support value proposition, are really what sets Hitachi apart and enables them to be a true vendor partner. Knowing that my equipment service and support needs will always be addressed gives me peace of mind and allows me to focus on what really matters: my patients.”