Community Hospital Makes Strategic Post-reform Decision
In the aftermath of imaging reimbursement cuts and health care reform, provider organizations are looking at how to do more with less, and making purchasing decisions that position them to be able to accommodate the widest range of patients. That’s why Brian Wetzel, RT, CNMT, radiology administrator at 267-bed Lourdes Hospital in Binghamton, New York, chose an MRI system that could effectively image any patient, especially extra-large patients. Founded by the Daughters of Charity, Lourdes Hospital is an Ascension Health hospital that offers a full range of services, including a 15-practice primary-care network, a diabetic center, wound care and hyperbaric-oxygen therapy, women’s and pediatric health care, a regional cancer center, and orthopedics and rehabilitation. The hospital referred an average of six claustrophobic, pediatric, and bariatric patients a week to neighboring hospitals due to weight restrictions and a lack of open technology. A single, closed 1.5T magnet represented the hospital’s MRI capacity, according to Wetzel, administrative director of diagnostic imaging, cardiology, and the vascular laboratory. He presented “Know Your Market to Grow Your Market,” on August 24, at the annual meeting of AHRA: The Association for Medical Imaging Management, in Washington, DC.
“We averaged five claustrophobic patients per month, most unaware that they were claustrophobic when they first came in; we averaged six patients per month who were exceeding weight restrictions identified within screening upon arrival. Approximately six patients per week were referred to another facility due to weight and other restrictions. We were sending away patients.”
—Brian Wetzel, RT, CNMT, administrative director, Lourdes Hospital, Binghamton, New York
A local competitor with a 0.7T open magnet was more than happy to accommodate these patients, but Wetzel was already formulating a strategy to recapture them. “We identified the patients we wanted to serve: bariatric, pediatric, and claustrophobic patients,” he says. “We wanted to form a connection with our patients, so we went with the theme of exceptional service: We wanted flawless processes; we wanted our people to act with kindness, caring, and a positive attitude; and we wanted attention to detail.” Decisions, Decisions Having launched a $70 million expansion, the hospital planned to acquire a 1.5T open MRI to occupy the open MRI suite that it was building. When a new radiology group assumed coverage, however, it recommended going with the Oasis 1.2T Bore-Less MRI from Hitachi Medical Systems America Inc. It was a decision that Wetzel has not regretted. On the pediatric front, the open architecture has been a success. “The patient-centered open design allows for family members to go in together, and we’ve actually done that,” he reports. “We had a mother in the magnet with her four–year-old son, which is something to see.” On the bariatric front, the Oasis can accommodate patients weighing up to 660 pounds, and it features an extra-wide table for added comfort. Wetzel recalls, “One thing our sales rep told our technical staff was, ‘Be ready. You will put it in, and they will come.’ One day, I think 325 pounds was the weight of the lightest patient on the magnet.” Another important factor in the decision was Hitachi’s commitment to providing applications support. All six Lourdes Hospital technologists were given access to the Hitachi Institute for training, and the company also offers unlimited access to applications support for customers whose equipment is under warranty or a service contract.
Figure 1
Figure 1.
Community—and media—interest was piqued when Lourdes Hospital lowered the magnet (Figure 1) through the roof of its new custom-built suite earlier this year. “As you can see, it was not every day a piece of equipment weighing 30,000 pounds or so was installed in the system,” Wetzel notes.
Figure 2
Figure 2.
A large skylight forms a canopy over the Oasis in the suite where the magnet now sits (Figure 2), adding an extra element of openness to the patient experience. Spreading the Word Before the magnet was sited, the marketing machine moved into action, spreading the word that Lourdes Hospital could meet the needs of claustrophobic, bariatric, and pediatric patients. Wetzel began by putting his referring-physician liaison on alert. “I have a full-time MRI technologist who works three days a week doing marketing for diagnostic imaging,” Wetzel says. “She personally visits the referring physicians within a 60-mile radius.”
Figure 3
Figure 3.
Wetzel also used a local radio show, television, local sports-venue advertisements, billboards, and pamphlets to explain the benefits of the technology to consumers. “This was with the support of Hitachi’s customer marketing support department helping our marketing department develop this strategy,” he says. Binghamton is home to a minor-league Mets team, so Wetzel invited the team mascots into the magnet for a photo shoot and flashes the pictures (Figure 3) at the local Mets stadium. “If you go to the New York Mets stadium, they will sometimes show this, up on their billboard, when they announce what their minor leagues are doing,” he says. A newspaper ad created by Hitachi, now running in the local newspaper, features a large male patient. “We’ve had patients up to almost 600 pounds,” Wetzel says; this is well outside the range of patients able to be adequately scanned on the local 0.7T magnet. “These are patients who could never have this done before, and now are being served by us here at Lourdes Hospital,” he says. Early Results Installed in April, the Oasis is performing well for Lourdes Hospital, Wetzel says. Not all six technologists have yet been trained in operating the magnet, so the department is currently scheduling just eight patients per day, but it scans an average of 12 per day by accommodating add-on patients. “We are ramping up both technologist comfort with the equipment and staffing, so we can go from 6:30 in the morning to 10 at night, Monday through Friday, and two shifts on Saturday,” Wetzel says. “We are a Catholic hospital, so they make us rest on Sunday.”
Figure 3
Figure 4.
In the first three months of the year, Lourdes Hospital scanned 643, 636, and 692 patients (Figure 4). The hospital scanned its first patient on the Oasis on April 22, and by month’s end had scanned 73 patients on the Oasis. In June, the second full month of operating the Bore-Less magnet, the department scanned 205 patients on the Oasis, with the potential to do 172 additional patients if the Oasis schedule mirrored the closed system schedule, which Wetzel plans to do after all six technologists have been trained on the Bore-Less magnet. In closing, Wetzel notes that it is important to seize current opportunities today in order to ensure tomorrow’s successes. Cheryl Proval is editorial director of