The Economic Case for Patient-friendly Imaging

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As the technology used for radiologic studies matures, providers and referrers are increasingly focused on providing patients with a friendlier imaging environment—with good reason, according to Tariq Gill, MD. “We need to make a conscious effort to make things nonthreatening,” he says. “In our community, we have three main hospitals, and each one has its own style that patients can sense. Providing a patient-friendly environment isn’t just a care-giving issue—it’s a business issue.”
Gill is chair of the diagnostic-imaging department at 365-bed Our Lady of Lourdes Memorial Hospital (OLLMH), Binghamton, New York, which is currently undergoing a $70 million renovation in its radiology and emergency departments for this very reason. “Every time somebody walks into a hospital, it’s a very threatening environment,” he says. “A little bit of cosmetics and the right technology can go a long way.” Timely Technology Gill observes that while CT scan times have been greatly reduced by increases in detector rows and other improvements in CT technology, MRI remains a lengthy, noisy, and claustrophobic experience for many patients. He speaks from personal experience: “When I needed an MRI of my neck, all of a sudden I was very uncomfortable being in this confined space with a coil over my face,” he recalls. “I started to swallow a lot, and that can create artifacts and cause degradation of the picture. We had to repeat some of the scans. I don’t view myself as claustrophobic, so I realized how uncomfortable this must be for our patients.” Last year, OLLMH selected an Oasis high-field, bore-less MRI system from Hitachi Medical Systems America Inc, Twinsburg, Ohio, to address the issues that it was facing with claustrophobic, bariatric, and pediatric patients. Gill explains that these patients were “defaulting to lesser technology” in the absence of a high-field option, seeking imaging centers with low-field open MRI technology instead of coming to OLLMH for their imaging. “People in fields that don’t have MRI as part of the discipline don’t understand the difference between the various Tesla strengths,” he says. “The marketing people at the places that own these take out ads claiming that 0.3T is equivalent to 3T or better. Our technology is not only user friendly—it has the strength to give the same quality images we’d expect from a traditional, donut-type scanner.” Now OLLMH is able to attract patients who might previously have gone elsewhere, including pediatric patients—or, more to the point, the parents of pediatric patients. “One of our biggest dilemmas, as practitioners in a moderate-sized community, was that when parents were told their children needed an MRI, it became a difficult situation for them,” Gill says. “You’d have to get an anesthesiologist in, which made it a nightmare for that patient to be scheduled, but it was equally difficult for the parents to go out of town in search of a more child-friendly MRI scanner.” Now, Gill says, pediatric patients are imaged at OLLMH without difficulty and with no need for anesthesiology support. “Sometimes, parents can lie down and put the children on their laps, and you can do the scan,” he says. “There’s a closeness and a comfort that they have that way. This technology has enabled us to do these procedures efficiently and effectively here.” Of course, there are advantages for claustrophobic and bariatric patients as well. “There’s a whole segment of patients out there who prefer bore-less MRI,” Gill says. “Whether they prefer it because of their size or because of claustrophobia, we knew we weren’t capturing that market, and now we are.” A New Look and Feel While other imaging technologies (such as ultrasound, radiography, or even today’s high-speed CT) present less of a challenge when it comes to patient claustrophobia, the environment in which patients receive their imaging can still be improved to have a positive impact on their overall experience, Gill says. “Things don’t have to look opulent,” he notes. “That’s no good either. I’ve been to some freestanding imaging centers that look like spas, and that may appeal to a certain kind of clientele, but I’d imagine many average Joes would see that and feel that’s why health care is so expensive.” Instead, Gill says, the key is creating an environment that’s cheerful and nonthreatening, but still professional. This is a goal that OLLMH intends to accomplish through adding murals, skylights, and small touches like wallpaper. “Most imaging in traditional hospitals goes on in small rooms. They’re very confining,” Gill says. “As human beings, a lot of what we experience is subliminal. Patients might not be touching the wall and saying to themselves, ‘This is very high-end wallpaper,’ but it adds to their overall experience if the place is less threatening.” In addition to leveraging traditional advertising—print, billboards, and so on—to spread the word about advances and improvements at the hospital, OLLMH also uses social media, including a very active Facebook page, to reach patients. “I’m becoming a big fan of pushing the word around through social media,” Gill says. “There’s no question that for businesses, it’s a huge resource, and it’s free.” The radiology department at OLLMH is in the process of developing its own Facebook presence to get the word out about both its facelift and its new bore-less MRI. “We’re going to put cases and stories on it, like the mother with her child lying in her lap during the MRI,” he says. “From there, it becomes word of mouth.” Of course, $70 million is no small capital investment to drum up in the current uncertain health-care market, but Gill notes that Ascension Health, the Catholic health-care organization of which OLLMH is a flagship hospital, expects to see a prompt return on its investment in patient-friendly imaging. “We have to do more cases,” he says. “We have to offer a unique experience and bring in new services that people had to leave the community to get before. This technology, and the experience through the cosmetic upgrade, will eventually realize more cases and more revenue.” Cat Vasko is editor of and associate editor of Radiology Business Journal.