Matching Imaging Purchases With Patient Demographics: WellSpan Health

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While traditional closed MRI systems continue to offer a multitude of benefits, competition and a growing population of patients who cannot tolerate them make a closer look at alternative modalities warranted, according to Ronald F. Bernardi, FAHRA. He presented “Know Your Market to Grow Your Market” on August 24, 2010, at the annual meeting of AHRA: The Association for Medical Imaging Management, in Washington, DC (and later provided additional details). Ronald F. Bernardi, FAHRAThese catalysts led York, Pennsylvania-based WellSpan Health (where Bernardi serves as director of imaging services for York Hospital) to install a 1.2T boreless MRI unit from Hitachi Medical Systems America Inc (Twinsburg, Ohio) in February 2010. The unit, Bernardi states, allows the health-care provider to offer imaging services that better correlate with patient demographics and overall business strategies, thereby fostering growth. WellSpan Health serves Pennsylvania’s York County and Adams County at York Hospital in York and Gettysburg Hospital in Gettysburg; the facilities are licensed for a combined 614 beds. It also operates more than 40 outpatient facilities, including 18 imaging sites, in the two counties, as well as in Northern Maryland. It encompasses 47 primary-care and specialty physician practices, and it has 8,000 employees. A third hospital, the 73-bed WellSpan Surgery and Rehabilitation Hospital, is slated to open in 2012 on the health care provider’s Apple Hill Health Campus in York. Bigger and Older Bernardi first previewed a boreless MRI system several years ago, at an annual RSNA meeting, but “at the time, the technology wasn’t developed enough for us even to consider whether it would be a good fit for us,” he says. The tide had turned, however, by 2009, when he and his colleagues began to see a place for boreless MRI within the WellSpan Health spectrum, he says. A close look at statistics and demographics indicated that York County’s aging and obese population would be well served by a boreless MRI configuration, Bernardi observes. Of all US counties, York County has the fourth-largest population of obese residents. Some 28.6% of people living in York and 28.9% of those living in York County have a body-mass index (BMI) that classifies them as obese; a respective 44.5% and 38.6% have a BMI that classifies them as overweight. Moreover, York County’s population is increasing at a rate of 4% annually. The number of individuals aged 65 and older residing in York and Adams counties is also on the upswing, rising from 13.5% of the total population (475,043 residents) in 2000 to 13.8% of the total population (523,740 residents) in 2007. Current projections indicate that 557,486 residents of the two counties will be part of this age group in 2012, accounting for 15.2% of the total population, with these figures slated to reach 611,348 residents, or 19.2% of the total population, in 2020. “It was clear to us that even many nonobese older patients in our market would be good candidates for boreless MRI because their extremely low percentage of body fat could make it uncomfortable for them to submit to the discomfort of a traditional exam,” Bernardi says. Bernardi and his colleagues also concluded that the availability of boreless MRI technology would support two key strategic growth initiatives that had recently gotten underway. These include recruitment of additional physician staff in the areas of cardiothoracic surgery, neurosciences, orthopedics, and rehabilitative services, as well as the expansion of existing bariatric and cardiology practices. “There was obvious appeal here, too,” he says. WellSpan Health installed the Hitachi boreless MRI system on the Apple Hill Health Campus, where it also has one traditional 3T and one traditional 1.5T magnet, in February 2010. Bernardi says that Apple Hill was deemed the best location for the unit because it correlates with WellSpan Health’s vision of providing a coordinated, team approach to orthopedic, neurologic, spine, and bariatric imaging on the campus, which houses the offices of many specialists in these fields. Feedback from patients also indicated a strong desire to avoid the inconvenience of undergoing imaging exams in a hospital setting. Bernardi notes that 2,330 exams were completed between February 15 and October 31, 2010, on the new boreless system. He adds, "We're doing 11 to 14 boreless MRI exams per day, which is a lot, in the MRI world." Strategic Marketing While demographics and other factors clearly bode well for WellSpan Health’s boreless MRI installation, Bernardi notes that a carefully targeted marketing strategy has also contributed heavily to the health-care system’s success with the unit. “We have overcome the mindset among many physicians that using boreless MRI necessitates sacrificing at least some image quality and may interfere with precise diagnostics,” he explains. Boreless-MRI sell sheets—one each covering orthopedic, neurologic, spine, and bariatric imaging—were produced in-house and distributed to WellSpan physicians. In addition to outlining the benefits of enhanced patient satisfaction and care, each sell sheet included a detailed explanation of how boreless MRI technology has evolved to produce images with quality levels comparable to those of images generated by traditional 1.5T magnets. Side-by-side images from closed and boreless MRI equipment were featured as well; these differed, based on the specialty of the physicians to whom the literature was targeted. WellSpan Health undertook a separate marketing initiative geared toward residents of York County, a move that Bernardi says was necessary to update them on the latest developments in MRI. “It was our belief that physicians weren’t the only ones with outdated information about boreless MRI,” he says. “We knew that many patients had been told, and might still be told, that the results of an exam with boreless MRI were not as reliable as the results of an exam with a traditional MRI machine.” To reverse the trend, WellSpan ran newspaper and radio advertisements bearing the slogan, “Clarity, meet comfort. Comfort, meet clarity.” The advertisements drove home the idea that boreless MRI has evolved to a point where existing and prospective patients need not give up the comfort of a boreless exam in order for their physicians to obtain the most accurate results. “Our usage rates on the Hitachi unit are now such that we aren’t currently distributing the physician sell sheets or running the ads,” Bernardi concludes. “We’re continuing to meet our objectives, proving that boreless MRI is the right choice for us, now and in the future.” Julie Ritzer Ross is a contributing writer for