Sole-source Vendor Agreements: Not Always the Best Option

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At Charlotte Orthopedic Hospital (COH) in North Carolina, a change similar to that happening in many hospitals across the country is underway: The facility is becoming more strongly linked to its parent organization, Novant Health. As Charnaye Bosley, RT, manager of radiology at COH, explains, “Where before, each facility kind of stood on its own and practiced what was best for it, now we’re all more deeply connected. We have a large footprint in and outside of the Charlotte community, but patients didn’t realize what a large network we have. Our goal, moving forward, is to be integrated, and part of my role is making that transition as smooth as possible.” That meant reconciling two sets of priorities when selecting a new MRI system to replace the hospital’s 15–year-old system: the needs of the larger organization and the needs of COH’s patient base. “Each facility has its own budgetary limits, but as part of such a large system, we needed to look at what would complement the units that we have now,” Bosley says. “We also looked at the types of patients we image and the needs of the consumer in our area, as well as where we’re located and what’s around us, which is lots of other hospital facilities and imaging centers—some in our network and some competitive.” Market Assessment The team at COH knew that image quality was its first priority, which led it to investigate wide-bore systems with high field strengths. “There wasn’t an open MRI unit in our system, although we do already have wide-bore units,” Bosley says. “In the past, we’ve always acquired imaging equipment from one particular vendor and have been satisfied, but in this case, we knew our patient population was changing.” Specifically, Bosley says, the patient base at COH was growing in both physical size and in understanding of its health-care options. “We’re seeing larger patients and larger athletes,” she says. “We’re also seeing patients with claustrophobia who are more educated about their options and what is available in the market, and more parents who don’t want their children to have sedation. We knew we needed a system that would fit the needs of the community, as well as the education level of our patient base.” In January 2013, COH installed its selection: the 1.2T boreless Oasis system from Hitachi Medical Systems. “When we looked at our patient population, the first thing that made Hitachi stand out was its flex coils,” Bosley says. “The comfort level of the coils is excellent. The isocenter of the Oasis also played a role in the decision because the number-one type of patient we see has broad shoulders, and the isocenter helps get really great images, even on bigger patients. It also didn’t hurt that there was no 1.2T system in our area. The Oasis performs like a closed unit, and the image quality is just as good, but the level of comfort it offers our patients is higher than with a closed system.” After Implementation In the six months since COH installed the Oasis system, it has experienced significant increases in MRI volume, Bosley says. “We’ve tripled our volume on some days, and on average, we’ve doubled it,” she notes. “Our throughput is high because scan times are so much shorter, and our patient base is broader now: We can image patients without sedation, which means they choose to come here, where before, they might not have had MRI exams at all. For the physicians, the longer we’ve had the system, the more they have believed in it.” To spread the word about the implementation, COH sent referring physicians educational mailers and hosted a lunch-and-learn event. The hospital also had an open-house celebration to showcase the new system. “The radiologists talked to everyone about the benefits of open MRI for physicians and patients,” Bosley says. “We had about 200 people come through that day.” As part of Novant Health’s more integrated approach to managing its facilities, Bosley and her team reported budgetary numbers to the larger organization, and were pleased that the Oasis exceeded expectations, in terms of return on investment. It’s perhaps more important, Bosley says, that patient satisfaction is measurably on the rise. “Patients in the community are very educated, and they look for things that will make imaging safe and easy for them,” she notes. “This is a system they feel good about. They know the system is safe; for instance, we’re getting pediatric patients we never had before.” The system is sited in a large room with floor-to-ceiling windows, she adds, contributing to the open feel. “Patient-satisfaction scores are at 100%,” she says. “The patients, physicians, and radiologists all couldn’t be happier.” Bosley concludes by observing that at the outset of the MRI selection process, she couldn’t have imagined seeing such positive results from an open system. “Traditionally, open MRI systems just haven’t had the best reputation,” she notes. “I was not the biggest fan of them because of their history, but Hitachi really did its homework with this system and made sure nothing was left by the wayside. The machine speaks for itself: You can’t help but be happy with it. We’ve been very successful with this choice.” Cat Vasko is editor of and associate editor of Radiology Business Journal.