Can low-dose, whole-body x-ray improve revenue and make your hospital more competitive?

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Call it a classic case of not wanting to be the last kid on the block to own one. A few months ago, the company EOS imaging installed its ultra-low dose, whole-body imaging system at a hospital in the mid-Atlantic region. Afterward, the hospital launched a print-and-broadcast marketing campaign to let patients and physicians know that it now possessed this innovative x-ray technology and to spell out for them its many benefits—reduced irradiation, speed, comfort, accuracy, economy, and more. Referrals to the hospital began to pour in from orthopedic surgeons and pediatricians. A second hospital in the area took note and arranged to acquire an EOS equipment of its own. With that move, the second hospital ensured retention of its position in the market, says Marie Meynadier, chief executive officer of EOS imaging, Cambridge, Massachusetts. “Our product is inspiring a gratifying level of interest among hospitals,” she says. “For example, one of our recent customers—a hospital in the Southeast—attracted a key surgeon they wanted to hire by contractually promising he’d have access to EOS for his patients. We had the same thing happen with a customer in Germany.” Remarkably Accurate Images The appeal of the French-made EOS system begins with its design. According to Meynadier, it employs slot-scanner x-ray technology based on Nobel Prize-winning physics that permits capture of two whole-body images in a single scan without stitching or vertical distortion. The system provides 2D as well as 3D images of patients and automatically calculates a number of clinical parameters for informed diagnosis of orthopedic conditions. “Our Nobel Prize-winning technology makes it possible for surgeons to radiologically assess the condition of the patient in a functional, weight-bearing position very easily,” she says. “Frontal and lateral digital images up to 5 feet, 9 inches, and in 1:1 scale are acquired simultaneously. EOS then provides a 3D skeletal image in that functional, standing or seated position. It is the only system with this 3D capability which is very meaningful for orthopedic surgeons.” Notably, these images are remarkably accurate, and are generated with very low doses of radiation. Meynadier points to peer-reviewed European studies that have found the radiation dose of EOS to be as much as nine times less than that of CR and 20 and more times less than that of CT. “The low radiation dose of EOS is especially advantageous for the imaging of pediatric patients, for instance those with scoliosis,” she says, “because the monitoring of scoliosis progression in children entails frequent imaging. Parents worry about the health effects of frequent imaging using conventional doses of radiation.” The EOS scanner is packaged with a workstation that adds to the low dose full length x-rays a 3D renderings of skeletal anatomy, and calculates over 100 clinical parameters for spine, pelvis, and lower limb for better spine and joint diagnosis, planning and follow up., Meynadier says. Revenue Generator, Cost Saver At the end of the third-quarter of 2012, EOS systems were installed in approximately 50 sites across Europe, North America, and Asia-Pacific; combined they have logged more than 250,000 imaging sessions, according to EOS imaging, which is based in Paris and conducts business in the U.S. through a branch in Cambridge, Mass. Meynadier says the EOS system is proving popular among hospital CEOs and CFOs because it “addresses all the key issues visionary leaders must articulate to their constituents.” “It is an ideal revenue generator,” she says. “In part, it drives revenues by virtue of fast throughput for very complex exams,” she says. “The system acquires image data in less time than required by other modalities—simultaneous frontal and lateral whole body images can be acquired in an exam that takes in whole less than four minutes. Because of that speed, some of our sites have recorded workflows of 100 patients per day. This is a pace impossible to match using traditional x-ray systems because of the time it takes them to build by stitching images, and render the data.” EOS also drives revenues by giving orthopedic surgeons more reliable clinical information to make better surgical decisions and plans, Meynadier says. “The level of imaging data accuracy is beyond that which was previously obtainable—and since the images are more accurate, surgical planning is improved,” she explains. “With improvement in planning can come improvement in outcomes and, by extension, improvement in patient-satisfaction scores.” Meynadier hints that an EOS-equipped hospital can, with advantages like those, emerge as an imaging referral center and orthopedic center of excellence. “In France, the experience with EOS has been that users have seen their referral revenue increase substantially,” she says. “When outside orthopedic surgeons who cannot obtain the data they need from their own site or from any other imaging provider learn of the availability of EOS at a site, they tend to start sending there as many patients as they can. There is however a risk for them to lose not only the imaging session but even the surgery itself as patients get familiar with the EOS-owning site. Elimination of Bottlenecks On the opposite side of the ledger, EOS carries a price tag a notch or two above conventional x-ray systems. However, there are significant offsets that, taken together, make acquisition of EOS a sound investment offering the potential for a good return, Meynadier describes. One such offset is the potential savings realized from surgical procedures that are completed without complications —a benefit of the improved planning afforded by the EOS’s superior image output. “If the images lead to measurements that are wrong, it won’t matter how skilled the surgeon is —the outcome of the surgery will still be suboptimal,” Meynadier proffers. “The costs are in the treatment and particularly in the revision of these less-than-optimal treatments.” Another offset is found in the speedy throughput of EOS, which helps busy clinics avoid production bottlenecks. “Skeletal exams take the longest time,” says Meynadier. “Having a tool to complete these exams faster reduces or eliminates pressure to add more rooms and outfit them with traditional technology.” What Forward-looking CEOs Want The return-on-investment potential of an EOS installation varies by hospital and is dependent on imaging volume, but an ROI of about two to three years seems to be the norm for a room seeing 10 patients per day,” Meynadier suggests. “In France, EOS units are very profitable. We are seeing manifold returns from our private sites, mainly from the recruitment of patients that were referred to EOS rather than to a standard exam.” Meynadier says U.S. hospital CEOs and CFOs are very sharp in their appreciation of the competitive marketplace in which their institutions operate. “The last thing any of them want is to lose patients, surgeons, and market position for lack of the right tools,” she argues. “Today’s forward-looking hospital CEO or CFO understands more than ever that their hospital is first and foremost a business, and that they must create value for their stakeholders—their patients, their physicians and their board. EOS is a very valuable piece for accomplishing precisely that.” Rich Smith is a contributing writer for imagingBiz, Tustin, California.