Know the Market, Grow the Market: St Joseph Mercy Hospital
Donna WadeIn today’s business environment, it is critical for health care organizations and their leaders to demonstrate a thorough understanding of their respective markets’ dynamics, needs and demands—and to make decisions accordingly, said Donna Wade in the “Know Your Market to Grow Your Market” session held on August 24 at the annual meeting of the AHRA: The Association for Medical Imaging Management, in Washington, DC. It was this concept that led Wade, who is MRI coordinator at St. Joseph Mercy Hospital Ann Arbor (Superior Township, Michigan), and her colleagues to select a 1.2T bore-less MRI unit for their facility rather than a traditional closed MRI system. This decision, Wade says, helped St. Joseph Mercy sharpen its competitive position in the marketplace, meet the needs of its respective service area populations, and, ultimately, achieve even greater volume growth than expected. St Joseph Mercy Hospital Ann Arbor is part of St Joseph Mercy Health System, which operates seven hospitals, holds a license for 1,726 beds, has a medical staff of nearly 2,700 physicians, and also maintains a network of outpatient sites that includes two facilities where cancer treatment and surgical services are provided. Founded in 1911 in downtown Ann Arbor and relocated to Superior Township in 1977, St Joseph Mercy Hospital Ann Arbor is licensed for 537 beds, has a 341-acre campus, and employs more than 6,500 people. Changing Needs In 2007, St Joseph Mercy Hospital Ann Arbor had four traditional 1.5T magnets with “all the newest technology bells and whistles,” Wade told session attendees. Anticipating growth in demand for MRI services following the opening of two new buildings—the 11-story east tower and the seven-story north tower—the hospital obtained a certificate of need for a fifth magnet. Then came the question of whether to invest in an even more technologically advanced 3T system or a bore-less MRI unit, both of which had intriguing possibilities. A team comprising Wade, several hospital administrators, and representatives from the radiology staff began to evaluate both options. “We studied our geographic location and what technology would best meet the needs of our surrounding communities,” Wade notes, adding that in doing so, the team identified a trend among many area residents of leaving Michigan in order to undergo MRI examinations because the equipment available in local institutions did not accommodate patients with such conditions as obesity and claustrophobia. “That clinched the decision to go with a bore-less MRI architecture.” The team then set stringent criteria for the new system. The most significant of these, Wade says, were that the selected magnet needed to function as a workhorse and to allow high-quality imaging; to aid in decreasing the number of patients requiring anesthesia or sedation prior to commencing MRI examinations; to eliminate, or drastically minimize, the need for triage when scheduling all patients, pediatric through bariatric; to increase patient-satisfaction levels by affording enhanced comfort and decreasing overall anxiety; and to yield the hospital an edge over its competition. Vendor criteria were also established. These encompassed a willingness to offer in-depth training for the hospital’s technical and clinical-engineering personnel and the ability to provide short response times when service was requested. Following an in-depth comparison of several options and benchmarking against the established criteria, Wade and her colleagues concluded that the Hitachi Oasis 1.2T Bore-Less MRI system most closely fit the hospital’s requirements. The system’s arrival, during the summer of 2008, was followed by a smooth, on-time installation and several days of hands-on training by Hitachi. Architectural Advantage The first scan on the Oasis was performed on August 29, 2008, and the benefits afforded by its bore-less architecture became evident almost immediately. A patient who had been scheduled for an MRI examination using one of the hospital’s traditional magnets quickly became agitated at the beginning of the procedure, with such strong feelings of claustrophobia that he was unable to allow it to continue. Instead of compelling the patient to return on another day and undergo imaging with sedation or anesthesia, the staff redirected him to the new system. He quickly calmed down and completed the examination with no further difficulties. Wade says that the Hitachi Oasis continues to satisfy or exceed all the criteria set for it. Image quality is comparable to that afforded by the hospital’s 1.5T magnets and superior to that offered by other bore-less MRI systems on the market, she asserts. Some of the hospital’s radiologists actually find images of certain patients captured by the bore-less architecture to be better than those captured with traditional MRI equipment, she says. “We are far better equipped now to accommodate a broader spectrum of patients, whether bariatric, pediatric, claustrophobic, or just too anxious to undergo closed MRI,” Wade states. “Many people are coming to us now, instead of going elsewhere for their exams; in fact, local hospitals call us to schedule some of the inpatients they cannot accommodate due to these issues.” She adds that patient volumes clearly warrant the investment in bore-less MRI over a closed 3T system. In 2008, the hospital performed 717 scans on the Hitachi Oasis; in 2009, that number rose to 3,791 scans. The hospital is currently on target to have performed more than 4,500 scans with the unit in 2010—a 16% increase over last year’s figures.

Figure 1: Bore-less MRI volume trend by year at St. Joseph Mercy.
“Just as important, we are getting consistently very good service and communication from Hitachi,” Wade notes. “There is very little downtime, and it also is not unusual for the vendor to call us when there is an application specialist in the area who can sit down with us and do some additional technical training or tweak things for us a bit. Bore-less architecture was definitely the right road for us.” Julie Ritzer Ross is a contributing writer for