Like most CAH facilities, this specific hospital is located in an underserved rural area. Patients prefer to receive their medical care ‘at home’ but typically are required to travel to medical centers in larger cities to receive many of the necessary diagnostic tests. This results in a hardship for the patient, a loss of revenue for the hospital, patients being absorbed into the care of the larger medical center and/or patients forgoing care due to the hardship involved with traveling.
As mentioned, this case study reviews the implementation of a nuclear medicine service. Nuclear medicine is used to diagnose a wide range of disease including cardiac, gallbladder, cancer, gastric and lung. Hospitalists, cardiologists, internal medicine physicians and family practice physicians find it a valuable tool. However, due to the capital equipment costs, personnel costs and licensing requirements it is not offered at many Critical Access Hospital (CAH) facilities.
HCI has been providing nuclear services for small and large facilities since 1998. The management of HCI has more than three decades of experience in the industry, which allows HCI to source equipment and personnel in such a manner that they can overcome many of the obstacles that prevent CAH facilities to provide this important service.
In this particular case, HCI provided a ‘state of the art’ nuclear medicine camera, computer, hot lab and treadmill.
HCI provides personnel based on the needs of the facility eliminating the need for a F/T technologist. HCI works with the hospital to educate physicians, physician extenders and patients by sponsoring open houses, news advertisements and personal calls on referring physicians.
Working with the hospital management, a small but suitable site was located. HCI’s physicist provided the necessary paperwork for the hospital to apply for the new license. After the initial license application, the hospital requested some administrative changes to the paperwork. HCI provided the necessary support for license amendments. Drawings specifications, provided by HCI and their service team, allowed the hospital engineering team to prep the site for delivery of the equipment.
The equipment was delivered and installed as planned.
The treadmill was installed and later moved to accommodate additional ‘non- nuclear’ patients. HCI personnel worked with hospital personnel and physicians to ensure stress tests were performed efficiently and properly. HCI provided the support necessary for a Radiation Safety Officer and the required safety meetings. The initial inspection was perfect.
Financially, the project has been successful for the hospital. Service is provided two full days per week. Initially, volume started at 10 scans in the first month but has grown steadily each month.
Today, we are scanning over 30 patients per month. Based on referring physician’s requests, we are looking to add one to two half-days per week to accommodate emergency scans. Volume grew due to physician and patient education about nuclear medicine as well as the availability of the service.
HCI provided support for open houses, personal visits and follow-up visits, referring physicians, local newspaper advertisement of the service, marketing flyers, press releases and more.
At a volume of 30 scans per month (divided 70% cardiac and 30% general nuclear) the hospital is ‘netting’ $6,500 per month, or almost $80,000 per year. The attainable goal of the hospital is 40 scans per month. At the previously mentioned split between cardiac and general nuclear tests, the hospital will net in excess of $160,000 per year. This financial analysis does not take into account the additional revenue generated by keeping the patients “in town,” the expense savings that result due to quickly diagnosing and treating patients, nor does it take into account the marketing expense savings included in our program.
In conclusion, the partnership with HCI has enabled the hospital to provide a necessary service for their patient population while positively adding to the hospital’s bottom line. HCI’s program has provided a model that fosters growth, improves patient care and provides the community access to advanced medical technology.
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