Shantanu Thatte, Head Bio-med, HOSMAC highlights why understanding how to plan the different types of radiology/imaging equipment thereby covering a few aspects of project preparation, procurement, project delivery, total cost of ownership, and emerging new technologies is of crucial importance
Human body is a complex and mystifying structure and so is the different applications of various modalities in the department of Radiology and Imaging. It refers to several different technologies that use imaging methods to scan and image the human body to diagnose, monitor or assess treatment of medical conditions. Some of the high ticket equipment under radiology include CT Scan, X-Ray and Cathlab, among others.
Understanding how to plan the different types of radiology/imaging equipment thereby covering a few aspects of project preparation, procurement, project delivery, total cost of ownership, and emerging new technologies is of crucial importance.
If a hospital buys equipment without proper planning, it may result in over-killing or suboptimal results. In order to achieve value for money and improve overall project outcome, the planning and procurement must be done in a systematic manner.
The locus of points for planning and procurement of radiology equipment are as follows:
Budget: In medical industry, the cost of medical equipment/infrastructure is to the tune of 25 to 30 per cent of the overall Capex of the hospital facility. If we go by a thumb rule cost, then the per bed cost of medical equipment for a multispecialty (tertiary care) facility would be in the range of Rs 19 to 20 lacs. For a 100-bed hospital, if the equipment cost goes to the tune of Rs 25 to 30 crores then approximately half of the cost will be attributed to radiology equipment i.e. Rs 12 to 15 crores.
Need assessment: Before initiating the procurement of any radiology equipment, it is important to consider the overarching goals of the health facility. Most well-run hospitals have a multi-year strategic plan that clearly defines priorities and guides major procurement decisions. With the increasingly rapid speed of innovation and commercialisation of medical technologies, in planning a greenfield site, it is important to conduct a need assessment study covering parameters, such as type & location of facility, number of patients, special infrastructure needs, adequate staff & their training and maintenance.
Level of technology: In order to establish the level of technology and brand options, it is very important to curb oneself from buying and maintaining a white elephant. Technology selection should be retrospectively upgradable. A typical bone of contentions could be exemplified with following examples; 1.5 T MR vs 3 T MR, 10-inch detector Cathlab or 20-inch and Retro-fit DR or full room DR.
Space & engineering planning: Coordination between Interior designers and Architects is a must w.r.t room and space planning and finalising the location of the equipment. By compiling an equipment book including manufacturer’s installation data and cut sheets and forwarding the necessary info to the interfacing departments to develop architectural and engineering components of the facility can be an effective way.
Procurement schedule: It is important to draw up a procurement schedule to understand the timelines to by which the equipment orders finally need to be placed. Depending on the modality, 4 to 6 months is the estimated lead time from the day of release of PO till commissioning.
Preparing techno commercials: Technical Commercials Evaluation of the bids received is the most critical factor in the entire process. There should be a demo arranged for the client in coordination with the respective vendor for the equipment in consideration. Price alone may not necessarily represent the value of money, hence the buyer should consider other points such as the reputation of the equipment supplier, bundling of packaged deal, provision of turn key design solution, among others.
Total cost of ownership
TCO is an estimate of the total costs associated with a solution over the whole of the operational life. Different types of equipment may have different TCO elements. The three common elements under this include acquisition costs, commissioning costs and operation/ maintenance costs.
Emerging trends and potential of technology
With advancement in technology at such a rapid pace, more and more sophisticated and high modality equipment is emerging in to the domain of Diagnostics and Investigations. Artificial Intelligence in MRI and CT imaging is the new boon in the radiology segment which allows deep learning of every organ of our body under scan. AI based tools have eliminated the redundant and manuals ways of scanning a patient body and have actually assisted in making the life of the radiologists simpler. New algorithms and new technology coils allow better patient compliance, assists in auto-planning, helps in monitoring the patient vital signs without any extra gadgets, minimises the risk of re-scan and removes the artifacts post acquisition. Today a patient while under scan can breathe freely without any body strap and watch a movie of his / her interest during the time of examination. A new CT scan with dual energy pattern, (high and low energy image) allows less exposure to the source and gives better anatomical results.