Whitney Palmer

Healthcare. Politics. Family.

What to Consider When Purchasing Refurbished Equipment

Published on the June 21, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

Purchasing a refurbished CT or MRI machine could be a good option, particularly if your budget is tight. But practices should proceed with caution, said Joyce Bates, RT, director of imaging and radiation oncology at Carolinas Medical Center-Union in Charlotte, N.C., who offered a few considerations.

First, be sure to select a company with a strong reputation for quality products and service. If possible, she said, purchase a refurbished machine from a vendor with whom you have an existing relationship, and be sure to secure a warranty. Next, be sure the vendor fully updates their machines, including replacing parts, installing new software, and painting the equipment. Everything should look new, she said.

Second, she said, only consider purchasing refurbished machines that are less than three years old. Technology changes so rapidly in the industry that older equipment cannot give you the same clinical capabilities.

Lastly, it’s also important to remember, Bates said, that refurbished equipment isn’t suited for every modality. Machines that approach $1 million in price, such as CTs and MRIs, can be refurbished and provide the same level of performance as a new machine would. Nuclear medicine cameras, although their price tag hovers around $300,000 to $400,000 dollars, can also offer suitable refurbished options. However, Bates recommended avoiding refurbished equipment of less than $100,000, such as ultrasound machines, because the technology becomes obsolete much more quickly.

Above all else, she said, consider the current health care landscape when making your purchasing decisions.

“We don’t know what’s going to happen to affect our capital equipment choices,” she said. “Budgets will be tighter, and health care economics will be really tough. It could very well be that refurbished equipment will be the standard within the next five years.”

To read the story at its original location: http://www.diagnosticimaging.com/practice-management/content/article/113619/2085255

Advertisements

June 25, 2012 Posted by | Healthcare | , , , , , | Leave a comment

Is Refurbished Imaging Equipment Right for You?

Published on the June 21, 2012, DiagnosticImaging.com website

By Whitney L.J. Howell

If you’re looking to add another CT or MRI machine to your imaging suite or you need to replace one that will no longer pass muster under accreditation, you’re likely juggling the question of whether to buy a refurbished machine.

Acquiring refurbished versions of these machines is a growing trend as practices and facilities grapple with concerns over decreasing reimbursement or consider the possibility of future consolidations. Technology advancements over the past five years — and the desire of some larger facilities to purchase the most up-to-date machines — have made CT and MRI machines increasingly available for refurbishment. These machines are best suited for refurbishment, although some less-expensive equipment — mainly ultrasounds — account for solid portion of pre-owned equipment purchases.

“You can get really high-end, latest-technology equipment for refurbishment after five years,” said Sabine Duffy-Sandstrom, vice president of Refurbished Systems (U.S.) at Siemens Healthcare. “That’s why CTs and MRIs are the leading modalities in refurbishment. Facilities tend to keep other machines, such as angiography, for a much longer time.”

An Increase in Demand

If health care reform passes U.S. Supreme Court scrutiny this month, the industry anticipates approximately 37 million new patients will have access to clinical services. It’s possible this uptick will translate into a 14 percent jump in diagnostic imaging utilization, according to a recent study based on Kaiser Permanente data from imaging consultant firm Regents Health Resources in Tennessee.

As a result, Regents president Brian Baker predicted imaging centers could run an additional half-million scans during the next decade, meaning you must find a way to meet the increase in demand. The good news, he said, is that you don’t always have to purchase a new, $1.5 million machine.

“You have to take a look at the entire market. The most advanced technology might be a 3T MRI machine, but you don’t necessary need it to accommodate your patient base or the kinds of exams your referring physicians are ordering,” Baker said. “Often, we recommend refurbished equipment because it’s so much better and faster than what they already have and it will help them better meet the standards of care without carrying the larger price.”

The Refurbishing Process

It could be tempting to think of a refurbished machine simply as a used one with a proverbial new paint job. But that’s not accurate, Siemens’ Duffy-Sandstrom said.

“Everyone tends to use the word refurbished,” she said. “So, when facilities are looking to buy not-new equipment, it’s very important to understand the differences between refurbished and used, especially with the concerns about lowest dose and CT scanners.”

According to Duffy-Sandstrom, Siemens follows a five-step process when refurbishing equipment. First, the refurbishment team considers the machine’s age, performance, and service history. They also check whether the machine’s software and hardware can be upgraded and if service parts will be available for the next five years. Next, the team de-installs the machine and ships it back to a Siemens factory in its original packaging.

Machines are cleaned, disinfected, and painted; worn parts are replaced; hardware and software updates are installed; and the machine is reset to new customer specifications, she said. After passing a final check, refurbished machines receive a quality seal.

The same Siemens team re-installs the machine, which carries the same warranty as a new machine, with the new customer and provides standard training.

Other companies, such as Philips and GE Healthcare, also refurbish their machines. Philips’ five-step process is similar to what Siemens offers, and it focuses on bringing a wide range of modalities to customers looking to purchase updated machines on a budget, said Jim Moran, director of equipment remarketing for Philips Healthcare for North America.

On the other hand, purchasing a used machine from a third-party retailer is an option. There is no hazard to doing so, Moran said, but all updating processes are not created equal. It’s akin to purchasing a used car — you must choose from what the dealer has on the lot.

“Not everyone can access the proper software and safety upgrades for all machines,” he said. “This is a big investment so you want to make sure the refurbisher has sound processes. My guidance to clients is to go to the facility, oversee the process, and be mindful of whether the equipment looks new and has been brought up to current industry specifications.”

To read the remainder of the article at its original location: http://www.diagnosticimaging.com/practice-management/content/article/113619/2085269?pageNumber=1

June 25, 2012 Posted by | Healthcare | , , , , , , , , , , , , , , , , , , , , , , , | Leave a comment

N.C. State researchers develop a better test for cat scratch fever

Published in the June 25, 2012, Raleigh News & Observer and Charlotte Observer

By Whitney L.J. Howell

“Cat Scratch Fever” might be best known as a catchy song, but the infection of the same name, scientifically known as Bartonella – is an easy-to-catch infection caused by a common, hard-to-detect microbe. But a test developed by N.C. State researchers could make it simpler to pinpoint the pathogen and treat the resulting symptoms.

Using a patented insect medium and a sensitive, sophisticated DNA analysis tool, N.C. State investigators have developed a Bartonella diagnostic test for humans. The goal is to identify Bartonella infections faster and more accurately, and a partnership with Research Triangle Park-based company Galaxy Diagnostics, Inc. could make the test widely available.

“This microbe is one of a handful that physicians who specialize in chronic disease

There are more than 25 known Bartonella strains, and roughly nine have been linked to disease development in humans. The difficult-to-detect pathogen is transmitted by blood-sucking insects. Individuals with frequent animal exposure, especially to cats, can be at high risk.
PHOTO CREDIT: JANET BLACKMON MORGAN – MCT

look at now, but a lot of doctors don’t test for it because of the high false-negative rates. If you don’t know exactly what to look for or if you don’t have the tools, why look for it?” said Amanda Elam, Galaxy Diagnostics president. “We think we’ve found a way to identify the bacteria, and we’re helping to find it in patients with this test.”

Currently, there are more than 25 known Bartonella strains, and roughly nine have been linked to disease development in humans.

However, diagnosis is challenging because it only takes a few Bartonella particles to prompt an infection. Small amounts mean even highly sensitive tests, such as DNA analysis with the help of polymerase chain reactions (PCR), often yield false negatives.

“Locating Bartonella is like finding a needle in a haystack with the infection being the needle and the haystack being the patient,” said Ed Breitschwerdt, internal medicine professor at N.C. State’s College of Veterinary Medicine. “If the haystack is too big and there are only a few needles, PCR will miss the infection more often than not.”

How the test works

Getting a Bartonella diagnosis faster means relying on the bugs that carry it, said Breitschwerdt, who led the test’s development team.

“During our 15 years of research, it became obvious many different insects – sand flies, lice, fleas, biting flies on cattle, and ticks – were confirmed Bartonella carriers,” Breitschwerdt said. What made his research different was finding the way to grow Bartonella more quickly in a Petrie dish.

“We asked whether Bartonella would be happier in an insect-growth medium compared to mammal-growth. It’s not too sophisticated a question, but it proved important because the answer was yes.”

To identify an infection, scientists kick-start Bartonella growth by putting a small ( 4 milliliter) blood sample into an insect growth medium called Bartonella alpha Proteobacteria Growth Medium that stimulates bacteria production. Within 10 days, there are enough bacteria present in the blood for a PCR test to yield an accurate diagnosis. Through a series of up to 40 temperature changes, PCR produces multiple copies of any bacteria DNA present, allowing scientists to definitively determine whether Bartonella is present.

The entire process – from petrie dish to verified results – takes between two to three weeks, said Galaxy’s Elam. Scientists can also run the test using non-blood bodily fluids or tissue samples.

Ed Breitschwerdt, internal medicine professor at N.C. State’s College of Veterinary Medicine, led the team that developed an analysis to more accurately diagnose Bartonella — cat scratch fever.
PHOTO CREDIT: ROGER W WINSTEAD – NCSU

Testing teams at Galaxy Diagnostics run PCR analyses on patient samples before inserting it into the insect growth medium in order to accurately gauge the bacteria’s growth. They also determine which Bartonella strain is present by running DNA sequence verification.

According to company data, the enhanced PCR analysis is four to five times more sensitive than the traditional PCR technique used to pinpoint the bacteria in the bloodstream, Elam said. With this extra sensitivity, Breitschwerdt estimated the tests will accurately diagnose between 80 percent to 90 percent of tested individuals who have Bartonella infections.

But identifying the pathogen is only part of the battle, he said.

“Our major contribution is that we’ve gone from thinking this bacterium only occurs in immuno-compromised patients or people with cat scratch disease to knowing there are quite a few people out there in specific populations who have this bacterium in their blood,” he said. “Now, we need research to find out what it means for patients to have this bacterium in their bloodstream.”

Proceeding with caution

Terry Yamauchi, M.D., an Arkansas Children’s Hospital pediatrician with infectious disease expertise, agreed with Breitschwerdt. While the insect growth medium-enhanced PCR is a valid method of identifying Bartonella, the analysis should not be a stand-alone clinical tool.

“The test itself seems to be scientifically very sound – growing more of the organism you’re searching for to improve test sensitivity will be helpful,” he said. “However, I worry about putting all our treatment-plan bets on this test because there’s little hard-core evidence indicating Bartonella is responsible for the chronic effects attributed to these infections.”

Until additional investigations into Bartonella yield a more definitive link between the bacteria and long-term symptoms, he said, physicians should opt to pair the test with traditional clinical observation and assessment.

WHAT IS BARTONELLA?

Bartonella, also called cat scratch fever, is a difficult-to-detect pathogen transmitted by blood-sucking insects, such as fleas, lice, or ticks. Individuals with frequent animal exposure, especially to cats, are also at high risk.

Many clinicians view Bartonella as a common culprit in chronic Lyme disease, arthritis, and multiple sclerosis-like neurological disorders, and is suspected to contribute to swollen lymph nodes, joint and muscle pain, inflammation, headaches, memory loss, and numbness in the hands and feet.

Once believed to only induce disease in animals, more recent research reveals this bacteria is also a threat to humans. According to the American Veterinary Medicine Association, nearly 60 percent of the 1,500 diseases recognized in humans can make the leap from animals to people. And, the phenomenon is growing. The Centers for Disease Control and Prevention estimates 70 percent of newly-identified human infections spring from animals.

To read the story at its Raleigh News & Observer location: http://www.newsobserver.com/2012/06/25/2151203/sharper-infection-detection.html#storylink=cpy

To read the story at its Charlotte Observer location: http://www.charlotteobserver.com/2012/06/24/3332959/sharper-infection-detection.html#storylink=misearch

June 25, 2012 Posted by | Healthcare, Science | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , | 1 Comment

   

%d bloggers like this: