Building a ModernDiagnostic Center

Chain- Dr Vas Metupalle

Clarity Radiology Pte Ltd www.clarityradiology.com

 

Contents

Introduction..................................................................3Location........................................................................4Layout...........................................................................5, 6, 7, 8Infrastructure...............................................................9, 10, 11, 12Equipment....................................................................13, 14, 15Staffing.........................................................................16Training........................................................................17Digital radiology..........................................................18, 19,20Projections....................................................................21, 22,23Franchise Model...........................................................24, 25

INTRO

This presentation aims to detail the components of a central diagnostic center with several satellite imaging centers.

Xray, Ultrasound, Mammo, CT , MRXray,

Ultrasound, Mammo,

Xray, Ultrasound, Mammo,

Xray, Ultrasound, Mammo,

Location

Central advanced diagnostic center

- City - good transport links

- Building with adequate floor loading / frontage /space, carpark space

- Nearby Hospitals with service lacking

- Outpatient specialists in vicinity

Sattelite diagnostic centers

- Well Populated, self contained neighbourhoods

- GP groups in vicinity

Layout

Components:

1. Advanced Diagnostic center- Waiting area x2 (outer, inner)- Reception- Admin / Marketing / Accounting Room- Pantry- Meeting / Training Room- Radiologist reporting room- rest room- Changing rooms- Technician Work area- Xray Room- Mammo Room- Ultrasound Room - CT Room- MR Room- CT/MR control room

Likely 4000sq feet

Possible Advanced center Layout 4000 sq feet

Layout

Components:

2. Satellite Radiology Center- Waiting area - Reception- Changing rooms- Technician Work area- Xray Room- Mammo Room- Ultrasound Room Likely 1500sq feet

Proposed Sattelite center Layout

1250sq ft

INFRASTRUCTURE1) Floor LoadingMRI area – 12kNCT area - 5KNRest - 3 KNSpecialists required:- Specialist contractor-Professional Engineer- Radiation safety adviser- MR / CT installation +commissioning engineers 

2) Radiation Protection , RF insulation

- RF insulation for MR room

- 3mm thickness lead rooms for xray, mammo, CT rooms. - Lead doors, lead glass- specialist contractors needed to consult with local contractors 

3) Power- Uninterrupted Power Supply vital to preserve medical equipment circuit boards from damage. UPS machines tested for medical equipment eg. Caterpillar , Toshiba UPS. Advanced Center - 200 to 300kVASatellite Center - 60 to 100kVA - Generator supply important for business to run in developing countries.

4) Network- Internet , ADSL / VSAT broadband2MB/sec Download , 1MB/sec upload

- LAN network, Gigabit ethernet within each center

- 1x server , with 4x windows professional PCs satellite center

- 2x Server, 9 x Windows XP pro advanced center

EquipmentNewVendors : GE , Phillips, Toshiba, Siemens , HitachiRecommendation is to get all equipment form single vendor for good price and servicing agreement.

RefurbishedSuppliers:1) Amber Dignostics : http://www.amberusa.com/ , http://www.amberafrica.com (Located in Cameroon) 2) Block Imaging : http://www.blockimaging.com

Comparison Pricing

Equipment                       New                              Refurbished (5 yr old)

1.5T MRI (closed MR)  US$ 1.2mil                            US$ 300 to 400kOpen MRI                      US$ 600k                             US $ 250k16 Slice CT                        US$ 650k                        US $ 200k

Maintenance

1.5T MRI - US$ 70k / yearOpen MRI - US $ 25k / yearCT 16 slice - US $15k / year

Equipment – Advanced Center

• Open MRI , 0.4 Tesla• 16 Slice CT• Xray Machine • Ultrasound machine• Mammogram machine• BMD

Equipment – Sattelite Clinic

Xray Machine • Ultrasound machine• Mammogram machine

Staffing Advanced diagnostic center

• 2 principle radiologists • 6 Radiographers• 1 nurse• 2 front desk staff• 3 admin staff

Satellite center

• 3 radiographers• 2 front desk staff• 1 admin

Training• Advanced modalities- CT/ MR/PETCT

• IT, training of PACs, Telerad

• Customer support

• Specialist Marketing

All centers would have DIGITAL SOLUTION- Fast , Secure, Scalable

• Fast & Efficient - When its needed

• Geographically limitless – accessible from anywhere

• Secure – Ensuring absolute information privacy

• High quality - transmitting demonstrably perfect images

• Easy to use – minimal training and barriers to use = rapid adoption

• Cost Effective – In time and money.

• Highly Scalable – robust for large volume

PACS/ RIS/ TeleRadiologyThe TELE-RADIOLOGY Hub model provides entire workflow for an online diagnosis and reporting allowing radiologists to remain in central diagnostic center.

MiniPACs at Sattelite Imaging centers

MiniPACs at Sattelite Imaging centers

AdvancedCenter

Teleradiologist

Load Balancing a breeze with teleradiology

Teleradiologistsfor Load balancing

Projections for 1xAdvanced Center , and3xSattelite centers

-SAMPLE-

Projections have to suit local conditions and prices.

-SAMPLE-

ROI Calculator for Single Modality

-SAMPLE-

Franchise Model

• Establish model center locally

• Legal documentationo Letter of intent, Area agreement, Master

agreement• Creating corporate identity

o Trademark, Namecards, Letterhead, envlopes, signpost, Uniforms

• New Center Setupo Process, Pre renovation consult, Renovation details, Final preparation,

checklists

• Operational Infoo Organisational structure, IT linkups, operational matters

• Service Qualityo Philosophy, attire, Customer relations, Complaints structure

• Human Resourceso Recruitment procedure, appraisal, application/ acceptance forms,

employee handbook.

Franchise Process1. A Prospect expresses interest

2. Confidentialmeeting &offfer

No

yes

3. Sign Letter of intent

4. Survey of premise

5. Proposal

No

yes6. Sign agreement

7. Set-Up

8. Training

9. Marketing

10. Opening