Research a Capital Purchase, Costing More Than $5,000, That Your Company Could Benefit From

Research a Capital Project

Section I of the Capital Project

Write a 3,000- to 3,500-word paper in which you complete the following:

o Research a capital purchase, costing more than $5,000, that your company could

benefit from. Examples include a new X-ray machine, an MRI processor,

software for filing patient records, a research library, or any large item that your

company might use.

o Identify the management goals that expenditure would support. Management

goals might include revenue, improvement, productivity, quality assurance,

employee development, or management services consultant packages.

o Explain how the item could enhance the economic environment of the

organization.

o Identify the organizational goals the expenditure would support. Goals might

include patient care, medical and allied health education, community service, cost

containment, leadership role, and clinical research.

o Explain how the expenditure would relate to the needs of the organization.

Explain how it would be beneficial to the organization.


o Justify the expense to the organization. Relate the reasons to the hospital goals,

including departmental and management goals, and how the acquisition might be

beneficial.

Format your paper consistent with APA guidelines. Use the APA Sample

Paper in Center for Writing Excellence (CWE) as a guide.

Use headings appropriately to provide organization and structure for your

thoughts.

Sections II, III, & IV of the Capital Project

Section II: Establishing Acceptability

Write a 1,050- to 1,200-word paper in which you include the following:

o Complete and discuss the results of the acceptability of the item for key

stakeholders.

o Respond based on research to the purchase and use of the items at other

organizations.

o Determine organizational risk and compliance issues related to the purchase and

use of the capital item.

o Recommend risk avoidance strategies.


o Explain management roles and risks in accordance to compliance.

Format your paper consistent with APA guidelines. Use the APA Sample Paper in

Center for Writing Excellence (CWE) as a guide.

Use headings appropriately to provide organization and structure for your thoughts.

Section III: Economic Feasibility

Create a budget that demonstrates the effect of the capital purchase on the service

line, including the productivity of the service line.

Complete a financial analysis of the capital expenditure. Provide responses in a

Microsoft® Excel® spreadsheet.

Create a pro forma summary sheet showing the net revenue and cost impact of

purchasing this item.

Section IV: Final Project Summary

Write a 1,200-word executive summary for the justification and include it at the

beginning of the paper. Attach the financial statement.

Format your paper consistent with APA guidelines.


Capital Expenditure

The Ambulatory Service Center has determined a proposal supporting a capital

expenditure for a Digital Imaging System is needed. The cost of the BioVison Digital

Surgical Biopsy Specimen Imaging System by Faxitron will be $99,875.00 total. This

includes the 10cm x 15cm digital detector, high resolution 2.3 MP flat-panel LCD

monitor, Ergonomic Keyboard, Transparent Imaging Door, 3 Hour Battery Backup

Operation, Battery Life Indicator, Automatic Exposure, Automatic Calibration, 2 times

Magnification, and DICOM compliant. Additionally it includes (1) One year warranty

and (1) one day in-service training by a factory trained representative. This proposal

explains how the purchase of Faxitron’s BioVision is supported by the management and

organizational goals of need and improving the economic environment of the ASC.

Executive Summary

The purpose of this report is to establish the need and costs to add Digital

Radiology (DR) to the Ambulatory Surgery Center (ASC). The ASC was built at a cost

of $2.9 million dollars. The report will disclose financials and operating costs. The

Ambulatory Surgery Center is a corporation that provides outpatient treatments to

patients in its targeted area. At issue is that 85% to 90% of patients will have health

insurance or a medical cost reimbursement program. The lower cost of ASC will attract

patients who are paying for their own procedures, for example cosmetic surgery

procedures.

The ASC offers outpatient services to adults and children in the targeted area.

These services include consultation and outpatient procedures. A source of secondary


revenue for the Ambulatory Service Center is MRI, CAT scan, ultrasound, and other

diagnostic services provided to patients through the ASC’s ultramodern facility. The ASC

employs two radiologists who provide these services to outpatients using existing in

equipment. The Ambulatory Service Center’s mission is to provide outpatients with

specialized and general high-tech care at reasonable costs and with an eye toward

compassion.

Ambulatory Surgery Centers (ASCs) provide same day surgery and medical care

including diagnostic care and preventative healthcare. ASCs area modern concept

healthcare locations where patients can have outpatient procedures and other procedures

performed in a professional and ultramodern facility without being admitted to a hospital.

ASCs have were introduced in the United States in the 1970s and have expanded in

number and services so that today they are looked to for their exceptional care capacity,

high quality personnel and equipment, and customer service attitude. Medical care costs

have become prohibitive for much of the population. In order to obtain health care

services and benefit from high-end technology most outpatients travel to large hospitals

and medical centers. ASCs continue to change that by providing millions of people with

an alternative to in hospital outpatient procedures. The ASC expanded faster than had

been expected and was servicing a wider market than originally planned within the first

three years.

The main source of revenue for the Ambulatory Service Center is outpatient

services performed onsite. In ASCs, the standard assumption is that patients stay

between 6 to 10 hours onsite depending on the procedure. The ASC has three

ultramodern operating rooms plus a recovery room. The procedures currently offered


include outpatient procedures, cosmetic procedures, and emergency outpatient services.

The ASC receives payments from co-pays, Medicare, and insurance companies.

Approximately 85% of the ASC’s current patients use private insurance,

Medicare, or Medicaid. There is going to be huge growth in the ASC industry. The

“Value Based Purchasing” options available via The Affordable Care Act have already

been established. This plan allows for payments to ASCs similar to those that are already

popular under the Medicare program. The report to Congress referred to need to improve

payment quality and speed for ASC services. The intention is to reward ASCs for

providing “better value, outcomes, and innovations, instead of merely volume” (Centers

for Medicare & Medicaid Services, 2013).

Because of the changes in the population that will enjoy medical care in the

future, ASCs are in position to service the demographic of outpatients who will be

seeking disease management, surgery, and other payer made decisions. The issues facing

ASCs will be complicated and ASC growth will need to be planned in order to meet the

increasing demands for ASC services.

ASC’s consistently operated at a profit. Even during periods of recession,

outpatient centers enjoy economic stability. People always need specialized diagnostic

care and cancer patients require radiation treatments continuously. Costs for providing

outpatient care is paid by insurance and healthcare systems, in the future this will include

ACA payments. There are over 200,000 outpatient service facilities in the United States.

These outpatient facilities produce approximately $180 billion dollars in revenue

annually and employ almost 2 million people. As the population increases so does the

demand for outpatient treatment. The predicted growth rate of outpatient care in the next


two decades is expected to grow rapidly as the baby-boomers demand treatment.

Analysis reveals three factors that traditionally define the number of outpatient

procedures performed at ASCs. Firstly, there is an acknowledged need for increased

healthcare and medical procedures on an outpatient basis. The healthcare procedures

performed relate to the population served, the protocols for screening used by a given

facility, and the advancement and availability of technology (equipment). Secondly, a

determination must be made as to whether a give procedure requires the patient be

admitted for a hospital stay or if the patient can receive treatment as an outpatient. This

is often a technologically driven decision based on the services provided by the ASC as

well as issues related to anesthesia and outpatient technology and techniques available.

Thirdly, there is a site-of-service decision to be made. This decision takes into account

the ambulatory setting, for example, the ASC, the physician’s office, or a Hospital’s

Outpatient Department.

The demand for ASCs increase based on the medical cause of the patient’s

treatment. For example, as the baby boomers age there is an increased demand for

disease management, this includes screening, diagnostics, and consultation. Cost

becomes an issue and leads to the necessity for analyzing not only the quantitative

aspects of care but also the corresponding quality of that care.

PubMed includes studies that address growth factors in ambulatory surgery, as

well as predicted changes in the ambulatory aspect of healthcare and private payment

trends. A study of the growth rate of ASCs reveals that between 2000 and 2007

Medicare-certified ASCs grew at an average rate of 7.3% per year. The amount of

payments from Medicare to ASCs over the same period increased 11.4% per year


(MedPAC). Of note is that Medicare payments to hospitals for outpatient services during

the same period increased 6.9% per year (MedPAC, 2008). Demand for outpatient

services has increased and the use of the Hospital Outpatient Department (HOPD) at

medical centers and ASCs will continue to increase in the future. ASCs provide

advantages over HOPDs such as location, shorter wait times, and flexible schedules

(MedPAC). Co-payments are lower at ASCs than they are at HOPDs. There are also

reports that the focused nature of care at ASCs as are Medicare program payments for

services (Chukmaitov, et. al., 2008). An important draw for patients is that ASCs provide

them access to ultramodern technology.

Based on Medicare data for the period 2000 to 2007 supplied by Medicare

Physician/Supplier Procedure Summary (PSPS) growth in outpatient services for all

kinds will continue to increase and this means updated technology will be required for

ASCs, HOPDs, and physician offices as well as other facilities that offer alternative sites

for of outpatient procedures. We conducted a comprehensive study of the growth factors

for ASCs. The predicted growth in ASCs will mirror the movement away from hospital

inpatient surgeries to outpatient settings. ASCs need to be prepared to use disease

screening for common procedures, for example, colorectal cancer. Because these patients

will have a choice, they will be drawn to ASCs that can provide them with improved

technology, fast recovery times, pharmaceutical services, and modern ex-ray procedures.

Productivity at the ASC

One of the goals of management at ASC is productivity. The ASC is committed to being

at the forefront when it comes to technology. This will be accomplished by Faxitron’s

BioVison. This system is not only useful for daily imagining procedures. ASC surgeons


will be able to use the BioVison in the operating room to reduce procedure times and

advance patient care. The cutting-edge digital imaging technology comes with user-

friendly software that is designed to be learned intuitively so that training time is short

and the results are the finest images every time thereby bettering the workflow at the

ASC and in the surgical suite. Specimen radiographs are ready for review immediately.

This means that surgeons, technicians, and radiologists can view the x-ray

simultaneously. The BioVision consistently reduces procedure times and saves on per

procedure costs.

Efficiency in the ASC

The ASC is in need of updated radiology equipment. The film x-ray equipment currently

in use is outdated, requires frequent repairs, and uses a slow process by which the ex-ray

results take a long period to produce and read. This means long wait times for ASC

patients and multiple appointments. The addition of a BioVision Digital Surgical Biopsy

Specimen Imaging System would save ASC money because the image is a twenty second

process and can be read on site rather than sent out for reads. Cost savings would be

realized because it uses far less consumables. The BioVision does not use any film, it is

100% digital. Additional savings would result from using less paper, less employee time

transferring the film to courier service to the read location, and less time trying to contact

and reschedule patients to review their ex-rays.

The addition of new radiology equipment would eliminate the need for employees

to wait on ex-ray results, re-contact patients to explain the results or arrange for patients

to make an extra appointment at the ASC in order to review results. The BioVision uses

the most recent and best technology available. It is especially beneficial in practices such


as ASC where the diagnosis of breast cancer is a major concern. The BioVision would

significantly improve the standard of patient care. Additionally it would increase

operational effectiveness. Working to improve quality care for patients is the best done

by offering them technically advanced equipment.

Increased Revenue

Advanced customer service is one of the best ways to enhance the economic environment

of the ASC. Joel French, CEO of SCI Solutions, studies revenue management for

healthcare organizations. His recommendations include optimizing physician referrals

and physician orders. Because ASCs are in competition with hospitals and medical

centers the good way to attract business from physicians is by offering them the ability to

refer patients and get results back as fast and as conveniently as possible (French, 2011).

The BioVision would definitely attract the attention of local physicians who would send

their patients to the ASC for ex-rays as well as other tests and procedures. MRI and CAT

scans constitute a steady revenue source. Besides the cost of the MRI or CAT scan, the

patient usually generates between $2,500 and $3,000 in additional services.

Quality Assurance

The management goals of the ASC include making sure that the facilities are prepared to

enter into the next era of patient care, surgical treatments, and professional management

by means of planned design and regularization to ensure a dependable, consistent

experience for patients, providers, families, and staff. ASC seeks to maintain a high level

of clinical quality. In doing so the organization will be better able to evaluate, monitor,

and increase the clinical outcomes for its patients. By creating standardized procedures

that capitalize on the use of modern technology, ASC will be able to simplify employee


workflow and increase employee productivity. To establish better patient access the ASC

was originally designed using standards that enhance patient and family experiences.

State-of-the-art clinical care was and is one of the main goals.

An example of how the BioVison would enhance quality assurance is the application of

the equipment to core specimens. When the physician is about to release a patient from

the stereotactic core needle biopsy procedure, the physician needs to be sure that he or

she wants to be certain that the core specimens taken are representative of the micro-

calcifications recognized on the mammogram. The BioVison eliminates the need to

move the specimen to a different location because the unit is in the stereotactic suite. It

sets up easily and provides a superior digital image on the spot (Faxitron, 2013, p 6).

This assures that the patient will be inconvenienced or forced into an uncomfortable

position for as short a time as possible. The time saving element reduces the workload

for employees thereby saving money on every procedure.

Cleverley & Cameron (2007) mention quality assurance in relation to revenue, but

quality assurance in relation to patient care can be improved using the Digital Imaging

System. Data can easily be accessed from the system and reports generated for patients

who have fallen, have frequent pain, are currently experiencing a urinary tract infection

or have shown a decline in activities of daily living. These reports can be used to

compare historical trends within the facility, the state, and the industry. The reports also

can be used by the clinical staff to improve infection control procedures, increase fall

prevention plans and address a patient’s pain more efficiently. The reports generated

from the Digital Imaging System can provide nursing management an opportunity to

review documentation for accuracy and follow through by the registered nurse, licensed


practical nurse, and the nursing assistants. This information can be then forwarded to the

appropriate person to ensure quality patient care.

Economic Environment

Most of the comments relate to Independent research and user experience suggest that

the use of Digital Imaging System systems can help organizations save money and can be

used as sources of new revenue” (Renner, 1996, para. 7). The economic environment of

ASC will certainly improve once the transition has taken place. The financial benefits to

implement the Digital Imaging System is a reduction in labor costs in the medical

records department, for personnel involved in coding, billing or manually retrieving lab

results, the nursing department in the transcription of hand-written physician orders and

redundant documentation. The system will be integrated with the business office and the

billing and coding department. The automated system will ensure that the process links

clinical information to financial information and lost charges can be reduced substantially

with improved documentation. The length of time accounts receivables are outstanding

will decrease increasing revenue monthly or quarterly. Storage and supply costs will

decrease with the use of the Digital Imaging System. Storage costs can be eliminated or

decreased because of the amount of paper a health care facility must keep. Supplies such

as paper, folders, filing cabinets, dividers, and storage boxes will decrease. Another

factor to consider is the cost of an outside vendor to shred sensitive information. With

the use of the Digital Imaging System the paper, needing to be shred will decrease and so

will the cost.

A decrease in the amount of funds necessary for labor is a large benefit to the

Center. An improvement for the economic environment also can be seen in the reduction


of repeated lab tests, such as x-rays, ultrasounds, and blood draws because of a misplaced

document. The physician’s access to the complete clinical record will ensure medication

orders are complete and covered by the patients insurance. Many times the facility has

been responsible to pay the pharmacy charges for non-covered medication or medications

ordered too soon. Having access to pertinent data will decrease pharmacy charges. With

the reduction in labor needed to perform all the above duties the staff will spend time that

is more productive with the patients.

Cost Containment

ASC has detected an inefficient practice related to the medical record. Areas of concern

are the location of needed documents, inadequate documentation, missing documentation,

inappropriate diagnosis codes, and failure to follow through on necessary patient care

needs. All of these concerns increase cost and unnecessary treatments or inefficient

treatment of the patient. The initial cost of the system will be large for the organization

and the effects may not be seen for quite some time. The organizations goal is to

improve patient care by reducing the cost of labor and increasing productivity.

Decreasing the need for costly medications and unnecessary medications will help in cost

containment and better patient outcomes.

Leadership Role in the ASC Community

There are many testimonials available from reliable leaders and researchers in the field.

The following are just a few from notables. Dr. and Professor G.W. Eklund at the

University of Illinois College of Medicine states that "Faxitron's unit has opened a new

era in specimen radiography. The ultra-high resolution and 5 times magnification

capability of needle core and excisional biopsy tissue have enabled us to find micro-


calcification that would otherwise escape detection. The superior contrast achieved with

very low kV enables discrimination of soft tissue lesions that have similar density to

normal glandular tissue. With Faxitron specimen radiography we can predict the extent

and location of disease more accurately.” Surgeon and Director Dr. Christine B. Teal of

George Washington University Hospital wrote “The BioVision system allows us to see

the specimen radiographs immediately which has improved our efficiency substantially,

benefitting us and our patients.” Dr. Michael N. Linver of the University of New Mexico

School of Medicine considers the BioVision "…one of the great breakthroughs in breast

cancer diagnosis in the past 10 years.” In his praise, Dr. Linver said of the BioVision

“Through its exquisitely detailed magnification images, the Faxitron has expanded our

understanding of breast pathophysiology, resulting in more accurate and complete

diagnosis and better patient outcomes." These leaders in the field point up many benefits

to the BioVision. It assists the institutes in guiding workflow, meets the needs of the

whole clinical staff that includes administration, nurses, assistants, and physicians. Using

this imagining system will allow the ASC to take and maintain its place as a leading ASC

as well as take a leadership role in educating its employees in the most modern

technology.

Organizational Need

ASC’s goal to provide high-quality clinical care means that all processes at the

facility should not only be standardized but also should be state-of-the-art. This goal sets

the standard for all of the clinic specialties the staff offers to its patients and their

families. Standardization provisions regulatory compliance. In order to assure that an

organized and dependable patient approval process takes place the ASC must consistently


maintain the best possible inventory of equipment. The ASC must demonstrate that its

goals include a coordinated effort to accomplish constant enhancements to the patient

experience. The BioVision improves the ASCs ability to increase the standard of care to

patients going through a surgical excision or a biopsy.

Nurses will be able to bring patient care plans up to in real time because of the

presence of the BioVision results and the ease in transferring the information. Staff will

spend less time on the phones with other locations, handling film, arranging new appoint,

or worse making the patient come in to the facility for a re-shoot of the x-rays because of

film development issues. Repairs and the procurement of film, paper, transport packets

and other consumables associated with film x-rays will be eliminated. Because of the

timesavings, the staff will not be required to work over-time nor will they have cause to

fall behind schedule. The auditing process will be streamlined because the digital images

with travel with the patient file. In this way the staff can ensure that all of the patient’s

records are complete, up-to-date, and accurate. Physician orders will be contained in the

file and available immediately upon the review of the record. This comprehensive way

of maintaining patient records, will all available information including x-ray images in

one place will assist the lab and other sectors in the ASC. This will allow the ASC staff

to make informed and speedy decisions about a patient’s healthcare needs.

The acquisition, simple delivery method and installation, along with the training provided

by Faxitron (and included in the quote price) correlates directly with the ASC goals of

value-added patient care, long-term revenue enhancement, community leadership, and

ethical responsibility. Comprehensive, precise, readable images will enhance the

maintenance of medical records, ensure a continuousness high standard of patient care,


lessen the possibility of error during transport of and development of film and above all

guarantee that diagnosis and treatment for patients occurs in a timely fashion.

The staff will require less time in performing clerical duties. This will increase

cost containment overall. The ASC budget apportioned to clerical and staff labor hours,

technician, nurse and physician labor hours, materials, consumable supplies and their

storage, space used for film x-ray storage, as well as medical records will be cut. This

will reduce stress in the ASC as the staff will not be burdened with non-patient care tasks

and will feel confident that their records are up-to-date and comprehensive. This should

increase employee job satisfaction thereby reducing the risk of staff resignation and

discharge. Physicians, technicians, surgeons, nurse, and nursing assistants, in fact all the

clinical staff, will be gratified to be using the most modern imaging equipment available.

Justification

This capital expenditure is justified because the BioVision Digital Imaging System

meets the administrative, business, and clinical needs of the ASC. The improvement in

information management will enhance employee job satisfaction and advance the quality

of patient care. The problems associated with film will be eliminated because here is no

development, transfer, and transport of physical film x-rays required. The elimination of

film problems will increase efficiency, productivity, quality, and profits. Cost

containment with regards to employees will be assured.

Acquiring the Digital Imaging System will allow ASC staff to focus on clinical issues

such as patient diagnosis and treatment. The capability of reviewing a patient’s medical

records comprehensively will reduce wait times as well as the very timely task of

telephoning laboratories, read services, and other external support sources. Patient


histories and regularly scheduled physicals will be conducted with the knowledge that the

clinical staff is approaching patient care in a holistic manner due to the completeness of

the information contained in the patient’s medical record. Redundancy will be

eliminated, there will be no need for duplication services, or multiple copies of an x-ray

because clinicians can review x-rays digitally.

The Digital Imaging System will reduce the time required to file, warehouse, and

preserve the film and paper x-ray reports. Off site and on site storage space that has been

allocated to x-rays can be eliminated in the future. This will be an immediate hard cost

savings as will the reduction on supplies needed to maintain a film and paper records

including storage cabinets. The incorporation of the patient’s clinical record, insurance

records, and payment record will allow for more accurate and timely billing. It will

streamline the procedure for billing insurance companies because all the information will

be in one comprehensive patient file.

Conclusion

The BioVision cost of $99,875.00 total will be recouped in less than a year with a

minimum number of procedures benefitting from the new equipment. The attached Time

& Cost Savings calculations demonstrate that using a low estimate of four surgical

procedures and assuming patient screens of approximately 32 per day the immediate

monthly savings compared to film will be an estimated $20,800.00 per month. This

equates to an estimated savings of $249,600.00 in the first year. This more than meets

the requirements established by Cleverley & Cameron whose studies indicate that a

capital expenditure should be based on the assumption that it will not only deliver


benefits for a decent time period ( two years being the established minimum) but also that

the expenditure will be recouped (Cleverley & Cameron, 2007, p. 397).

As has been demonstrated in this report the ASC will benefit in many aspects of

operation form the acquisition of a BioVison. The organization has long been aware of

the need to modernize radiology services and streamline the handling of patient

information. The call for this report and proposal is an acknowledgment that the ASC

wants to advance patient care, address employee productivity issues, increase overall

efficiency and service, and ensure high quality patient experiences. The decrease in

duplication of documentation alone will allow for increased organization when meeting

patient needs and simultaneously increase employee job satisfaction and therefore

employee retention. New higher levels of productivity and precision will cause revenues

to increase because of cost containment and patient loyalty.

Section II: Establishing Acceptability

In Section I and in the attachments that comprise Section III the acceptability of

the purchase for revenue enhancement has been examined. Section I addresses the payers

whose focus is cost-effectiveness; and the ASC as an employer whose focus is cost

constraints and improved employee productivity.

This Section of the report addresses the acceptability of the BioVision for key

stakeholders at the ASC. The providers of direct care to patients, those being the

clinicians including physicians, radiologists, and nurses are key stakeholders. Clinicians

focus on high quality and advanced technology as well as providing an accurate

diagnosis, selecting the correct course of patient care and therapies, and finally the best

result for the patient’s health outcome. The patients themselves are key stakeholders as


well and concerned with many of the same things as are providers, additionally they look

for compassion and communication (Duke University, 2005).

Research from other organizations point to the valuable contributions that digital

imaging has made in the field of breast cancer diagnosis and treatment. Because

mammograms are so much in demand, it is important that the ASC offer the best possible

service to these patients. The speed of the digital mammogram recommends itself to the

patient. Additionally the capability of manipulating the digital image of a mammogram

electronically is very useful for radiologists, physicians, and surgeons. A digital

mammogram is much better than the film mammograms currently in use because the

digital imaging system utilizes an exceptional detector that captures and converts the x-

ray energy into a digital image. There are obvious advantages to offering digital

mammography at the ASC, not the least of which is patient and employee expediency.

There is not film that needs to be developed. This means the radiologist or technician

doing the imaging can appraise the quality and usability of the image immediately. The

patient and the technician will not need as much time for the examination. Also, because

the technician can check the images as they are taken there will not be a need for

repeating the procedure at another time as happens so often when film images are over-

exposed (URMC, 2013).

From a patient point-of-view, the fact that they will not need to twist themselves into

awkward and even painful positions for x-rays will appreciate how much faster the digital

imaging is compared to film. Once the mammogram is ready to view, the technician can

change the setting for brightness, contrast, or darkness as well as zoom in or magnify

specific areas in the image. This allows for a high quality and refined appraisal of the


tissue under examination. Experts praise the way in which they can manipulate the

contrast feature of a digital image in mammograms because this aspect of the image is

vital to readings that reveal dense tissue. The problem with film mammograms is that

malignant cells and dense tissue both look white on a film mammogram. Other

advantages of digital imaging noted were that the images can be stored and retrieved

easily, they can be transmitted between doctors quickly and easily, and they can be used

with the latest advances in software to aid in the early detection of breast cancer (URMC,

2013). The BioVision delivers instantaneous confirmation of excised breast tissue

margins.

A publication that points up the advantages of this digital radiology is Abdominal

Imaging experts discuss the benefits of digital imaging when doing examinations of the

pelvis and abdomen. In this book, the experts discuss a variety of organs and systems

that benefit from being examined using digital equipment. Suggestions for imaging

methods and exam protocols are explained. The book uses many excellent digital images

to demonstrate how effectively a physician can differentiate between a normal scan and a

scan that reveals pathologic entities (Hamm & Ros, 2013). This type of ability to render

complete and accurate diagnosis in a timely manner will reduce organizational risk and

increase the ASC’s compliance record.

Because it is important that the ASC management make certain that the

organization stays in accordance with accreditation sources recommendations from such

agencies as The Joint Commission need to be examined. That organization has in place

guidelines whereby the ASC must provide modern diagnostic imaging services.

Additionally there are special requirements for ASCs that want to obtain an advanced


diagnostic imaging certification. The criteria regulates safety issues, in particular the

issue of claustrophobia that larger, older ex-ray equipment exacerbates. This problem

can be avoided by using a digital imagining system. Another issue for The Joint

Commission is that either quality of the imaging equipment. For ASCs that offer

diagnostic computed tomography (CT) services, they consider it necessary that a

diagnostic medical physicist evaluate the imaging equipment. The following is a list of

what the evaluator would be looking for in terms of quality imaging results (The Joint

Commission, 2013):

● Image uniformity

● Slice thickness accuracy

● Slice position accuracy

● Alignment light accuracy

● Table travel accuracy

● Radiation beam width

● High-contrast resolution

● Low-contrast resolution

● Geometric or distance accuracy

● CT number accuracy and uniformity

● Artifact evaluation

Owning and operating a state-of-the art digital system would insure the ASC passes all of

the above requirements and achieves the very desirable advanced diagnostic imaging

certification.

Sensitivity Analysis


Healthcare businesses are immune from negative changes in the economy due to

the simple fact that people will continue to get sick and require outpatient treatments.

Additionally, these treatments are often paid for by private insurance companies and

publicly funded health systems. As such, the Ambulatory Service Center should have no

issues generating top line income or receiving payments from its patient base.

It is possible that ASCs are held to even higher standards that HOPD and

physician offices because of the newness of ASCs and the remarkable growth in their

facilities as those of choice for patients. Compliance with state and national standards

means on-site surveys during which the ASC is subject to evaluation. Licensures differ

according to the state and ASCs need to be prepared for on-going re-inspections. When

Medicare patients are involved, the ASC must meet federal facility standards. There are

several accreditation organizations, the main one being The Joint Commission and the

Accreditation Association for Ambulatory Health Care (AAAHC). The reason it is so

important for an ASC to offer the best possible technology is that they are expected to use

innovations in all aspects of outpatient care including ex-ray, anesthesia, and outpatient

techniques. The development of minimally invasive techniques, including the technology

that replaced intraocular lens is now expected. Procedures such as this are used one

million times every year to treat Medicare patients for cataracts. These and other

procedures that used to take place in hospitals are now performed at ASCs with greater

customer service and at lower costs.

The ASC would benefit from the purchase of the BioVision because it would

provide for intra-operative use. This makes for less time-consuming procedures. The

unit provides point-of-care specimen radiography so that surgeons can immediately read


breast biopsies and lumpectomy specimens. The estimated timesaving using digital

imaging is a minimum of twenty minutes for patients under anesthesia. The surgeon and

others do not need to send the specimens to another department or location for imaging.

The radiologist and the surgeon can view the digital image instantaneously and make

decisions accordingly.

References

Chukmaitov, Askar S, Menachemi, Nir, Brown, L Steven, Saunders, Charles, & Brooks,

Robert G.

(2008). A Comparative Study of Quality Outcomes in Freestanding Ambulatory

Surgery

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Research a Capital Purchase, Costing More Than $5,000, That Your Company Could Benefit From

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