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Marketing as Education to Generate Awareness

August 1, 2009

In July 2008, Glendale Memorial Hospital in California implemented two new imaging technologies from Toshiba: a Vantage MRI system and an Aquilion 32-detector row CT scanner. Amy Stricker, manager of marketing and communications, knew that educating Glendale’s referring clinicians on the capabilities of the new technology would be crucial to the hospital’s marketing efforts.

“When you get new technology, it’s important to educate physicians on what makes it different,” Stricker says. “Technologies like this are a big investment, and they are huge assets to the community. Physicians and their patients will benefit from the new features, but they need to know what they are.”

Stricker developed print materials for Glendale’s referring community that highlighted the clinical benefits of the new technologies. “It was a matter of finding out what made our technology better and conveying that in a simple way,” she says. “With the CT, we talked about how you could get high-resolution images for any part of the body in seconds. For the MRI, we emphasized the superior image quality and the availability of non-contrast MR angiography, which is particularly important to patients with renal complications because of the Nephrogenic Systemic Fibrosis risk.”

The materials also focused on aspects of the new technologies that made them more patient friendly, including the MRI system’s proprietary Pianissimo™ noise reduction feature (which reduces noise by 90 percent during scanning) and the CT unit’s rapid speed of scanning, which results in shorter waiting times. “Referring physicians want to make sure their patients have the best experience possible,” Stricker notes.

Jim Burch, director of communications for TAMS, says, “As an imaging-services provider, your currency is information. You’re taking images, but what you’re really doing is providing information about the patient to the referring physician, so the best way to market to that physician is through diagnostic clinical information. You’re speaking the same language.”

Stricker used the TAMS Image Maker kit as a resource for both clinical images and information. “We have our own campaign branding and images we use for most of our materials,” she notes, “but the sample ads and pieces provided with Image Maker were helpful in giving us ideas and showing what the key messages in our promotions should be.”

While Stricker chose to focus primarily on referring-physician marketing, Burch notes the same principle can be applied to patient outreach. “Consumers can get their information from a wide variety of locations, not all of which are trusted. I think the savvy hospitals and imaging centers are working to provide valuable, in-depth information and resources for patients. A print ad doesn’t help them take control; it only provides them with enough information to be curious. The additional educational materials are what consumers are looking for,” he says.

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Purchasing Your Optimal Service Plan

July 1, 2009

In this challenging economic climate, extending the life of imaging equipment through proper service and maintenance is more important than ever. Over a period of years, however, the aggregate cost of a service agreement could rival the original price tag of the equipment, making it crucial for purchasers to balance cost against their facilities’ needs.

Imaging equipment is generally guaranteed (under warranty) for a year; after that year, a service agreement usually covers the next four years, meaning that hospitals look at the five-year life-cycle cost when making purchasing decisions. Weighing the additional cost of a service agreement can be a tricky proposition, requiring facilities to accurately predict how the equipment will be used over this five-year life cycle. An improperly structured service agreement could result in unplanned downtime, making preventive maintenance crucial to ensure the equipment runs properly. Patient volume is also an important consideration. High-volume facilities may need more entitlements and coverage than those performing fewer scans.

The first step in negotiating the right service agreement is assessing your needs. Are you in a critical care facility that needs its scanner running 24/7 or in a community hospital with more than one scanner, allowing flexibility if one system is out of commission for a short time? Ask yourself these other questions in assessing your needs: What is the scanner’s average daily volume? Is the scanner regularly used after hours? For what types of studies is the scanner generally used? How many scanners do we have? Do we have our own internal biomedical-engineering team?

Having answered these questions, you will be better prepared to discuss service options for your facility with your Original Equipment Manufacturer (OEM). Ted Nemetz is vice president of Service at Toshiba America Medical Systems, Inc. in Tustin, California. He says, “What we want to accomplish on our end is finding out the customers’ needs and what their expectation levels are. At Toshiba, a standard service agreement covers service from 8 AM to 5 PM, and we guarantee 98 percent uptime.” Your facility, however, may need more than the standard service agreement. “You may need 24/7 coverage. Our objective is to provide the placement of parts and people to support what you’re paying for,” Nemetz says.

When you sit down with your OEM to formulate an ideal service agreement, factors to consider include:

• your service needs for this equipment;
• what type of coverage you will need (for example, full coverage, with the OEM providing all necessary support, or partial coverage, with in-house biomedical-engineering staff providing primary service);
• what hours of service/repair coverage you will require;
• what hours of preventive maintenance coverage you will require;
• what other system options you will require, such as coverage for coils or X-ray tubes;
• your risk tolerance;
• whether or not this service agreement will be your long-term solution.

Because your service needs can change over time, shifting with the acquisition of a new piece of equipment or merely exceeding your original estimates, Nemetz also emphasizes the importance of flexibility on the part of your OEM. “We are willing to amend your agreement as time goes on,” he says. “If we see you don’t have enough coverage, or if (conversely) you’re spending money you don’t need to spend, our management team will work with you to adjust your agreement to better meet your needs.”

Remember, as well, to take into account your geographic location, which will affect how quickly service engineers will be able to reach your facility in the event of unplanned downtime. “Most OEMs say they will respond by phone within 15 minutes and be on-site within two hours, but customers in rural areas should be sure the right people are trained and available,” Nemetz says. “Find out how close their parts depots are and how close their personnel are. Personnel and parts are not really on the service agreement, but they are a major part of the service OEMs provide.”

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FLEX Plan Offers Long-term Flexibility

In May 2009, Toshiba America Medical Systems introduced its InTouch FLEX service plan, designed specifically for customers with shifting service needs. The FLEX plan allows facilities to switch back and forth between a full-service security agreement and a partnership agreement on an as-needed basis.

Joe Graham, vice president of Service for Enterprise and Strategic Business Groups at Toshiba, says, “We have fulfilled some customers’ requests, over the years, to allow a transition between Service agreement programs. The FLEX plan formalizes that model, giving customers the flexibility to craft an agreement according to their own requirements, moving from model to model and customizing their own solutions.”

The FLEX plan encompasses two service agreement models: Toshiba’s InTouch Full Security Agreement (which provides full protection for imaging systems, fixed-price support and customized Service solutions) and the InTouch Partnership Agreement (which allows hospitals to balance fixed and variable service costs while benefiting from discounted rates on parts and labor).

Graham explains the FLEX plan arose out of hospitals’ need to balance the technical expertise of in-house biomedical-engineering staff against vendor support. “The real catalyst for transitioning back and forth generally has more to do with clinical engineering manpower changes than anything else,” he says. “If the hospital didn’t have anyone who worked on CT, and then it hired someone, that would necessitate a change—or if it had someone, but the person resigned or took another position, the hospital would need to move away from a partnership agreement and back to a full-service model.”

The FLEX plan allows customers to secure fixed price points for both the full-service model and the partnership model, giving them the freedom to move back and forth between the two as often as necessary over a five-year equipment life cycle. “We identify the lowest prices, and the hospital is guaranteed that over the course of the agreement,” Graham says. “What’s unique about this plan is the hospital knows, from the outset, what it is going to pay for whatever service model they choose. That’s really the advantage of formalizing a flexible service agreement.”

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Independent Analysts Rate Service Providers

In March 2009, IMV Ltd., an independent health care market-research company, released the results of its 2008 ServiceTrak survey, which analyzes service trends in the imaging industry. In the CT system service category, Toshiba America Medical Systems received the top ranking in 21 of 34 service attributes, including overall OEM service performance and overall value.

In June, KLAS ranked Toshiba as the #1 Medical Equipment Vendor in the “2009 Top 20 Best in KLAS Awards: Medical Equipment” report. Additionally, Toshiba products were named Best in KLAS in CT 64 slice and greater (Aquilion® 64), 1.5T MRI (Vantage) and Ultrasound (Xario™). For more information, visit www.KLASresearch.com.

Through Spring of 2009, Toshiba was ranked number one by MD Buyline, another third-party analyst, in the CT category for the sixth year running. The company’s service quality was a major contributing factor to its high ranking.

Loretta Loncoske, a clinical analyst for MD Buyline, explains that the company arrives at its vendor rankings by surveying customers about specific technologies on a quarterly basis, then comparing their responses, which involve rating various aspects of vendor performance on a scale of one to 10, with five being average.

Ratings are based on a target of 30 active calls per vendor and technology over the course of a year. Questions related to applications, technical support and service and support account for two of nine categories and assess factors including:

• the type of telephone response time that you typically experience;
• if you need more advanced support, how long it takes for that to happen;
• how well service personnel communicate what is wrong, what they did to correct the problem, and any indication of what caused the problem in the first place; and
• whether the service representative accommodates your patient schedule for non-emergency repairs and/or after-hours calls.

Loncoske says MD Buyline’s survey respondents have commented specifically on Toshiba’s rapid response times and consistent parts availability, as well as on the quality of its training programs. “What I’ve seen, over the course of two years now, is they will send the same person to the facility for training,” she notes. “This ensures consistency—the trainers know where they’ve left off, and they know the capabilities of the staff they’re training, offering a more consistent experience.”

Respondents also emphasized the company’s customer-driven approach to service. “Because it’s a smaller company, it’s more like a family,” Loncoske says. “It really takes care of its customers. It’s a very personalized approach.”

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Validating Improved Outcomes for Diabetic Patients

June 1, 2009

According to the American Diabetes Association, more than 75 percent of today’s 23.6 million U.S. residents with diabetes will die of heart disease. Many of these diabetic individuals are asymptomatic for coronary heart disease (CHD) until their first heart attack, and there is no accepted method of detecting CHD, to date.

“Patients with diabetes have a risk of cardiovascular disease that is two to four times greater than that of nondiabetic patients,” Donald Lappe, MD, chief of cardiology at Intermountain Medical Center, Salt Lake City, explains. “The ability to detect CHD in at-risk, asymptomatic patients will have a significant impact on the ability to improve their cardiac conditions and will help save lives.”

To assess the viability of using 64-detector row CT to diagnose CHD in asymptomatic patients, Toshiba America Medical Systems, Inc. in Tustin, Calif., funded faCTor64, a 1,100-patient prospective study conducted by researchers at Intermountain Healthcare, Salt Lake City. Investigators will identify asymptomatic diabetic patients using Intermountain’s diabetes database; then, they will compare two patient groups. Half will be evaluated for CHD using cardiac CT angiography (CTA) using the Toshiba Aquilion® CT system, while the other half will undergo traditional diabetes management. Researchers will follow both groups for five years to assess which group experiences better outcomes.

So far, 261 patients have been enrolled in the study, with 93 patients scanned; Intermountain hopes to complete enrollment by 2010. Using the Aquilion’s Volume Imaging protocol, Intermountain researchers have been able to create up to five different reconstructions using data from a single acquisition, allowing them to review more aspects of the patients’ cardiac function. Intermountain physicians also are able to develop their own CT protocols based on specific patient needs, and they can customize Toshiba’s proprietary SURECardio software to reduce the amount of contrast, and the radiation dose, that patients receive.

Researchers say the study’s initial results are promising. CHD has been diagnosed in approximately 75 percent of the scanned asymptomatic diabetic patients, and many of them also have high-grade, severe stenosis warranting revascularization. Several of the patients also have a defective anginal warning system, possibly providing a clue as to why they are asymptomatic, in spite of the severity of their CHD. The team at Intermountain also notes the results of the CTA scans have helped with patients’ health management; many patients who need to lose weight or make other lifestyle changes have been more compliant after seeing their CT results.

Access to Capital Remains Critical

January 1, 2009

Like most of us, hospitals have seen their investment portfolios shrink and access to capital diminished. Pending healthcare reform and the recent passage of the State Children’s Health Insurance Program may lead to an increase in patients within the healthcare system and presents a new set of challenges. This confluence of events places many healthcare executives at a crossroads as they determine their priorities for the months and years ahead.

In the midst of this turmoil, Toshiba America Medical Credit (TAMC) has been helping healthcare organizations gain access to the capital they need to address their patient care priorities. “Our ability to secure funding from our consortium of AAA rated partners is undiminished”, said Kevin Abbott, Toshiba America Medical Systems, Senior Vice President and Chief Financial Officer, “so we’ve been able to provide many of our customers with capital during this stressful period.”

TAMC provides Toshiba customers with a range of financing solutions including extensive financial product offerings, competitive interest rates, upgrade programs and quick credit decisions.

AHRA Announces Patient First Program Recipients

December 1, 2008

Improving patient care and safety in diagnostic imaging is an important issue to hospitals, physicians and administrators today. Helping to support this need, the AHRA, the association for medical imaging management announced grant recipients of the Patient First Program at this month’s Radiological Society of North America annual meeting in Chicago. The program was funded by an unrestricted educational grant from Toshiba America Medical Systems, Inc.

The first recipients include:

St. Mary’s Regional Medical Center’s “Best Practices in Computerized Tomography”
Focusing on the use of the ACR Appropriateness Criteria, this program will use evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging and treatment decisions, coupled with the most appropriate scanning protocols for CT to image patients more safely.

Washington Hospital Center’s “Standardized Handoff Communication”
This program focuses on the use of green, yellow and red handoff forms as an effective tool to improve patient safety and outcomes.

Jennie Edmundson Hospital’s “Metformin Flagging Process”
This program uses barcodes for Type II diabetic patients’ armbands and IV contrast with the goal of developing a decision support rule that will alert pharmacists.

Clinical Experiences Shared by World-Renowned Physicians at 2008 RSNA

Although professional attendance was down slightly, the science was strong at the Radiological Society of North America’s (RSNA) Scientific Assembly and Annual Meeting. Physicians from around the world continue to gather in Chicago to share their clinical experiences with each other. At the 94th meeting held earlier this month, Toshiba worked with innovative physicians to ensure that collaboration extended beyond the session hours by holding evening events where leading physicians were able to present their validation of imaging technology.

This year Toshiba’s Ultrasound (UL) and Magnetic Resonance (MR) modalities introduced new techniques and equipment dedicated to improving women’s imaging. In conjunction, Toshiba sponsored an evening event where physicians shared how Toshiba’s technology is helping women.

Pamela M. Otto, M.D., professor and director of Breast Imaging & Intervention, Department of Radiology, UT Health Science Center & University Health System, San Antonio discussed her experiences with Toshiba’s newRadiance Plus Breast Imaging Coil, which optimizes Magnetic Resonance Mammography (MRM) on the Toshiba Vantage systems. In fact, this coil enabled Dr. Otto to conduct the first contrast-free breast MRA exams. Toshiba is a pioneer in contrast-free MRA techniques, and now plans to develop a sequence that will enable contrast-free breast MR exams.

Ellen B. Mendelson, M.D., F.A.C.R., Northwestern University and Thomas Fischer, M.D., Charite Hospital, University of Berlin presented their experiences with Toshiba’s ultrasound technology. Both discussedToshiba’s new and exclusive ultrasound technique — MicroPure™, which helps physicians detect breast lesions and micro-calcifications more clearly, as well the sonoelastography suite, ElastoQ (works-in-progress), a non-invasive medical imaging technique that evaluates tumors based on their stiffness (elasticity) compared to normal tissue. Both of these Toshiba collaborators presented cases that provided insight on ultrasound’s future as an effective tool for diagnosing breast disease.

At a CT event the same evening, Frank J. Rybicki, M.D., Ph.D., director, Cardiac CT & Vascular CT/MRI, Brigham and Women’s Hospital and William W. Orrison, M.D., MBA chief of neuroradiology, Nevada Imaging Centers shared their experiences with the Aquilion® ONE 320 detector row CT.

Dr. Rybicki provided insights into key research that has been completed on the Aquilion ONE over the last year. For the first time, CT can now visualize how the cardiac vessels curve and measure flow dynamically within the vessels. He also discussed Brigham and Women’s work on the recently announced CORE 320 worldwide multicenter trial that will compare dynamic volume CT to SPECT for evaluating myocardial perfusion.

Dr. Orrison has completed more than 3,500 patient studies on the Aquilion ONE and shared the way this technology is changing his practice. Not only did Dr. Orrison showcase his whole brain perfusion studies, but he also showed advanced dynamic motion studies of musculoskeletal anatomy, which were clinically used for surgery planning and follow up.

Increasing Productivity and Patient Comfort While Eliminating Film

November 1, 2008

In today’s healthcare environment, maximizing imaging resources and improving patient throughput is critical to success. Toshiba’s Kalare™ X-ray system helps medical centers accomplish these goals while lowering costs and improving patient care. The system is also specifically designed to accommodate the needs of busy facilities, like Nacogdoches Memorial Hospital in Texas, a Level III Trauma Center which uses two Kalare systems.

“The versatility of Toshiba’s Kalare R&F system coupled with its high-quality images resulted in immediate improvements in patient care, increased overall workflow and eliminated the need for conventional film,” stated Freddie Gibson, director, Medical Imaging Services, Nacogdoches Memorial Hospital.

In addition, the system allows clinicians flexibility to obtain images from virtually any position without moving the patient for improved comfort and faster exams. This makes it ideal for imaging ambulatory, wheelchair and stretcher patients. This flexibility also dramatically increases room utilization and overall operational efficiency.

“The Kalare has saved my department time by helping us complete most of our studies twice as fast as we used to,” said Gibson. “The Kalare is extremely user-friendly, making it comfortable for technologists to perform multiple exams a day with little fatigue. Some exams, which used to require two technologists, can now be performed by one. The chief technologist now has more time to oversee the entire department and work one-on-one with staff.”

AHRA and Toshiba Announce Patient First Program

Improving patient care and safety in diagnostic imaging is an important issue to hospitals, physicians and administrators today. Helping to support this need, the AHRA has created the Patient First Program funded by an unrestricted educational grant from Toshiba America Medical Systems, Inc.

The Patient First Program will provide grants to hospitals to create programs, training and/or seminars to improve patient care and safety in CT, MR, Ultrasound, X-ray and X-ray Vascular diagnostic imaging and to develop best imaging practices to share with other hospitals.

“With hospitals being pressured to lower costs while continuing to provide the highest level of patient care, this type of program funding is more critical today than ever before,” said Edward J. Cronin, Jr., CAE and executive director, AHRA. “The Patient First grants will allow hospitals to fund important programs and training to improve the quality of care they offer.”

The AHRA will award three Patient First grants of $7,500. All eligible hospitals are encouraged to apply by completing an application at www.ahraonline.org or www.medical.toshiba.com. The deadline to apply is November 15, 2008.