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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