NCD Medical

Very often there is a need to acquire additional capability in our health care facilities but there isn’t always the funds to purchase a new, full functioned, state of the art, diagnostic imaging system. Therefore, a decision must be made to determine if the additional services can be shifted to another facility, or if it is critical or at least necessary to remain at your facility. The decision usually comes back that it needs to remain and options to accommodate it must be considered.

The first activity is to investigate potential solutions starting with new systems that deliver latest technology and extended functionality. Inviting manufacturer’s sales representatives in usually begins the ball rolling. Generally, long meetings full of important facts about the capabilities of their systems help make you familiar with what’s available and what it costs. Once the sticker shock subsides, you must now determine which of the features and functions discussed are absolutely necessary to carry out the application testing you need to accommodate. You probably will determine, in most cases, that basic functionality will be very appropriate to accommodate your requirement. For example, after investigating a 256 slice CT scanner’s additional functionality and its cost, you may determine that a 16 slice unit would work quite well. But you also know that 16 slice technology has been available for some time and your budget is quite conservative (small). Therefore, you make the decision to investigate both new systems and pre-owned systems.

The first step is to re-contact the manufacturer’s sales representatives and determine what the cost is for a new unit of older technology or if it is even still available. Now the sales people will be concerned you made this choice to move down to this older technology and probably won’t offer any encouraging incentives unless you re-consider a more recent vintage, or they will claim these systems are no longer available and they will only be able to provide a price on a 32 or 64 slice system. It is at this point you decide that you will need to consider a pre-owned system, but how do you begin? You have heard horror stories of shady brokers who have run off with facilities money, delivered something totally inferior to what was ordered, or delivered systems missing components and requiring tens of thousands of additional dollars to complete the project. So where do you start?

The first thing you might consider doing is visiting the International Association of Medical Equipment Resellers and Servicers (IAMERS) web site. The organization was formed in the early 90’s with the task of establishing a membership of companies committed to providing exceptional medical equipment, that maintained the highest ethical standards, and were willing to commit to being evaluated and monitored by its governing membership. Additionally, the organization is in continual contact with the FDA establishing important rules and operating procedures consistent with government policy. If you are considering acquiring pre-owned medical equipment, a quick visit to the IAMERS web site will provide you a list of companies that will provide a broad choice of available systems. Go to: www.iamers.org.

Choose several potential providers and give them your choice of system to be acquired. It is important to share with them as much information as possible to save time and money during the selection process. They should be aware of the preferred manufacturer (ie. GE, Siemens, Philips, etc), the model, the basic system functions, any options, required delivery date, and most importantly the amount budgeted for the system. Many organizations are hesitant to share available budget on concerns the supplier will move his sale price up to match the budgeted amount. This is silly. You will have multiple suppliers quoting and all interested in obtaining the business. They will be very aggressive to win your business, which means big-time competition. Also, why have a supplier spend the time to locate and offer you a $400K solution when you only have $250K to spend? As soon as you share with him your budget, he will undoubtedly share with you whether you are in the ball park for what you want or if you need to rethink what you are able to afford.

Once you have identified a supplier that can provide the preferred system, make sure you have considered all costs associated with the project, such as the cost of removing an existing system. Many times you will be able to have the system removed at no charge in trade for the system, or sometimes it may be a negotiated trade-in value, and other times it may be an out-right sale to the supplier or another third party. Room remodeling may be sometimes as simple as a new coat of paint or as involved as installing, shielding, changing power, installing new cable troughs, changing HVAC, lighting, flooring and/or the control room. The system supplier should provide detailed drawings indicating system location and required resources to successfully install the system. You need to consider access paths for the removal of old equipment and delivery of replacement equipment. Narrow hallways, tight corners, steps, ceiling heights, elevator capacities, door openings and truck docks (or the lack of) all need to be considered. Timing is usually critical. If you are removing an older system before installing the replacement, you are going to be without a system for as long as it takes to remove the old system and remodel the room. Schedule all activity and be sure the building contractors selected can meet the desired schedule. The supplier should provide in-service and/or application on-site training of the operation of the system. Lastly, you should identify a local service support group (it could be the manufacturer’s service group or a third party group) who will offer an on-site system service contract once the suppliers warranty has expired.

Although the project may sound complicated, your organization will probably realize a savings of 50% or more and will have substantially increased capabilities. Most of the project activity is required whether you purchase new or pre-owned, so be prepared and tackle most of the things I addressed regardless of what you purchase. Although you can do more than one project at a time, you may want to limit yourself to one at a time unless you have a qualified staff to take on some of the tasks.

If you have concerns or questions about any of the issues discussed, don’t hesitate contacting me, as we are involved with these projects continually.