Proposal project

Running head: PROPOSAL FOR BONE DENSITY 1 Proposal for Hologic QDR 4500 Elite Bone Densitometer Student Name Adventist University of Health Sciences PROPOSAL FOR BONE DENSITY UNIT 2 2 TABLE OF CONTENTS 1.0 ABSTRACT ………………………………………………………………………… … 3 2.0 PROBLEM S UMMARY………………………………………………………… ....... 4 2.1 Statistics and Demographics ……………………………………………………… … …. 4 2.1 Analysis…………………………………………………………………………… … .... 5 3.0 PROJECT DESCRIPTION …………………………………………………… … ….. 7 3.1 Relevant Alter natives………………………………………………………………… ...8 3.2 Work Plan…………………………………………………………………………… …. 8 3.3 Significance…………………………………………………………………………… ..9 4.0 METHODS…………………………………………………………………………… .10 5.0 BARRIERS………………………………………………………………………… ....12 6.0 BUDG ET……………………………………………………………………………... .12 6.1 Projected Reimburs ement……………………………………………………………… .14 7.0 TIMELINE…………………………………………………………………………… .14 8.0 EMPLOYEE QUA LIFICATIONS…………………………………………………..15 9.0 References…………………………………………………………………………….. .16 PROPOSAL FOR BONE DENSITY UNIT 3 3 1.0 Abstract The radiology department at Claiborne Medical Center does not currently have a bone density unit. Bone density scanning, also called dual -energy x -ray absorptiometry, or DEXA scan, can generate higher volumes of patients that patronize the facility, thereby having a significant impact on revenue for the hospital. A used bone density unit is available at a sister facility. This facility is upgrading their equipment and their current bone density unit is on the market. This unit can be purchased for a fraction of the cost of a new unit. Bone fragility in men and women 65 years and older along with younger postmenopausal women who have certain risk factors for osteoporosis can be evaluated with DEXA scan using only a small amount of radiation. DEXA scan is considered preventive medicine because it can diagnose and result in the treatment of osteoporosis and as a result decrease the amount fractures that can occur due to brittle bones. The following proposal will display the need for a bone density unit and how it can be beneficial for the facility as well as patients. PROPOSAL FOR BONE DENSITY UNIT 4 4 2.0 Problem Summary Cl aiborne Medical Center does not currently have the capabilities to perform DEXA scans. There is no known clinic or facility in the area that perfo rms DEXA scans, resulting in p atients driving approximately 45 minutes to another facility. 2.1 Statistics and Demographics Statistics show that approximately 25 percent of women and 6 percent of men have osteoporosis. These numbers increase when involving osteopenia, where bone loss is apparent but has not reached osteoporosis. Almost half of seniors (48 pe rcent) -more than 52 percent being women and 44 percent being men -have osteopenia (Osteoporosis Facts and Statis tics, n.d.). 2.2 Analysis A SWOT analysis (Figure 1 ) was performed to identify the strengths, weaknesses, opportunities and threats that comprise the Hologic QDR 4500 Elite bone density unit. PROPOSAL FOR BONE DENSITY UNIT 5 5 Strengths  No other bone density unit in close proximity  Uses a small amount of radiati on to obtain images  Non -invasive  Most accurate method for the diagnosis of osteoporosis  Simple, quick exam Weaknesses  Used machine  No warranty  Can produce magnification and/or distortion of images  2nd generation x -ray bone densitome ter with fan beam geometry; may affect BMD as sessment Opportunities  Technological advancement for facility  Increase in patient load  Increase in revenue for facility Threats  Possible obsolete parts for unit  Equipment breakdown  More advanced equipment at other facilities PROPOSAL FOR BONE DENSITY UNIT 6 6 One of the strengths displayed in the SWOT analysis is that there is no other bone density unit in close proximity to Claiborne Medical Center. This is a positive factor because patients will not have to travel long distances to have this exam done. 3.0 Project Description There are certain elements that impact the decision to invest in new or different equipment. Every aspect must be considered, from cost of the equipment to where the equipment will be housed once it is at the facility. 3.1 Relevant Alternatives A different alternative to the Hologic QDR 4500 Elite bone density unit was researched. Information gathered from GE about the Lunar Prodigy bone density unit was obtained. This unit is available in two sizes, full size, which is 8 feet long, and compact , which is 6 feet long. The Lunar Prodigy unit has a closed format. 3.2 Work Plan  Reduced amount of surgeries due to fractures owing to osteoporosis  Denial of insurance claims PROPOSAL FOR BONE DENSITY UNIT 7 7 Hologic was contacted to request a list of facilities in East Tennessee that use the QDR 4500 Elite bone density unit. Their report showed that two facilities in Knoxville, Tennessee and one facility in Morr istown, Tennessee used this specific bone density unit. 3.3 Significance A bone density unit is needed at Claiborne Medical Center for a number of reasons. First, it will increase patient load for the hospital since patients will not have to go elsewhere to have this type of exam performed. 4.0 Methods The two bone density units that were compared were the GE Lunar Prodigy and the Hologic QDR 4500 Elite. The GE Lunar Prodigy was available brand new for $32,000.00. Thi s unit is state -of-the -art but is not within the radiology depar tment’s budget. 5.0 Barriers The Hologic QDR 4500 Elite bone density unit, although used, is within the radiology department’s b udget. However, there are some concerns regarding this unit. First, the unit is 12 years old and has no available warranty. 6.0 Budget The Hologic QDR 4500 Elite bone density unit can be purchased from Cumberland Medical Center for $2,500.00. Figure 2 visualizes … . Figure 2 ITEM COST Hologic QDR 4500 Elite bone density unit $2,500.00 PROPOSAL FOR BONE DENSITY UNIT 8 8 from Cumberland Medical Center Dismantle, transport and reassembly of unit, test of operation and completion of FDA 2579 form fulfilled by Remesta Medical Corporation $5,500.00 Physicist inspection and survey $400.00 HL7 interface and license, linkage to Aspyra PACS $1,000.00 Upgrade to FRAX software $500.00 Lead shielding for room where bone density room will be housed $400.00 Grand total: $10,300.00 6.1 Projected Reimbursement Projected reimbursement is based on the amount of patients who receive mammograms; research shows that the majority of the patients who come to the Women’s Imaging Center are postmenopausal women. Projected reimbursement is as follows:  Research conducted shows that Claiborne Me dical Center performs 3,500 mammograms a year; if only 25 percent (875) of these patients undergo bone density testing and reimbursement is $60.00 per exam, this equals $52,500.00.  Worst case scenario: 600 bone density exams at $30.00 reimbursement for exa ms equals $18,000.00  By performing helical scans of the torso and hip, which the Hologic QDR 4500 Elite unit is capable of, the CPT code #77080 can be used and the reimbursement per exam is $79.91. If only 25 percent (875) of patients who receive mammogra ms undergo bone PROPOSAL FOR BONE DENSITY UNIT 9 9 density testing with a reimbursement of $79.91 per exam, this equals $69,921.25. The Hologic bone density unit will be more than paid for in a year. 7.0 Timeline Site visits to three other facilities that use the Hologic bone densit y unit were conducted on September 14, 2015 and September 22, 2015. The Women’s Imaging Center where the bone density unit will be going is undergoing minor construction; this project is estimated to take two weeks. The projected date for the bone densit y unit to be operational is January 2, 2016. Lead shielding for the room where the bone density unit will be housed is scheduled to take place on November 30, 2015. Arrival and reassembly of the unit will be on December 7, 2015. This is estimated to tak e one day. HL7 interface and license and linkage to Aspyra PACS will take place on December 11, 2015. Software upgrade will take place during this time as well. The physicist will be contacted and estimated arrival for this inspection is December 14, 20 15. Training sessions for radiologic technologists will begin on December 15 th through December 18 th and December 21 st through December 23 rd. All technologists will be trained on t he unit. The unit is projected to be operational on January 2, 2016. 8.0 E mployee Qualifications The radiologic technologists at Claiborne Medical Center are all registered through the American Registry of Radiologic Technologists (ARRT). The technologists will be cross - trained in bone density imaging by a fellow technolog ist who has five years experience in performing these exams and who has previously worked with and is knowledgeable about the Hologic QDR 4500 Elite bone density unit. All technologists must acquire Tennessee PROPOSAL FOR BONE DENSITY UNIT 10 10 radiation operator license. Technologists may become certified in bone de nsity at their discretion. 9.0 References Bone Densitometry (DEXA, DXA). (2014). Retrieved from http://www.radiologyinfo.org/en/info.cfm?pg=dexa#limitations Osteoporosis Facts and Statistics . (n.d.). Retrieved from http://www.iofbonehealth.org/facts -\ statistics PROPOSAL FOR BONE DENSITY UNIT 11 11