Imaging Technology News 9/08

> > special report Race Against Cancer continued from page 29 effective decision that would allow us to not only replace an older accelerator but to enter the IGRT, SRS/SRT and gating markets,” McGraner noted. “The Trilogy allowed us to meet those objectives, while also beam-matching the Trilogy with our other accelerators. The acquisition of the Trilogy provided us greater flexibility with existing equipment.” In fact, BCCC ROC maintains a favorable longstanding relationship with Varian Medical Systems that includes linear accelerators, HDR brachytherapy, prostate brachytherapy seed planting, simulators, radiotherapy planning and EMR software. It uses GE Healthcare for computed tomography (CT) and positron emission tomography (PET/CT) imaging; C.R. Bard for radioactive material for the ProSeed prostate brachytherapy implant technique; B-K Medical for ultrasound; PAR Scientific A/S for block cutters; Scanditronix Wellhofer for physics calibration equipment; and CIVCO Medical Solutions for immobilization devices and treatment supplies. But McGraner’s team doesn’t operate in a vacuum at the Baptist system. For example, the radiation oncology team participated in the evaluation of PET/CT scanners alongside the diagnostic radiology department. “We work well with the MRI, CT and PET/CT teams when our physicians order diagnostic tests, as the imaging will later be used for treatment planning purposes,” she said. “Our medical physicists and technical team work to ensure accurate positioning, scanning geometry.” Another hospital within the Baptist organization plans to install a Trilogy and duplicate the integrated environment used by BCCC ROC. “As an organization we understand the difficulty in recruiting highly skilled/knowledge workers, such as medical physicists and dosimetrists,” McGraner noted. “We hope that with integration of equipment across our system that remote dosimetry will now be an option/solution for future staffing challenges and for patients moving across our system.” In addition, the Baptist system can generate considerable savings on capital and service/support contracts, as well as maintain the integrity and security of sensitive patient data as it’s transmitted throughout the organization when patients transfer between system healthcare facilities. With this integrated technology environment, including customized electronic forms in the EMR system, BCCC ROC recorded increased clinical and IT-related financial efficiencies, removed redundant processes, improved productivity and eliminated waste, according to McGraner, who estimated that they have decreased total expenses by approximately 23 percent. Completing the whole BCCC ROC currently is a department of the nonprofit Baptist Memorial Health Care Corp., which comprises 15 hospitals throughout Tennessee, Mississippi and Arkansas, and six radiotherapy facilities, among other nonacute care facilities. Baptist Memorial Hospital – Memphis represents the flagship and largest hospital of the corporation on whose campus BCCC ROC resides. As a result, often a patient’s diagnosis and treatments start at the flagship facility before moving to another center close to home where radiotherapy is completed, according to McGraner. But BCCC ROC wasn’t always so tightly intertwined with Baptist Memorial. In 1993, Baptist Centers for Cancer Care initially opened as a joint venture between a physician group and Baptist Memorial Health Care Corp. as the Mid-South’s first freestanding radiation oncology center. Physicians from competing practices joined together to form a partnership in the venture. But the Stark II changes passed by Congress and enacted in 1995 forced some changes in the initial radiation oncology center structure, McGraner indicated. Three years later, BCCC became a hospital department even as it remained a freestanding facility, but it ended the relationship with the partnering physicians from competing practices. The organization’s payer mix is approximately 50 percent Medicare, 37 percent commercial and 13 percent Medicaid and self-pay. “Regardless where the patient is in the continuum of the cancer experience, from diagnosis to cure or end-of-life, specialized care is available within the oncology service line,” McGraner said. “Our service line consists of many who provide the Radiation therapy team (left to right): Front Row: Justin Redd, radiation therapist, Shelley Bray, radiation therapist, Margie Pence, lead radiation therapist; Back Row: Joan Simone, radiation therapist, Laurie Trahan, radiation therapist, Lori Timaeus, radiation therapist, Michelle Robinson, radiation therapist, Betty Leming, radiation therapist, Jenny Folden, radiation therapist, Amanda Klinger, radiation therapist (not pictured) Secrets to BCCC ROC’s Success Karen McGraner, director, Baptist Centers for Cancer Care’s Radiation Oncology Center, Memphis, TN, offers some valuable insights into her facility’s operations and the staff’s motivations about what generates successful outcomes. OPCT: What’s the key strategy that makes an outpatient oncology center a leader in cancer treatment? How does Baptist Centers for Cancer Care implement that strategy? McGraner: The BCCC key strategy is to demonstrate commitment to excellence provided by caring and passionate individuals. To achieve excellence all members of the team have to pay attention to detail, regardless of the requirement of the task, or the communication with patients or team members. The team has to own the task(s) and be accountable. The involvement and participation of the entire team at each key step has been the critical to the successful implementation of new technology, with no compromise. In your opinion, what is Baptist Centers for Cancer Care’s toughest administrative challenge? How might you solve it? Our toughest administrative challenge is to take our position as an early adopter (in our region) to another level, to consistently separate us from our competitors, and to be the provider of choice for radiation therapy. By obtaining that goal, we would also create the financial opportunities that would allow further capital investments in order to carry out the mission and vision of our organization. The solution: Create opportunity for strategic partnership with others in our community. The challenge is that consolidation will work when we all come together with a commitment to improving cancer care in the community and when a win-win approach philosophy is adopted. Further administrative benefit for such strategic alignment is to realize sustainable financial viability. What is Baptist Centers for Cancer Care’s toughest operational challenge? How might you solve it? In this day of declining reimbursement, we realize our greatest operational challenge is to plan for capital equipment and ongoing expenses, much like many others. For example, as we planned to acquire image-guidance technology (IGRT), codes were being reimbursed, but today they are not. The dollars that were forecast at the purchase of our Trilogy are now not realized. We face increased scrutiny for expenses and are challenged 30 > special report > S e p t e m b e r 2 0 0 8 to always focus on accuracy and efficiency without compromising customer satisfaction. As shifts in volume occur, it will be our challenge to maintain schedules and coverage. Over the last year, we feel that we have successfully managed productivity and utilized all opportunities to work with staff so they might gain new expertise (to build for the future). For example, all members of our individual teams are proficient and competent to complete the necessary work in their respective units. We have a rotation through dosimetry for our therapists. This is an example of increasing employee satisfaction/morale and providing professional development in a hard to recruit position to meet existing and future needs. What are your top three priorities for the remainder of 2008 and for 2009? 1. Strategic partnerships, building relationships with physicians in order to improve cancer care in our region for shared visions and goals. Integration of care with our strategic partners. 2. Adaptive radiotherapy. 3. Foster a supportive environment in which our team is empowered to rise to next challenge. What’s the most enjoyable, as the well as the most difficult, part of your organization’s function? Most Enjoyable: I posed this question to our entire team. The overwhelming responses echoed two themes – “Caring for our patients” and “Teamwork!” I enjoy working with a team of dedicated individuals. Over the last years, I have watched them sacrifice, learn and achieve. There was never a time when through any challenges that were faced that I did not witness the compassion that they provided to our patients; they consistently demonstrated the passion that they have in their professions. Most difficult: Our greatest challenge is dealing with our financial challenges. The investment in our equipment and our best resources (people) comes with its price, and BCCC is not unique to that challenge today. In a large organization and age of declining reimbursement, our department is not the only one that requires new radiation oncology investment. It’s critical to constantly work on your strategic plan and your budgets. http://new.reillycomm.com/imaging/special-report-b.php

Table of Contents Feed for the Digital Edition of Imaging Technology News 9/08

Imaging Technology News 9/08 Contents IGRT How IGRT Targets the Prostate ASTRO Oncology Information Management Systems (OIMS) Imaging Leading the Intense Race Against Cancer SBRT - The New Treatment of Choice Top IMRT/IGRT Centers to Watch Molecular Imaging: Ready for the Limelight CR or DR in the ER? Have You Hit the Glass Ceiling?

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