Cardiovascular Business - March/April 2008 - (Page 24) BOTTOM LINE › By BETH WALsH CoroNary iNterveNtioN Financial Factors cath labs facing R “We’re certainly using our labs for multiple reasons by mulecent trial results, multidetector CT and new and tiple users,” says Stephen Green, MD, associate director of the more uses for the services and equipment of the cardiac catheterization lab at North Shore University Hospital in traditional cardiac catheterization lab are impactManhasset, N.Y. His facility was ahead of the curve when it began ing the bottom line of facilities across the coundoing peripheral work in 1996. Newer lab users include vascular try. These and more factors may have temporarily surgeons, interventional radiologists and neurointerventional decreased cath lab procedures, but experts in the radiologists. Labs have more functionality today so more physifield predict recovery—albeit a changing face for the cath lab. cians can use the equipment for endoscopic procedures, clips and An estimated 4.21 million patient cases were performed at coils in the head and more—all in the same lab, he says. 1,970 cardiac cath lab sites in 2006, according to a report from Another benefit of more modern equipment is the caconsulting firm IMV. This represents a 9 percent increase pabilities offered by information systems. They’re so from 2002, which also indicates a slightly slower good these days, Green says, that they can help rate of growth (2 percent a year) than in prewith the bottom line by allowing users to track vious years. The vast majority (89 percent) diagnostic volumes and look for various of procedures are cardiac-related and the trends and patterns. With these advantages, remaining 11 percent are non-cardiac ap“business is not going to get smaller.” plications, such as carotid, iliac, femoral, The other challenge for individual run-off, renal and extremity studies. facilities is keeping their patient popuFrom 2003 to 2006, the average delation growing. “The economics of the vice budget per cath lab increased 18 community you’re in is important, plus percent per year to $1.8 million, driven the level of competition,” says Yakubov. by the adoption of more sophisticated The more labs in your area, the more you devices such as drug-eluting stents, achave to show that you have superiority in cording to the report. Also, the proportion these multidimensional imaging systems. of sites with capital budgets of over $1.5 mil“Your lab’s physicians all need to be experts in lion has increased from 14 percent in 2000 to their field for that cath lab to stand out 30 percent in 2006, as hospitals invest The impact on cath labs of the increasing use of coronary in an area where there are multiple labs in new technology such as flat panel CT angiography is still being debated. Coronary stent visualized with CTA. (source: Philips Healthcare) competing for the same patient base.” digital detectors. Despite the new and expanded uses for cath lab resources, there are forces at work chipping away growing the business at revenue. Recent study results are part of the current “perfect With that kind of investment, it’s no wonder that many cath labs storm” in cardiology that’s forcing reevaluation of cath labs, says are growing their business by making it possible for more subspeThomas H. Maloney, RT, director of clinical education for Boscialists to use the equipment. ton Scientific. A series of trials all came in a sequence that has To continue to succeed and grow, cath labs have to become driven stent utilization down from 90 percent to 60 percent and a multi-imaging destinations, according to Steven Yakubov, measured reduction of 10 percent in cath lab procedures between MD, an interventional radiologist with OhioHealth. “They September 2006 and September 2007. Recovery from that decline have to include CT angiography suites, maybe MRI, and interwill be gradual but steady in 2008, he predicts. ventional procedures. The cath lab of the future is a multi-imPart of that recovery requires savvy about how to increase volaging destination.” 24 Cardiovascular Business March/April 2008
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