In fact, among ECRI's clients, 128-slice is often at the top of their wish-lists. According to internal research by the institute, by the third quarter of this year, interest peaked around 128-slice scanners, while interest in 64-slice ones dropped to third place, behind premium equipment, which saw a boost at the end of last year with the release of new technology. Sixteen-slice scanners, basic and relatively cheap systems that are usually not upgradeable, saw a slight jump this past quarter, even though interest is still well below its more powerful cousins.

These trends were reflected by the voting preferences of webinar participants. When asked in a poll, more than one-third said they would be most interested in buying a 64-slice system, another one-third wanted 128-slice, with premium and 16-slice rounding out the bottom.


Good service

The scanner's specifications and cost are only part of the equation. There's also the not-so-small matter of the service contract.

When buying the equipment, most hospitals opt for a multi-year contract at point-of-sale, Maliff said. Typically, these contracts last 12-60 months post-warranty.

Service isn't cheap. On average, expect to pay between 6.3 and 9.5 percent of the total acquisition costs each year, he said. This means bills average well above $100,000 annually.

Among several points to keep in mind, two issues stand out: travel minimums and uptime guarantees. Travel minimums are, in effect, the minimum charge a vendor hits you with for sending out a field service engineer. If your travel minimums are four hours, that means even if an engineer fixes your machine within 15 minutes, you'll still be billed for four full hours. Urban and suburban providers might have some wiggle room here in negotiating better terms for their minimums, but not everyone is so lucky. "You might not have leverage for that if you're in a rural area of an exurb of a major city," Maliff said

For uptime guarantees, vendors like to calculate uptime over the course of a year, Maliff said. That's good for them, as it gives them leeway, but it's probably in the best interest of the hospital to have uptime calculated monthly or quarterly, he said.

"Be aggressive here," he suggested.

Other costs

There are also other costs to keep in mind when siting the equipment. The X-ray tube in the scanner generates an immense amount of heat, and if there isn't a water-cooling system in place you'll have to increase the air-conditioning to the room, Launders said - in some cases, you'll have to double it. "(It's a) major consideration for siting a new machine," he observed.

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