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The bumpy road to imaging access in rural America

por John R. Fischer, Senior Reporter | June 18, 2018
Mobile Imaging
Insight Imaging mobile units support
providers in areas where in-house systems
are not financially justified.
From the June 2018 issue of HealthCare Business News magazine

Palo Pinto General is a hospital in the grassy plains of Mineral Wells, Texas, located over an hour west of the Fort Worth-Dallas area. Radiologist Dr. Charles Myers has worked there for almost 12 years but does not know the nearest supplier of radiopharmaceuticals.

“Either it’s too expensive or takes too long for us to get those radiopharmaceuticals,” Myers told HCB News. “When we have a need for PET imaging or other nuclear medicine tests, such as tagged white blood cells studies to look for infections, we need to refer that case out to either Weatherford or Fort Worth, closer to the suppliers where patients can get those exams done.”

As a result, many patients experience delays in care as financial and logistical hurdles prevent them from making the trip to the urban care centers.
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Providing PET imaging is not feasible for Palo Pinto due to the expenses that come with it and the distance and time in obtaining radioisotopes, according to Myers, but mobile MR and CT units have been successfully deployed whenever in-house scanners are down or require maintenance.

The rural provider, which serves a population of 20 to 30 thousand residents, is not unique in its struggle to deliver excellent care with limited resources. In fact, it’s a common problem throughout the country.

Making the most of what’s available
In rural areas where physically laborious work like farming and lumber are more prevalent and healthcare facilities are farther away, the rate of unintentional injury deaths is 50 percent higher, according to research published by the Centers for Disease Control and Prevention in 2017.

The problem highlighted in those staggering statistics applies to access to advanced imaging too, meaning that sometimes patients simply can’t get access to urgent diagnostic scans when they need them.

“If it’s an emergent injury and we don’t have the modality they need that day, then we have to have an ambulance transport the patient,” said Jon Linnell, CEO of North Valley Health Center and CEO and executive director of the North Region Health Alliance in Minnesota. His hospital works with DMS Health, a Digirad company and a member of the OpenMarkets Community.

“If it’s a modality that we use very infrequently, say like three times a month, we will send those patients out to our tertiary facility or our referral hospitals for those modalities because, often, a patient can’t wait weeks,” he said. “They may be able to wait a couple of days but not weeks.”

For patients who require PET or PET/CT scans, the situation is even more complex, requiring facilities to have timely access to radiopharmaceuticals due to their short half-lives. In addition, regulatory requirements for handling isotopes must be adhered to and patients need to be educated about special scan instructions.

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