Point-of-Care CT Scanning in Otolaryngology: Boon for Patients and Physicians: Part 1 of 2

Interpretation of the scans can be accomplished using built-in teleradiology features, which offer real-time reads of the scans. Dr. Hopp-who is also President of InHouse Radiology Medical Group, a start-up company that provides teleradiology services to physicians with imaging devices in their offices-uses this feature with his in-office CT scanner to sign off on scans. Dr. Sillers reads his own scans, a practice he has carried out for 14 years. In Alabama, he is not reimbursed for reading his own scans (a radiologist doing the read could bill for this function, however). Thus, there is no financial incentive for him to read the scans. Sometimes, he said, people may incorrectly assume that otolaryngologists read their own scans simply to capture all the income streams from in-office CT scanning.

Costs and Gains

Otolaryngologists interviewed by ENT Today cited patient convenience and satisfaction as the major benefits of acquiring point-of-service CT. Point-of-service CT scans minimize the interruption in patients’ lives, noted Jacquie Lipton, Marketing Manager for GE Healthcare. They don’t need to leave work twice or schedule someone to take them for a scan. Others have validated an increase in practice revenue.

Ms. Vestevich of Xoran commented that payback can vary from four to 30 months, with the typical time frame being about a year. Otolaryngologists have reported a 300% return on investment, she said. Many GE customers, said Sofiane Laoussadi, Commercial Leader for GE Healthcare Financial Services, opt for a fair market value lease, which enables the physician to upgrade to a newer generation product at the end of the lease term-a plus in this era of fast-evolving technology.

Installation does not usually require reinforcement of floors, or installation of cooling systems or additional power supply (as are required for installation of full-body CT machines). Other attendant costs can include time and money to obtain credentialing as a diagnostic laboratory, and ongoing training and safety certification. (The latter two issues will be addressed in Part 2 of this article.) Obtaining precertification with payers for CT scans, observed our sources, may require some adjustments (such as establishing online or phone approvals) to retain the convenience factor for patients of same-day office visits and scans (see sidebar).

Although it took about 18 months for Dr. Sillers to realize a return on his investment for the in-office CT scanner, increased revenue was not the primary factor in his decision to buy the machine. It’s a tool that’s quite helpful in caring for my patients, particularly those with complicated rhinologic disease, he said. I look upon it as a piece of equipment that I need to practice my trade.