Dose is Still the Hot Topic in CT

This article appeared as an introduction to the CT Systems comparison chart.

As the computed tomography (CT) market has moved through the slice wars and volumetric imaging, managing dose has now emerged as top priority for providers and vendors. This was one key finding of recent research on CT systems conducted by KLAS, which gathered information from 265 provider organizations regarding their systems. A brief overview of the research findings is below.

Dose is a Key Factor
Improvements in dose management technology are evident in most CT scanners, particularly in the next-generation systems. Providers have become more discriminating regarding dose-reduction strategies, resulting in dose moving up the decision tree and becoming very influential in new CT purchases. One provider, who is very happy with that hospital’s CT vendor, described the importance of dose, “The only compelling reason for us to change would be if there was a technology that significantly reduced the dose.”

In many ways, when differentiating CT capabilities, dose is now king. Vendors are addressing dose management issues and delivering new functionalities that allow clients to reduce dose. Some are using better protocols and image reconstruction, and some have software upgrades that allow them to reduce dose on exams. In some systems, providing a higher speed procedure has helped lower dose as well.

While all vendors are rolling out dose reduction tools, there is still a tremendous need for functionality that automates active dose monitoring and reporting. Vendors are at various stages in providing this, although respondents to the latest KLAS research indicate tools such as these will only become more essential as additional quality initiatives are mandated.

Next-Generation CT: Worth the Investment?
As CT vendors have pushed the envelope on functionality and capability (more volume covered in a single rotation), providers have started questioning how broadly applicable these expensive scanners are. While providers recognize the tremendous new capabilities with these advanced scanners, they come with high price tags. Providers feel these new scanners don’t have broad enough applications beyond cardiac- or organ-specific scanning to make economic sense for their specific needs.

A 64-slice or lower scanner may be a more cost-effective purchase for cases outside of cardiac. It all depends on an organization’s volume and patient mix.

During the course of the KLAS research, several respondents were found who use a CT in the emergency department (ED). Using CT in the ED is fraught with atypical issues, including a high-stress environment with patients who are in need of urgent care or who are uncooperative. Speed and accuracy are key in the ED.

Service Practices Differentiate
Technology advances at a blistering pace, but time and time again it is shown service and support make a difference, even in CT. This is especially true for those considering a 16-slice system, where systems are viewed by some as more of a commodity than their higher-slice brothers. In KLAS’ new CT report, the vendor that provided the most excellent customer service was raised to the top ranking.

Dose has become the hot-button issue for CT. Every vendor is working diligently to deliver dose-reduction enhancements. All the next-generation scanners deliver lower dose through some combination of hardware and software, and some of these innovations are flowing down to the lower-slice platforms. Credit here goes to the vendors for working with their customer base to help get lower dose to everyone, not just those with the latest and greatest scanners.

Providers, however, grapple with the economics of CT imaging. Cardiac reimbursements and scan volumes have not been as high as hoped, leading providers to question the benefit of a large investment in next-generation scanners.

While the next-generation scanners’ abilities can extend beyond cardiac imaging to varying degrees, providers must question how much of the total population can benefit from the leading-edge technology, and by how much. Many providers have found a place for these scanners, but many more continue to turn to 64-slice and below scanners. Providers know they must search for the optimal mix of what they need for their varying procedure needs in order to reduce costs, increase access and improve quality.

KLAS’ mission is to improve the delivery of healthcare technology by independently measuring and reporting on vendor performance. For information about the findings and vendors examined in “CT 2010: Slice and Dose,” co-authored by Kirk Ising and Chris O’Neal, visit www.KLASresearch.com or phone 800.920.4109.

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