Proposal project

Running head: PROPOSAL FOR BONE DENSITY 1

Proposal for Hologic QDR 4500 Elite Bone Densitometer

Student Name

Adventist University of Health Sciences

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TABLE OF CONTENTS

1.0 ABSTRACT……………………………………………………………………………3

2.0 PROBLEM SUMMARY………………………………………………………….......4

2.1 Statistics and Demographics…………………………………………………………….4

2.1 Analysis………………………………………………………………………………....5

3.0 PROJECT DESCRIPTION…………………………………………………………..7

3.1 Relevant Alternatives…………………………………………………………………...8

3.2 Work Plan……………………………………………………………………………….8

3.3 Significance……………………………………………………………………………..9

4.0 METHODS…………………………………………………………………………….10

5.0 BARRIERS…………………………………………………………………………....12

6.0 BUDGET……………………………………………………………………………....12

6.1 Projected Reimbursement……………………………………………………………….14

7.0 TIMELINE…………………………………………………………………………….14

8.0 EMPLOYEE QUALIFICATIONS…………………………………………………..15

9.0 References……………………………………………………………………………...16

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1.0 Abstract

The radiology department at Claiborne Medical Center does not currently have a bone density

unit. Bone density scanning, also called dual-energy x-ray absorptiometry, or DEXA scan, can

generate higher volumes of patients that patronize the facility, thereby having a significant

impact on revenue for the hospital. A used bone density unit is available at a sister facility. This

facility is upgrading their equipment and their current bone density unit is on the market. This

unit can be purchased for a fraction of the cost of a new unit. Bone fragility in men and women

65 years and older along with younger postmenopausal women who have certain risk factors for

osteoporosis can be evaluated with DEXA scan using only a small amount of radiation. DEXA

scan is considered preventive medicine because it can diagnose and result in the treatment of

osteoporosis and as a result decrease the amount fractures that can occur due to brittle bones.

The following proposal will display the need for a bone density unit and how it can be beneficial

for the facility as well as patients.

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2.0 Problem Summary

Claiborne Medical Center does not currently have the capabilities to perform DEXA scans.

There is no known clinic or facility in the area that performs DEXA scans, resulting in patients

driving approximately 45 minutes to another facility.

2.1 Statistics and Demographics

Statistics show that approximately 25 percent of women and 6 percent of men have

osteoporosis. These numbers increase when involving osteopenia, where bone loss is apparent

but has not reached osteoporosis. Almost half of seniors (48 percent)-more than 52 percent

being women and 44 percent being men-have osteopenia (Osteoporosis Facts and Statistics,

n.d.).

2.2 Analysis

A SWOT analysis (Figure 1) was performed to identify the strengths, weaknesses,

opportunities and threats that comprise the Hologic QDR 4500 Elite bone density unit.

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Strengths

 No other bone density unit in close

proximity

 Uses a small amount of radiation to

obtain images

 Non-invasive

 Most accurate method for the

diagnosis of osteoporosis

 Simple, quick exam

Weaknesses

 Used machine

 No warranty

 Can produce magnification and/or

distortion of images

 2nd generation x-ray bone

densitometer with fan beam geometry;

may affect BMD assessment

Opportunities

 Technological advancement for

facility

 Increase in patient load

 Increase in revenue for facility

Threats

 Possible obsolete parts for unit

 Equipment breakdown

 More advanced equipment at other

facilities

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One of the strengths displayed in the SWOT analysis is that there is no other bone density unit

in close proximity to Claiborne Medical Center. This is a positive factor because patients will

not have to travel long distances to have this exam done.

3.0 Project Description

There are certain elements that impact the decision to invest in new or different equipment.

Every aspect must be considered, from cost of the equipment to where the equipment will be

housed once it is at the facility.

3.1 Relevant Alternatives

A different alternative to the Hologic QDR 4500 Elite bone density unit was researched.

Information gathered from GE about the Lunar Prodigy bone density unit was obtained. This

unit is available in two sizes, full size, which is 8 feet long, and compact, which is 6 feet long.

The Lunar Prodigy unit has a closed format.

3.2 Work Plan

 Reduced amount of surgeries due to

fractures owing to osteoporosis

 Denial of insurance claims

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Hologic was contacted to request a list of facilities in East Tennessee that use the QDR 4500

Elite bone density unit. Their report showed that two facilities in Knoxville, Tennessee and one

facility in Morristown, Tennessee used this specific bone density unit.

3.3 Significance

A bone density unit is needed at Claiborne Medical Center for a number of reasons. First, it

will increase patient load for the hospital since patients will not have to go elsewhere to have this

type of exam performed.

4.0 Methods

The two bone density units that were compared were the GE Lunar Prodigy and the Hologic

QDR 4500 Elite. The GE Lunar Prodigy was available brand new for $32,000.00. This unit is

state-of-the-art but is not within the radiology department’s budget.

5.0 Barriers

The Hologic QDR 4500 Elite bone density unit, although used, is within the radiology

department’s budget. However, there are some concerns regarding this unit. First, the unit is 12

years old and has no available warranty.

6.0 Budget

The Hologic QDR 4500 Elite bone density unit can be purchased from Cumberland Medical

Center for $2,500.00. Figure 2 visualizes ….

Figure 2

ITEM COST

Hologic QDR 4500 Elite bone density unit $2,500.00

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from Cumberland Medical Center

Dismantle, transport and reassembly of unit,

test of operation and completion of FDA 2579 form

fulfilled by Remesta Medical Corporation

$5,500.00

Physicist inspection and survey

$400.00

HL7 interface and license, linkage to Aspyra PACS

$1,000.00

Upgrade to FRAX software

$500.00

Lead shielding for room where bone density room will

be housed

$400.00

Grand total:

$10,300.00

6.1 Projected Reimbursement

Projected reimbursement is based on the amount of patients who receive mammograms;

research shows that the majority of the patients who come to the Women’s Imaging Center are

postmenopausal women. Projected reimbursement is as follows:

 Research conducted shows that Claiborne Medical Center performs 3,500 mammograms

a year; if only 25 percent (875) of these patients undergo bone density testing and

reimbursement is $60.00 per exam, this equals $52,500.00.

 Worst case scenario: 600 bone density exams at $30.00 reimbursement for exams equals

$18,000.00

 By performing helical scans of the torso and hip, which the Hologic QDR 4500 Elite unit

is capable of, the CPT code #77080 can be used and the reimbursement per exam is

$79.91. If only 25 percent (875) of patients who receive mammograms undergo bone

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density testing with a reimbursement of $79.91 per exam, this equals $69,921.25. The

Hologic bone density unit will be more than paid for in a year.

7.0 Timeline

Site visits to three other facilities that use the Hologic bone density unit were conducted

on September 14, 2015 and September 22, 2015. The Women’s Imaging Center where the

bone density unit will be going is undergoing minor construction; this project is estimated to

take two weeks. The projected date for the bone density unit to be operational is January 2,

2016. Lead shielding for the room where the bone density unit will be housed is scheduled

to take place on November 30, 2015. Arrival and reassembly of the unit will be on

December 7, 2015. This is estimated to take one day. HL7 interface and license and linkage

to Aspyra PACS will take place on December 11, 2015. Software upgrade will take place

during this time as well. The physicist will be contacted and estimated arrival for this

inspection is December 14, 2015. Training sessions for radiologic technologists will begin

on December 15th through December 18th and December 21st through December 23rd. All

technologists will be trained on the unit. The unit is projected to be operational on January

2, 2016.

8.0 Employee Qualifications

The radiologic technologists at Claiborne Medical Center are all registered through the

American Registry of Radiologic Technologists (ARRT). The technologists will be cross-

trained in bone density imaging by a fellow technologist who has five years experience in

performing these exams and who has previously worked with and is knowledgeable about

the Hologic QDR 4500 Elite bone density unit. All technologists must acquire Tennessee

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radiation operator license. Technologists may become certified in bone density at their

discretion.

9.0 References

Bone Densitometry (DEXA, DXA). (2014). Retrieved from

http://www.radiologyinfo.org/en/info.cfm?pg=dexa#limitations

Osteoporosis Facts and Statistics. (n.d.). Retrieved from http://www.iofbonehealth.org/facts-\

statistics

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