Mobile alternative brings PET to the door

PET has grown more rapidly in the past few years than at any time in its 30-year history, thanks to improvements in technology, expanding reimbursement, and an ever-growing list of applications. However, the cost of a fixed-site PET installation can still be prohibitive for many institutions.

"Mobile PET services can provide you with an economical way to offer the modality to your customers. But, as with any new business venture, you have to research and investigate if the modality is right for your facility," said David Frazee at the 2001 American Healthcare Radiology Administrators (AHRA) conference in Las Vegas.

Frazee, of the Cleveland-based Frazee Consulting Group, said the first prudent step on the road to PET is a thorough market and needs analysis. The study should include the population demographics of the institution’s service area, tumor registry data for the locale, and the status of current competition. A survey of referring physicians is helpful in determining their interest in the use of PET services.

The administrator will also want to evaluate PET's impact on operations. Workflow changes will be required to handle scheduling, and then interpretation, of PET studies. New equipment on which to perform the reads may also need to be purchased.

"You’ll need to involve your institution's radiologists early on in the decision-making process," said Frazee. "Their familiarity and expertise in using PET will be a determining factor in whether your facility can successfully implement the modality."

The incentives to start a mobile PET program are very attractive, such as easy market entry, minimal capital outlay, no risk of equipment obsolescence, and the ability to build income gradually, according to Frazee. Moreover, there are no licensing issues, and the only construction involved is providing a pad and electrical power for the mobile coach.

Most mobile PET vendors will limit their contracts with a facility to four or five years' duration. Some vendors will sign year-to-year service contracts, but expect to pay a premium for this flexibility, Frazee said.

"No matter the length of the contract, be sure to negotiate an ‘out clause’ in case business is not growing as expected or it’s growing better than expected and you decide to build a fixed PET site," noted Frazee. If the market analysis indicates that a facility can reasonably expect to perform four to six PET studies per day, then it may be time to consider having the modality on site. Although a fixed PET installation can be expensive, it does offer the advantages of potentially higher revenue and flexible scheduling.

Frazee recommended a review of all potential mobile vendors using a seven-point checklist:

• Consider only established companies with a reliable track record
• Check the company’s client lists for satisfaction levels
• Verify a company’s uptime performance
• Ensure that its technologists are experienced
• Look for strong training and support for a facility’s radiologists
• Coding and billing expertise should be provided
• Marketing support for the PET services at the facility