CANCER: 8 percent of survivors develop a second different malignancy

In this study of over 2 million adult cancer survivors, 8 percent were found to have later acquired a second, unrelated type of cancer.  Those patients who had bladder cancer or non-Hodgkin lymphoma originally were found to be more likely to have a second cancer, which was most often lung cancer.  An argument is made for more routine CT scans of the lungs of bladder cancer survivors as long-term follow-up.

Sources:

[Interview with author]: Irwin, K. (2016, July 13). Nearly 1 in 12 patients with a common cancer develop a second, unrelated malignancy. UCLA Press Release.  Full text free here: http://newsroom.ucla.edu/releases/nearly-1-in-12-patients-with-a-common-cancer-develop-a-second-unrelated-malignancy

[The medical journal article]: Dorin, N., Filson, C., Drakaki, A., and others. (2016, June). Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008. Cancer.  Click here for access to publisher’s website: http://onlinelibrary.wiley.com/doi/10.1002/cncr.30164/abstract  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

INCIDENCE: One lung cancer detected per every 65 screenings at OhioHealth program

The OhioHealth Lung Cancer Screening Program, implemented in mid-2013 and based on a low-dose chest CT scan, is described in this article.  A key part of this program is the team of oncology lung nurse navigators who accompany and guide the patient through the process.

I particularly wanted to note the incidence rate that they have encountered to date:

• “Currently, the OhioHealth Lung Cancer Screening Program has diagnosed, on average, one lung cancer for every 65 screenings.  The statistic is a substantially higher ratio than the National Lung Screening Trial ratio of one in 320 screenings.”

Of the 16 patients found to have lung cancer in the OhioHealth program, 14 were at an early stage.

Sources:

[About the OhioHealth program]: Jansak, B. (2015, Nov.-Dec.). Expanding a comprehensive lung cancer screening program. Radiology Management, 37(6), 42-46.  Publisher’s website here: http://www.ahraonline.org/radiologymanagement

[Here is the earlier article about the National Lung Screening Trial]: The National Lung Screening Trial Research Team. (2011, Aug. 4). Reduced lung-cancer mortality with low-dose computed tomographic screening. The New England Journal of Medicine, 365(5), 395-409.  Click here for full text: http://www.nejm.org/doi/full/10.1056/NEJMoa1102873#t=articleResults  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

SPACE PLANNING: Imaging GSF per procedure room

Health facility space planners sometimes make use of benchmark ratios such as those given in this very short article to determine a preliminary space estimate based on the number of procedure rooms desired.  Here is an example: For CT scanners, 1,200 to 1,500 departmental gross square feet per procedure room.  The lower end of the range is for larger suites; the higher end for smaller suites.  Similar ratios are given for radiography/fluoroscopy, mammography, MRI, ultrasound, and nuclear medicine.  There is also a ratio given for outpatient multi-modality diagnostic imaging centers.

This information comes from Hayward & Associates, a health care facility planning consultancy that publishes the design manual SpaceMed.

Source: Estimating diagnostic imaging space based on the number of procedure rooms. (2015, Fall).  SpaceMed Newsletter. https://www.spacemed.com/newsletter/rule-83-imagingspace.pdf

OPERATING ROOMS: Planning tips for hybrid ORs

Here are some of the considerations / recommendations in planning a hybrid operating room, which integrates imaging equipment into the operating room, based on comments of a steering committee responsible for developing an exhibit at an upcoming national conference:

• Physician champions are needed
• Turf issues as far as who controls the hybrid OR must be worked out
• It takes about a year in planning time
• Multi-disciplinary hybrid OR steering committee should meet every 2 to 3 weeks
• 1,200 sf should be adequate for the hybrid OR and the control room
• The hybrid OR should be part of the surgical suite and close to blood bank

Source: Wood, E. (2015, Sept.). Learn from hybrid OR experts at annual conference Town Hall. OR Manager, 31(9), 1, 7-9.  http://www.ormanager.com/learn-hybrid-experts-annual-conference-town-hall/  Posted by AHA Resource Center (312) 422-2050 rc@aha.org

BENCHMARKS: Vascular procedure utilization

There is opportunity in 2015 for developing or coordinating vascular services, according to the author, an exec with the consulting firm Corazon.  These services are often fragmented and can be characterized as part of turf wars between interventional radiologists, vascular surgeons, and interventional cardiologists.  Reasons why planners should take a look at the vascular service line are reviewed.  I especially like this one planning benchmark given:

• “…current utilization of vascular procedures is at a ratio of 1.2 : 1 when compared to cardiac procedures.”

Source: Fuller, D. (2015, July). Does vascular remain an untapped market? Cath Lab Digest, 23(7). Retrieved from http://www.cathlabdigest.com/print/25436 Posted by AHA Resource Center (312) 422-2050, rc@aha.org 

PET SCANS: About 1.6 million clinical scans in 2014

My favorite source for imaging procedure utilization estimates for the U.S. is the data vendor IMV Medical Information Division, Inc.  They offer Benchmark Reports for different imaging modalities; the latest one out is for positron emission tomography (PET) scanning.  I like it that they have data from hospital and non-hospital sites and that some comparative historical data are given.

Here is an example:

• 1,616,900 total clinical PET scans (2014)
• Comparable data are given for each year from 2005 to 2013
• Interestingly, the inflection point was 2011, when the clinical PET utilization topped out at 1,853,700
• Anybody have thoughts as to why clinical PET utilization, after rising steadily and consistently from 2005 to 2011 is now headed down?

Source: Benchmark Report: PET Imaging 2014. (2014). Des Plaines, Ill.: IMV Medical Information Division.

PET scanner scheduling efficiency: how Mayo does it

This is a lengthy, thorough description of a study undertaken at the Mayo Clinic’s Rochester (MN) campus to model and improve efficiency in a busy positron emission tomography (PET) suite.  Patient flow is discussed and the PET scanning process described.  The most frequently used radiopharmaceuticals, their half-lives and uptake times, are listed.  Among the findings were the value of knowing–when scheduling–what the patient’s BMI (body mass index) is.

Source: Marmor, Y.N., Kemp, B.J., and others.  Improving patient access in nuclear medicine: a case study of PET scanner scheduling.  Quality Management in Health Care;22(4):293-305, Oct.-Dec. 2013.  Click here for access to publisher’s website: http://journals.lww.com/qmhcjournal/pages/default.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Radiology exam volume in academic medical centers

This is a survey with responses from 50 members of the Society of Chairmen of Academic Radiology Departments about the cost of doing business in the academic radiology department.  The article includes the survey questionnaire and some of the results.  Here are a couple of interesting findings:

RADIOLOGY EXAMS per YEAR in academic radiology departments

• 200,000 to 400,000 (47 percent)
• 400,000 to 500,000 (23 percent)
• 500,0000-plus (25 percent)

EMPLOYMENT OF RADIOLOGISTS

• Employed by hospital/health system (41 percent)
• Employed by medical school (39 percent)
• Independently owned radiology departments (20 percent)

Source: Novak, R.D., Mansoori, B., and others.  The cost of doing business in academic radiology departments.  Radiology Management;35(5):26-37, Sept.-Oct. 2013.  Click here for publisher’s website: http://www.ahraonline.org/am/custom/rm_search.aspx  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Characteristics of a radiology observation unit

Before 2007, outpatients scheduled for interventional radiology procedures at Southern New Hampshire Medical Center (Nashua, NH) were prepped and recovered in an inpatient room.  With an expansion of the radiology department, a 4-bay observation unit with a minor procedure room was added.  Afterwards, when the volume of certain targeted interventional procedures did not grow as much as projected, the unit began to care for outpatients needing blood transfusions and patients scheduled for cardiac cath procedures.  The unit is credited with these patients’ time spent at the hospital and with increasing the availability of inpatient beds.
Source: Dionne, D.T.  Growing the range of services in a radiology observation unit.  Radiology Management;35(3):34-38, May/June 2013.  Click here for the publisher’s website: http://www.ahraonline.org/am/custom/rm_search.aspx  Posted by AHA Resource Center (312) 422-2003, rc@aha.org

BENCHMARKS: 2.5 radiation therapy courses per 1,000 pop

In the ’80s, the British Columbia Cancer Agency established a radiation therapy database that captures data on ALL radiation therapy treatments delivered in British Columbia.  This article presents trend data from 1984 through 2008 drawn from this database.  Here are the population-based utilization metrics that are available:

• Percentage of cancer patients who receive radiation therapy
• Radiation therapy courses per million population (I re-calculated as per 1,000 population for the headline of this blog post)
• Treatment visits (called “fractions”) per million population
• Treatment visits / course of treatment (how many times does the patient have to come in for a radiation therapy treatment)
• Fields / treatment visit 

Why do I like this article?  Tough to find population-based (per 1,000 pop) ancillary service utilization data.  Interesting treatment trends over the past quarter century.

Source: Jackson, S.M., and others.  Are the creation and maintenance of databases in healthcare worthwhile? An example of a unique, populated-based, radiation therapy database.  Healthcare Quarterly;15(4):71-77, 2012.  Click here to purchase full text: http://www.longwoods.com/content/23195  Posted by AHA Resource Center, (312) 422-2050, rc@aha.org