Building a Modern Diagnostic Center Chain

- Dr Vas Metupalle Clarity Radiology Pte Ltd www.clarityradiology.com

Contents
Introduction..................................................................3 Location........................................................................4 Layout...........................................................................5, 6, 7, 8 Infrastructure...............................................................9, 10, 11, 12 Equipment....................................................................13, 14, 15 Staffing.........................................................................16 Training........................................................................17 Digital radiology..........................................................18, 19,20 Projections....................................................................21, 22,23 Franchise Model...........................................................24, 25

INTRO
This presentation aims to detail the components of a central diagnostic center with several satellite imaging centers.

Xray, Ultrasound, Mammo,

Xray, Ultrasound, Mammo, CT , MR

Xray, Ultrasound, Mammo,

Xray, Ultrasound, Mammo,

Location Central advanced diagnostic center

- City - good transport links - Building with adequate floor loading / frontage /space, carpark space - Nearby Hospitals with service lacking - Outpatient specialists in vicinity

Sattelite diagnostic centers

- Well Populated, self contained neighbourhoods

- GP groups in vicinity

Layout
Components: 1. Advanced Diagnostic center - Waiting area x2 (outer, inner) - Reception - Admin / Marketing / Accounting Room - Pantry - Meeting / Training Room - Radiologist reporting room - rest room - Changing rooms - Technician Work area - Xray Room - Mammo Room - Ultrasound Room - CT Room - MR Room - CT/MR control room Likely 4000sq feet

Possible Advanced center Layout

4000 sq feet

Layout
Components: 2. Satellite Radiology Center - Waiting area - Reception - Changing rooms - Technician Work area - Xray Room - Mammo Room - Ultrasound Room Likely 1500sq feet

Proposed Sattelite center Layout

1250sq ft

INFRASTRUCTURE
1) Floor Loading MRI area 12kN CT area - 5KN Rest - 3 KN
Specialists required: - Specialist contractor -Professional Engineer - Radiation safety adviser - MR / CT installation +commissioning engineers

2) Radiation Protection , RF insulation

- RF insulation for MR room

- 3mm thickness lead rooms for xray, mammo, CT rooms. - Lead doors, lead glass - specialist contractors needed to consult with local contractors

3) Power - Uninterrupted Power Supply vital to preserve medical equipment circuit boards from damage. UPS machines tested for medical equipment eg. Caterpillar , Toshiba UPS. Advanced Center - 200 to 300kVA Satellite Center - 60 to 100kVA - Generator supply important for business to run in developing countries.

4) Network
- Internet , ADSL / VSAT broadband 2MB/sec Download , 1MB/sec upload

- LAN network, Gigabit ethernet within each center

- 1x server , with 4x windows professional PCs satellite center - 2x Server, 9 x Windows XP pro advanced center

Equipment New
Vendors : GE , Phillips, Toshiba, Siemens , Hitachi
Recommendation is to get all equipment form single vendor for good price and servicing agreement.

Refurbished
Suppliers: 1) Amber Dignostics : http://www.amberusa.com/ , http://www.amberafrica.com (Located in Cameroon) 2) Block Imaging : http://www.blockimaging.com

Comparison Pricing
Equipment New Refurbished (5 yr old)

1.5T MRI (closed MR) US$ 1.2mil Open MRI US$ 600k 16 Slice CT US$ 650k

US$ 300 to 400k US $ 250k US $ 200k

Maintenance 1.5T MRI - US$ 70k / year Open MRI - US $ 25k / year CT 16 slice - US $15k / year

Equipment Advanced Center

Open MRI , 0.4 Tesla 16 Slice CT Xray Machine Ultrasound machine Mammogram machine BMD

Equipment Sattelite Clinic

Xray Machine Ultrasound machine Mammogram machine

Staffing
Advanced diagnostic center
2 principle radiologists 6 Radiographers 1 nurse 2 front desk staff 3 admin staff

Satellite center
3 radiographers 2 front desk staff 1 admin

Training
Advanced modalities- CT/ MR/PETCT

IT, training of PACs, Telerad

Customer support Specialist Marketing

All centers would have DIGITAL SOLUTION- Fast , Secure, Scalable

Fast & Efficient - When its needed Geographically limitless accessible from anywhere Secure Ensuring absolute information privacy High quality - transmitting demonstrably perfect images Easy to use minimal training and barriers to use = rapid adoption Cost Effective In time and money. Highly Scalable robust for large volume

PACS/ RIS/ TeleRadiology

The TELE-RADIOLOGY Hub model provides entire workflow for an online diagnosis and reporting allowing radiologists to remain in central diagnostic center.

MiniPACs at Sattelite Imaging centers

Advanced Center

MiniPACs at Sattelite Imaging centers

Load Balancing a breeze with teleradiology

Teleradiologists for Load balancing

Teleradiologist

Projections for 1xAdvanced Center , and 3xSattelite centers

-SAMPLE-

Projections have to suit local conditions and prices.

-SAMPLE-

ROI Calculator for Single Modality

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Franchise Model
Establish model center locally Legal documentation
o

Letter of intent, Area agreement, Master agreement

Trademark, Namecards, Letterhead, envlopes, signpost, Uniforms Process, Pre renovation consult, Renovation details, Final preparation, checklists

Creating corporate identity

o

New Center Setup

o

Operational Info
o

Organisational structure, IT linkups, operational matters

Service Quality
o

Philosophy, attire, Customer relations, Complaints structure

Human Resources
o

Recruitment procedure, appraisal, application/ acceptance forms, employee handbook.

Franchise Process
1. A Prospect expresses interest

2. Confidential meeting &offfer

yes

6. Sign agreement

No
7. Set-Up

yes
3. Sign Letter of intent 8. Training 4. Survey of premise 9. Marketing 5. Proposal

10. Opening

No