By Jeremy Probst
Less than a year into the COVID-19 pandemic, the medical imaging community began to recognize the inevitability of a post-pandemic surge in diagnostic imaging procedures and the resulting need for additional maintenance to avoid costly downtime. At first, the potential magnitude of the upcoming utilization wave was unknown, and hence, formulating an appropriate response was difficult. Compounding the issue was a rapidly increasing shortage of qualified imaging engineers and the potential for decreased availability of OEM service and parts.
As time passed, healthcare leaders prepared accordingly and made sure their people, procedures, and equipment were ready for the increase in system usage. Many facilities solidified their relationships with OEMs and third-party providers, while others prepared by bolstering their in-house service capabilities. For those who chose the latter, strategies included uptraining their existing biomedical imaging equipment technicians (BMETs), building an in-house inventory of common replacement parts and supplies, putting their installed fleet of scanners into tip-top operating condition, and developing relationships with technical support providers who have the expertise to keep their systems up and running.
Now that vaccines are readily available and some masking mandates have eased, the long-predicted rise in MRI and CT scans has become a reality. However, increased infections due to COVID variants may create a temporary trend back toward lower medical imaging utilization. Whether this will create another surge similar to the first is unknown. However, a new and unexpected player has stepped into the medical imaging arena, and its profound long-term impact on the imaging industry is quickly becoming evident.
The Next Wave of Diagnostic Medical Imaging Utilization: Long COVID
Looking back to a 2020 P&S Market Research report, the U.S. medical equipment maintenance market was expected to experience a growth rate of 9.2% over the 10 years following the pandemic. What couldn’t be predicted then was the recent development of a condition commonly referred to as “long COVID” and its compounding impact on the need for medical imaging utilization. It has become abundantly clear that MRI and CT scans will play a key role in determining the impact of the COVID-19 infection on a patient’s long-term health.
According to studies by the National Institutes of Health, the University of Oxford, Northwestern University, the Alzheimer’s Association, and countless others, a high percentage of coronavirus survivors suffer medium- or long-term reductions in organ health, exercise capacity, cognition, quality of life, and mental health and may even face permanent lung damage. This range of symptoms, known as long COVID, can last weeks or months after the patient has been infected.
Although the reasons behind these effects are still unclear, the studies have demonstrated just how vital CT and MRI scans are in determining the nature, severity, and potential duration of long COVID. For example, according to researchers at Northwestern, traditional imaging techniques “can help explain why someone might have prolonged musculoskeletal symptoms after COVID, directing them to seek the right physician for treatment, such as a rheumatologist or dermatologist.”
Meanwhile, more exotic technologies, like MRI machines using hyperpolarized xenon-129, are coming to the forefront. One Oxford University study found that “the use of cutting-edge scanning techniques may detect previously unseen lung damage” caused by coronavirus infection.
Preparing Imaging Departments and Equipment for a New Level of Care
For mainstream healthcare providers, the appearance of long COVID means that a robust service and maintenance program for imaging systems will continue to be a top priority in the foreseeable future. What was initially predicted to be a temporary surge in utilization may well become the new normal.
The question isn’t whether MRI and CT scanners will play a role in the diagnosis and management of long COVID symptoms—based on current research and clinical practice, it’s clear that imaging systems will be a substantial part of the medical protocols developed—but just how substantial will that role become?
Multiple factors are converging in the post-COVID imaging world, including a lack of qualified imaging engineers, the potential for an industry-wide parts shortage, and the possibility that the current OEM service system is ill-prepared for the upcoming need. If you’re part of medical imaging leadership or involved in equipment maintenance for your organization, this leads to a pertinent question: Is your facility’s imaging department—and your installed fleet of scanners—ready for a permanent increase in system utilization?
To answer this question, three specific areas should be evaluated:
- Service/Maintenance: Do you have in-house service and preventive maintenance capabilities managed by an AAMI Credentials Institute (ACI)-certified imaging engineer, or at least a solid relationship with a third-party service provider who could be there in hours should an OEM repair technician be unavailable? If not, you may want to consider establishing a contingency plan with an independent service organization, or ISO. If the OEM is unable to provide timely service, the third-party relationship you’ve established could prevent excess downtime and a significant loss of revenue. When partnering with a service provider, find one that offers field service with maintenance standards that meet or exceed OEM and American College of Radiology specifications. Look for former OEM engineers and confirm that they provide 24/7 onsite support to ensure peak functionality of your equipment.
- In-House Expertise: If you do have an in-house team, are they ACI-certified and trained to not only repair a malfunctioning scanner but to also prevent downtime and stay on top of new, developing technologies? If you don’t have an in-house service team, now is the time to seriously consider it. Having in-house service capabilities with at least one ACI-certified imaging engineer who’s available at a moment’s notice, is a big part of the long-term success, patient satisfaction, and profitability of the organization. Equally important is that they have access to a technical support team that’s ready and willing to help them troubleshoot with only a phone call. Many ISOs provide this service and it’s often included free of charge with parts purchases.
- Replacement Parts: When a medical imaging device goes down, or needs preventive maintenance, time is of the essence for getting it up and running again. Every hour that’s lost leads to delays in vital patient care and can cost thousands of dollars in lost revenue for the healthcare organization that owns the equipment. In an ideal world, the imaging department would have an inventory of all the parts that could potentially fail. Any service outage could be quickly remedied by replacing the offending part, but it’s often not feasible to keep a large stockpile of replacement parts on-hand, and it’s difficult to accurately predict which part might be needed the next time a machine goes down.
However, there are a few common supplies and spare parts that should always be readily available for quick replacement. A conversation with your OEM or ISO service provider will help you identify them and create an inventory of replacement parts for those that most commonly fail on your installed systems.
While the details of long COVID’s ultimate impact on the medical imaging community are largely unknown, it’s clear that it will have a profound effect on total overall utilization, the development of new technologies, and the need for creating more reliable and cost-effective equipment servicing solutions.
As an imaging professional, having solid vendor relationships, a well-trained staff, an inventory of critical replacement parts, overnight access to parts, and a team of experts who are only a phone call away could mean the difference between surfing the utilization wave or drowning beneath it.
Jeremy Probst is president and CEO of Technical Prospects and the son of company founder, Bob Probst. Jeremy has spent over 19 years in the medical imaging and engineering field and holds a bachelor’s degree in industrial technology management, as well as a minor in electrical control systems and ﬂuid power. Questions and comments can be directed to 24×7 Magazine chief editor Keri Forsythe-Stephens at [email protected].