Tag Archives: detection

Is Ferromagnetic (Ferrous) Detection Cost Effective?

In a word, ‘Yes,’ but not by the conventional ways that imaging providers are accustomed to...

Would using ferromagnetic detection (FMD), to add a new and effective layer of pre-MRI screening, be reimbursed? What I mean is, is there a CPT code to get paid back for providing this additional service?

No, but the lack of a CPT code has little to do with the fact that using FMD can contribute, directly, to an MRI provider’s bottom-line. In fact, there are two concrete ways, off of the top of my head, that I know have provided financial ‘payback’ to users of ferromagnetic detection systems.

Click Here To Learn How FMD Pays Back…

5 Phases Of Ferromagnetic Detection Acceptance

Ferromagnetic detection for pre-MRI screening is disruptive. Not that it slows down your patient throughput (it doesn’t), or that it makes imaging problematic (it doesn’t do that, either), but it does provide an entirely new type of feedback that MR staff and Technologists have never had before. It tells us whether subjects are actually listening to the self-screening instructions we’ve been giving for years. These instruments, more precisely the feedback that they provide, does take a little getting used to. The introduction of ferromagnetic detection is often met with 5 steps towards acceptance…

Click Here To Learn The 5 Phases. C’mon. I Know You Want To…

The Supreme Court, MRI Accidents, And You…

Last year, the United States Supreme Court decided that medical device manufacturers that had gone through the trial-by-fire of a FDA pre-market review are immune from civil action in the state courts for product liability (Riegel v. Medtronic). Just a few weeks ago, the Court threw what many considered to be a major curve-ball when they decided that comparable protections do NOT apply to pharmaceutical manufacturers (Levine v. Wyeth). What does this suggest to MRI providers (Technologists, Radiologists and Administrators)?

Click To Learn What This Supreme Court Decision Suggests…

MRI Safety Nets: The Holes We Don’t Know About

“You don’t know what you don’t know.”

This phrase isn’t meant to make anyone feel small. It doesn’t mean “you should know,” or “everybody else knows this,” or even that “the guy writing this knows.” This phrase is very democratic… it applies to each of us (particularly the guy writing this).

What it means is that, if our brains are libraries, even big ones, there’s only so much information that can fit inside. We may know the next 10, 100 or 1,000 books we want to add to our mental Alexandria, but we can’t want (or even hate) the book that we don’t know exists. The same is true of MRI safety.

Click to read more about protecting against MRI accidents…

New MRI Safety Standards Published By ASHE

The American Society for Healthcare Engineering (ASHE) has just published a monograph for those planning MRI installations and the design professionals (architects, engineers and equipment planners) who help them.

ASHE MRI Safety Monograph

Click to read more on the content and ordering options for the ASHE monograph…

27.5 Million People DON’T Want Their 175% Raise!

27.5 million people… That’s how many people the healthcare market research company IMV estimates received MR exams in the US in 2007. Other estimates put the number over 30 million, but regardless of whichever number you use, we’re talking about a lot of people (27.5 million is roughly equivalent to those living inside all of the 13 most populous cities in the US)!

And when I say that these millions of people don’t want the 175% raise they’ve received, I’m not referring to their salary. No, the raise that these millions of people got — and most definitely don’t want — is … Click To Learn What 175% Raise They Got…

MRI Safety at AHRA Fall Meeting

Last month, I was honored to have been given the opportunity to present to one of the national American Healthcare Radiology Administrators (AHRA) meetings. In October I gave a presentation on the current state of MRI Safety, including regulatory, legal and accreditation changes that are all in the works.

The full presentation was 90 minutes, including an extensive audience Q&A, but I’ve pulled out one particular section that is particularly relevant to our topic at hand, ferromagnetic detection for MRI pre-screening.

The video excerpt below addresses forthcoming changes to the ‘Guidelines for Design and Construction of Health Care Facilities’, a poly-cyllabic mouthful that roughly translated means the healthcare building code, and changes regarding MRI suite design…

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As mentioned in the video above, the proposed changes to the healthcare building code are currently open for public review and comment. The proposed language includes references to the ACR 4-zone principles as well as planning for ferromagnetic detection.

If you would like to see, review or even comment upon the proposed changes to the hospital and healthcare provider building code, public comment for the ‘Guidelines’ is open until December 15th, 2008.

Tobias Gilk, President & MRI Safety Director
Mednovus, Inc.
Tobias.Gilk@Mednovus.com
www.MEDNOVUS.com

MRI Safety Planning Season

Ahh the four seasons… Winter, Spring, Summer, and MRI Safety Planning.

What, you’ve only heard it referred to as ‘Autumn‘ before? Well, that’s not terribly surprising. We’re so inundated with honorary days, weeks, and even months, that the season of MRI Safety Planning fails to get its fair share of media time. But here’s why MRI Safety Planning season should be tops on your list right now.

First, while there is a growing awareness of MRI Safety Week, a single week doesn’t really afford the time needed to plan for improvements to MRI safety. Real improvements come from refinements in operations and process, coupled with effective tools and training. That sort of interdisciplinary approach often requires more than a couple days to put together.

Second, MRI Safety Week falls in the middle of summer when budget-wrangling loses the attention-span battle to thoughts of barbecues and coco-butter suntan lotion. It is precisely now, when so many organizations are hammering out their financial priorities for next year’s budget, that MRI safety planning should be in full-swing.

By combining the operations planning with the budgeting, you can reap some real multi-task benefits from these synergistic efforts, and – buoyed by the support of our whole Mednovus organization – I’m here to help you make it as productive as possible.

When making your MRI safety plans, it’s important to know what new criteria are going to be expected of your facility. Accrediting bodies are all looking at MRI safety in a new way, and this is starting with the Joint Commission’s Environment of Care requirements, effective January of 2009.

There is also the flurry of recent MRI safety Best-Practice recommendations from a number of documents, all of which should be part of the Administrator / Technologist library of reference materials. One common element to the Joint Commission’s Sentinel Event Alert #38, the ACR’s Guidance Document for Safe MR Practices, and the recent Veterans Administration MRI Design Guide, is the recommendation for the use of ferromagnetic detection (see below).

While ferromagnetic detection systems can be readily incorporated into both new and operational MRI facilities with minimal muss & fuss, even the most easily-installed and cost-effective systems typically require advanced budgetary planning.

The upshot? Please start thinking today about your planned MRI safety improvements for 2009 and budget accordingly.

Whether you’re considering the newly-released Mednovus Sentinel® GS 2.0 portals (both the 24-inch Patient Sentinel® GS 2.0 and the 48-inch Entry Sentinel® GS 2.0) or our SAFESCAN® hand-held Target Scanner™ (or the optimal combination of both), it would be a privilege to be at your service.

We at Mednovus are delighted to announce our new association with Siemens Medical Solutions, a world leader in MR imaging, and we encourage you to contact your local Siemens sales rep to get product quotes for your budgeting purposes. Alternatively, simply let us know where you are located, and we will put you in touch with the appropriate Mednovus product expert from Siemens’ national accessories division. Contact us soon so that we can arm you with the information you need to secure MRI safety improvements in next year’s budget.

Yes! Please put me in touch with the right Siemens’ accessories product expert!

By reviewing your current MRI safety protocols against published best-practices, and soon-to-be accreditation standards, you can prioritize the areas for improvement in 2009. In many cases, no-cost operational changes will help you achieve your goals, but whether it’s a new MRI-friendly infusion pump, improved signage, or the thrice-recommended ferromagnetic detector, you will probably need to have a few MRI safety line-items in next year’s budget.

Please contact us if we can be of any assistance in helping you with your observances of MRI Safety Planning season.

Tobias Gilk, President & MRI Safety Director
Mednovus, Inc.
Tobias.Gilk@Mednovus.com
www.MEDNOVUS.com

Inside The Scanner Room? Too Little, Far Too Late!

Many facilities planning for ferromagnetic detectors, particularly existing MRI providers who must retrofit the new technology into tight-fit suite layouts, have a hard time finding optimal locations for the new MRI pre-screening instruments.

Real estate within the outer walls of the hospital is at such a premium that a good proportion of MRI providers are already working within MRI suites into which their large (and frequently growing) operational requirements have been shoehorned-in. They could really do with several hundred additional square feet, so the addition of anything to the suite can trigger a domino series of complications.

Pass-through ferromagnetic detection portals, such as the Mednovus Sentinel® series products, can be sited as either free-standing or doorway-mounted instruments. One caveat for doorway-mounted versions is that the door should not swing through the aperture of the portal (door hardware, even on most RF-shielded doors for MRI suites, has ferromagnetic components and would set off the detector). This means that there is one side of the doorway that is ill-suited to receive a mounted portal.

For MRI suites where space is already at a premium, it is sometimes felt that mounting a ferromagnetic detector at the door into the magnet room is the only place where both existing operations and available space will permit.

But if the door to that room swings out (as is currently recommended by the majority of MRI equipment manufacturers), can you put the detector on the other side of the doorway; on the inside of the MRI scanner room? Physically, yes, you can put the instrument there. Physically, you could also use your MRI scanner room as a waiting area for patients with unknown medical implants and devices, but both ideas would have grave dangers.

The intention of ferromagnetic detection is to alert you to the presence of magnetically attracted materials before they get close to the magnet. Placing a ferromagnetic detector inside the room would only be less effective if were mounted at the face of the bore of the magnet.

Since it often takes a moment to react to the alarm of a ferromagnetic detector, the step or two that a person may take past the ferromagnetic detector isn’t typically a problem outside the MRI scanner room, but in the room where inches can make enormous differences in the magnetically attractive effects, those couple steps can make the difference between avoiding an accident or cleaning-up after one.

Couple the compromised effectiveness with the fact that – at one time or another – everything needs servicing, and you’ve introduced another object into the MRI scanner room that may necessitate servicing from workers with tools. The attempt at increasing safety has actually introduced a new opportunity for accidents.

Lastly, MRI equipment manufactures are (justifiably) nervous about the introduction of equipment into the room which supports the MRI scanner. Does this other equipment emit RF noise that might interfere with the MRI images? Is it going to compromise the function of the scanner? Will the magnetic fields of the scanner adversely effect the other equipment?

In response to these concerns, MRI equipment vendors typically prohibit equipment or devices that haven’t been tested and deemed non-disruptive. Even just placing a ferromagnetic detector inside the MRI scanner room would very likely void significant portions of your MRI manufacturer’s warranty.

The fact is that there are often alternate locations for siting of a pass-through ferromagnetic detectors. It may take a little creative thought or a willingness to slightly modify operational protocols, but typically there are a handful of possibilities for each site. There is no reason – whatsoever – to place a ferromagnetic detector inside the MRI scanning room, and it is extremely ill-advised to do so.

Tobias Gilk, President & MRI Safety Director
Mednovus, Inc.
Tobias.Gilk@Mednovus.com
www.MEDNOVUS.com

New Joint Commission Environment of Care (EC) Requirements

Starting in January of 2009, the drought of MRI safety regulation will begin to end.

It surprises many that the Joint Commission has no specific MRI safety accreditation standards. Surveys of accredited MRI providers have, over the past many years, focused largely on general safety standards, adapted for the MRI environment. Historically, a surveyor’s check for a non-magnetic portable fire extinguisher was the only MRI-specific safety check provided by the Joint Commission.

Despite the fact that many MRI-specific safety articles, recommendations, and, most recently, Sentinel Event #38 have been offered by the Joint Commission and its allied Joint Commission Resources educational arm, there have not previously been specific MRI safety standards for accreditation, and it is only through the new Environment of Care requirements that MRI safety will become an implicit standard for Joint Commission accredited facilities.

Starting this coming January 2009, inpatient and outpatient accredited facilities will need to abide by the new Risk Management provisions of the Joint Commission Environment of Care standard. The Standards Improvement Initiative will require facilities to prospectively define the physical hazards within the facility and develop specific responses to manage and mitigate those hazards.

The new standard specifically cites Sentinel Event Alerts as one external reference that must be considered in defining risks. For MRI, this automatically means Sentinel Event Alert #38. And since SEA #38 draws so heavily from the ACR Guidance Document for Safe MR Practices: 2007, it only follows that the ACR Guidance Document is the underlying industry standard document for defining MRI safety. Another external reference that specifically addresses MRI physical hazards which should be used as a basis for risk analysis is the VA MRI Design Guide.

What do Sentinel Event Alert #38, the ACR Guidance Document, and the VA MRI Design Guide all recommend? Well, lots of common elements, actually, but one of the key recommendations is for the use of ferromagnetic screening (click here to download a PDF document that outlines many of the recent recommendations for ferromagnetic detection).

While it is starting with the Joint Commission Environment of Care, my expectation is that MRI-specific patient safety requirements will spread to other accreditation requirements, building codes, and standards of practice. This will include not just recommendations, but requirements for the use of ferromagnetic detection for MRI pre-screening.

Over the next few months, all Joint Commission accredited MRI providers will need to review the standards of practice in the ACR Guidance Document for MR Safe Practices. Specific actions must be taken to identify, document, and respond to the unique hazards in the MR environment. One of those immediate actions should be planning for ferromagnetic detection at your MRI facility.

If you have any questions about the new MRI safety standards, the best-practice recommendations for ferromagnetic equipment siting, and incorporating these vital safety instruments in your MRI screening practices, I recommend that you heed the advice of the ACR Guidance Document, the VA MRI Design Guide, and other safety practice documents. If you still have questions about these standards, I invite you to contact me.

Tobias Gilk, President & MRI Safety Director
Mednovus, Inc.
Tobias.Gilk@Mednovus.com
www.MEDNOVUS.com