Much to my surprise (and delight), this is happening with the new Guidelines for Design and Construction of Health Care Facilities (or Guidelines, for short). Though the 2010 edition of Guidelines has only been published for about a month (and the publisher has been struggling to catch up on back-ordered copies), two states have already adopted the 2010 edition as their requirements for licensure.

That’s right, in less than a month, the states of New Jersey and Georgia have already moved to the new 2010 edition of Guidelines, complete with its wholly rewritten section on MRI suite design and safety. What does this lightning-fast adoption of the new edition of Guidelines foretell for the other states and authorities (like the Joint Commission) that use Guidelines for their standard?

"As go Georgia and New Jersey, so goes the rest of the nation..."

“If the Guidelines code is updated every 3 – 4 years, why is this update so significant for MRI suite safety and design?”

Excellent question. The answer lies in what hasn’t been in the past 25-years worth of Guidelines, and that is any sort of design standard pertaining to safety for the MRI suite. Clinical MRI has been around that long, and yet the last edition of the standard (released in 2006) had nothing about MRI safety. If you just compared the number of words in that prior edition, there was nearly 5 times as much guidance for laundry facilities as there was for MRI.

And though it may not be significant from an MRI safety standpoint, a number of authorities – the Joint Commission among them – still reference the 2003 edition of Guidelines! Given the pace of healthcare developments, it’s hard to imagine anything remaining unchanged over a 7-year period. Georgia and New Jersey are just the first in what appears to be a multi-jurisdiction sprint to the new standards (some just staying current, others playing ‘catch-up’).

“What does this mean for MRI suites and the hospitals and imaging centers that build them?”

Among other things, it means that the verbatim cut-and-paste templates from the MRI equipment vendors are now insufficient for state licensure approval (I contend that they, alone, have been insufficient on many levels, but until now state licensure hasn’t been one of them). MRI suites will now have to be designed to respond to the new line-of-sight, access-controls, and ferromagnetic screening requirements in the 2010 edition of Guidelines.

Architects, engineers, equipment planners and facility managers are all having the performance bar raised relative to MRI safety design provisions. Here’s just one section of the new requirements for MRI suite design in the 2010 edition of Guidelines:

2.2-3.4.4.2 Design configuration of the MRI suite

(1) Suites for MRI equipment shall be planned to conform to the four-zone screening and access control protocols identified in the American College of Radiology’s “Guidance Document for Safe MR Practices.”

(2) The layout shall include provisions for the following functions:

(a) Patient interviews and clinical screening
(b) Physical screening and changing areas (as indicated)
(c) Siting of ferromagnetic detection systems
(d) Access control
(e) Accommodation of site-specific clinical and operational requirements

While I was expecting the roll-call of states adopting the contemporary 2010 edition of Guidelines to begin late this spring, or even this summer, I’m very pleased that this has bested my expectations. This means that as of right now, the new MRI safety standards are already required at the state level in Georgia and New Jersey… months ahead of schedule. We may actually see a very sizable number of authorities moved to the current version by this summer, the time I had expected the first adopters to announce.

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Is GE Preparing For The MRI Rebound?

In September / October of 2008, when the bond markets froze solid (the vehicle through which most hospitals get their equipment capital), orders for multi-million dollar MRI machines ground to an abrupt halt. In fact, many pending orders were suspended, or canceled outright. Over the past 18 months, the MRI equipment sales market has remained similarly depressed.

While sales of new MRI’s all but disappeared, the financial stresses on many MRI providers led to a glut of used MRI equipment hitting the market. A provider could buy a gently-used MRI scanner for ten cents on the dollar (as compared to the cost of a new system). But neither the slowdown in purchase of new equipment, nor the increased trading of used MRI scanners, did anything to slow the obsolescence curve of in-service MRI equipment.

In the US, the typical ‘first-use’ life of a new MRI scanner is around 7 – 8 years. The 18 months of depressed sales is equal to the time in which 20% of ‘purchased new’ MRI scanners crossed the fuzzy obsolescence boundary.

To be sure, that threshold has been established with not only technical considerations, but in direct response to competitive forces that have significantly changed in the last couple years. Perhaps ‘first-use’ life will be permanently stretched as a result of the market changes, but the fact remains that many MRI scanners that were slated for replacement a year-and-a-half ago are still in service, awaiting their retirement. Apparently GE is thinking that there will be a number of retirement parties for past-their-prime MRI scanners in the near future.

In Florence, SC, where GE builds the magnets that are at the heart of their MRI systems, a major plan is afoot to increase staffing at the plant. Early in January, the company announced that they were creating 20 – 25 new jobs at the Florence plant.

As questions continue to hit the mass media about the safety of ionizing modalities such as CT, and with breaking new applications for MR such as the first MR-guided heart catheterization, MRI will continue to have a growing clinical demand. This is to say nothing of the aging demographics of the US, and the dramatic increase in imaging utilization based on patient age.

It appears that the long winter for MRI is showing signs of ending, and that spring, though it may be slow to develop, it right around the corner.

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This new publication is intended to assist Architects, Engineers, Designers, Facility Planners, Radiology Administrators, Radiologists and Technologists, in planning the design of safe and effective MRI suites.

To obtain your copy, please click on the cover image, above.