Scanner sales stay in the doghouse as facilities streamline operations

But partnering could spark vendor/user bliss

Medical imaging device sales in the U.S. continue to hover inan odd transitional phase marked by general sluggishness interspersedwith spurts of demand for premium technology, according to oneconsultant. These contradictory market conditions will likelycontinue as the U.S. health-care industry accelerates its adoptionof managed-care techniques while facing the uncertainty of governmenthealth-care reform.

On the one hand, new system sales remain sluggish. Vendor discountingcontinues. Users are hanging on to their scanners longer and givingfresh consideration to used, refurbished and lower tier new equipment.

On the other hand, some facilities, fearing that opportunitiesfor premium purchases will decline in the future, go for all theglitz they can get.

"There has been a major market shift in that there ismuch less (imaging) equipment being purchased. The pressure ison (service providers) to figure out how to maximize the use oftheir current resources," said Kenneth C. Johnson, presidentof Kenneth Johnson & Associates of Columbus, OH. Johnson specializesin medical imaging technology and practice planning.

"At the same time, there is a crazy dichotomy," hesaid. "A number of people are saying, `Things are going bad.This may be the last time we will be able to buy. So let's buythe biggest (scanner) with all the bells and whistles.

These two extremes are occurring in the marketplace at thispoint."

As imaging sites stretch out the useful lives of their equipment,they are also approaching the upgrade purchase process with amore critical eye, Johnson said. Users are taking a harder lookbefore automatically buying the streams of upgrade packages offeredby scanner manufacturers.

Part of this heightened upgrade scrutiny could spring froman awareness that vendors are scrambling for revenue to offsetsluggish new system sales, he said. In general, however, administratorsand hospital boards are more closely monitoring imaging technologyon the basis of cost relative to increased clinical utility.

"There is a difference between having the most expensivegadget and providing a quality service," Johnson said. "Ifit can be shown that the newer equipment has an absolute diagnosticadvantage, that may be a factor. But it had better not raise thecost of providing the service. If you do something better butat a higher cost, that may or may not be a winner."

An increasing number of Johnson's hospital and imaging centercustomers are looking for a comprehensive review of current operationsrather than technology assessment of new equipment, he said. Theywant a thorough review of existing technology, procedures, staffingand the physical facility. Following the review, benchmarks areset for reengineering the site and improving operational performance.

"This involves an overall assessment of operations todetermine things that can be done in the short term -- to increaseproductivity and throughput and reduce cost -- as well as reengineeringfor the long term," he said. "Once you buy a piece ofequipment, the question is, how do you maximize the work thatyou do with the least personnel, at the lowest cost, yet providinga high level of service?"The need for imaging departmentsand centers to improve their operations over the long term, combinedwith a desire on the part of equipment vendors to lock in business,has helped create the latest industry buzzword: partnering.

When partnering, vendors work to help their customer sitesperform better and, in turn, are rewarded with additional business.Partnerships could lead to a single-vendor department but aremore likely to involve ongoing user relationships with a limitednumber -- perhaps two or three -- of equipment providers, Johnsonsaid.

If successful, partnerships allow the vendor to develop a fullrange of services for their users, including financing, trainingand upgrades, rather than only offering hardware at a discount,he said.

While there are benefits to both sides in partnering, hazardsexist that could deflate budding relationships, Johnson said.In particular, users don't want to think that their vendor partnersare interested only in shoring up profits.

Talk of vendor partnering is fashionable among users, althougha limited number of relationships have formed, and few have continuedlong enough to prove the concept, he said.

"They (vendors and users) are beginning to enter intopartnerships where the goal is to have that long-term relationship,"Johnson said. "I would equate it to couples becoming engaged.It is not until you have been married for five or 10 years thatyou can really say you have a partnership."