Marketing, Promotion, Public Relations

The Benefits of “Step & Shoot”
Community Hospital Wins an MRI!
Keys to Recruiting
Award-Winning Patient Campaign Focuses on Quality

The Benefits of “Step & Shoot”

CT with “Step & Shoot” can do a diagnosis of the heart quicker, less expensively, and with less trauma than other procedures.

With a new capability exhibited by two CT units from Philips’ Brilliance family of products, the old is new again. Specifically, a recently added “Step & Shoot” function is actually a throwback to an older, established feature that is used to estimate calcium score. Donald Reed, Philips product manager for cardiovascular CT, describes to Axis Imaging News how it is being used for the first time on a gated, contrast-injected cardiac study. “When you inject contrast, you can see a lot more detail in your heart muscle and coronary vessels,” he explained. “That’s what you need in a diagnostic tool: low dose and good diagnostic imaging quality.” Here is more of what Reed had to say:

IE: Please tell us about the Step & Shoot feature you included in your Brilliance line. What are its benefits?

Reed: On the Philips Brilliance iCT 256-slice scanner and Brilliance 64-slice model, we offer a Step & Shoot Cardiac function, which is a low-dose function. Step & Shoot means that the x-ray tube is only on at discrete steps of the process. The table goes forward to a point, the x-ray comes on, takes a picture, x-ray turns off, and the table moves forward over whatever the coverage is. Typically, 12 to 16 cm for a cardiac scan. For example, the 64-slice scanner has a coverage of 4 cm. You cover 4 cm each time the gantry rotates around it, when you move the table through the spiral. This is called the “z” axis, that direction along the table length. The more you can cover in one rotation, the faster you can acquire the heart, the less time for the patient to hold their breath, and the clearer your final image will be.

IE: So how does this affect reducing radiation dose?

Reed: When you do a spiral CT acquisition, which is the standard acquisition, the x-ray tube is on all the time. If your scan takes 7 seconds, that is 7 seconds of continuous radiation. You can modulate this acquisition to reduce the radiation, if necessary. With the Step & Shoot cardiac protocol, you can move your patient through the same distance in a series of “steps,” but the x-ray tube is on only at that discrete acquisition point. The scanner is only taking a picture (acquiring the data) at a point when the table is stationary. With the 256-slice, your heart is taken in two pictures (with the 64-slice, four pictures). They are put together, and you have your diagnostic image, plus the dose is 80% less than that done on a typical spiral acquisition. When you look at radiation dose, a normal spiral CT will be in the range of 10 to 15 mSv. If you do a Step & Shoot cardiac, it will be somewhere between 3 and 4 mSv. Background radiation for people living in the United States is around 3 mSv per year.

IE: From a marketing and economic perspective, why is this technology an important advance?

Reed: The CMS is requiring that physicians and industry prove cardiac CTA’s efficacy through economic and clinical outcomes. Basically, why is CT such a good technique for a procedure or instrument to market? It can do a diagnosis of your heart quicker, cheaper, and with less trauma than the other procedures. This diagnostic imaging is more accurate than existing testing. If you get chest pain, maybe you feel like you’re having a heart attack, you go to your cardiologist. What they can do is put you on an ECG and take some blood for enzyme analysis and try to determine that you need a diagnostic cath, or a stent put in, or you need to have surgery, or send you home with aspirin. This standard of care can take up to 23 hours.

If you go back to the same patient with the same chest pain story, and if there is an indeterminate or unreliable ECG or enzyme result, then you could use CTA for diagnosis. The patient gets the results quicker, noninvasively (versus diagnostic catheterization), and cheaper, compared to waiting in the observation room, which has costs associated with it.

—Elaine Sanchez

Community Hospital Wins an MRI!

In late January, Siemens Medical Solutions awarded Lockport Memorial Hospital with a brand-new Magnetom Essenza MRI. The upstate NY community hospital created the winning video for Siemens’ “Win an MRI” contest.

Knowing how to promote your institution can win you more than referrals. Just ask the folks at Lockport Memorial Hospital in Lockport, NY.

In October 2007, Siemens Medical Solutions, Malvern, Pa, launched an online video contest through which community hospitals could compete to win a free Magnetom Essenza MRI system. More than 100 US hospitals posted short videos at, and the public was invited to vote as frequently as they wanted for their favorite hospital. In 2 months, the contest generated 1.4 million total votes; the most votes went to Lockport Memorial Hospital for its “Is It Here Yet?” video.

“We’d never made a video, so all of us were rookies,” said Susan Wendler, director of development, community relations, and volunteer services at Lockport. “We did all our own editing using Movie Maker, we used the staff’s own video cameras, and then it was edited and presented to the administrative team and the Board for comment.”

The video humorously portrays clinical situations in which an MRI is necessary, highlighting Lockport’s lack of an in-house MRI. Throughout the video, patients and clinicians repeatedly ask the provocative question: “Is It Here Yet?”

“A group of employees, managers, and supervisors brainstormed the idea,” explained Wendler. “They were very clever, because the phrase ‘Is It Here Yet?’ made a great slogan.”

The team at Lockport decided to keep the video short and snappy—though the contest rules permitted videos to run as long as 2 minutes, “Is It Here Yet?” clocks in at just over 1 minute. “We wanted it to be fast-paced, funny, but in good taste,” said Wendler. “One of our strategies was to get the video up as early as possible to get the longest length of time for voting. If we were going to win this, we needed to get all the votes we possibly could. Then, while the video was being edited, we started thinking about a promotion team.”

Wendler credits Lockport’s strength in the competition to aggressive marketing in the community—all linked to the “Is It Here Yet?” slogan. “It made great buttons,” she recalled. “We had a sign out front; we had a sign on the local theater marquee; pizza parlors put our stickers on their takeout boxes; restaurants handed out our pens with people’s bills.”

It didn’t stop there. Lockport employees went out to local businesses and schools to encourage anyone with access to a computer to vote as frequently as possible; promotional items printed with the slogan were handed out at fall and winter holiday events. “To keep energized with voting every day for that length of time is a big deal,” said Wendler. “Our local newspaper was phenomenal with stories about the MRI, encouraging voting and letting the community know where we were.”

All of this was accomplished on a minimal budget, Wendler notes. “We kept it pretty bare bones,” she said. “We tried to utilize our staff as much as possible. We did a lot of printing in our hospital print shop. We purchased pens, pencils, buttons, and wrapped candy, and a local screenprinting business printed up some leftover T-shirts with the slogan and donated them to us. The paper donated advertising space. We had to spend some money, but as fund-raisers go, this was very economical.”

In addition to winning Lockport a much-needed MRI, Wendler says the competition helped the hospital in other, less tangible ways. “We won the MRI, and that’s wonderful, but there were other benefits,” she said. “It united staff members who normally don’t work closely together, and it also made a lot of friends for the hospital in the community. It was a fund-raiser without asking anybody for a dime.”

—Cat Vasko

Keys to Recruiting

Facilities looking to recruit radiologists might want to know that more free time to spend with family and less politics were among the changes radiologists wished to see in their practice of medicine, according to a survey conducted by

Of the approximately 200 respondents, 42% indicated that they plan to change their job within the next 3 years, with more than half of them preparing to do so within the next year. Almost half of the participants (49%) will turn to networking and word of mouth to find their new employer, followed by 19% using recruitment agencies. About 110 radiologists said that when making a job change, they seek places that offer better work environments or better communities.

“Radiologists are among the top earners in medicine in part because of the cost of their medical liability insurance,” said Katie Thrill, vice president. “Declining reimbursements and physician shortages mean greater time pressure and often longer hours to provide care for an expanding patient base.”

Furthermore, 28% said higher compensation would be the top reason for a job search. According to the survey, the average annual salary of a diagnostic radiologist is $343,330, while interventional radiologists earn $479,629 on a yearly average. Physicians practicing in suburban areas make an average of $357,353, metropolitan areas $349,380, and rural communities $288,083.

Medical liability issues topped the list of frustrations for physicians, with 31% of respondents claiming this as their number one concern. Malpractice statutes, defensive medicine, lawyers, and politicians were factors that aggravated the working radiologist. “I am all for getting bad doctors out of practice and holding people accountable,” wrote one doctor, “but there has to be the same amount of accountability on the patient side, and damages should be paid to doctors who win their cases.”

Also, 24% of the radiologists polled said what bothered them the most was reimbursement issues, or, as one participant put it, “constantly declining reimbursements in the face of more demands for immediate perfect service.”

Yet despite these concerns, 70% of respondents said they’d stick with medicine even if they were presented with the opportunity to plan their careers all over again.

“I like the diagnostic challenges that radiology presents,” one radiologist wrote. “My daily work is akin to solving a math problem or crossword puzzle. I have to put the pieces together to come up with an answer that works.”

—E. Sanchez

Award-Winning Patient Campaign Focuses on Quality

Northwest Radiology Network radiologists Lori Wells, MD, and Eric Elliott, MD, view CT images at one of the group’s four outpatient locations.

Northwest Radiology Network (NWR), a comprehensive subspecialty inpatient and outpatient and related services provider based in Indianapolis, knows that when shopping for health care, quality counts. And that is precisely the message it has relayed to its community of patients and referring physicians, a slogan declared in its billing statements, order forms, and an award-winning Patient Guide that is revamped each year.

“Shopping for healthcare? …Quality Counts!” the documents proclaim.

Available at all four of its freestanding imaging centers and distributed to the offices of referring physicians, the Patient Guide was crafted for patients to learn not only about NWR, but also about their exam procedures, preparations, and expectations. The annual edition of the Patient Guide features new radiologists, new modalities, and new facilities.

“What we are trying to convey not only to patients, but also to referring physicians, is that with the high costs of health care, we want people to realize that we may not be the cheapest, and we are certainly not the most expensive; however, we do offer the best quality imaging,” said Debbie Lawrence, marketing manager, adding that all of the practice’s modalities, technologists, and radiologists are board-certified and accredited by the American College of Radiology. “When patients start to comparison shop, they will find out that we stand out from the competition.”

The Patient Guide is an 8.5 by 11 high-gloss covered magazine written in lay terms, informing patients on what to expect and helping them to understand the steps involved in their procedures. The front and back covers are an eye-catching bright red and white. This way, a patient can notice the publication, read through it, and hopefully reduce any fears or anxiety they may have.

“It has been stated that one patient tells 20 others of their experiences, therefore, we want to make our patients happy with all aspects of their imaging experience and encourage others to use our services,” Lawrence said.

In addition to the Patient Guide, NWR has also designed informational brochures on its different modalities and specialties, such as MRI, PET-CT, and CT for Oncology. These are distributed to patients and their families. All are invited to offer feedback through Patient Satisfaction Surveys that provide them with a forum for compliments, constructive criticism, and suggestions. “Whenever there is a major patient concern voiced to us via the Patient Satisfaction Surveys, we address it directly with the patient if they have left their name on the survey,” Lawrence said. “Many times, patients are pleasantly surprised and pleased with our responding to them so quickly, directly, and personally.”

Last April, Lawrence found herself in a similar position. Winners for the Radiology Business Management Association (RBMA) Quest Awards were announced at the organization’s Radiology Summit Meeting, which Lawrence couldn’t attend. However, she was able to log into the RBMA Web site to read the good news: Northwest Radiology had earned three awards. Specifically, its Web site won a gold award, while its patient marketing received the highest platinum award. Even more, NWR had been awarded the “Best of Show” platinum distinction for its patient campaign.

“While I take great pride in my job and these awards, to me these awards are indicative of our teamwork at NWR—not just from a marketing standpoint, but from everyone employed by our company filtering down to the patient,” Lawrence said. She also pointed out that not being a graphic artist, she has reached out for assistance with colors, graphics, and designs from two firms, Bellamy Designs of Southlake, Tex, and Hightower Graphic of Indianapolis.

Next up for the NWR are preparations for the kickoff of an Informative Breakfast Series, directed to referring physician office personnel. The gatherings, which will be held early in the morning before typical office hours, will consist of a continental breakfast, discussion session, and international speakers. Lawrence said she continually strives to establish a good rapport with referring physician office personnel.

Nevertheless, the Patient Campaign will continue to be NWR’s main focus. As Lawrence puts it, “Without our patients, we can not survive.”

NWR has a staff of 180 employees and is composed of four freestanding imaging centers and a business headquarters. Additionally, it reads for 10 hospitals, ranging from large institutions to small facilities, and eight other imaging facilities that range from women’s health centers to MRI centers.

—Elaine Sanchez