How Old Is Too Old for a Nuclear Cardiology Gamma Camera?Posted on: 09.12.19 by Digirad
Is your practice running an older gamma camera and, if so, how old is “too old” when it comes to those systems?
If you think that manufacturers simply want you to keep upgrading you’re right, but there’s much more to the equation. Here’s when you should be considering upgrading your old camera for a new model:
1. The camera is reaching the ten-year mark
Technologists are very familiar with the cameras they use and any limitations that go with them, so what should cause them to decide it’s time to buy a new camera?
One of the first things is if the camera is ten years old or more. When you’re approaching the ten-year mark, you’re reaching “end of life” support provided for the camera by the manufacturer.
When a camera reaches this age, the original manufacturer has determined that the vintage of the parts is such that they can no longer reliably repair and maintain the system. The OEM is saying that they can’t support the machine anymore to the standards of the industry should be a huge red flag to your clinic.
What happens once the OEM has decided they’re no longer able to offer maintenance for the machine? There is a third-party parts market available – some of those businesses are great, but some are questionable. The specific part you need to repair your older nuclear camera may be available out there somewhere. There are warehouses full of them – some refurbished, say from machines that were sold for parts. It’s a real mixed bag in terms of what’s available.
A lesser-known reason that OEMs declare products as “end of life” is at the subcomponent level rather than the main part. Let’s say there’s a multiplier tube where the tube itself is still available, but there will be a specific connector or other subcomponent that’s no longer available. Once those small pieces can’t be found, that multiplier tube can’t be repaired. While of course manufacturers want you to buy their new equipment, those subcomponents are the greater reason for OEMs ceasing to support the machine.
It’s important to note too, that when we say ten years, we mean ten years since the date of manufacture. If you bought a camera five years ago refurbished and it was ten years old at the time, you have a fifteen-year-old device. This is a risky proposition when you consider needing to make repairs for things like routine wear and tear. As soon as your camera is nine years old, you should be seriously making plans for what you’re going to do about replacing it.Plan to replace gamma cameras that are approaching ten years old Click To Tweet
2. The camera is becoming inconsistent
Every day, technologists perform a set routine of quality control tasks to ensure that the system is operating as it should be. They check that it is performing to its original specifications and that it’s performing well enough to provide diagnostic quality studies.
What can happen is that over time they start to see “specification drift.” The tolerance level (such as for intrinsic spatial resolution) might drift to within plus or minus 10%, then all of a sudden shift outside of those bounds. Now there is a need to get the system serviced, so they’ll be calling in a service person to do this.
While drift does happen, it’s not something that should be common – maybe once or twice a year at the most. If a system starts to drift outside of tolerance levels every couple of weeks or monthly, then it’s suggesting there is an issue with it starting to wear out.
When you reach this stage and you have an older machine, you can face the scenario where it takes several days of your system being down for repairs to be made. Often one thing leads to another and more than one part or subcomponent needs repair or replacing. This is a risk for doctors, especially in competitive markets. If they’re having to ask patients to reschedule, there’s a chance they may go elsewhere. It’s a sign that the machine really is reaching the end of its life when repairs take longer than usual. Regular repairs on a healthy system usually take less than a day.
3. Results are questionable
Another issue related to consistency is if clinicians start to notice that they get a lot of positive studies, or (possibly worse) a lot of negatives. One thing that no one wants is for treatable conditions to be missed because of false negatives. If clinicians are starting to question their confidence in what they’re looking at, then this can be a sign that the camera is too old. Sometimes there will be a noticeable decline in image quality.
4. Further spend on the machine doesn’t make sense
If there is a serious malfunction with the camera, such as where a crystal cracks and you’re looking at putting tens of thousands of dollars into fixing the camera, it is worth pausing.
If you’re going to put $30,000 or more into a camera that is ten years old or more, you’re potentially putting good money after bad. It should give you pause to consider whether that money is better spent being put toward new equipment.
There is often a tendency to grind the most possible use out of any camera. It makes sense when you consider how much is usually invested in the camera. New nuclear gamma cameras can cost over $200,000, so clinics want to get the most they can from them.
On top of that, many physicians assume that “paid for” can’t be beaten. So if they’ve paid off their current camera, they see it as purely producing them profit. However, you need to look very carefully at those numbers.
Let’s say you’re used to doing ten studies per day and your camera goes down for a week. You’re now behind 50 studies. If you’re charging $800 per study, that’s $40,000 behind. You might assume you can simply reschedule patients and make that back, but the reality of any rescheduling situation is that you almost never get all back that you started with. Life happens and people fall through the cracks, while others will be anxious to get their study done and will schedule elsewhere.
If you would have been paying $3,000 per month for a new camera, it only takes four missed studies on the “paid for”, older camera to put you behind where you would be financially with a new camera. These are the kinds of things that need to be factored in, but are often missed by clinics.
5. Newer technology could be a game-changer
Most practices will have their “norms” based on the equipment and processes that they have. For example, if you have an older machine, perhaps six studies per day is normal.
However, newer systems can help to shift the boundaries of what has become the norm for the practice. Instead of six studies per day, you might be able to do twelve or fifteen, significantly improving output.
This plays out with the differences between single, double and triple-head cameras. Over time, more heads win. With a single head, you might try to move patients through more quickly, but as a general rule image quality will suffer.
Newer technology can improve the quality of your outcomes for patients as well as the speed with which you’re able to get results. Let’s just say right now – if you’re still running a single head camera, those were great machines in the 1980s. Newer technology means that it makes little sense to continue running the single head.
Summary: The obvious signs you need a new gamma camera
- The system goes down often
- When the system goes down it takes longer to repair
- The camera was manufactured ten years or more ago
- You want to realize some residual value and the age of the camera is approaching the “sweet spot” of seven years old or less.
- You sense that your practice could benefit from the flexibility offered by newer technology.