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Letting Go

By John Garrett

Knowing when to let go can be a challenge. You see it everywhere for various reasons. There are emotional attachments, the fear of something new and sometimes there are financial obligations that make it difficult. However, sometimes you just need to let go of equipment and replace it with something new.

Obviously, imaging equipment is not cheap nor easy to replace. The process of deciding to replace equipment is challenging and often painful. After accessing what is available, there is the process of getting quotes, making sure that the capital is available, attempting to keep doctors and users happy or at least grudgingly satisfied with whatever is purchased. Then there is the need for room remodeling, making sure the new unit has a footprint that fits in the space available, and the dreaded interface with IT. The result of buying new equipment should be that there is improved treatment for a patient. But, an X-ray is just an X-ray, isn’t it?

As equipment ages, the hospital or imaging center should be calculating depreciation of the asset. This is with all imaging modalities and medical equipment. From this calculation alone there will be a point where the equipment should be replaced. However, there are times when a major repair will have the hospital in a situation where it is illogical to keep repairing the equipment. When this point is reached, the money spent repairing the equipment would be better spent as part of a new capital purchase. It drives up the hospital’s (or imaging center’s) cost to care for patients. This is not good for the company or the patient. It will contribute to worse outcomes over time. This most commonly happens when there is not a robust capital purchasing plan in place.

What can be done to assist? Having a purchase price and knowing the depreciation of the equipment is a start. There are industry standards for expected life of different modalities of equipment that can be used for calculation, or your CFO can assist. Knowing what you have spent repairing the equipment is key. This should be able to be pulled from your computerized maintenance management system (CMMS). This calculation includes the cost of any in-house labor. What is downtime costing the department? That is an important figure in the calculation.

Knowing the yearly total cost of ownership is key in proper capital planning. This includes preventive and corrective maintenance costs as well as downtime costs. Accurate documentation of these items should be a standard part of the process. This documentation allows for a CMMS to report your cost of ownership. Obviously, as equipment ages it is expected that the yearly cost increases. Working with the owner of the capital process will allow them to make the most informed decisions and plan accordingly.

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