Digital Health

Site Neutrality | Elekta Out of MEG | More Focused US Breakthroughs

“With today’s proposed rule, CMS has once again showed a lack of understanding about the reality in which hospitals and health systems operate daily to serve the needs of their communities.”

American Hospital Association EVP, Tom Nickels, taking a stand against CMS’ proposal to adopt a site-neutral fee schedule for outpatient services.



The Imaging Wire


Elekta Sells MEG Business
Elekta agreed to sell its magnetoencephalography (MEG) technology business to Croton Healthcare subsidiary, York Instruments, as part of Elekta’s strategic decision to prioritize its treatment solutions and oncology informatics portfolio. MEG is a diagnostic functional neuroimaging technique for mapping brain activity, finding locations of abnormalities in clinical settings and measuring brain activity in research settings. Elekta’s MEG business, known as MEGIN, has more than 100 systems installed worldwide and SEK 102 million in annual sales ($11.5m), making Elekta (and now York) a leader it this space. However, given that Elekta generated over $1.28 billion in revenue last year, MEG was a relatively small contributor to its overall business.


Focused Ultrasound Breaks the Brain-Blood Barrier
Focused Ultrasound Foundation-funded researchers in Canada made a major advancement in the treatment of neurologic disease. The potential breakthrough was achieved by injecting microscopic bubbles into patients’ bloodstream and applying MRI-guided focused ultrasound waves to target the bubbles at the blood-brain barrier, temporarily opening the membrane to apply drugs. The blood-brain barrier protects the brain from germs and other threats, but historically blocks drugs that could treat neurologic diseases like Alzheimer’s and brain tumors. Initial research tested if patients’ fragile blood vessels could withstand the breach without bleeding or other side effects, and although more safety testing is needed, the new approach is definitely promising.


CMS Proposes Site-Neutral Fee Structure
CMS proposed a new ‘site-neutral’ fee structure that would pay all healthcare providers the same for performing the same outpatient procedures starting in 2019, regardless of whether services were delivered in a hospital outpatient department (currently higher payments) or a non-hospital outpatient site such as a doctor’s office or clinic (currently lower payments). This uneven payment structure has been a major driver behind healthcare provider consolidation, as hospitals started buying doctor offices and rebranding them as outpatient departments able to charge higher Medicare rates. The proposal would reduce Medicare costs by $760 million and save patients about $150 million in co-payments in 2019 alone, making the fee structure change popular across political parties. However, hospitals unsurprisingly hate the idea of a 40% reduction in off-campus hospital clinic rates and a 1% cut to their $75 billion in annual Medicare outpatient billings, calling it reckless and suggesting that it shows CMS’ lack of understanding of the healthcare system. It will be interesting to see if CMS will hold strong in the face of this objection or if it will compromise with hospital groups.


Blood Test May Mean Fewer Brain CTs
A study from the University of Rochester School of Medicine found that administering the FDA-cleared Banyan Brain Trauma Indicator blood test within 12 hours of a suspected traumatic brain injury may reduce the use of CT scans by a third. The blood test would replace the use of subjective markers (headaches, nausea, or light sensitivity) to identify patients with potential brain trauma bad enough to require a head CT scan. In the study of 1,959 patients, the blood test was found to correctly identify 99.6% of patents who did not have a traumatic intracranial injury and 97.6% of patients who did have a traumatic brain injury. However, some in the research community voiced concerns about this study, claiming that the researchers didn’t prove whether the blood test was more effective than current biomarkers and therefore may not be clinically or financially beneficial.



The Wire


  • University of Oxford scientists found that applying focused ultrasound from outside the body can improve the delivery of cancer drugs to tumors. The scientists injected heat-sensitive capsules filled with a chemotherapy agent and then heated the tumors via focused ultrasound to release the drug to the tumor. This approach may reduce required dosage for cancer treatment, limit the toxic impact of chemo on other parts of the body, and create new approaches for tumors that are hard to treat with conventional chemotherapy. The number and variety of focused ultrasound breakthroughs emerging each month is impressive.
  • Sectra announced the installation of its DoseTrack cloud-based enterprise radiation dose monitoring software at the Memorial Hermann Health System in Southwest Texas. The software collects patient radiation exposure data throughout the imaging department, ensures compliance with regulatory requirements, and standardizes radiation dose data across the enterprise.
  • GE Healthcare Korea installed its PETtrace 880 cyclotron with a complete PET radiopharmacy suite at the Korea Institute of Radiological & Medical Sciences (KIRAMS), making the nuclear medicine institute the 400th GE-branded cyclotron production facility worldwide. The new KIRAMS cyclotron will be used to support cancer diagnosis, treatment, and drug R&D.
  • A new study from Emory University found that the expanding adoption of breast density notification laws (now at least 35 states) increased the use of follow-up ultrasound evaluations after mammography screenings by 1.02% between 2007 and 2014 (when there were laws in roughly 17 states). The breast density notification laws require that providers inform women if they have dense breasts and advise them to consider additional imaging options, driving the increase in follow-up ultrasounds.
  • Philips Canada named Jeffrey H. Barnes as the company’s new president and CEO, succeeding Iain Burns after roughly 18 years on the job, and now reporting to Philips North America CEO, Vitor Rocha. Barnes takes the Canada CEO role with 27 years of experience, most recently serving as Philips Healthcare SVP and North American Commercial Leader, with responsibility over Diagnostic Imaging (MR, CT, and Cardiovascular X-Ray), Patient Monitoring, Ultrasound, Ventilation, Defibrillation and Home Healthcare.
  • Frost & Sullivan forecasts that AI will accelerate and improve image analysis, lead to cloud-based AI marketplaces, bring more cognitive applications to improve medical imaging workflow, and lead to the development of imaging devices with embedded AI.
  • Canon Medical Systems installed its Infinix-i Dual Plane angiography system at Slidell Memorial Hospital in Slidell, Louisiana, highlighting that the new system allows the hospital to perform coronary and peripheral vascular interventional procedures in the same room.



The Resource Wire

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