Some Straight Talk on Bringing Medical Imaging to the Patient

“We offload the equipment, roll it into the setting and we image at the location. At the end of the day, we roll it back into the van and drive away.”

Marty Shirley, President, Diagnostic Services, Digirad.
Image Credit: Shutterstock.com

Mobile medical imaging is certainly not a new phenomenon. Mobile x-ray systems were used on the battlefield in both World Wars. Mobile chest x-ray units could be found on many street corners during the 1950s as the country grappled with the TB epidemic. Even shoe stores had fluoroscopic units in place so customers could check the fit of a pair of shoes before purchase. (Really, I’m not making this up.)

TB unit image credit: American Lung Association
Shoe-fitting Fluoroscope Image Credit: Wired.com

The COVID-19 pandemic has posed many unprecedented challenges to the healthcare system. And imaging providers had to innovate new ways for imaging seriously ill COVID-19 patients while minimizing risk to staff. For example, a new chest x-ray technique implemented during the COVID-19 pandemic of imaging patients through glass produced diagnostic-quality radiographs while reducing hospital costs and infection risk.

Image Credit: RSNA

And health care systems have been providing mobile mammography, CT, MRI for years now.

Image Credit: USA Today

So why talk about this now? – Advances in technology, computerized imaging, AI, and networks have opened up new opportunities to bring medical imaging directly to patients, whether inpatient, outpatient, or in the home or workplace. Also, the cost of some of these systems has been reduced significantly, thus eliminating some of the traditional barriers to entry of other competitors in health care.


What imaging modalities can be delivered to the patient wherever they are? – We are used to providing portable x-ray, mobile c-arm fluoroscopy, and mammography to patients already. Recently, with the development of portable CT scanners, we’ve seen an increase in their use in ICUs, ERs, and ambulance services to help diagnose stroke patients and screen for lung cancer at the point of care.

Image Credit: UCLA Health

What’s new in this space is the development of low-cost technology like portable MRI and handheld ultrasound units. I’ve long been impressed with the work being done by Jonathan Rothberg and the companies he has spun out of his 4Catalyzer firm. Last year, Hyperfine, his portable MRI company, received FDA clearance for their Swoop system. This low-field MRI system can be easily moved, plugged into a conventional wall outlet, and run from an included tablet. Although the system is currently cleared for neuroimaging, the company has plans to expand its use to other areas in the future. Butterfly, his point-of-care ultrasound company, has demonstrated the use of their handheld systems in multiple clinical settings, including anesthesia, cardiology, critical care units, emergency medicine, musculoskeletal imaging, OB/GYN, and primary care.

Swoop Portable MRI Image Credit: Hyperfine, Inc.
Butterfly IQ Image Credit: Butterfly Network, Inc.

“Providing ultrasound at the bedside where the patient really needs it is a huge innovation and a step forward for health care.”

Gary Cohen, M.D., Diagnostic Imaging Chair and Professor, Radiology, Temple University Health System

Where are the business opportunities in mobile imaging services? – In addition to the traditional use cases in both inpatient and outpatient imaging, providers should explore potential business opportunities and partnerships in the following areas:

  • Nursing Homes & Assisted Living Facilities
  • Hospital at Home programs
  • Home Health & Hospice facilities
  • Urgent Care Centers
  • Physician Offices
  • LTAC & Rehabilitation Centers
  • Surgical Centers
  • Behavioral Health Centers
  • Sports Teams – Professional, College, High School, Community
  • Community Health Centers
  • Companies with on-site health clinics
  • Industrial Plants & Refineries
  • Correctional facilities

What are some of the qualifying reasons for mobile imaging services at the point of care? – Insurance carriers will generally reimburse for mobile imaging at the point of care for various reasons. Some of the most common are:

  • Bedridden due to illness
  • Chronic disease
  • Contact isolation
  • Continuous IV
  • Dementia
  • Fall risk/status post fall
  • Injury
  • Medication (adverse side effects)
  • Mentally challenged
  • Pneumonia
  • Oxygen dependent
  • Senile/confused
  • Unresponsive
  • Weakness/frail
  • Wheelchair bound

Benefits of mobile imaging services – Mobile imaging services help care providers conduct many kinds of essential screenings, actively monitor a patient’s condition, and are flexible enough to accommodate patients in any environment. Most importantly, mobile imaging is considerably faster and measurably cheaper than other alternatives. With 24 hour turnaround times and near-instant access to imaging scans through online portals, mobile imaging allows care providers to diagnose issues in a much faster timeframe than third-party providers. This shorter time frame, combined with the flexibility of mobile imaging, leads to less overall operational expenses for care providers.

“If there’s one thing we’ve learned through the hub-and-spoke model we’ve adopted for our health system, it’s that we need to meet people where they are rather than have them travel to us for their care.”

Albert Wright Jr., President and CEO, West Virginia University Health System

My take – I believe that we are at the beginning of a new growth phase in the deployment of mobile medical imaging. The mobile radiology trend is anticipated to receive a considerable push from increasing focus on point-of-care testing and ongoing advances in this direction. The concept is expected to play an essential role in complementing traditional imaging practices and enabling users to perform many radiology examinations effectively. Amid the COVID-19 crisis, the global market for Mobile Imaging Services, estimated at US$1.7 Billion in the year 2020, is projected to reach a revised size of US$2.2 Billion by 2026, growing at a CAGR of 4.5% over the analysis period. The Mobile Imaging Services market in the U.S. is estimated at US$542 Million in the year 2021.

If you take into account the rise in the elderly population, the COVID-19 impact, the increase in hospital at home programs, the increase in the prevalence of cardiovascular diseases, renal disorders, neurological disorders, and cancer, and the increase in the awareness among the people about these mobile services, health care providers should give serious thought to expanding these alternative options as part of their overall imaging strategy.

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