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The Imaging Gap

Magnetic resonance imaging (MRI) has become incredibly sophisticated. The newest technologies, such as machines from Siemens boast 3T field strength and total imaging matrix. The problem is that not every healthcare facility has the latest and greatest MRI system.

If you've ever had an MRI that came back inconclusive, chance are that's because the imaging center uses an old machine. And there is little incentive for imaging centers to upgrade, says a recent article in the New York Times. Because of the extreme cost of MRI technology, many MRIs in use today are 10 years old. Furthermore, reimbursement for an image on an old machine is the same as it is on a new machine. These older machines don't have the same clarity of image seen in new machines, which means the results are, at best, harder to read, and at worst, completely uselessâEUR"but no less expensive to produce. The Times article reports, for example that "as many as 20% to 50% of the procedures should never have been done because their results did not help diagnose ailments or treat patients." The solution? The Times article puts forth mandatory accreditation for imaging centers and implies that a national registry might also help. Accreditation from the American College of Radiology will be a requirement by Medicare by 2021. However, such accreditation may be in name only, because experts do not agree on what standards should be put in place. Dana Blankenhorn from ZDNet Healthcare says depreciation might the best way to control the use of outdated MRI machines. Depreciation, she says, is the process of spreading the cost of a capital good over its useful life. Once the end point is reached, all that is left is salvageable value. Such a process encourages businesses to replace depreciated machines. Finding the depreciation rate of electronics is complex, because a worthless piece of electronics may still be functional. A laptop that only runs Windows 95 is of no value in the market. In addition, electronics depreciate more rapidly than other capital goodsâEUR"that's why the original iPhone (introduced less than 3 years ago) is already less desirable than the new model slated to come out in summer 2009. According to Blankenhorn, "Depreciation acceleration turns out to be especially newsworthy when we turn to things like MRIs. TodayâEUR(TM)s MRIs are so much better than yesterdayâEUR(TM)s, the old stuff is worthless, even though it may work well, even though it may have cost a fortune." She says companies such as Siemens have records on facilities that still use old products. Those companies should be motivated to help customers depreciate old technology and transition to the new electronics.

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