This presentation examines a possible definition of "value in MRI" and offers a non-limiting interpretation from one of multiple possible perspectives of an industrial vendor and research collaborator. The seemingly simple equation defining value, like the Larmor equation, hides a considerable complexity with respect to the paths and dimensions to increasing value. We will examine the components that make up one version of the value equation and offer examples of the technologies, disciplines and strategies that are considered as part of an industrial investment in the development of tools that could increase value when embraced by healthcare professionals and organizations.
As defined in the central theme of this topic, the concept of value, as it pertains to MRI, can be formulated through a kind of "Larmor" equation of value:
$$Value = Outcome/Cost$$
As with the Larmor equation, the simplicity of the equation hides a considerable complexity. Depending on which part of a healthcare organization is involved, the definition of Outcome and the meaning of Cost can vary. From an industry perspective, we can contribute to both the numerator and denominator.
When we think of the meaning of Outcome, we can equate that primarily to the domain of diagnosis. In MRI terms this translates to, for example, the information content of the acquired signal/image, the relevance of that information to the clinical question and the robustness of that information. Robustness is a necessary part of enabling confidence in the diagnosis.
When we think of the meaning of Cost, in this context, it generally equates to a financial quantity. However, the impact industry can have on that financial quantity goes much deeper than simply the price of an MRI system. From the MR industrial perspective, Cost is typically equated to the time it takes to acquire the necessary data. If we were to look beyond the MRI alone, and to the cost of healthcare in general, we might also question why MRI is often the last resort, when its earlier use could have given a definitive diagnosis sooner. This aspect of Cost is primarily to do with the way healthcare systems are organized. A single MRI examination yielding a definitive diagnosis is likely to be less expensive overall compared to, for example, an X-ray followed by Utrasound then CT and finally MR. The aspect of standardization across healthcare organizations can also help on cost. Industry can provide the tools to do that, but its implementation needs to be driven by medical professionals and their organizations.
From an industrial perspective, Cost can mean many things including, for example, the cost of equipment and the cost of time. Focusing on the cost of time, this can relate to minimizing the time. It can mean, for example, the time it takes to install a system, the time it takes to prepare the patient, the time it takes to prepare and conclude the examination, the time the patient is on the table. So, the time axis is multifaceted and includes multiple stakeholders. A technology that improves acquisition speed and/or the robustness of the acquired data, leads to both a shorter table time for the patient and a more robust Outcome. We also observe that the patient table time is often not the longest time period during the total examination. The patient preparation and operator workflow contribute significantly and technologies that aid the patient to accept the scanning environment also positively impact on the total examination time by reducing the need to repeat scans.
In the presentation, we will examine some of the ongoing developments that aim to address both Outcome and Cost and how they may contribute to increasing the value of MRI for a variety of stakeholders.
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