An estimated 73.0 million CT procedures were performed in 2020 on fixed CT scanners used by radiology/imaging departments in U.S. hospitals, their associated outpatient locations, and independent imaging centers, according to IMV Medical Information Division’s newly published 2020 CT Market Outlook Report. Compared to 91.4 million reported by IMV in 2019, total CT procedures decreased 20%, likely due to COVID-19.
The COVID-19 pandemic had an immediate impact nationwide on total CT procedure volume in early 2020. IMV’s survey was conducted in August/September 2020, and the respondents were asked how many patient exams were conducted in January and April 2020. Based on their responses, the estimated nationwide monthly patient exam volume in January 2020 was nearly 6.9 million but declined by about 40% in April 2020 to 4.2 million.
Respondents were also asked to estimate their anticipated 2020 year-end CT procedures, which resulted in IMV’s year-end 2020 estimate of 73.0 million. On a monthly basis this averages to about 6.1 million, which is 45% higher than the April estimate of 4.2 million but is still lower than their “pre-COVID” January 2020 monthly estimate of 6.9 million.
The survey respondents were asked about their perspective on what changes have affected their departments due to the current COVID-19 pandemic and economic climate. Two of the top changes affecting CT operations due to COVID-19 are “CT outpatient cancellations or no-shows due to fear of exposure to COVID and/or stay-at-home guidelines/orders” and “declines in CT patient exam volume due to reduction in related elective procedures,” with over 70% of the respondents so indicating.
Indeed, CT procedures conducted on outpatients took a bigger hit in 2020 than emergency or inpatient procedures. Overall, the proportion of outpatient CT procedures dropped from 44% in 2019 to 34% of the total while emergency patients increased from 39% to 45% and CT procedures performed on inpatients increased from 17% to 21% of the total.
Interestingly, 13% of the 2020 CT procedures are estimated to have been performed for the purpose of assessing patients for (or with) COVID-19, with a higher 17% of the CT inpatients and emergency CT patients being assessed for COVID-19, compared to 6% of the CT outpatients.
The CT respondents were asked what actions their departments have already completed in order to deal with the ongoing COVID-19 crisis and to prepare for the future. The top two actions taken to date have been to “strengthen disinfection routines for cleaning CT scanners and the rooms the CT equipment is used in” and “modify waiting room protocols/layouts to facilitate social/physical distancing of CT patients” with about 90% of the sites so indicating. A major impact of the disinfection routines on their CT workflow that respondents commented on is the need to increase the shut-down time after COVID-19 patients are scanned, which has reduced their operational efficiency and revenue.
- “Having to shut down our only CT machine after scanning potential COVID patients, leaving ER without CT capabilities.”
- “We only have one CT scanner, so when we have to scan COVID patients, we have to shut down the room for at least one hour for a terminal cleaning.”
- “After performing an exam on a COVID positive patient we are required to shut down the room for a minimum of one hour for a terminal clean. This has a very negative impact on our workflow, especially with emergent cases.”
- “After each COVID-19 patient, the CT scanner is considered down for 1.5-3 hours so the entire suite can be cleaned and disinfected prior to next patient. This results in going on diversion during this time for trauma/stroke patients.”
As a result of the pandemic, CT departments across the country have experienced issues affecting their CT staff, with one third of the respondents saying the pandemic has caused a hiring freeze for their CT staff, layoffs/furloughs, or CT technologists taking sick leave due to actual illness of fear of getting COVID. One quarter of the sites reduced their operating hours or days open at CT locations at some point during 2020 due to the pandemic.
Going forward, staff morale is a key concern for the department administrators due to these operational issues and the associated stress with day-to-day uncertainties. Over 90% of the respondents indicated that even if “post-COVID recovery” has taken place, “improving staff satisfaction and morale” will be a top department priority, second only to “improving patient satisfaction with their CT experience.”
Regarding their future plans for acquiring CT scanners over the next three years, the respondents were asked what impact the pandemic may have had on their purchase plans. Due to the COVID-19 pandemic, one fifth of the respondents said the pandemic has caused “decreased funding for purchasing new CT scanners” or they are experiencing “operating budget reductions for CT accessories and consumables.” Moreover, 20% of the CT sites said their original plans to order CT scanners from 2020-2023 have “Yes” or “Maybe” changed, with the key impacts being a possible delay in ordering/replacing some units or a reduced number of CTs ordered.
While COVID-19 may be slowing the purchase of CT equipment, “in-person contact” is still the most preferred method as opposed to virtual on-line alternatives to evaluate CT equipment, either at other healthcare facilities or at a manufacturer location. Presentations by sales reps are the top information source the respondents have used when purchasing CT equipment, with 63% of the respondents so using, but given the pandemic, many are open to flexible arrangements. While respondents still lean toward in-person contact for presentations by sales reps, with 45% giving preferring in-person contact, one third prefer virtual on-line alternatives, depending on the phase of their buying process. Regarding professional conferences/conventions, an almost equal proportion of the respondents prefer in-person (38%) vs. virtual alternatives (35%).
- “We feel the site visit to see equipment in action and for conversations with users is vital when purchasing imaging equipment.”
- “Seeing equipment in person makes it easier to visualize potential room layout concerns. Being able to touch the equipment and talk with people who are already using it is also helpful.”
- “The virtual presentations have been helpful. Unfortunately, they have not been as helpful as on-site visits or visits to the training hubs of the vendors.”
- “Virtual meetings and presentations have a place but site visits to other healthcare facilities are a must.”
Lorna Young is senior director, imaging insights, at IMV Medical Information Division, part of Science and Medicine Group.
IMV’s 2020 CT Market Outlook Report explores market trends in U.S. hospitals and imaging centers, including procedure volume, manufacturer installed base features and share, the use of OEM vs. third-party service providers, purchase plans, brand loyalty, contrast utilization/budgets, CT power injectors, and site operations characteristics. In addition, due to the unprecedented COVID-19 pandemic, this report covers the impact COVID-19 is having on CT operations nationwide.
The report is based on responses from 330 radiology/CT administrators who participated in IMV’s nationwide survey in August-September 2020. Their responses have been projected to the IMV-identified universe of hospitals and imaging centers in the U.S. that use fixed CT scanners, and the report provides market forecast scenarios addressing the CT unit market in the United States for 2020-2024. Vendors covered in this report include Bayer/Medrad, Bracco Imaging, Canon/Toshiba Medical Systems, GE Healthcare, Guerbet, Hitachi Healthcare, Neusoft, Philips Healthcare, Samsung Healthcare, Siemens Healthineers, and United Imaging.