United Medical Instruments - Diagnostic Ultrasound Blog!

Guidelines Established by American College of Cardiology for Appropriate Use of Ultrasound for Peripheral Vascular Testing

As reimbursement cuts continue to be made, determining if and when a diagnostic test is necessary is becoming more prevalent. The American College of Cardiology (ACC) collaborated with 10 other medical organizations to develop a set of guidelines to assist clinicians with their decision making process for diagnostic testing. The group focused on determining testing appropriateness for vascular ultrasound and functional testing for patients with suspected or known non-coronary arterial disorders.

Ultrasound is a cost-effective diagnostic tool that provides information to physicians needing to evaluate vascular blockages and disease in areas such as arteries of the neck, kidneys, abdomen, and lower extremities. In addition to be used as a screening measure, ultrasound is also used for determining the status post peripheral vascular procedures, such as arterial bypass, surgical removal of plaque (endarterectomy), or stenting.

The team used a rating scale coupled with timeframe intervals. According to the press release "The group found arterial vascular testing to be "appropriate" in about half of the clinical situations evaluated. Overall, vascular studies were deemed appropriate when clinical signs and symptoms were the main reason for testing. For example, Dr. Mohler explains it is reasonable to order a lower extremity vascular study for a patient who reports calf pain upon walking that resolves with rest. Tests that were conducted in patients with existing atherosclerotic disease or to establish a "baseline" after a revascularization procedure were also considered appropriate based on ratings."

• Ordering an ultrasound of the carotids or neck arteries in someone at low risk for heart attack or stroke.

• Screening for kidney artery disease in someone with peripheral artery disease with well controlled high blood pressure (hypertension) on one medication

• Choosing to perform an abdominal ultrasound in a patient with non-specific lower extremity discomfort

• Ordering a mesenteric artery ultrasound (arteries that supply the small and large intestines) as an initial test to evaluate the patient with chronic constipation or diarrhea

• Having current ultrasound technology in a clinician's facility is essential for careful diagnosis. To learn more about our recommended Toshiba Viamo portable ultrasound machine for vascular procedures, click here.

As physicians struggle with the need to diversify patient services while managing their cash flow, one company has implemented an innovative program to help customers demo ultrasound equipment, online, before committing to a major purchase – a program which has increased customer satisfaction by ensuring the ultrasound machine meets their needs.  Providing customers with ultrasound system demonstrations is not a new concept, all the large manufacturers like Siemens, Toshiba, and SonoSite typically go on-site to customer offices’ or hospital departments to demonstrate the equipment prior to purchase. Demoing a system is a great opportunity for customers to engage with a clinical person to ensure the ultrasound machine is going to meet their expectations: See image quality, verify software features for their clinical exams, and ask questions to a clinical expert. In these economic times, a private physician cannot risk spending thousands of dollars on capital equipment and have it not meet his or her needs.

United Medical Instruments, Inc. is a multi-vendor ultrasound reseller, selling both new and used ultrasound equipment, and now they offer its customers a new program to evaluate systems prior to purchase. It’s called UMI Interactive™ and it’s the first program of its kind where physicians and sonographers can evaluate ultrasound equipment prior to purchase.

Purchasing new or used ultrasound machines from a reputable ultrasound reseller is a good solution for those working with a budget. But on the flip side, there isn’t enough money built into these transactions to allow for onsite ultrasound system demonstrations. But with the UMI Interactive™, customers have the ability to schedule a convenient demo time and work directly with one of the registered staff sonographers to participate in live scanning and verify the system features and image quality meet their requirements.

To learn more about this program and schedule an online demo, click here. Explore United Medical Instruments, Inc. by visiting their website.

Armed now with feedback from your peers, an understanding of what your current reputation is, and a vision to strengthen that reputation, the next step is to embrace the multitude of online communities to market yourself or your practice. Regardless if you are a student, a seasoned professional or a practice owner, the best way to convey your online physician reputation and find opportunities for success is to market yourself.

Last week, I suggested you invite feedback from your colleagues on how they perceive you, as a way to get a good understanding of your reputation in the field. Were you able to solicit and hear the feedback? Did you hear adjectives like team player, flexible, innovative -- or aloof, unapproachable, unrealistic? Did you hear a few adjectives that weren't what you expected?

Who needs to worry about marketing and branding? You do. The reality is that we form opinions about people every day, whether or not we think we're being judgmental and regardless if we know someone personally. You are forming an opinion about me right now as you read this post. My reputation has been built over the past two decades in the ultrasound market. I may think I have a good reputation but — here's the kicker — what I think doesn't matter. It's how I'm perceived and what others think of me that truly forms my reputation.

Adding ultrasound to your practice not only helps improve patient services by allowing you to keep control over the care your patients receive, but it also creates an additional source of revenue. For a private physician considering an ultrasound system purchase selecting the right system can be a challenge. Hospitals typically have funds allocated for capital equipment purchases or have group buying power through contracts established with pre-negotiated and discounted prices. What about the private physician making a solo or partner-driven ultrasound purchase? During a time when there is a question of budget vs. quality, how do you choose? Do you pay new system prices, or, take a risk and purchase a used ultrasound system?

Let's look at new ultrasound equipment first. Just like buying a new car, buying new ultrasound equipment at first looks lucrative: nobody has used it, the probes and elements are all functioning, and it comes with a warranty. However, just like a brand new car depreciates the minute you drive it off the lot, so does the ultrasound system. Can you imagine needing to resell or trade-in that brand new ultrasound system within a month to find that it depreciated by 20%

Second, is the topic of used ultrasound equipment. Used ultrasound is defined as buying from a website like EBay or from an unknown reseller because what is being sold is cheap and fits into your budget. This is the ultimate scenario of Buyer Beware. When buying from an unknown entity you do not know if the equipment has the software features enabled that you need for your exams, you don't know if the ultrasound transducers have dead elements, which compromises image quality and jeopardizes care for your patients, and it doesn't come with a warranty. If it sounds too good to be true, it is.

Third, is the great compromise of being on a budget and having quality ultrasound equipment. How? When you purchase refurbished ultrasound equipment from a quality ultrasound reseller you can be assured that the equipment you buy has gone through an extensive OEM and ACR recommended inspection process. The ultrasound machine and attached probes are checked in, tested repeatedly for functioning boards, heating capacity, etc. In addition, all repairs, if needed, are made to manufacturer specifications. The ultrasound system then leaves the facility with a warranty in place to provide peace of mind to the customer

To learn more about the inspection guideline requirement enforced by the American College of Radiology visit our blog Ultrasound Equipment Maintenance is Mandatory for Accreditation

Click below to download the FREE "Guide to Buying Refurbished Ultrasound Equipment" or to learn more about the refurbished process at United Medical Instruments.

The online social media company, Social Media Today , LLC has recently partnered with Siemens Healthcare

The online social media company, Social Media Today , LLC has recently partnered with Siemens Healthcare with the launch of the site HealthWorksCollective. The site offers editorial feedback in the areas of medical technology, healthcare policy, remote diagnostics, and medical education. Siemens jumped on board with a sponsorship as a platform to hear and learn from other industry experts as the field of healthcare is transformed.

John Glaser, PhD, CEO, Health Services Business Unit, Siemens Healthcare, states "It is only through collaborative and open discussion that the most insightful ideas come to the fore," said Dr. Glaser. "In the United States, the field of healthcare informatics is enabling many aspects of healthcare reform and is a salient discussion point in our most critical conversations on accountability, quality and cost. Globally, information technology is proving that it can be a significant driver for higher quality and lower cost care. The Siemens Healthcare Sector is actively positioning itself to address these issues through our Agenda 2013 initiative and I look forward to sharing my perspective and, more importantly, to learning from the wider array of assembled experts."

The site is an independent venue for industry experts to blog and share information, so solicitation of products or services is not permitted.

The release of 5010 HIPAA standard transactions will incorporate the new ICD-10 billing codes for procedures and diagnosis so that any concerns you may have will be alleviated because the work will be done for you. Having said that, the coding changes are significant. According to ASCO.org “There are a total of 197,769 codes in ICD-10-PCS, a substantial increase in the number of codes relative to ICD-9-CM procedure codes, which total 4,000 codes. The number of codes from ICD-9-CM diagnosis codes, totaling 13,000, has also increased substantially with the creation of ICD-10-CM diagnosis codes, which total 120,000. Overall, several major changes have taken place between each ICD-CM classification structure. The biggest change has occurred from the ICD-9-CM to ICD-10-CM. The whole system has been completely revamped to be able to meet current coding needs.”

The new code includes a lot of detailed information that you should be aware of as you move through the billing process – accurately coding will allow for timely reimbursement. Those who perform the billing tasks for practices would be better off becoming familiar with anatomy and physiology. When coding you will be more efficient at understanding the doctor’s notes on the patient and better able to code to the highest level of specificity. Physicians document for patient health, not for coding purposes, but with the government requiring more information the better the coding, the better the reimbursement.

According to a recent announcement from EHR/EMR audits are beginning for not just hospitals but also for private practice physicians. To read more about preparing your office for electronic medical records, read our blog Electronic Records, Physician Incentives or Penalties – the Scoop. Not only are electronic records on the way to becoming mandatory staples of practice, so are new rules regarding reimbursement.   The controversy surrounding SGR with Congress now has a Band-Aid in place which will either freeze or cap physician reimbursement levels at 2% from Medicare. The two year patch is to prevent focus on reimbursement during an election year.

There are 9 more days left in 2011 to take advantage of the Small Business Job Act of 2010. This is called Section179 Tax Deduction, and applies to both new and used equipment, purchased by small business. According to Section179.org it's explained as follows:

Essentially, Section 179 of the IRS tax code allows businesses to deduct the full purchase price of qualifying equipment and/or software purchased or financed during the tax year. That means that if you buy (or lease) a piece of qualifying equipment, you can deduct the FULL PURCHASE PRICE from your gross income. It's an incentive created by the U.S. Government to encourage businesses to buy equipment and invest in themselves.

If you are a private practice physician looking to add ultrasound to your practice, now is the time to take advantage of this tax break before the clock runs out. Concierge medicine has grown to 5,000 practitioners and according to the American Academy of Private Physicians, embraces the philosophy of "improving the quality of patient care and care coordination, strengthening the bond between patients and their physicians, and empowering patients as healthcare consumers." Ultrasound is an excellent tool to improve patient services.

Even if you are on a budget, there are ultrasound equipment options available to you. When considering buying used ultrasound equipment, keep the following tips in mind during vendor selection:

Commitment to Quality

What is their process for repair and warranty work? What is their process for refurbishing the ultrasound equipment? Whether it's just an additional transducer you need or a fully loaded laptop ultrasound system, do they just paint the nicks and send it out the door or is there a comprehensive checklist including safety points that are reviewed?

Scope of Resources

How many people work at the company, is it a broker working from his house? Or will you receive post sale support in the form of onsite training, continued lifetime online training for new staff? Do they repair the equipment in-house or source it to another company?

Price

This is a tricky area and one where you need to make SURE you are comparing apples to apples, not an apple to a grape. If it seems too good to be true, guess what? It is! Make sure you have a quote that details which features are enabled on the system you are going to purchase and that if you have requested a linear transducer for vascular access you are looking at two identical descriptions - there are multiple linear probes from SonoSite for example and they are different.

References/Reputation/Relationships

This is either an area you can start with, asking colleagues for references, or end with.... check the website, are there testimonials from past customers? Can you talk with a customer about their experience? Online resources such as Dotmed.com post feedback about resellers, be educated about who you are working with.

Get on board and join the millions of physicians who are using portable ultrasound and refurbished ultrasound for applications ranging from vascular to MSK to family practice. Contact United Medical Instruments, Inc to learn how you can apply the Section 179 Tax Deduction and start using ultrasound tomorrow.