PET Scanners May Be Coming Locally But Not Immediately
LANSING — Physicians in West Michigan are still months, perhaps more than a year, away from having a PET scanner in the region to use to diagnose patients, even with a pending rule change that would more than triple the number of the high-tech diagnostic tools in use across Michigan.
Presuming the state Certificate of Need Commission, as expected, adopts a proposed rule change in December that will increase the number of licenses for PETs in Michigan from three to 10, subsequent procedures will keep hospitals from acquiring a scanner for some time yet.
“This time next year, that would be lightning speed,” said Bob Meeker, vice president of strategic planning at Spectrum Health in Grand Rapids.
January 2003 is a more realistic timeframe for a PET scanner to go into operation in the local market, Meeker said, alleviating the need for physicians to send their patients to Detroit to perform a procedure.
Spectrum is partnering with Saint Mary’s Mercy Medical Center to acquire a PET scanner locally and apply for the lone state license that would become available in the West Michigan market under an ad-hoc committee’s proposal. The proposed rule would distribute the seven additional licenses around the state based on population.
Also vying for the West Michigan license is a group of minority investors, headed by Grand Rapids physician Dr. Khan Nedd, which has filed an application to acquire a PET scanner for a new medical imaging center they want to establish. The group, however, may not get the chance, since the proposed rule change would only allow hospitals or hospital-based service providers to offer PET scan procedures.
Mercy General Health Partners in Muskegon, partnering with other hospitals in West Michigan, at one time was seeking state OK to acquire a PET scanner, but has since withdrawn the application, Marketing Director Roberta King said.
A PET scanner — short for positron emission tomography — is the latest high-tech diagnostic tool that provides doctors a computer-generated image of the biological activities within the human body. Physicians use PET in diagnosing diseases and planning treatments for certain cancer, cardiac and neurological patients.
Current rules, established in 1993, limit the number of PET scanners in the state to three, all of which are now operated by hospitals in southeast Michigan.
The CON Commission, prodded by the medical community and West Michigan legislators, state Sen. Bill Van Regenmorter in particular, formed an ad-hoc committee in July to draft a new standard designed to make the technology much more accessible to other areas of the state.
The commission on Sept. 21 agreed to schedule a public hearing for mid-October on the proposal from the ad-hoc committee to raise the number of PET scanner licenses from three to 10, even as the panel refines “technical issues.”
“The committee certainly recognizes the importance of distributing this technology throughout the state,” said Dr. Michael Sandler, a diagnostic radiologist at Henry Ford Hospital in Detroit and chairman of the ad-hoc committee.
Among the technical issues the panel will continue to look at between now and December is whether to exempt university-based hospitals from the standard, and the threshold in the number of annual potential scans a hospital will need to demonstrate it can perform in order to obtain state approval for a PET scanner.
The threshold is designed to assure that hospitals acquiring a PET scanner have enough market to make it an economically viable venture.
Presently proposed is a benchmark of 3,500 potential scans within a given market for a hospital to initiate service with a fixed unit, and 4,000 scans annually for a mobile unit.
Speakers at the Sept. 21 commission meeting in Lansing, while supporting the intent of the proposal, said the proposed threshold is too high and needs to come down.
Spectrum’s Meeker doubts the health system could meet the proposed standard now. He urged the panel to lower the threshold, particularly at a time when the use of PET scanners is still evolving and physicians are finding the technology applicable to additional forms of cancer and other diseases.
“There is a lot we don’t know about how PET scanners are and will be operated in the future,” Meeker said. “A multitude of uncertainty can be counter-balanced by that provision.”
The commission is expected to adopt the ad-hoc committee’s final proposal at its Dec. 11 meeting, then send it on for a 45-day public comment period, and then to Gov. John Engler and the Legislature for concurrence.
If all goes as planned, the new CON standard for reviewing applications to acquire a PET scanner would go into effect sometime in February. With a CON application typically taking five months for the Michigan Department of Community Health to review, hospitals seeking to acquire a PET scanner likely won’t see them until this time next year, at the very earliest.
Deb Stienmann, vice president of strategic advancement at Saint Mary’s, expects the hospital’s joint project with Spectrum to take a “minimum of a year” before it puts a PET scanner into operation.