Buying liquid helium 15 years ago for an MR magnet cost less than $5 a liter. Those days are long gone, with rising demand and the scarcity of the gas lifting the cost to anywhere between $15 and $30 a liter.
“Some of the party stores have actually quit selling helium balloons because of the price. That’s just balloon grade helium, the low end of the spectrum,” Mark Abbs, regional service manager of the west region for MXR Imaging, told HCB News. “Every high-field MR contains anywhere from 1500–2000 liters of liquid helium for the superconducting magnet to operate. If everything is not working properly to keep that helium in the magnet, it boils off and needs to be replaced.”
A number of issues can lead to helium boil-off, which, when left unchecked, can cause the magnet to quench. This, in turn, leads to costly repairs that can take weeks and delays in scheduled diagnostic scans for patients who may require immediate attention.
To prevent this scenario, providers are investing more in remote monitoring technology so they can be alerted to and address issues early on. But choosing the correct technology requires not just an understanding of the capabilities it provides, but the risks it can detect and the impact it has on MR environments.
Patient throughput and total cost of ownership
Providers today face continual pressure to keep their systems up and running, to provide patients with fast, quality care. This has led to an increase in proactive measures and planning to detect and address problems that interfere with the availability of the system.
“They have to optimize their patient throughput and increase utilization of their diagnostic equipment throughout their facilities,” said Jessica Weems, MR product manager for the services business at Siemens Healthineers. “I think all of these different factors are what result in this increased need for them to really minimize the downtime of these systems and push a lot of maintenance activities to be more predictable and to be scheduled during off peak times.”
Behind that pressure is increasing emphasis on total cost of ownership. Unplanned downtime eats into exam schedules, leads to overtime and frustration among staff members, and prevents providers from generating revenue.
“Total cost of ownership grew in significance, and with that, the recognition and impact of remote monitoring on the bottom line,” said Andrea Hearn, senior manager of life cycle marketing for Canon Medical Systems USA. “And so did the benefits on the clinical area by being able to offer high-quality imaging on a continuous basis.”
Risks to be on the lookout for
Whereas scheduled on-site visits to check on MR systems is the norm of traditional maintenance management, scanner performance today can be checked daily from remote locations by personnel, who can alert providers via email, text or phone to an issue in real time.
“Beyond basic magnet remote monitoring, our system can extract error messages from the host computer for remote review by service engineers,” said Kishore Mogatadakala, president of DI Insights. “This eliminates the need for unnecessary trips by the service engineer to the sites for troubleshooting basic system-related problems.”
The causes of these issues can range from halts in chiller water flow to power outages. The loss of power during disasters, for instance, can lead cooling systems to shut down, allowing liquid helium to convert into a gas and increase pressure in the magnet. This causes a pressure relief valve to open for the gas to escape.
Remote monitoring can keep track of many components, from chiller water flow to coil performance.
Environmental factors such as room temperature, humidity and atmospheric pressure are also concerns to look out for, as are incorrect signal-to-noise ratios for the performance of surface coils.
“From a magnet performance perspective, we can remotely monitor for helium boil-off and detect occurrences that would impact the ability for the cold head/compressor to keep the magnet cool,” said Daniel Bellinger, global MR remote service manager for GE Healthcare. “From a system performance perspective, we can detect emerging issues with coil performance, environmental factors that can impact system performance and/or patient comfort, and scan room noise that can impact image quality.”
Properly addressing these situations means knowing which ones require immediate attention, and which can wait, according to Weems. “Immediate scenarios are ones where we’re working with the customer to resolve issues before anything catastrophic happens. But then there are some things the program picks up on that may not be an imminent catastrophic event but something we can schedule to fix during a customer’s off hours.”
Onno Bense, remote manager for the global operations team for service and solutions at Philips, says it is essential to validate that alerts are highly reliable. “We’re seeing an increasing shift from reactive to proactive maintenance, leading to a reduction of unscheduled downtime, maximizing system uptime and availability. It is very important that we don’t have false alerts, which is why we’ve developed platforms and models for proactive monitoring with high reliability.”
Another aspect to consider is the time it takes to notify providers of an issue. Tim True, senior director of sales and service operations at Advanced Cooling Technologies, a manufacturer of MR chiller and cooling technologies, says before remote monitoring, notifications were entirely dependent on someone being at the site to recognize the issue.
“Now, our technical support team receives a push notification anytime a reading is outside of normal or an alarm goes off, even if the chiller still appears to be operating fine,” he said. “Once this occurs, the diagnostic/repair process is initiated by ACT and the customer is notified. “
Tapping into greater insights
Pressure to avoid unplanned downtimes and cater to rising volumes of patients has caused providers to seek out remote monitoring systems for their MR suites.
Detecting any issue within an MR system requires access to data. The more data available, the quicker and easier it is to address and solve a potential issue. Because of this, many providers have turned their attention to big data science and predictive analytics for identifying any faults within their MR systems and diagnostic equipment.
“These tools, like big data and predictive analytics, enhance insight and enable fact-based decision-making,” said Hearn. “Therefore, utilizing this data mining and machine learning to analyze this kind of history and to predict the future is imperative to maintain and actually gain a competitive edge.”
This attention has in turn led to research around the development of AI and machine learning-based tools, though sources agree that such solutions are still in their infancy and have not yet been implemented within the remote monitoring sphere.
Although Abbs acknowledges such tools are necessary, he notes that humans are still required for validating the accuracy of alerts and determining the best approach for addressing these issues. “There are so many variables with what can go wrong that someone still needs to look at various alarms that are coming in to determine the course of action. It still takes a pair of eyes to look at the alarms.”
Choosing the correct vendor to perform remote monitoring services requires compatibility with the requirements of the MR system, according to Jon LeBeau, director of sales at Total Data Connect. “OEM's have their own systems but they cannot monitor other units. Many facilities and mobile providers have several makes of scanners. The flexibility to monitor the entire fleet is a big advantage for Total Data Connect. And our environmental capabilities give users additional insight on their equipment and conditions around machines.”
In addition, remote monitoring should complement the operations of the provider and be negotiated and carried out in ways that best support the individual needs of the site.
“We tailor our proactive remote monitoring to our customer’s needs, augmenting their own capabilities. For some providers we support their biomed teams who do the manual labor and the services for themselves,” said Bense. “Providers can also buy proactive monitoring as a separate item with a support contract.”
It also must be “completely transparent” to the MR system, according to Mogatadakala. “It shall strictly perform like a simple data acquisition system and its failure shall not have any impact on the performance of the MR system.”