por Gus Iversen
, Editor in Chief | October 16, 2020
From the October 2020 issue of HealthCare Business News magazine
Back in 2016, Joern Meissner, CEO of Meissner Consulting, provided HealthCare Business News with a detailed outline of what goes into opening a new proton therapy facility.
We checked back in with Dr. Meissner for an update on his insights and to find out how the process has evolved in the last four years.
HCB News: When planning a new proton therapy facility, what are some of the very first questions that must be asked?
The first questions need to deal with the business plan’s top line: who will refer patients to the center? Many proton therapy facilities overestimate the number of patients that will be arriving at their door with reimbursement for the treatment. How many patients shall be treated per year using conventional multi-fraction treatments? How will future treatment technologies like FLASH or Arc be incorporated? Answers to these questions will then need to be balanced against number of treatment rooms, proton therapy vendor’s specifications, and of course budget.
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Presently, I would consider a two- or three-treatment room facility to have the best return on investment. This would allow about 800 to 1500 patient per year using present day technology treatment. FLASH would increase the capacity of the facility and may increase wall thicknesses in some areas.
HCB News: Does that mean you are in favor or multiroom facilities instead of single room facilities?
There is a specific place for both types. Multiroom facilities likely have the better return on investment, can treat more patient and optimizes operation and maintenance cost, especially if the facility is standalone. Whereas, single room systems, for example IBA’s ProteusOne, Varian’s ProBeam 360° Single Room, or the MEVION S250i Proton Therapy Systems, fill a niche for local or decentralized radio oncology centers.
In the past few years I have seen many more single room systems sold than multiroom systems. If an existing radio oncology center already has a few linacs operating, the addition of one proton treatment room can benefit from a lot of synergies and optimize overall operational costs.
HCB News: How does one go about selecting a design and construction team?
Even before the proton vendors provide their formal bid, a test fit layout should be obtained from each of candidate. The footprint each vendors’ vault requires is different, and seldom includes the clinical area required to operate the future facility efficiently.
When we receive the vendors’ generic test fits, we usually integrate those with the clinical user’s ideas on workflow, adapted to the specific piece of land available. Once a vendor is selected, the clinical layout and the associated technical rooms can be detailed in the design development stage, and handed off to locally registered architect and engineering (A&E) firms to create construction drawings.