MRI, CT and X-ray machines have dynamic power demands, which create unique requirements for the critical power protection equipment supporting them. When idle, these imaging devices do not use a lot of power (usually between 5 and 20 kVA), but while scanning, the maximum power demand can reach up to 200 kVA for 10 to 50 milliseconds. These abrupt spikes in current may cause a power outage or damage the equipment if not properly managed, resulting in repeated diagnostic tests, wasted medical supplies, expensive repair calls and risks to patient safety.

To prevent electrical interruption, most hospitals and health care facilities install an uninterruptible power supply (UPS). UPS systems not only supply short-term power protection by bridging the gap between utility failure and generator start-up during an outage, but also condition incoming utility power, which is of equal importance to health care facility managers. These units regulate voltage when imaging equipment is in use, ensuring scans are successful and the facility does not lose power.

Traditionally, hospitals have relied upon UPS systems with valve-regulated lead acid batteries (VRLA) to backup diagnostic imaging systems and other critical applications, but these units come with a host of disadvantages, including exposure to hazardous gases and toxic contents. In recent years, UPS systems with integrated flywheel energy storage have disrupted the health and safety market and are actively reducing the health care industry’s dependence on VRLA batteries, but widespread adoption has been slow due to the risk-averse nature of hospital administrators.

Selecting the right UPS system for your facility is paramount, especially with patients’ lives on the line. Each hospital’s critical power requirements are unique, so there is not a one-size-fits-all solution, but here are four main factors to consider when selecting a UPS.

Total Cost of Ownership (TCO)

Battery-based UPS systems have long been the industry standard, not only because they can produce high amounts of current on short notice and have longer runtimes compared to other technologies available, but also because they have a relatively low initial cost. However, the operating expenses of these units can be quite high.

In order to function properly, batteries need to be kept at an ambient temperature of 77 degrees Fahrenheit, so they must be housed in special air-conditioned and well-ventilated rooms. Additionally, batteries must be maintained quarterly and replaced every four to eight years. While this preventative maintenance ensures the batteries are working, human error is the leading cause of site failures.

A number of factors go into calculating TCO for a UPS product, including initial cost and installation, energy losses based on product efficiency and cooling requirements, service and maintenance costs, and battery replacement costs. For facilities where budget constraints exist, flywheel-based UPS may be the better choice due to their high-energy efficiency, reduced cooling needs and permanent energy storage, which doesn’t require replacement every few years.

System Performance

Like all products, there is no point in purchasing something if it does not meet the demands of your facility’s applications. As mentioned above, health care facilities need a UPS system that can handle step loads when diagnostic imaging equipment is in use. Product specification sheets from vendors may only cover the system’s performance in standard operating modes, so be sure to research the UPS’s ability to handle overloads and step loads without going to bypass. Ask industry peers about the UPS products they use. Put simply, does the UPS work when called upon or do you run the risk of dropping a critical load due to the product’s inability to manage large swings in voltage?

Runtime

The code requirements in the National Fire Protection Association (NFPA) standards and the National Electrical Code (NEC) require emergency power to be restored within 10 seconds in a hospital or similar facility in the event of an outage. On-site backup generators can keep a facility operational for as long as they have fuel, but can take up to 15 seconds to start and assume the load. Historically, several minutes of UPS runtime was preferred, but with the recent advancements in backup generator technology, longer ride-through time is no longer needed or advisable for cost-conscious end users.

Reliability

When called upon, a UPS system is expected to work — no questions asked. For electrical equipment, reliability is measured by how likely a product is to fail. Although a fraction of a percentage may not seem like much, it is a big gamble when patients’ lives are at stake. When considering a UPS, ask for independent, third-party reliability assessments comparing their product with competitors.

When selecting a UPS, it’s important to consider all of these factors to ensure that you are purchasing and installing a system that meets your facility needs today and in the future. Take your questions about your facility needs and speak with others, including UPS manufacturers, health care facility engineers and consultants. Don’t be afraid to ask a vendor for customer referrals from facilities with similar requirements. Review relevant case studies. Request the supplier walk you through their TCO calculations. Only then will you have the information needed to make the right purchasing decision, so your doctors can order MRI, CT and X-rays of their patients without you having to worry if it will cause the lights to go out — or worse.

Todd Kiehn is the vice president of marketing and modular solutions for Austin, Texas-headquartered Active Power.

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ECRI Institute used its Selectplus User Experience Network, a service that helps medical technology purchasers with vendor and product information, to gauge MRI operators on what they thought of vendors’ image quality, coil selection and setup, ease of use, patient throughput and vendor support. The results include function, feature and service ratings for each model, grouped by vendor.

“Hospital leaders and technology purchasers need all the supporting data and market insight they can get to make informed buying decisions, with a keen focus on safety and quality,” said Jennifer L. Myers, ECRI Institute’s vice president of Select Health Technology Services, in a statement. “We rely on our partner health care organizations’ end-user experiences as one of the many tools hospitals can use to help make cost-effective purchasing decisions.”

Key findings of the survey show that MRI models with the highest overall user rating scored high in ease-of-use and image-quality criteria. MRI models with the lowest overall user rating scored lowest in reliability and vendor service.

MRI systems are grouped into three general categories based on magnetic field strength: 3T scanners, 1.5T scanners and low-field (1.2T or less) scanners. On a scale of 1 to 5, with 5 being the best, the average user rating for image quality across all 3T systems was 4.3 compared to 4.2 for all 1.5T systems.

When comparing the four MRI market leaders and their 1.5T MRI systems, the survey found the GE Optima MR450w had the highest average list price at approximately $3.5 million, and the Toshiba Vantage Titan 1.5T was the lowest at about $2.1 million. The system with the highest average quoted price was the Philips Ingenia 1.5T at $1.7 million compared to the Toshiba Vantage Titan 1.5T, which again came at the lowest price at $1.3 million. The highest average annual service price was for the Philips Ingenia 1.5T at $153,015 and the lowest price was for the Simens Magnetom Aera at $115,201.

The full report is available to ECRI Institute members on its website.

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The project was designed by BSA LifeStructures, while McGrath & Associates served as the construction manager, with both companies operating out of their St. Louis offices. The facility was constructed in an area adjacent to the previously existing MRI rooms, which continued to function until the project was completed and the machines could be moved to the new site.

“Managing the project phasing was a challenge,” said McGrath Project Manager Jamie Gensits. “We made sure that the MRI staff could maintain excellent patient care throughout our construction process.”

McGrath installed a copper enclosure to prevent radio frequency and electromagnetic interference from penetrating the room. An MRI works by manipulating radio frequency fields in the body to produce a magnetic field that the machine can detect to create an image. This means outside sources of radio or electromagnetic waves can cause interference, limiting the clarity of the resulting image. Copper conducts electricity very effectively and tends to absorb rather than reflect it. This makes it ideal for keeping outside radio and electromagnetic waves from passing through the outer walls and penetrating an MRI machine. Other efforts included using an isolated electrical ground. Usually electricians can use one ground for multiple electrical devices, but the sensitive nature of an MRI machine makes this a bad idea, as electrical interference can result from connecting other devices to the same ground as the machine.

McGrath also employed electrical filters, which filter extra electrical frequencies that might be conducted by wiring and waveguides. This corrals electromagnetic waves and channels them through a narrow pipe. These measures were taken to make sure wires and cords don’t accidentally guide additional interference-producing waves into the machine.

The new machine also has to be supported in a way that eliminates vibration transfer between the structure and the massive magnet the machine relies upon. This stops movements in the structure, caused by shifting or a bus driving by, from being absorbed by the highly sensitive magnet, which would also cloud the picture.

McGrath used a special mixture of fast-setting concrete to speed the construction process, helping the project move from inception in December of 2011 to completion in June of 2012.

BSA LifeStructures is a design firm that specializes in health care, higher education and research institutions. McGrath & Associates is a general contracting company specializing in commercial, health care, industrial, institutional and pharmaceutical construction projects.

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Tom Rauch, global sourcing manager for GE Healthcare, told Wisconsin’s Herald Times Register, “Helium is currently the only element on Earth that can effectively keep the magnet this cold and allow for the high-field strength, stable and uniform magnetic fields that make modern MRI systems possible.”

“If the supply constraint on helium continues unabated, it could be very harmful to patient care,” Rauch added. “If there were no helium to properly service an MRI, a ‘quench,’ or sudden boil-off could occur.

“While there is no immediate patient safety risk, a magnet could sustain permanent damage and may need to be replaced — an expensive and time-consuming process,” he concluded.

Needless to say, most hospitals cannot afford to risk damaging one of their most important, expensive and sensitive pieces of equipment. Helium is also often used in the arc welding process for various reasons, which could theoretically impact hospital construction costs in a round about way.

As expected, the federal government has found itself at the epicenter of a debate on the resource’s management. The U.S. has a federal helium reserve 12 miles north of Amarillo, Texas, which was established in the 1920s when the element was considered very important for the nation’s military. The facility’s location in the Lone Star state seems fitting, as the reserve is the biggest in the world. Helium is often harvested as a bi-product of natural gas extraction. This means America’s vast deposits of natural gas are accompanied by massive amounts of helium, making it the largest producer of the element in the world.

The shortage has led health care experts and economists across to country to call for everything from questioning the use of helium in balloons to closing the national reserve and selling off all the current supply as soon as possible. The current federal plan, formed by Congress in 1966, calls for all reserves to be sold off by 2015. Some commentators have embraced this plan, as they believe the national reserve artificially deflates the price of helium, preventing private companies from entering the market. Others argue that the reserve is connected to a helium deposit that could sit in the ground untapped if the federal facility is mothballed.

The Helium Stewardship Act of 2012, a federal senate bill attempting to address the issue, was announced in early September. Two Republican senators from Wyoming, John Barrasso and Mike Enzi, have cosponsored the bill with Democrats Jeff Bingaman of New Mexico and Ron Wyden of Oregon. The bill calls for the federal reserve to be maintained beyond 2015, while changing rules regulating how and when the government sells off its reserves. The bill’s authors believe this action would reduce the artificial alteration of helium prices, while ensuring federal researchers have a steady supply through the year 2030 when private entities will hopefully have entered the market and stabilized the situation.

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The 5,700-square-foot Advanced Multimodality Image Guided Operation (AMIGO) suite, designed by Boston-based architecture firm Payette, includes a central operating room linked to adjacent imaging rooms on either side, allowing the patient to remain positioned on the operating table while the ceiling-mounted MRI can move to the patient during a surgical procedure.

In addition to the imaging equipment, the clinical care and research facility includes surgical navigation tools and image registering and integration software.

“Building an operating suite of this complexity is unprecedented,” said Brendan Whalen, project manager of the suite from BWH Real Estate and Facilities. “Never before has a project involved so much design planning around surgical suite safety. Because of the radiofrequency energy and magnetic field from the MRI and energy from radioisotopes, and x-ray equipment, the suite has extensive lead, steel and copper shielding to protect staff and patients from these emissions.”

The project required suspending a moving 33,000-pound magnet system on a ceiling mounted track in order to use in the multiple processes, permitting rapid and seamless transitions between imaging and intervention.

“The integrated systems provide immediate access to imaging and enable the precise, minimally-invasive image-guided techniques,” a statement from the design firm said. “The end result is a safe and expeditious experience for the patient and a more effective application of intraoperative imaging for the surgeons, radiologists, nurses and technologists providing care.”

The infrastructure for the various systems was “deftly” concealed behind walls and above ceilings, kept neutral in appearance to prevent competing with critical patient information displays, the firm stated.

Kinetic qualities of the suite were captured on the floor, with the arc of the operating table’s rotation and the limits of the magnet’s Gauss lines rendered in a palette of colors.

While the suite was designed as innovative for today’s standards, it also allows for future growth and development, the firm said.

“The project team strove to create an environment that was ‘future-proof,’ using insights from previous installations at BWH and other hospitals that incorporated intraoperative MRI only to better anticipate future needs and accommodate growth and change,” the statement said.

Project Team:
Construction Manager: Suffolk Construction of Boston
Mechanical and Electrical Consultant: BR+A Engineers of Watertown
Plumbing and Fire Protection Consultant: RW Sullivan of Boston Structural Engineer: Weidlinger Associates, Inc. of Cambridge

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