There is a lot to consider before bringing any new piece of equipment home to the hospital. This is especially true when you’re preparing to rent a temporary or permanent mobile MRI, CT or PET/CT system. HealthCare Business News spoke with Donald McCormack, the chief executive officer of Southwest Medical Resources, to get an idea of what to expect when you’re expecting a mobile unit.

HCB News: How far ahead should you plan to rent a mobile unit?
DM: In the past, they were readily available when you needed them, but in this last year we’ve seen a significant change in demand. Back in 2008, there were several mobile companies building trailers, and now there are very few and their capacity is much lower than it was back then. You need to be doing a rental as far in advance as possible. The real solution here is to have a Rolodex with numerous companies who can provide these services to you to really get an answer. Two or three months is the minimum time if you’re looking for a long-term production. In our company, I need 90 to 120 days to build a mobile solution to suit.

HCB News: Do you need a special location for the mobile unit?
DM: There are three ways to go about this. The most preferred, when you have a mobile that you’re going to use for an extended period of time, is a concrete pad that’s poured specifically for the use of mobiles. For short-term interim needs, it is perfectly acceptable to use an asphalt location, five or six parking spots that are set aside. But, it’s really important to note that they’re going to put steel plates underneath the landing legs of the mobile to disperse the weight and that there will be damage to the asphalt, especially if it’s a really hot environment. The mobile provider will never take responsibility for this and you will end up with some parking lot damage if it’s really hot. An interim solution to that is a pad for each wheel.

The last one that is the least desirable, but has been used for short-term solutions, is having compacted dirt. This is only good in arid climates and it’s only for really short-term solutions.

HCB News: What are the power requirements?
DM: Depending on the type of mobile that you’re going to be putting in place, it’s always 480/three-phase power as the maximum, and 200 amps is the maximum need. The power requirements are typically a Russellstoll connector for a mobile unit. That’s a four- or five-wire [connection] and the OEMs decide which one they’re using. That four- or five-wire connection can be adapted. So, if you’re putting one in your facility, it’s better to have a five-wire Russellstoll connector than to use an adapted connection to go down to the four-wire for the mobile if you get one that’s a four wire.

The other way the power is hooked up is by hardwiring the trailer into the facility, but you have to be aware and make sure that you get a licensed electrical contractor and/or certified staff of the facility. The last, and least desirable, is a generator. This should only be considered as a temporary solution. I’ve had situations in which the generator was as expensive as the mobile unit.

HCB News: What are the state, county and city regulatory requirements?
DM: It’s important to note that a lot of states require Certificates of Need, and this is typically related to demographics of the local area and utilization rates. So, a lot of times, if you have the demand, you can get past the Certificate of Need, especially for a mobile interim solution. But, if it’s going to go any time longer than that, you’ll have to get a Certificate of Need.

There [may also be] health department and/or Housing and Urban Development codes. Make sure that the trailer you’re getting comes pre-certified for whatever local health department and/or HUD stickers you might need. There are insurance requirements by the mobile provider that some states and counties require. You show proof of it and you have to have it up and mounted.

HCB News: Are there security concerns?
DM: The trailers usually come with locks on the doors and underneath the belly boxes. The technologists should be locking up the trailers when they leave them, every time they go inside the facility. It is a pain, but it should be done. We’ve had situations in which people have taken up residence inside of our equipment because it was left open. It’s common to set up barriers to keep cars and trucks from getting too close to the equipment. When the rented equipment is in your facility, you’re responsible for it, so damage from somebody backing into it can cause trouble.

On the MRI side, it is necessary to keep some distance from the magnet, especially on some of the older systems, in order to keep the quality of the images coming out of it as good as possible. A three- to eight-foot barrier is common. Newer technology needs no more than 3 feet.

HCB News: Are there wear and tear concerns, and should a facility be wary of any unanticipated expenses associated with the rental?
DM: It’s common to see additional charges for abnormal wear and tear, so be very careful here. Make sure your personnel are very aware if there is a deposit. It’s common for the personnel that are using the mobile to go, ‘Hey, this is just a temporary thing’ and not take care of it, and it can cost you a lot of money.

HCB News: What can be done to help make the patient experience better?
DM: If you’re doing something more permanent, [I’ve seen] grass settings around them, picnic benches set up around them, planters, ramps leading up to them. You can even pull one inside, so you don’t even know you’re in a mobile. (If) there’s a service entrance at the back of the building where you have a roll-up door, the mobile pulls in and parks and then there’s this hood that extends the hallway and connects it to the side of the building, so you never actually walk into a mobile.