Without any outreach to patients, UCSF managed to average two to three patient referrals a week and eligible patients chose focal HIFU. The hospital's ROI was to break even after 2.1 years, with approximately one to two Medicare or privately insured patient per month after an initial ramping up period. Instead of one or two patients per month, we saw, on average, five patients per month in the first year of using the HIFU platform. It looks like we will break even in the first year.

For patients on active surveillance who choose to have the HIFU procedure, they are converted from an office visit to outpatient surgery, which produces more revenue but also gives the patient greater peace of mind. Our goal, going forward is to provide the highest quality of care as well as offering all treatment options to our patients.


All cases have come by word of mouth and through internal referrals. UCSF hasn't even begun to market this procedure yet! We have far exceeded projections for the number of cases expected to be performed initially. In addition to being an important new option for the clinical benefit of our patients, focal HIFU has already proven to be a new revenue-generating service line complementing our comprehensive prostate cancer care program.

My take-aways from the experience
There are four key lessons from going through this process with UCSF Health that might apply to all physicians who wish to bring on new medical technologies:

• Have a global vision on the investment and factor in the direct and indirect positive impact of adding a new service line to a department.
• Physicians applying for a new piece of equipment for their department should partner with a business administrator who can support their effort.
• Understand the patient population and estimate how many patients will benefit from the procedure.
• Ultimately we must advocate for the highest quality of care for our patients and be prepared to overcome the challenges of doing the right thing.

About the author: Laura Crocitto, MD, is the vice president and chief medical officer of cancer services in the Helen Diller Family Comprehensive Cancer Center at UCSF. She is also a board certified urologist.

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