Total cost of high volume multi-detector CT data management

The number of CT images increased significantly when 16-row multi-detector CT scanners (MDCT) were introduced. The purpose of this study is to quantify the total data management cost of MDCTand to identify cost drivers. An activity-based costing (ABC) method was used to analyze cost drivers in MDCT data management. Changing from 4-row to 16-row CT, mean image count per exam was increased from 699 to 1465 images per exam, reaching up to 18,000 images per exam. Cost analysis was implemented in four steps: (1) identify activities; (2) assign direct costs to activities; (3) define bases for indirect costs; (4) assign indirect cost to the activities. Four major activities were identified in MDCT data management: PACS check-in, data handling during digital reporting, storage, and hospital-wide digital image distribution. Total direct and indirect costs were $49 per mean exam. With $15.27 per exam, storage turned out to be the main cost driver. Therefore, two scenarios for selective storage are discussed. When 50% of the images are deleted before long-term storage, savings of $7.63 per exam are achieved, while additional labor cost for data selection is only $4.55 per exam. When 80% of the images are deleted in a labor-intensive process, savings of $9.11 per examwill result. Awhat-if-analysis shows that long-term storage ofMDCT data is cost-effective below a storage cost of $8.40 per exam. Given the actual total cost of ownership (TCO) of $53 per GB, high performance storage is not cost-effective for long-term storage of high volume MDCT data. If the storage price decay of annually 45% continues, the break-even cost of $8.40 per examwill be reached in the next 1– 2 years. In themeantime, only the most relevant parts ofMDCTexams should be kept, or low cost mass storage media should be used to optimize the cost–value relation.D 2004 CARS and Elsevier B.V. All rights reserved.