| General
1.
What are the advantages of a Mobile Interim Solution?
- Flexibility:
Renting AMIS mobiles allow healthcare providers to respond quickly
to developing situations in an economical manner.
You may rental the mobile unit for as long as you need it: a
week, three weeks, three months, one year, four years.
This solution allows customers to use their own staff/radiographers,
giving them maximum continuity and minimum impact on budgets.
- Value-added:
A mobile interim service aloows you to meet a temporary imaging
need that would otherwise cost the department and hospital lost
revenues and/or an increase in your waiting list, from not having
an imaging system.
- No capital commitment:
A mobile interim service allows you to have immediate access
to the imaging equipment required without being exposed to the
financial risks of acquisition and long-term commitments.
- All-inclusive price and service
AMIS prices include a fully comprehensive service and maintenance
contract on all equipment and structures: this includes the scanner,
trailer and the printing facilities provided on board.
Site planning guidance and emergency coverage are also part of
the contract.
One competitive fixed price for the rental period is given with
flexible monthly payments and no hidden costs.
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2. How far in advance should
a booking confirmation be made?
Once you know the exact or approximate rental period, we will allocate
the mobile system that best suits your needs. However, we operate
on a “first come…first served” basis, therefore
a booking confirmation should be made as soon as possible. An offer
is subject to availability at the time of booking. In the event
that another party may request the unit allocated to you, we would
inform you and request a firm booking within 48 hours.
There are occasions when the hospital is unable to establish exact
rental dates. As it is our aim to provide our customers with the
system that best suits their needs, whenever it is needed, we endeavour
to maintain constant communication with you regarding any occurring
developments.
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3. Will the system be different
from the one I am using or getting?
We have a wide range of systems and we will do our best to offer
you the system that best meets your needs. Not all our customers
operate the same system. Our applications training specialist will
make sure that your radiographers feel comfortable by the end of
the standard training period.
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4. Does an Interim Solution
include radiographer service?
No, a mobile interim solution does not include radiographer service.
However if required, and depending upon availability, staff can
be provided through the services of Alliance Medical Ltd at an additional
cost.
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5. Is the image quality affected
by the unit being transported from site to site?
All our trailers are built to imaging equipment manufacturer guidelines
and with their authorisation. Consequently, the imaging equipment
contained within the trailer is specifically installed and set up
to be a mobile system by the original equipment manufacturer. Strict
procedures are followed and only specially trained drivers are used
to deliver the units. No image quality is lost despite the fact
that some units may move to a new site every day.
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6. What insurance cover do
I need?
Whilst on site and during transportation, trailer and scanner insurance
is included. Public liability and the usual professional liability
insurance must be provided by the hospital.
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7. How can I download the documents
on the site?
Web site help - Adobe Acrobat PDF documents : Some of the documents
available for download on this site are in PDF format. To download
this FREE software please click here.
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Training
8.
Do you provide training?
Applications training will be provided to enable you to safely
and confidently use the unit.
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9. How long is the training
period for?
A minimum of two days applications training is required. Additional
days of applications training may be required depending on the customer’s
experience with the equipment.
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10. We are familiar with the
system so will I still need training?
Applications training is required in all cases to ensure the safe
and proper operation of the equipment and familiarity with the trailer.
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11. Who will be training us?
Alliance Medical with its large pool of specialist radiographers
is in a position to be able to extend its business beyond the supply
of an excellent imaging service. Applications Specialists, highly
trained individuals, are supplied to some of the major manufacturers
of CT and MRI equipment to train their customers on the use of the
equipment.
This relationship with these customers demonstrates the level of
expertise that the Alliance Medical team can bring to any customer’s
site to support their imaging service. These applications specialists
are therefore able to train to the highest level in terms of system
use and clinical demand.
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12. Is Alliance Medical a recognised
training provider?
Since the business was established in 1989 Alliance Medical has
built its reputation on training its employees. An internal training
programme was developed to ensure that all of its radiographers
were trained to the highest standards possible.
This programme was then taken to St Martin’s College, part
of the University of Lancaster College Group, where it was recognised
as a quality course and an award of a College Certificate in Advanced
Studies (CCAS) was made, this course went on to win a national training
award. The course was then developed further and modified so produced
two course the CCAS in Applied MRI Technology and the CCAS in Clinical
MRI. Both of these courses were accredited at Masters level and
under the new arrangements were available to radiographers external
to Alliance Medical.
The partnership, which has been developed with St Martin’s
College, has flourished and in 2000 this culminated in the development
of a Post Graduate Certificate in MRI. This allows MRI radiographers
to gain a formally recognised postgraduate qualification at a high
level through Alliance Medical. Students are able to progress, if
they wish, to an MSc in MRI at St Martin’s College.
The development of MRI and CT courses continued with the inclusion
of an introductory MRI course, which is used as first level classroom
education in MRI. This course attracts a considerable number of
external candidates to Alliance Medical and is widely recognised
throughout the MRI community.
The Alliance Medical CT course has proved to be very popular and
is currently completely booked up for the year 2002. This non-qualificatory
course offers attendees a wide range of topics both scientific and
clinical on which to develop their CT knowledge. The demand for
the course and feedback from delegates has led Alliance Medical
to work with St Martin’s College to develop a PgC in CT ready
for 2003.
The expertise of the Alliance Medical training department has been
recognised by the most prestigious Neuroradiology course in the
UK; The Oxford Neuroradiology Review. This course, led by the Neuroradiology
department at the Oxford Radcliffe Infirmary has been run for over
5 years and covers a wide range of topics. In 2001 the group approached
Alliance Medical to take over the management of the course and this
has led to the formation of a strong relationship between Alliance
Medical and the Oxford Neuroradiologists.
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The Mobile Unit
13.
Can I work in the mobile just like I do in our own purpose-built
room in the hospital?
Our mobile MR and CT units are equipped with both the relevant
diagnostic imaging equipment and a dry laser imager. Our CT units
all have contrast injectors and extendable sides that increase the
area of the scan room. The separate control room gives radiographers
a comfortable location from which to work efficiently.
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14. Where will I get the patient
changed and ready?
Some of our CT units have a curtain which can be drawn across part
of the control room to form a sheltered area. The MRI units do not
have this area as the computer equipment room restricts the space
available. Many of our customers dedicate a space within the clinic
to allow patients to change.
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15. What are the power requirements?
For operational use, a 400 Volt 3 phase (min 125 amps per phase)
female connector is required. The five wire power cable (3 phase,
five wire, wye connection with neutral and ground) should, for safety
reasons, be connected to a mains switch. AMIS scanners come equipped
with both Marechal DS2 and Lewden PM125/808 type male connectors.
The Lewden connector is a version of the CeeForm CEE 17 125A 400V
(red) connector.
The mobile unit is supplied with approximately 10m of useable
power cable and male conductor, which are positioned mid-way along
the length of the trailer. Line voltage drops from the facility
mains to the receptacle must be included in all power calculations;
power range to be in +/- 5% of specified voltage.
A single electrical power source is required for operation of the
system. 3/N/PE AC 380/415 50 Hz fused at a minimum of 125 Amperes.
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16. If a power generator is
needed, does a mobile unit come with it?
We recommend that the unit be plugged into the customer's mains
supply but our units will function on an external generator power
supply. It is, however, the responsibility of the customer to provide
this power source but in some cases we may be able to provide you
with a local organisation who can deliver this service. Our units
need to be constantly on power so the noise of the generator at
night needs to be taken into consideration.
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17. What type of generator
would we need?
We would advise that you supply a 200 kVA 415 Volts 3 Phase 50
Hz AC Diesel Driven Super Silent Generator that can run on an unlimited
hour week. A suitably rated flexible rubber cable with a Marechal
DS2 type female connector will also be needed. It would also be
advisable to provide a fuel tank to avoid constant refilling of
the generator.
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18. In addition to standard
access for patients on foot, does the mobile facility offer accessibility
to patients in wheelchairs and on trolleys?
The mobile unit includes a safe and suitable patient lift, which
can accommodate trolleys and wheelchairs. The hospital staff will
be fully trained in the safe operation of this lift.
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19. Does the mobile have a
telephone?
All our units have a telephone on board. Therefore a normal telephone
line to enable the scanner to communicate with the hospital (with
outside dialling facility) is required. Optionally, a second dedicated
direct line of modem connection would enable external diagnostic
procedures to be carried out by the manufacturers during operation.
This will greatly aid fault diagnosis, prevent downtime and may
be used for image interpretation (in-dialling facility only and
connected to the modem line). Both of the above lines need an individual
phone socket, situated within a waterproof power-box.
In the trailer belly compartment, there is a Hubbell phone connection
socket. An adaptor must be provided to connect from the local phone
socket to the Hubbell.
- The connector type that is used is a model Hubbell PH-6595 (inlet).
- Two Hubbell PH-6599 15.24M (50’-0”) telephone-connecting
cables are included with the unit.
- The customer is required to purchase and install the necessary
- Hubbell phone connectors, model PH-6597 (weatherproof phone
outlets) at the site.
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20. Can I link up the mobile
to my hospital network?
This is possible if you tell us as soon as possible that you would
like to send images from the mobile to your own hospital network.
We then need to have an engineer from the equipment manufacturer
come to the site and configure the I.P. address of the system. A
hospital engineer also needs to be present to carry out a similar
procedure from the facility side.
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21. Who is responsible for
the connection of the power and telephone line?
The Customer is responsible for providing an engineer to arrange
for the connection of electrical and telephone services to the Equipment
on the day of delivery, and for the disconnection of such services
on the day of removal.
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22. What means of hard copy
is supplied for reporting purposes?
A Kodak DryView laser imager is provided on all our MR and CT
mobiles. The hospital will be responsible for the supply of the
necessary film (35 x 43cm Blue Laser DryView film)
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Customer Support
23.
What do I do if the equipment fails?
At the beginning of the rental, we will have supplied you with
the necessary emergency contact telephone numbers. If the equipment
fails, then you will telephone the relevant call centre and report
the problem. Our service providers will then either send an engineer
or they will try and help you resolve your problem over the phone.
Either way, your problem will be logged and dealt with as quickly
as possible. If you have any problems contacting the relevant call
centre, then a phone call to the Alliance Medical Interim Solutions
Operations Manager will enable us to help find the best response
to your situation.
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24. Who are my contacts?
Your contacts will be given to you just before the start of your
rental and will be, where possible, a local number with local language
speakers. Each part of the unit's equipment will have a dedicated
service number, i.e. scanner, trailer, camera. In addition to this
and in case of any other problem, you will have the telephone numbers
for the Alliance Medical Interim Solutions team.
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Mobile MRI
25.
What emergency facilities/equipment are available on a mobile MR
unit?
A mobile unit does not have pipe facilities; everything must be
mobile and has to be supplied by the hospital. It is IMPERATIVE
that all equipment taken into the magnet room must be MR-compatible.
A pulse oximeter and resuscitation kit for adults are also available
on the mobile.
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26. What is the exclusion zone
for a mobile MRI unit?
Due to the fact that the trailer is built with magnetic shielding,
the 5-gauss line remains within the width of the trailer. The 5
gauss (0.5mT) line is the recommended exclusion zone for cardiac
pacemakers, neuro-stimulators, and other bio-stimulation devices.
Therefore additional safety-provisions outside the trailer are
not necessary. Nevertheless heavy steel constructions may influence
the optimal image quality. If a patient walkway is constructed from
a building to the trailer it is therefore recommended that it be
of non-ferrous material.
An area of 1.52M x 1.52M (5’-0” x 5’-0”),
located directly below the magnet vent should be fenced off to prevent
injury in the event of magnet quenches.
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27. What type of magnetic shielding
is provided?
Active shielding in each orthogonal plane.
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28. What is the extent and
magnitude of the magnetic fringe field in a super-conducting 1.5
Tesla magnet?
The 0.5mT line (5 Gauss) is 4m in the axial direction and 2.5m
in the radial.
The 0.1mT line (1Gauss) is 5.70 m in the axial direction and 3.28
m in the radial.
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29. What type of cryogens does
a MRI unit use?
Helium is the cryogen used. Industry-unique K4 Cryo-cooling technology
achieves lowest helium consumption in the industry by liquefaction
of helium instead of cooling down the magnet cryostat. Helium boil-off
rate is typically 0.03 litres/hour under normal operating conditions.
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30. Who is responsible for
the cost of all cryogens required and filling of the system on a
regular basis?
Alliance Medical Interim Solutions is responsible for the service,
repair and maintenance of the equipment and for all costs associated
with this.
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31. Is fast emergency quench
available?
Yes. Gases are also vented out of the magnet room safely to the
atmosphere upon quenching.
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32. Are there detection systems
to alert personnel to problems in the system?
Yes: An oxygen monitor is used to alert personnel to low Oxygen
levels in the room. There is also a Magnet Monitor to record cryogen
levels and pressure.
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33. What would be the dB for
the sequence generating the highest Acoustic Noise level. (i.e.
Peak noise level at iso-centre and at patient aperture)?
MR Sequence generating most noise : SSFSE
Peak Noise level at iso-centre : 112dBA
Peak Noise level at Aperture : 105dBA
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34. What SAR safety cut off
points and safety standards are used?
All equipment is fully compliant with IEC requirements and therefore,
meets with the safety requirements for specific absorption rates
set forth in IEC 60601-2-33. All equipment is CE compliant and satisfies
Electro-Magnetic Compatibility (EMC) and Electro-Magnetic Interface
(EMI) regulations, pursuant to IEC-601.
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35. Is there a cooling system
for the magnet bore?
Yes, cool air is continuously circulated through the bore.
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36. How is bore temperature
monitored and information supplied to the operator?
A warning message is provided to the operator when the internal
bore temperature is superior to operationally specified levels.
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37. What are the typical shielding
factors at 2, 20, 40, 60 80 and 100 MHz?
- 2MHz >100dB
- 20MHz >100dB
- 40MHz >100dB
- 60MHz >100dB
- 80MHz >100dB
- 100MHz >100dB
The equipment provides an efficient radio-frequency shield to prevent
interference with devices/equipment in adjacent rooms/buildings.
The shield also restricts the entry of stray RF to the imaging room.
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38. Is extra hardware required
for phased array coils?
No.
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39. Does all equipment comply
with EC standards?
Yes. It complies with the EC Medical Devices Directive 93/42/EEC;
EC requirements for electrical interference and electromagnetic
compatibility (EC directives 89/336 and 92/31).
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40. Does the trailer require
a water supply?
No, but the trailer has a humidification system which contains
a water storage tank, located in the front technical compartment.
This tank must always contain water to ensure a specific humidity
level. You will be shown how to fill this tank during the training
period.
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Mobile CT
41.
What emergency facilities/equipment are available on a mobile CT
unit?
A defibrillator, suction and oxygen facility should be supplied
by the hospital. Including oxygen bottle G, suction kit and equipment.
A mobile unit does not have pipe facilities; everything must be
mobile and has to be supplied by the hospital. A pulse oximeter
and resuscitation kit for adults are available on a mobile.
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42. Does the CT unit need a water supply?
The CT trailers will need a site connection which
provides the needed water for both the humidifier and an onboard
sink. The unit does not utilize a water tank and all water that
is needed has to be obtained through a ¾" (1.905 cm)
diameter, 20'-0" (6.096m) long hose terminated with a ¾"
(1.905 cm) I.P.S male threaded hose connector located on the side
of the mobile unit. The site must provide a ¾" (1.905
cm) female connecter and a water supply.
With regards to waste water connections, the mobile unit is supplied
with a 20'-0" (6.096m) long 1½" (3.81 cm) diameter
hose that is terminated with a 1½" (3.81 cm) male threaded
connector for sanitary wastewater drainage located on the drivers
side of the mobile unit. The site must provide means of sanitary
wastewater drainage from the system, which complies with all local
applicable codes.
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43. Is there a Contrast Injector
on the CT
All of our mobile CT units have a contrast delivery system on-board.
Please contact us for details of the injector system and the type
of syringes used. It is, however, the responsibility of the hospital
to supply the consumable syringes.
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44. What radiation shielding
is present in the mobile CT?
The mobile unit has been designed to provide radiation shielding
for the areas adjacent to the procedure room. A proprietary and
highly effective lead shielding system is installed in the gantry
and patient prep room walls.
The lead shielding is designed to meet or exceed the mobile CT
site plan requirements of the medical equipment manufacturer. Lead
shielded windows are installed in the patient prep and gantry room
walls and doors. This allows easy patient monitoring from either
a standing position or a sitting position at the operator’s
console.
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45. How often is a radiation
protection survey carried out on your CT mobiles?
Our mobile CT units are checked annually by the Radiological Protection
Centre of St. George’s Hospital in London. Copies of the documented
reports can be had on request.
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Site Planning
46.
I am not sure about the feasibility of the hospital site, what do
I do?
Our site-planning guide, available through this website, will offer
you the general information you need. We will be pleased to answer
any questions regarding the feasibility of your site. If required,
someone will conduct a site survey to assess hard standings and
the trailer access route within the hospital.
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47. Where can I park the mobile?
Our mobile units comprise of a tractor and separate trailer unit,
which weigh up to 30 tonnes for MR and 23 tonnes for CT. The tractor
unit does not remain on site once the scanner has been parked correctly.
Access consideration must be given to the tractor, the patient lift
and the stairs. It is important, especially with CT, that the site
is level.
The trailers are 13 metres long and 2.6 metres wide. It is possible
to accommodate a fall of no more than 200 mm over the length and
100 mm over the width of the unit. For operational set-up an ordinary
flat and horizontal solidly paved parking space is needed. For correct
horizontal positioning of the unit the horizontal segment of the
parking space (support pad) should be 13 x 3 meters.
Road quality surface for the site is acceptable provided that
there are no drains, ducts or other below ground structures that
could be damaged by the weight of the scanner.
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48. If I don’t have
the right surface, do I need to have a pad installed?
In cases where the ground cannot support the scanner in the proposed
location, a concrete support pad, constructed to ensure a level
surface capable of accommodating the weight of a mobile scanning
unit, is recommended. A total paved area of at least 6 x 20 meters
is recommended for tractor access and patient handling.
A full pad measuring 3.04m x 13.68m (10’-0” x 44’-10½”)
is the recommended support pad. Recommendations for the width and
length of the pad are given above. It is recommended that non-ferrous
reinforcement materials be used for pad reinforcement. The support
pad must be leveled to ensure proper operation of the system.
The pad must not exceed .00317m deviation in 3.04m (.125”
deviation in 10’-0”).
A maximum of 20 kg\m2 (4 lbs per square foot) of steel is allowed
in the concrete pads beneath the mobile unit.
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49. How long will the mobile
unit take to set up?
The mobile unit should only take between 1 to 2 hours to set up
and make ready for use. We recommend that the customer have an engineer
on site to assist our driver with any connections such as power
or telephone.
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50. What time will the unit
arrive?
We suggest that the trailer arrive the night before the contract
is due to start. This allows the unit to be correctly set up and
on power well before scanning will take place. It is also easier
to manoeuvre on site at a time when there will be fewer parked vehicles.
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Alliance Medical Group- Diagnostic Imaging Services
51.
Who is Alliance Medical Group?
Alliance Medical Group (AMG) is a leading provider of diagnostic
imaging services in Europe owning and operating over 100 diagnostic
imaging systems throughout Europe.
The group comprises of:
Alliance Medical Ltd. - UK operation
Alliance Diagnostic S.r.l. - Italian operation
Alliance Viamed S.L. - Spanish operation
Molecular Imaging Services (MIS) - UK Radio-pharmaceutical
production for FDG
Alliance Medical Interim Solutions (AMIS) - European mobile
interim services
We work in partnership to provide value-added solutions across Europe.
Being a Pan-European organization means that we:
1. Proactively respond to market changes
2. Offer a greater portfolio of imaging services to our
customers
3. Enjoy the synergies of a large organization (resources,
support and expertise) whilst being able to retain a solid understanding
of local markets and individual market needs.
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52. What are the imaging solutions
available to me?
Alliance Medical Group (AMG) provides value-added diagnostic imaging
solutions:
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53. How can Alliance Medical
Group mobile managed services help me and my patients?
With this solution, our fleet of mobile CT, MRI, PET units can
provide a regular and flexible managed imaging service.
You are likely to require this service when:
Flexibility:
On average, a mobile managed service may be a one-off service (one
or two days) or perhaps, a long term solution which may include
a one-day weekly or biweekly visit to your site for as long as it
is needed i.e. six months, one year, three years, five years.
Highly Trained Teams:
A mobile managed service also means that the mobile unit will be
staffed by highly trained Radiographers that will scan your patients
professionally and efficiently. Obtaining the best results and highest
level of service to both your patients and your department requires
a culture of continuous improvement. Our Radiographers receive regular
training in the latest techniques from our prestigious UK Quality
and Education Department.
Latest Technology:
Our large fleet of mobile units and cross sectional technologies
are part of a consistent rolling upgrade program, ensuring that
our systems meet our customers’ clinical requirements with
the highest quality of diagnostic images.
Total Performance:
As a number of our mobiles can scan up to thirty patients in a
twelve-hour day, there is no difference between the capabilities
of a mobile service and a fixed imaging centre.
As with all of the Alliance Medical imaging services, once you
are in receipt of a mobile, you can rest assured that we provide
a fully comprehensive service arrangement to ensure continuity of
your scanning service to patients.
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54. How can Alliance Medical
Group fixed site partnerships help me and my patients?
A Fixed Site Partnership allows a hospital or clinic to acquire
advanced imaging facilities for MRI, CT, PET, on-site, without the
worry or risk of substantial investment. Our Fixed Site Partnerships
are based on in-depth consultation with our customers. We can construct,
install and manage the entire facility.
Continual Investment:
We undertake regular assessments to ensure that the equipment is
continuously updated with the latest configurations and hardware
to meet your clinical standards.
Stability:
Service costs are maintained.
Highly Trained Teams:
As with our mobile managed service, a fixed site partnership will
be staffed by our highly trained Radiographers, who will maintain
seamless integration with the hospital.
Flexibility:
Your facilities scope will always remain flexible as we can draw
resources to increase capacity by arranging for a mobile imaging
service.
We are not linked to any original equipment manufacturer and so
we will purchase the equipment that best suit your requirements.
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55. How can Alliance Medical
Group diagnostic imaging centres help me and my patients?
Our Diagnostic Imaging Centres in the UK and in Italy are a natural
extension of our commitment to clinicians and their patients.
Convenience and instant access: services that add value
Every Imaging Centre is being designed to provide immediate access
to the most advanced diagnostic imaging to Clinicians and their
patients. Clinicians can benefit from the latest tele-radiology
technology to access their patient reports and patients can benefit
from immediate appointments and speedy results.
Revolutionary modalities:
Such as PET/CT, specialist cardiac MRI, 16 slice CT systems, digital
X-Ray. This level of technology, all available from one centre,
set new standards for patient care and our ongoing investment programs
keep all our systems at the front of clinical demand.
Sophisticated reporting suites:
Allowing for a fast and accurate delivery of results
Centrally located:
In key population areas that provide easy access
Leading Clinicians:
We have brought together experts from a wide range of specialities
to form a leading team that delivers world-class clinical practice
and reporting. We work closely with members of this team to ensure
that our service continues to meet the needs of both the Clinician
and the patient.
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56. What is Alliance Medical
Group Molecular Imaging Services (MIS)?
Molecular Imaging Services Ltd (MIS) was established in 2002 to
produce radiopharmaceuticals for medical purposes to serve the increasing
demand for Positron Emission Tomography (PET) scanning in the United
Kingdom.
Radiopharmaceutical Production Unit:
The first commercial Radiopharmaceutical Production Unit (RPU)
based at Keele University Science Park is due to start operation
at the end of 2004 and will focus on the production of 18F-FDG,
which, with a half-life of only 110 minutes, needs to be produced
as near as possible to PET Scanner installations.
Collaborative research opportunities with the National Health
Service, Universities and Pharmaceuticals:
MIS primary goal is to set up a number of RPUs that will enable
equity of access to PET scanning for patients throughout the United
Kingdom. This RPU, and future installations, will serve both hospital
based PET facilities and mobile PET scanners.
MIS will play a key role in removing the main barrier to PET imaging
through local production of the necessary short-lived radiopharmaceutical,
18F-FDG in the UK.
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