Feasibility and Cost Analysis of Portable MRI Implementation in a Remote Setting in Canada

Chloe N DesRoche; Ana P Johnson; Elizabeth B Hore; Elaine Innes; Ian Silver; Donatella Tampieri; Benjamin Y M Kwan; Johanna Ortiz Jimenez; J Gordon Boyd; Omar Islam

doi:10.1017/cjn.2023.250

Feasibility and Cost Analysis of Portable MRI Implementation in a Remote Setting in Canada

Can J Neurol Sci. 2023 Jul 12:1-10. doi: 10.1017/cjn.2023.250. Online ahead of print.

Authors

Chloe N DesRoche¹, Ana P Johnson^{2

3}, Elizabeth B Hore², Elaine Innes⁴, Ian Silver⁵, Donatella Tampieri⁵, Benjamin Y M Kwan⁵, Johanna Ortiz Jimenez⁵, J Gordon Boyd^{6

7}, Omar Islam⁵

Affiliations

¹ School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
² Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
³ Institute for Clinical Evaluative Sciences (ICES)-Queen's, Queen's University, Kingston, ON, Canada.
⁴ Weeneebayko Area Health Authority, Moose Factory, ON, Canada.
⁵ Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, ON, Canada.
⁶ Department of Medicine (Neurology), Queen's University, Kingston, ON, Canada.
⁷ Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada.

PMID: 37434471
DOI: 10.1017/cjn.2023.250

Abstract

Objective: To conduct feasibility and cost analysis of portable MRI implementation in a remote setting where MRI access is otherwise unavailable.

Methods: Portable MRI (ultra-low field, 0.064T) was installed in Weeneebayko General Hospital, Moose Factory, Ontario. Adult patients, presenting with any indication for neuroimaging, were eligible for study inclusion. Scanning period was from November 14, 2021, to September 6, 2022. Images were sent via a secure PACS network for Neuroradiologist interpretation, available 24/7. Clinical indications, image quality, and report turnaround time were recorded. A cost analysis was conducted from a healthcare system's perspective in 2022 Canadian dollars, comparing cost of portable MRI implementation to transporting patients to a center with fixed MRI.

Results: Portable MRI was successfully implemented in a remote Canadian location. Twenty-five patients received a portable MRI scan. All studies were of diagnostic quality. No clinically significant pathologies were identified on any of the studies. However, based on clinical presentation and limitations of portable MRI resolution, it is estimated that 11 (44%) of patients would require transfer to a center with fixed MRI for further imaging workup. Cost savings were $854,841 based on 50 patients receiving portable MRI over 1 year. Five-year budget impact analysis showed nearly $8 million dollars saved.

Conclusions: Portable MRI implementation in a remote setting is feasible, with significant cost savings compared to fixed MRI. This study may serve as a model to democratize MRI access, offer timely care and improved triaging in remote areas where conventional MRI is unavailable.