Department of Radiology PET/CT Replacement Proposal $2.2 M Capital Request June 2016

Summary of Alignment of Project to Grady Pillars Goal Quality The PET/CT Scanner was purchased in 2003 and is the only scanner of that age still in use in Metropolitan Atlanta. All other GE Discovery ST Scanners have been decommissioned and replaced. Additionally, the resolution quality of the images is reduced requiring additional acquisition time per patient which contributes to decreased throughput. Service Excellence In 2014, 20 service calls were placed for the PET/CT Scanner; 17 service calls were placed in 2015; 11 service calls have been placed YTD 2016. The scanner downtimes have resulted in rescheduled exams and delays in Oncologic treatment. The current scanner also requires the technologist to spend one hour each day to transfer images to I-Site PACS. People Replacing the PET/CT Scanner with a state of the art unit would make the work environment less stressful and more efficient for the patients, referring physicians and others stakeholders who rely on the services of the department. Growth Continue to increase volume as overall system grows through garnering referrals from hospital-based clinics and promotion of differentiating services (i.e., Cardiac PET/CT Studies) Service projects growth in select services – Alzheimer’s Disease, Cancer Care ( Lung, Breast, GI, and Prostate), and Cardiac Disease. A projected increase of 10 additional patients per day would result in a growth rate of 167% daily. Our current capacity is 6 patients per day. Stewardship The Oncology market is expanding with new reimbursement. Neurology reimbursement is also growing with the reimbursement for Alzheimer's disease. With the aging of the baby boomer population and the emphasis on heart disease and its prevention, CMS continues to expand reimbursement in Cardiology. 2015 Contribution Margin: $705,847.00 Pay back period: 3.1 years

PET/CT Margin Analysis Reporting Period Cases Operating Revenue Per Case Direct Fixed Cost Per Case Direct Variable Cost Per Case Contribution Margin Per Case CM % Indirect Cost Per Case Operating Margin Per Case Operating margin % 2014 910 $1,857 $644 $481 $731 39% $492 $239 13% 2015 906 $2,045 $754 $512 $779 38% $521 $258 2016 400 $2,073 $669 $572 $832 40% $493 $339 16% Capital Request $2,209,493 2015 Contribution Margin 705,847 Payback Period 3.1 years Source: GHS Decision Support