GE allies with healthcare providers to develop CT colonography

GE Healthcare and outpatient provider AmSurg will sign today agreements with the Cleveland Clinic to explore how CT colonography might evolve into an accepted screening tool for colon cancer. The agreement with GE calls for that company to provide equipment, engineering, and support; eRadiology, the teleradiology group within the Cleveland Clinic radiology division, will provide clinical expertise. AmSurg's agreement calls for it to provide the outpatient facilities for conducting CTC exams.

The project is the first to cut across such a wide swath of the healthcare community for the express reason of developing a potentially useful yet widely ignored technology. The individual groups have much to gain from the project's success. GE stands to gain from the sale of scanners and IT technology optimized for virtual colonoscopy. AmSurg may open a new revenue stream for its growing legion of outpatient facilities. And eRadiology will benefit from being on the leading edge of a screening modality that will be optimized for remote interpretation.

The biggest winner, however, could be the U.S. public. AmSurg, which is the nation's largest provider of optical colonoscopy, estimates that 30,000 more GI specialists would be needed, if all the people in the U.S. who should get a colonoscopy actually did so.

"Colon cancer is one of the most curable forms of cancer, if detected early," said David Manning, AmSurg executive vice president and chief development officer. "As we document results from CTC, we believe we will be able to demonstrate its efficacy and cost benefit and convince third-party payers and the Centers for Medicare and Medicaid that it should be reimbursed appropriately."

Notable is the high level of commitment being given the project, as signatories to the agreements represent the upper crust of each organization. Joe Hogan, president and CEO of GE Healthcare; Dr. Delos M. "Toby" Cosgrove, chief executive officer and chairman of the board of governors of The Cleveland Clinic; and Ken P. McDonald, AmSurg CEO and president, are slated to sign the partnerships today in a ceremony hosted by the Cleveland Clinic.

In the weeks ahead, AmSurg will begin lining up the first centers to implement CT colonoscopy as a screening tool. Screening will start in mid-2007, according to Manning. These early adopters will install 16-slice CTs from GE as part of the project. Cleveland Clinic's eRadiology will interpret the exams via the Internet.

"Over the next two to three years we will have 10 of these sites operational and working," Manning said. "Over time we would like to offer the service in all of our centers offering colonoscopy."

AmSurg co-owns with local physicians 152 outpatient surgery facilities in 32 states and the District of Columbia. Of these, 101 offer colonoscopy. These numbers are expected to grow in the years to come, according to Manning.

As the largest provider of optical colonoscopy in the U.S., AmSurg is the ideal provider for this project, according to Dr. Michael Recht, chairman of eRadiology at the Cleveland Clinic, who brought the alliances together. Recht chose GE, he said, because the company has demonstrated a strong corporate commitment to CT colonography, as indicated by its designation of CTC as an "imagination breakthrough." (These breakthroughs are given priority funding and corporate support for development because of their long-term potential for growth, according to a GE spokesperson.)

The first AmSurg centers to adopt CTC will be in large metropolitan areas, but eventually smaller, lower volume centers will be folded in. Understanding and meeting the clinical needs of outpatient centers will be explored as the project expands.

Many of these needs have yet to be discovered, but Recht believes minimizing patient preparation will be a high priority. This will be necessary so that patients who need therapeutic colonoscopy can have the procedure performed the same day without a significant delay, he said.

Research directed at this and other objectives will help achieve the overriding goal of developing an effective and efficient system for conducting CTC. This will include storing, transmitting, processing, viewing, and interpreting the results. The real kicker in doing all this will be to use as little bandwidth as possible, so that studies can be transmitted efficiently for remote reading.

GE will focus on the technical aspects, including those related to the 16-slice CTs it will provide. Cleveland Clinic chose these scanners because they generate sufficient thin-slice data to support CTC and expose patients to minimum radiation dose, according to Recht. The evolution of CT technology has also made them the de facto entry points for high-performance scanning.

"We want to make colon screening available everywhere, so we don't want to just endorse the high-end systems for this procedure," said Bob Beckett, GE's global product manger for diagnostic oncology.

If experience with the 16-slice scanners indicates that more power is needed, the program can be adapted accordingly, Recht noted.

The project may have significance beyond expansion of colon cancer screening with CTC. The alliance of academia, for-profit providers, and an equipment vendor may serve as a model for how to win widespread adoption of other clinical techniques now in early stages of development, according to Beckett.

"This project should help us understand how to promote new products and how to get them out to the marketplace faster," he said.