Don’t buy equipment, identify the right vendor.

The bunkers that will contain the proton therapy equipment are purpose-built for this equipment. The bunkers have to house large machines and are to meet shielding requirements. With walls between 2 and 3 meters thick the bunker is to be no bigger than necessary. Each vendor has specific requirements with respect to the design of the bunkers (e.g. for cabling purposes). Consequently a vendor lock-in occurs when buying proton therapy equipment. For this reason alone it is only sensible to take a look not just at the performance of the equipment but also at the performance of the vendor.

A proton therapy center has to remain successful for a period of at least two decades. During this time its clinical benefits shall outweigh those of conventional radiotherapy. As conventional radiotherapy continues to develop (e.g. online volumetric imaging (MR Linac) and adaptive planning) also proton therapy must keep innovating. What vision does a vendor have for the future of proton therapy? What innovations are lined up? How easy will it be to implement them?

Realising a proton therapy center is a major challenge. It doesn’t stop at constructing a building and installing procured equipment either. A proton therapy center comes with additional challenges. Challenges with respect to IT-infrastructure,  the development of new work procedures, the integration of existing clinical services, training of personnel, education of stakeholders (including potential referrers). Some vendors already provide services in some of these areas. In other areas they can leverage their expertise.

All in all the vendor (its vision, its services, its expertise) will be of greater importance to the success of the proton therapy center than just the functionality of the equipment it is selling today. Trees with Character will help with identifying the right vendor for your project. Also in case of  a public tender.

 

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If you found this to be of interest perhaps you may want to read the following original contributions: Solutions in proton therapy — for initiatives (a report), Procuring proton therapy equipment (a case) and A Business Case for a proton therapy initiative (a case).

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This is how we make proton therapy a success

Proton therapy technology is the least of your worries.

There is too much risk in the field of proton therapy, but the problem is not the technology. Focussing on technology often results in underestimating the real challenges. Challenges a vendor may help you with.

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Independent consultancy made the difference for us.

Proton therapy vendors have a lot of expertise and a need to sell equipment. They may not protest when unrealistic assumptions are made. Some consultants combine great expertise with ties to a vendor. Independent consultancy can make a difference.

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Don’t buy equipment, identify the right vendor.

Because of the vendor lock-in for the lifetime of the proton therapy center, the services and capacity for innovation a vendor offers are of much greater importance than current functionality of the equipment. Shift the focus.

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Patient selection and patient referral are pivotal.

Many proton therapy centers struggle because of unrealistic projections of patients being treated. But even when making a realistic projection, the challenges of patient selection and referral remain.

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Patient selection and patient referral are pivotal.

Many proton therapy centers struggle because of an unrealistic projection of the number of patients that will be treated. In the past, and even in the present, the number of patients projected to be treated was simply the number that was required to make the business case look good. Today we know that the most successful centers treat, on average, no more than 300 patients per treatment room. But to achieve even this number takes great effort. There is the challenge of identifying the patients who will benefit from proton therapy, and there is the challenge of getting these people referred to the center.

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Don’t buy equipment, identify the right vendor.

Initiatives who want to provide proton therapy treatments — often hospital organisations — are confronted with very complex and very capital intensive equipment they have never procured before. A proton therapy project is perceived as a major risk, and rightly so. Too many centers have failed or are failing. The risk lies not with the equipment, however. All vendors build reliable machinery delivering identical protons. Not all vendors, however, provide the same expertise and solutions. Initiatives should not focus on technology, but on identifying the vendor who is best able to meet their particular challenges.

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You can start to minimise risk in proton therapy today.

A decision is a conclusion reached after careful consideration. If you have to think about something it means this something is not transparent. If you take a decision when something is not transparent risk increases. This risk is minimised by unambiguous aims and access to expertise. What is it that you need to achieve? Who is the expert that will help you achieve it? Trees with Character helps with both.

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Proton therapy technology is the least of your worries.

Cyclotrons and synchrotrons alike are built to last for decades — as is shown by the early proton therapy centers who became operational in the previous millennium. To this day, however, the complexity of the equipment often is an initiative’s biggest concern and many resources are spent on trying to understand it. Meanwhile none of the proton therapy centers who failed failed because of the technology. There are other, much more relevant issues and challenges to be considered.

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Independent consultancy made the difference for us.

Proton therapy vendors have a lot of expertise. They also need to sell their equipment and associated services and may not point out which of an initiative’s assumptions are unrealistic. Some consultants possess great expertise — as well as an agreement with a vendor. Independent consultancy can make a difference. Independent consultancy means that the only interest to consider is your interest. Trees with Character will help you to make the right choices.

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Proton Therapy’s biggest problem is lack of transparency.

Initiatives don’t share their overall aims, vendors focus on technology. Everybody is blind to the other side’s needs and capabilities. Without transparency everything is a risk. Everybody is looking for safety and control. Many resources are spent on inspections, on meetings, on the contract. But there is another way.

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