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Making Expertise Matter in Proton Therapy

Developing a Proton Therapy Business Case

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All initiatives benefit from a flexible business case providing a realistic account of both costs and revenues for a period of at least twenty years. A flexible business case is a business case that is built on an organisation-specific operational model. This model allows for a quick assessment of the impact of a range of scenario’s. What if the reimbursement rate drops 10%? How sensitive am I to changes in energy costs? What is the impact on revenues if I can shorten the ramp up phase? The list of questions and scenarios is endless.

In proton therapy an operational model is essential to get an idea of the investment involved, to visualise the importance and impact of a ramp up phase, to play out scenario’s, to be able to determine the relative importance of a range of cost components, and to provide the total investment and annual revenue and cost streams needed to organise financing.

Trees with Character can provide you with a business case/operational model to a varying degree of detail. Our standard business case solution consists out of a 20-year operational model that includes a Net Present Value calculation which will be tailor made. For some of our customers we have included — in collaboration — a cash flow calculation.

See also this case.

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This is how we make proton therapy a success

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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You can start to minimise risk in proton therapy today.

A decision is a conclusion reached after careful consideration. If you have to think it means something is not transparent. Each decision increases risk. Risk is minimised by unambiguous aims and access to expertise. You find it here.

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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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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 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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