Building a proton therapy center

Building a proton therapy center

IBA - The right partner in proton therapy

With proton therapy, a cancer center can continue to stay on the leading edge — offering the most advanced treatment to cancer patients.
Choosing the right partner turns a complex adventure into a simple, well mastered project.

Make your team of proton champions

Bringing proton therapy equipment to your institution will require the involvement of specialists from multiple fields. It is particularly critical to select proton therapy “champions” from both the medical and the medical physics specialties. Each proton project will have to compete against other capital projects e.g. upgrades to surgical suites, renovations, etc. and the champions will need to persuasively present the value of proton therapy. Furthermore, they will have to bring on board other professionals such as Radiation Oncologists, Radiation Therapists, and Medical Physicists. In addition, expertise from fields as diverse as finance, administration, law, reimbursement, regulation and construction is also required.

We therefore highly recommended that you form a multidisciplinary project team that is supported by administrative staff who are capable of handling and coordinating all aspects of the project. Their duties will include defining and scaling the project and answering questions on demographics within the region, the institution’s fields of excellence, the patient referral chain, the mix of treatment options and so on.

Build your business model

For a capital-intensive project of this scale, structuring and securing optimal financing is critical to success. The right partner can support you in building
a good business case, exploring funding options and serving as a liaison with potential investors and financial institutions.

Your ability to secure financing will be directly tied to your potential to generate income once your proton therapy center is operational. The following questions must be answered as you plan your project:

• How many patients could be treated per year?
• Which will be the referring hospitals and what level
of certainty do I have in reaching the expected number
of patients?
• Will the center specialize in certain cancer indications?
• Who will pay for the treatments? Do I need to make a finance agreement with payers such as private insurance companies, national health insurance, patients, etc…
• Will the center perform other related services, such as imaging?
• Will the center offer treatments only or will it also participate in research programs?
• Will 3rd parties such as developers be involved? If so, how?

In order to be economically feasible, your proton therapy
center will have to treat a certain number of patients each year. To minimize the risk of income loss, you may ask hospitals to commit to referring a certain number of patients per annum. You could utilize hospital internal data to assess what percentage of patients currently treated with traditional radiotherapy
could be instead treated with proton therapy. Typically, a center treats around 300 patients per room per year.

Equipment and design

A proton therapy facility requires both hardware and software components. An equipment provider must be able to partner with you in order to integrate the proton therapy center into the overall operations of your medical institution,
while keep it up and running for patient treatment. This is where experience matters.

The know-how and expertise gained by equipment providers over time and during past projects will ensure that you will reach your first patient treatment faster.

Clear identification of your clinical and business objectives will help you define your requirements for functionalities and treatment modalities. Flexibility
and adaptability is an important aspect when it comes to selecting the most appropriate equipment provider, as this will enable the perfect match between your ambition, your resources and your equipment configuration.

Last but not least, most equipment manufacturers specialize to some degree and for this reason may not offer every feature or service that you need. A good equipment provider routinely works with other vendors to ensure ancillary equipment is built to its own specifications in order to achieve complete compatibility and integration.

Design your center
Starting with a complete set of architectural drawings that are based on the center’s design and builder’s specifications saves time, workload and expense.
A facilities interface and construction manager (both from the vendor and the buyer of the system/hospital/clinic) should be designated for the coordination of building efforts and equipment installation, and also for the performance of
regular progress checks.

The entire team
should have the opportunity to consider how the building design could be adapted to patient workflow and treatment procedures in order to obtain maximum efficiency: in this, an experienced vendor will be highly valuable.

Build your center

Site selection
A typical proton therapy center occupies a fairly large space of up to several acres and provides four or five treatment rooms. However, new proton therapy systems now dramatically reduce space requirements: compact, single-treatment-room systems can be installed as a small building addition.
Some factors to consider when choosing the optimal site for construction
• Availability of real estate at or near an existing cancer treatment center
• Total number of planned treatment rooms
• Potential need or desire to expand the size of the proton therapy center in the future
• Center usage i.e. treatment only or treatment plus research, plus imaging and/or training
• Proximity to referring hospitals, lodging, public transportation

The type and number of governmental authorizations required will vary, depending upon the center location and the types of treatments offered.
The most common required approvals include land-use and building permits, certificates of need (CON), operating licenses, and import authorizations.
In addition, reimbursement schemes are defined by legal authorities and/or private insurers.

Building construction
The construction phase may last from one to three years, depending on the scope of the center. Construction time usually has a significant impact on the b plan. The center could be completed in phases in order to have the first treatment room operational as early as possible, while the other rooms are still being built and tested.

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