Since its inception in April of 2004, the computed tomographic (CT) colonography clinical program at our institution has rapidly grown into a bustling viable enterprise. This editorial will detail our philosophies and actions in building a successful CT colonography program, which has already become an integral part of colon cancer screening at our center. The concept of success in this editorial refers to the following: (a) the ability to provide noninvasive yet effective colon cancer screening through the use of CT colonography; (b) the ability to interweave CT colonography into an already established optical colonoscopy program while maintaining cooperation and col-legiality with gastroenterology colleagues; (c) the ability to provide a patient-friendly and seamless service for colorectal screening, including same-day polyp removal with optical colonoscopy, if needed; and (d) the ability to receive third-party reimbursement for screening CT colonography.
The factors necessary for success can occur at various levels. Broadly, there is a national level at which the current hurdles of demonstrating uniform clinical efficacy and addressing the continued resistance to reimbursement predominate. The local level relates to the milieu of hospitals and third-party payers that shapes the regional health care environment. Finally, there is the institutional level, at which equipment, personnel, hospital administration support, and clinical colleague relationships are critical. This editorial will deal with each of these three areas, taking note that the individual practitioner has more direct influence at the local and institutional levels. We will also provide a brief update on the current status of our CT colonography clinical program.
