Health systems are delaying tests due to a shortage of contrast dye used in many imaging procedures. Hospitals may not see normal supplies until well into the summer.
More than two years into the COVID-19 pandemic, hospitals are now dealing with another supply chain challenge that’s affecting their operations and patient care.
Hospitals are confronting a worldwide shortage of contrast dye, which is used in many imaging procedures. Contrast dyes, which are taken orally or intravenously, enable clinicians to see blood vessels, organs and tissues more easily in CT scans and other imaging.
Due to the shortage, many hospitals are delaying some screenings as they attempt to conserve dye for emergency care and diagnosing serious health events, such as stroke, cardiac events and cancer.
The shortage stems from the lockdowns in Shanghai due to COVID-19 transmission. GE Healthcare, one of the major suppliers of contrast dye, operates a plant in Shanghai that produces most of its Omnipaque products. The plant had shut down for weeks and is now reopened, but it’s not at full capacity. GE Healthcare is ramping up production at a facility in Cork, Ireland to help address the shortage.
Nancy Foster, vice president for quality and patient safety at the American Hospital Association, said it’s not clear how long it will take for hospitals to be restocked. But she said shortages could last until the middle of the summer.
“It is expected for the next few weeks, hospitals and imaging centers will not be getting their normal allotments,” Foster told Chief Healthcare Executive.
In a statement, GE Healthcare says the company is working to increase production of contrast dye products.
“Our priority is delivering for our customers and their patients, and we are working around the clock to expand capacity of our iodinated contrast media products,” GE said. “After having to close our Shanghai manufacturing facility for several weeks due to local COVID policies, we have been able to reopen and are utilizing our other global plants wherever we can. We are working to return to full capacity as soon as local authorities allow.”
GE Healthcare said the Shanghai plant has returned to about 50% of capacity and is working with local officials to bring back more workers as soon as possible. The company has switched shipments from sea to air at both its Shanghai and Ireland plants to move supplies more quickly.
‘A lot of questions’
The American Hospital Association said many members are getting about 20% of their normal allotments.
In a May 16 letter to GE Healthcare, the hospital association urged GE Healthcare to prioritize supplies to healthcare facilities treating patients with acute needs: stroke centers, heart care centers, cancer centers and those with large and active emergency departments.
“We think it would be in the nation's best interest if those places were of high priority to get the supplies that are needed,” Foster said.
GE Healthcare has been as transparent as one would hope in the situation, Foster said.
Still, the association said it’s hearing concerns from many members about the shortage.
“We have heard a lot of questions that people are asking so they can best plan for the management of their patient populations,” Foster said.
While hospitals are explaining to patients why some non-urgent scans are being postponed, Foster said, “You want to be able to tell them when they expect to do the scan. That’s what hospitals want.”
Matthew Davenport, vice chairman of the American College of Radiology’s Commission on Quality and Safety, said the shortage is serious. Nationally, about 50 million exams annually use contrast dye, Davenport said.
“It’s having a severe impact on healthcare systems in the U.S.,” he said.
“The supply has gone extraordinarily low for places that use GE products.”
GE has said it hopes to have supplies return to normal by the end of June, Davenport noted. Even if that occurs, Davenport said health systems are going to manage a backlog of delayed tests, because some non-urgent scans are being postponed.
“I’m expecting this to last through the summer,” he said.
The hospital association is also asking GE how it intends to meet the demand as health systems aim to manage all those delayed tests.
Asking for patience
Allina Health is notifying its patients on its website about the shortage of dye. The nonprofit system based in Minneapolis said it is “taking steps to conserve our supply of the dye while ensuring that all of our patients receive safe and appropriate care.”
The system is advising patients that it expects the dye shortage to last at least through June 30.
Ryan Else, Allina Health vice president, system clinical officer, said the system has seen a “significant decrease” in its supply over the last several weeks.
“The challenge is how long this will last and how long overall quantities will be reduced,” Else said. He stressed that patients needing scans for emergencies are getting them.
Allina clinicians are doing alternate procedures and telling some patients their scans need to be postponed.
“Most patients are typically understanding when you explain the situation,” Else said. “Frustration does come up.”
Hospitals are bracing for some agitation from patients as other scans and tests are delayed.
“We do ask for the public’s patience on this,” Foster said. “If any individual has to have their scan postponed because of this supply chain challenge, we hope they can take comfort in the fact that the best clinical minds agreed the scan could be postponed.”
The AHA has also reached out to insurers to communicate the scope of the shortage and why providers may be submitting other tests than CT scans, and to brace for a big uptick in scans when supplies of contrast dye improve. Foster said national insurance groups would be spreading the word to insurance firms. “We’re appreciative of the fact that they are letting folks know,” she said.
For hospital leaders, the shortage is the latest in supply chain challenges through the pandemic.
Soon after the arrival of COVID-19, many healthcare systems and long-term care facilities were scrambling for personal protective equipment. With the pandemic disrupting manufacturing, some health systems appealed to the public for used crutches and walkers.
With some tests being postponed due to the dye shortage, hospitals are taking another hit financially at a time when many are dealing with negative operating margins and higher supply and labor costs.
At Allina, Else said he had a moment of disbelief when he learned about the shortage of contrast dye. But he said he was impressed by how quickly staff turned to tackling the problem.
“Our mentality has gone into problem solving crisis after crisis,” Else said. “We've become very accustomed to dealing with these now.”