As health care organizations come under increasing pressure to lower costs and improve patient care, they're turning to companies like Professional Portable X-ray for help.

Technologists with the Bloomington-based business can wheel their mobile X-ray machines into a long-term care facility and take an X-ray from bedside or a wheelchair, without having to risk moving a frail or elderly patient with dementia to an off-site location.

The company, which goes by its initials PPX, also works in nine state prisons and 40 county jails, eliminating the need to transport inmates. And if there's an on-field injury at a Vikings or Gopher football game, PPX staff is there to help team doctors make an immediate diagnosis.

"We're like an on-demand house call," said Sue McNamee, a radiologic technologist who co-founded the company in 1989 while working at the University of Minnesota Hospitals and Clinics.

More of medicine is shifting to care outside of hospitals and clinics, especially for vulnerable people. Health reform efforts now penalize hospitals financially if patients are readmitted to hospitals for reasons that could have been prevented.

And as Medicare reimbursements continue to get slashed, hospitals and clinics must find ways to treat patients more efficiently. Medicare-covered services such as those offered by PPX are increasingly part of the mix.

PPX has relationships with all of the state's major hospital systems, including Allina, HealthPartners, Fairview, the Mayo Clinic, Essentia and Sanford Health.

"It's not something radiology departments in hospitals want to do, nor do they have the resources or expertise to do it — to be on call 24 hours a day and to span out geographically the way we do," McNamee said.

In the past five years, PPX has doubled in size, and revenue has increased 72 percent through a combination of acquisitions and market expansion into rural areas. With 61 employees, it now is the largest mobile X-ray operation in the state.

Relying on an army of X-ray techs working around hubs in the Twin Cities; Duluth; Superior, Wis.; Sioux Falls, S.D.; and Fargo, N.D., it generally can reach any patient in its four-state coverage area within an hour.

While PPX goes to private residences, about 65 percent of its business comes from long-term care facilities, where an aging population will provide a growing market for its services

Annie Westall, executive director of TowerLight Senior Living in St. Louis Park, said PPX is providing a "much-needed service" at the facility of 115 apartments.

TowerLight is staffed by on-site Fairview doctors and provides the full sweep of senior housing options, from independent and assisted living to memory and high-acuity care.

"Our population is older and has special needs," Westall said. "Getting out for a medical appointment can be hard on them, especially with this bitter cold winter we're having. PPX fills a gap by allowing people to stay in house and get their services here."

PPX benefited from adapting to the digital platform long before its competitors. It claims to be the nation's first mobile X-ray company to convert to a fully digital and wireless system, which it did between 2005 and the end of 2006.

"Now we can send wireless images to a radiologist who can read it before we've even left the building," said Mike McNamee, Sue's husband and business partner, who designed and retrofitted the machines for use outside of hospitals.

Today's sleek systems slide easily into the hatchback of the company's fleet of Pontiac Vibe station wagons. It's a far cry from the first Canon digital machine that employees dubbed "Big Bertha," as it weighed 250 pounds and cost about $157,000. The current models run from $32,000 to $80,000.

Monica Bergstrom sat eagerly on her bed at Minnesota Masonic Charities in Bloomington last week as a PPX technologist wheeled in the equipment. The 62-year-old fell off a ladder while putting away Christmas decorations in January, and broke her collarbone and smashed her knee. This was her first look at how well she was healing after knee surgery, which required two metal plates and nine screws to heal.

J. Noel, an orthopedic physician assistant and part of Bergstrom's medical team, looked over the images and gave her a thumbs up.

"This brings some immediate peace of mind to the patient," Noel said. "Monica is to be transferred out this week. Now, everyone leaves with more confidence that physical therapy is going well, that the plates put in during surgery are healing well."

Husband Bob Bergstrom said that the visit from PPX saved the family at least $88 in transportation costs, which wouldn't be covered by insurance. And his wife didn't have to leave the building, risk slipping on ice or miss any physical therapy sessions.

For Monica, "it was a breeze," she said. "When you go through something like this, you feel so vulnerable."