Imaging 2.0

Callan Emery spoke to Jay Mazelsky, Senior Vice President and General Manager Computed Tomography, Nuclear Medicine, Philips Healthcare, and Hans Kleine Schaars, Business Manager, Imaging Systems Cluster MCR Europe, Middle East & Africa, Senior Director, Philips – about Philips Healthcare’s Imaging 2.0 initiative.

Callan Emery: Can you give us some background to Philips Healthcare’s Imaging 2.0 initiative?

Jay Mazelsky:
Philips launched imaging 2.0 at RSNA in Chicago in 2010. For several years prior to this we went out as a company and talked to some 3,000 radiologists around the world in lots of different hospital and clinic settings.

We wanted to understand the big problems radiologists have and what we, as a big company, could do to help solve them.

That was really the birth of Imaging 2.0. And what our market research showed was that there are three principle areas that we could focus on:

- Integration and clinical collaboration
- Patient-centred issues and patient concerns
- Economic issues, such as patient access to healthcare and how a clinic can ensure that they get a reasonable return on their new equipment

We set off from an imaging standpoint. When we talk imaging systems it refers to a collection of Philips businesses that provide solutions in the diagnostic imaging space, such as CT, MRI, interventional x-ray and cardiovascular ultrasound. We wanted to provide a set of solutions that addresses these concerns.

Callan Emery: So let’s look at these concerns.

Hans Kleine Schaars:
The world of radiology is changing and also the position of radiology in the clinical field is evolving. Images are becoming increasingly good. There is increasingly more data in imaging.

So the old world of the radiologist interpreting an image and then informing a referring decision through a report – that’s over. Now we have a group of physicians that collectively treat the patient, a process in which a patient is screened, diagnosed, cured in successive cycles of care. And the radiologist plays a role in all of these processes, not as an individual, but as a member of the team. This is clinical integration and collaboration – and the radiologist, unless it is interventional imaging, plays a key part in all of these processes. Let’s say the radiologist is the ‘navigator’ of the team.

The diagnostic radiology profession is increasingly active in this team – as the function that says ‘this is what is wrong, this is where it is located’, but also ‘this is how you get to it’, ‘this is the result of the therapy that you did last week, but it is not all clear yet’.

So this goal of clinical integration and collaboration is to help the radiologist to integrate and collaborate more easily. And it can only be done with equipment that integrates easily. So we have integrated the machines, like PET-MR, PET-CT, the IntelliSpace Portal, a complete new line of workstations. Anywhere you have access to the Internet you can collaborate with your peers though what we call a thinclient architecture.

For example, an orthopaedic surgeon playing a round of golf can use his iPad to receive advice from the radiologist about how to do a difficult, complicated hip fracture the next day.

This clinical integration and collaboration is positioning the radiologist in the world of the Web 2.0.

Callan Emery: Can you explain this?

Web 1.0 was just one big data repository and you would search it for information. If we look at the new generation, they don’t use the Web to find stuff like the old generation did. They use the Web to chat with their friends, to have Facebook, to play online games with people in Korea, Brazil and Spain. They have this gadget on their desk that gives them access to the whole world.

It is the same thing in healthcare. The physician can have this gadget on their desk that can give them access to all the diagnostic information. And the radiologist puts it there for the physician ready to read. The physician doesn’t want a thousand [CT image] slices, they want that one 3D reconstruction that shows exactly where that arterial venous malformation is and shows the physician how to get to it – shows them, for example, that if they go in here they will cut that nerve – so they will go in over there.

Callan Emery: What patient-centred concerns did you find in your market research and what solutions have Philips come up with?

Hans Kleine Schaars:
Philips is a peoplecentred company. We view healthcare as a process where people take care of other people. From the outset Philips is a consumer-orientated company. We are in people’s households with shavers, lighting, CD players, kitchen appliances, etc. Our designs are famous and this is also reflected in the user interfaces that have been designed for easy interaction. We have carried this into our healthcare products.

We also take radiation dose reduction very seriously. In the area of CT we have introduced iDose – a quantum leap in dose reduction management. We have also recently shown a new architecture in interventional imaging that we have proven will significantly reduce [radiation] dose by up to 70%.

Jay Mazelsky: Some points about dose management: All vendors are trying to reduce dose. And this can be done by reducing the power of the CT scanner, but then the quality of the images is poorer. We don’t want to go back to go forwards. We want to give you lower dose, but as good or better image quality.

CT is like the Swiss Army knife of imaging. It is a utilitarian device and used for all types of imaging. So you don’t want have to wait while the scanner reconstructs the images. For example, if a patient comes in to the hospital with trauma from a car accident, you don’t want to have to wait while the scanner reconstructs the image. What we’re doing is giving you lower radiation dose without having to wait for image reconstruction. This is also Imaging 2.0. This respects work flow, it respects how the scanner is used, and it understands what the radiologist needs as a service. So we are trying to solve these problems without having to introduce compromises into the system.

Hans Kleine Schaars: Under the Imaging 2.0 banner – Philips has launched many new products. Take the PET-MR, which didn’t exist before. Take the Ingenia MR family. It is the first broadband digital MR and is considered a breakthrough. Up to this point radiologists had been using analogue MR. Instead of a wire for each coil, we now have one optic fibre for many coils. If we have a 30-channel coil and want to upgrade to a 100-channel coil, for example, we use the same optic fibre.

We have a whole new family of CT – the Ingenuity range, which also includes PETCT with ‘Time of Flight’.

We have a completely new digital x-ray with a wireless mobile digital detector. You take the image and it is instantly available on the image server. Like you take a picture on your iPhone and your wife and kids at home can see it in an instant.

In ultrasound we have introduced the X-Matrix transducer, which is really a three-dimensional transducer. It means you don’t have to move your wrist to change the view. It catches all this data and you can simply change the plane of view by turning a dial.

All over the world we see doctors struggling. Why? They all have to see more patients who have greater demands. They have more work and they have to do it all with fewer people and less money. So we have to help our customers with that. Of course, by providing them with equipment that is state of the art, but that is also user friendly and also easy to operate. Especially in the Middle East, the biggest issue of our customers is not that that don’t have access to the equipment, but rather that they have the right staff to operate all this fantastic equipment. And then it is important that you have equipment that can be simply operated by less qualified staff. For example, it is nice if the night nurse can do a basic CT with all the protocols preentered in the system.

Callan Emery: So this leads us to the economic concerns of your customers.

Jay Mazelsky:
Purchasers are much savvier now than they used to be. For example, the issue of upgradability is important to them. They are now not just purchasing a product, they are purchasing a partnership.

For example, you could purchase a piece of equipment, but if you can only get 20 patients using it a day, rather than 24, you are not going to be happy Or if you purchase a piece of equipment, but it is not going to be upgradable in two years’ time when the next technology innovation cycle comes round you are going to be left behind.

For example, although our Ingenia MR family’s digital system architecture is revolutionary, it is accessible for all existing MR users through an upgrade. It is a very important feature. We can take a MR scanner produced in 1999 and we can completely upgrade it to state-of-theart now.

Hans Kleine Schaars: This also includes after sales service. In the end you are as good as your after sales service. This is the ‘economic value’. In many businesses when the contract is signed that is the end of the relationship. In our business it is just the beginning. 

 Date of upload: 20th Jun 2012


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