April 2004

The online marketplace has teamed with InnoCentive (Andover, Mass) to offer the medical community an efficient way to purchase equipment online. More than 120 subcategories are featured under the site’s test and measurement listing. Used, refurbished, and new products—ranging from ultrasound equipment to X-ray film processors—can be purchased from anywhere in the world via the Internet.

“The category offers a solution for smaller practices that can’t afford to purchase the equipment directly from the OEMs,” said Jordan Glazier, general manager of eBay Business. “Inno-Centive provides an avenue for these types of buyers to reach us and purchase the types of equipment they need.”

According to Glazier, the average price for equipment bought through the site is anywhere from 29% to 70% less than conventional ways of purchasing equipment. And with time being an issue, especially within the medical industry, eBay’s Buy It Now feature allows customers to forego the bidding process in order to purchase the item instantly.

“We’ve seen a high adoption for this fixed-price format,” Glazier added. “We’ve found that the buyers for these types of equipment love being able to find what they are looking for, at a price they can afford, and then having the ability to buy it on the spot.”

Naturally, when purchasing anything from an unknown source, quality is a concern. And for those purchasing medical equipment online, that concern is amplified and coupled with a concern for safety.

“Each seller posting on the site has to verify that it is a certified medical facility, and the same goes for those who are purchasing the equipment,” Glazier explained. “We work with the FDA to make sure all the rules and regulations are in place for exchanging these types of machines in this kind of market.”

Purchasing the products online is just the beginning. For many small practices considering the purchase of equipment online, the act of buying is the simple part. The next decisions are how to ship the equipment and determining what installation and service contracts are involved.

“What we’ve found is that most medical facilities have their own service providers that they’ve been able to form relationships with over the years,” Glazier said. “The feedback for this entire segment of the purchase has been extremely positive. The companies buying the equipment are able to have someone they trust install and service the equipment, while the service companies love the extra business. It works out for everyone involved.”

The analysis reveals that the US ultrasound market generated revenues totaling $1.26 billion in 2003, and total revenues are expected to reach $1.89 billion by 2010. The survey attributes the increase in ultrasound imaging by physicians to readily available and affordable imaging equipment, such as hand-carried ultrasound (HCU) systems. The appeal of these machines is based on the advancements made in their software and the semiconductor technology that have increased amounts of processing power packed into smaller medical devices.

According to Frost & Sullivan, the HCU product segment is the fastest growing segment in the US ultrasound market, with an expected annual growth rate of 19%. The price difference and portability of HCU systems are rapidly expanding the installed base of ultrasound in various medical specialties; however, the growing tendency of vendors to use HCU systems as lower-cost replacements for more expensive cart-based systems could lower average selling prices and hamper overall ultrasound market revenues.

In addition to America’s concern regarding the costs and quality of healthcare, the survey also revealed:

• 43% of respondents blame medical errors on overworked staff or staff shortages.
• Three in 10 of those surveyed cite lack of communication amongst hospital departments as the second-largest cause of medical errors.
• 63% of those surveyed agree that it would be “very valuable” to have their complete medical history stored electronically in one computer file that can be accessed from anywhere in the hospital; 37% were not in favor of such a system.
• 89% of Americans 65 or older believe their doctor has all the necessary and important information about their medical history.

The textbook series will address domains pertaining to the field of radiology, including the ethics of healthcare, financial management, establishing a corporate compliance program, budgeting, capital equipment purchasing, and billing/coding for reimbursement. The information gathered for each of the textbooks will be collected from industry professionals who respond to information requests made by the AHRA.

Mel Allen, CRA, FAHRA, and Sheila Sferrella, CRA, FAHRA, will serve as editors of the first edition of the series. Allen is the strategic business program director of Philips Medical Systems (Shawnee Mission, Kan) as well as the president of the AHRA and a member of its Education Foundation Board of Directors. Sferrella currently serves as radiology administrator at Lehigh Valley Hospital (Allentown, Pa) and is a member of the AHRA Educational Foundation Board of Directors. Both writers are co-authors of Radiology Management.

The series of textbooks is designed to support the CRA program, which is unique to the industry. The CRA program works to raise the business acumen of imaging administrators, provide a standardized evaluation of an imaging administrator’s competence, enhance the status of imaging administration in the healthcare community, and ensure appropriate recognition of expertise as identified by the certification. The textbook is made possible through a grant provided by the diagnostic imaging unit of Berlex Laboratories (Montville, NJ).

According to the AHRA, expected completion dates and direct marketing for the textbooks is yet to be determined. For additional information, visit www.ahraonline.org or call 800-443-7591.

The mission vehicle, Rosetta, is traveling with the comet for 1 year to study and record changes to its nucleus en route to the sun, relying on sensors from e2v’s imaging technology. The mission began in February.

According to sources with the program, Rosetta is the most challenging mission to be launched by Europe to date. E2v Technologies has supplied image-sensor essentials for the spacecraft’s navigation system on its 11-year journey as well as high-resolution devices that form its main science camera. The light-sensitive sensors in the science camera will capture high-resolution images of the comet’s nucleus and surroundings from a distance of a few kilometers. Once safely in orbit around the comet, the breakaway Rosetta Lander will descend and anchor itself on the comet’s icy surface to allow for more detailed surveying. From here, e2v’s CCD42-40s technology will transmit the images back to Earth.

Scientists expect to see the development of the comet’s characteristic tail as the sun starts to thaw the ice and it evaporates in high-pressure jets from the surface of the comet.

E2v Technologies has a history of supplying standard and custom imaging devices for major space and astronomical research programs. The company previously delivered imaging sensors to guaranteed specifications and timescales for use on the Hubble space telescope, NASA’s Kepler telescope, and XMM-Newton’s X-ray telescope.

Paul Didier, director of the Santa Barbara, Calif, chapter of the United Way, accepts a check for $40,117. The total amount of funds raised since the inception of Indigo Systems’ program has reached more than $247,000.

As part of its technology showcase, Imagination Nation, GE Healthcare (Waukesha, Wis) hosted a panel discussion on the latest trends and innovations in healthcare technology on March 11 at Washington, DC’s Union Station. The location served as an apt starting point for this journey of ideas heralding upcoming changes in imaging and information technology. The 2-hour discussion focused on the promise of new technologies in imaging and information technology (IT).

The panel included Joseph M. Hogan, president and CEO of GE Healthcare; James M. Rippe, MD, director of Rippe Lifestyle Institute and associate professor of medicine at Tufts University School of Medicine; Phyllis E. Greenberger, president and CEO of the Society for Women’s Health Research; David Veillette, president and CEO of Indiana Heart Hospital; and Eugene Saragnese, VP of global technology and components at GE Healthcare.

GE Healthcare seeks to “bring a new level of care to patients, including enhanced clinical accuracy, speed, and efficiency” while reducing costs, Hogan said. Inevitably, IT must have a greater role in healthcare delivery, he explained, and the quality of care as well as productivity in healthcare can be significantly enhanced through the increased role of digitization. This is especially true for hospitals, Hogan added.

He noted that advances in IT and imaging, combined with the mapped human genome, are transforming medicine. One of the most exciting areas in medical technology and at the forefront of currently developing fields is diagnostic pharmacy, Hogan said. Realizing its potential will create a greater ability to “personalize” the potential for disease, its detection, and its effective treatment. Alzheimer’s disease, with its increase in absolute numbers as the US population ages, is one example of a growing problem that is likely to benefit from predicted gains in this field.

These advances will aid in the overarching goal of intervening sooner and less invasively. The combination of chemistry and physics, as well as other disciplines, has the potential to move medicine well beyond its currently limited capabilities of diagnose and treat.

Rather than treating after a disease has manifested, the “see and treat” model will be replaced by “intervene and prevent,” Saragnese explained. Imaging is continuing to see dramatic progress, he said, referencing that imaging technology, which took 45 seconds to produce an image in 1995, now takes less than 10 seconds. In addition to being faster, the higher resolutions available provide significantly better information, he noted. He concurred with Hogan about various disciplines coming together and creating new fields, such as diagnostic pharmacy, and suggested that future developments will be revolutionary in terms of the intersection of chemistry, biology, engineering, and medicine. 

Imaging also will permit a greater ability to visualize disease changes in the body, Saragnese said. “Imaging allows the physician to visualize inside the body,” he said. “It is an extension of the eyes.” In the future, medicine will use chemistry and biology to identify the presence, location, and quantity of disease in the body. Similarly, he noted, technology will increasingly permit robotics and imaging to provide an extension of the hands, “amplifying the dexterity of human beings so we will be able to do things that we can’t do today.”

Rippe also spoke on the theme of IT’s potential contribution through “personalizing” disease. A leading cardiologist who has published widely on the topic of heart disease and prevention, Rippe pointed out a recent study that concluded fitness level is more predictive of mortality from heart disease than any other risk factor. The key to educating and motivating behavior change, he said, is “the ability of technology to take a general epidemiological issue and personalize it.” If patients can visualize a condition, it will get their attention and help to educate and motivate more healthful behavior. This could have a broad and needed impact on reducing morbidity and mortality from heart disease, he said.

GE Healthcare has partnered with the Indiana Heart Hospital, Veillette said, and has developed what he calls “the first all-digital heart hospital in the world.” About a year old, the hospital has achieved an enviable record of reducing cardiac morbidity and mortality as well as in-patient length of stay. The greatest advance is getting information quickly to people who do the work, Veillette said. For example, hospital staff members receive timely images and test results through use of IT, allowing for critical decision-making without the typical delays of paper-based record systems.

In the future, progress in technology is likely to take medicine to a place where, Rippe said, the “use of technology is to understand the risk of disease, identify it, and fix it.”

Contributing writer Ellen Zagorin reported on this event.

Philips Medical Systems (Bothell, Wash) received five technology and industry leadership awards, including Medical Imaging Company of the Year. According to Frost & Sullivan, Philips demonstrates unparalleled excellence as an overall business unit in the areas of business development, competitive strategy, and customer service as well as outstanding management, consistent growth, strong sales performance, high-quality products and services, and a positive social and economic impact on local and national communities. Philips also won the Medical Imaging Technology of the Year award for its Live 3-D Echo ultrasound technology.

The Technology Leadership award recognizes Philips for its efforts to develop new defibrillation technologies and to bring innovative products to market. The New Care Setting of the Year award is for Philips’ introduction of the HeartStart Home Difibrillator. And the Services Innovation Leadership award in PACS was presented to Philips because of high levels of customer satisfaction from users of the company’s image management systems.

Eastman Kodak Co’s Health Imaging Group (Rochester, NY) was presented with a Customer Service Innovation award. According to Frost & Sullivan, Kodak achieved the award for services performed in Europe. The company provides healthcare organizations with a range of medical imaging services, including project management, business consulting and assessment, network and integration, education, and data storage and archiving services. Additionally, Kodak’s data privacy and security services provide protection of patient data for both digital and traditional medical film environments.

Labtronics Inc (Guelph, Ontario) also received a Customer Service award from Frost & Sullivan. Labtronics achieved the award for its ability to create products that enable information technology as well as deliver increased operational efficiency.

Finally, following analysis on world DR markets, Frost & Sullivan recognized two companies for their contributions. Lodox Systems (South Lyon, Mich) was presented with the 2004 Product Innova-tion Award for its Statscan technology, a system that enables full-body DR of critical care patients. And Swissray International (Elizabeth, NJ) was named a Global Leader in providing high-quality, cost-effective DR products, specifically the company’s ddR Modulaire system.

To determine the recipients of its annual awards, Frost & Sullivan takes customer surveys and conducts extensive secondary research and interviews with market participants. Organizations are ranked based on the input from these activities.

According to Timothy Guertin, president of Varian’s Oncology Systems business, the On-Board Imager is intended for IGRT. “It enables clinicians to obtain high-resolution X-ray images to pinpoint tumor sites, adjust patient positioning when necessary, and complete a treatment, all within the standard treatment time slot,” he said. Current procedures require radiation oncologists to contend with variations in patient positions and respiratory motion by treating a margin of healthy tissue around the tumor. IGRT enables doctors to locate the tumor while the patient is in the treatment position as well as to minimize the volume of healthy tissue exposed to radiation during treatment.

The On-Board Imager is mounted on a treatment machine by way of robotic arms that operate along three axes of motion, allowing for an ideal view of the tumor. An image detector then shows digital images of the internal anatomic landmarks with a high degree of precision. The image detector can track anatomic motion and provide doctors with a clear indication of exactly how a tumor will move during treatment due to respiration or other normal physiological processes.

Varian’s Clinac and Trilogy accelerators, equipped with the new On-Board Imager, will give doctors the best of two critical technologies for IGRT. The company has combined low-dose, high-resolution, kilovoltage X-ray imaging and integrated software control of all treatment parameters. These factors provide cost-efficient and automated treatments that are conducive to patient comfort.

Correction: In the March issue, Medical Imaging incorrectly named Planar Systems Inc’s VP of corporate development. His name is Matt Harris. We regret the error.

Able Software Corp
Able Software Corp (Lexington, Mass) has sold a multiple-node site license of its 3D-Doctor software to Singapore’s Temasek Engineering School. The school purchased the license for its Rapid Prototyping Technology Unit (RPT), which focuses on advanced engineering research and education. The 3D-Doctor equipment will be used by the RPT for creating 3-D computer and physical models from medical and industrial images.

Agfa
Agfa (Ridgefield Park, NJ) has entered into a 3-year, multisource contract with Premier Inc (San Diego) to provide CR products to Premier’s 1,500-member hospitals. The contract is valued at approximately $35 million per year, and includes Agfa’s entire line of ADC CR hardware, software, and service maintenance agreements.

Agfa and the Centre Hospitalier de l’Universit? de Montr?al (CHUM of Montreal), a Canadian healthcare institution and university teaching hospital, announced the successful completion of an enterprise-wide RIS/PACS integration project. The project was developed as a response to the shortage of radiologists in the province of Quebec as well as an urgent need to eliminate the costs associated with film-based imaging. Through the partnership with Agfa, CHUM has unified its radiology departments and hospitals into an integrated healthcare network.

Consorta Inc
Consorta Inc (Rolling Meadows, Ill) announced a strategic alliance with Crest Healthcare Supply (Sauk Rapids, Minn), a manufacturer and distributor of medical equipment, such as replacement nurse call products, like pillow speakers and call cords. According to Consorta, the agreement between the two companies represents an opportunity for its members to easily obtain and save on replacement parts for many pieces of equipment in their facilities.

Boca Raton Community Hospital has installed two Kodak DirectView CR 950 systems (right) in the general radiology department, one CR 950 system to serve its two emergency exam rooms, one CR 850 system (left) in the OR, and one of each CR system in the hospital’s outpatient imaging center.

Eastman Kodak Co
Eastman Kodak Co (Rochester, NY) reports that worldwide customer demand for its digital medical imaging and information systems has grown significantly in recent months. The company has signed more than 20 contracts for its DirectView PACS System 5 platform, and has installed more than 25 DirectView Web distribution systems in the United States alone.

For instance, Kodak was selected by Boca Raton Community Hospital (Boca Raton, Fla) for CR. In an act to propel its imaging department toward the digital age, the 394-bed hospital has installed six DirectView CR systems. Before selecting the systems, radiology department committee members from the hospital conducted an extensive evaluation process consisting of site visits, price quotes, and demonstrations of digital images produced by each machine under consideration.

Het Netherlands Kanker Institute–Antoni van Leeuwenhoek Ziekenhuis (NKL-AVL of Amsterdam) is a cancer institute specializing in patient care, research, and education that has chosen Kodak to support its transition to a digital medical image and information management workflow environment. NKL-AVL has purchased Kodak’s synchronized PACS/RIS system, featuring the DirectView PACS System 5 and Kodak’s radiology information system (RIS) 2010.

Lodi Memorial Hospital (Lodi, Calif) also selected Kodak’s DirectView PACS System 5 with Web distribution capability. The hospital also purchased four DirectView CR systems and one DryView laser imaging systems. Kodak’s Healthcare Project Management, RIS integration, and network services are also part of the order.

Finally, while focusing on three main areas of concern—trauma medicine, treating workplace-related injuries, and treating diseases caused by the working environment—Hospital MAZ (Zaragoza, Spain) has installed three DirectView CR 850s, one DirectView PACS System 5, and one DirectView versatile intelligent patient archive storage management software platform. With more than 65,000 diagnostic imaging procedures performed in the hospital each year, the new systems provide a solution for MAZ’s growing exam volume as well as image and report viewing, distribution, and storage management requirements within the radiology department.

Misys Healthcare Systems
Misys Healthcare Systems (Raleigh NC) announced that 11 medical practices have selected its Tiger electronic medical records (EMR) management solution. The new customers include Arbor Family Medicine PC (Thornton, Colo); Lynda Brady, MD

(St Louis); the Kidney and Hypertension Center (Cincinnati); Kidstown Pediatrics LLC (Miami, Fla); Louisville Bone & Joint (Louisville, Ky); Manchester Urology Associates (Manchester, NH); Manhattan Minimally Invasive (New York); Daryl Marx, MD (Monroe, La); OB/Gyn Associates of Holmdel (Holmdel, NJ); Pediatric Immediate Care (North Lindenhurst, NY); and Brenda S. Waller, MD (Lynchburg, Va). Misys’ EMR system provides electronic capabilities for routine tasks, such as transcription, imaging orders, management, messaging, and prescription writing as well as a point-of-care solution for physicians in the examination room.

Per-Se Technologies
Per-Se Technologies (Atlanta) has partnered with Christus Schumpert Health System (Shreveport, La) to provide billing and practice management services for 14 ER physicians and 26 certified registered nurse anesthetists employed by Christus Schumpert St Mary Place Hospital and Christus Schumpert Highland Hospital.

Per-Se also has agreed to outsource practice management services to Pathology Medical Laboratories (PML of Leesburg, Fla). Under the terms of the agreement, Per-Se’s physician services division will provide connective healthcare services to streamline PML’s reimbursement process and enhance its revenue cycle. Per-Se also will assist PML with anatomic and clinical pathology billing, credentials, HIPAA compliance, and managed care contract negotiation.

Additionally, Per-Se has entered into a 71/2-year agreement with the University of Texas Health Science Center at Houston to outsource revenue cycle management for the institution’s faculty practice plan. Throughout the duration of the agreement, Per-Se will provide its connective healthcare services for 16 clinical departments and more than 550 physicians employed by the UT Health Science Center. Also, Per-Se will implement technology to support reimbursement practices, provide medical staff with timely information, and deliver business intelligence reporting to physicians via the Web.

Siemens Medical Solutions
Siemens Medical Solutions Ultrasound Division (Mountain View, Calif) and U-Systems (San Jose, Calif) have entered into an agreement in which Siemens will provide the engine of its SonoLine Antares ultrasound system to be integrated into the FFBU system from U-Systems. The FFBU system is designed to image the whole breast, making it possible to perform high-volume ultrasound imaging on women with dense breasts.

Spacesaver Corp
Spacesaver Corp (Fort Atkinson, Wis) has formed an alliance with Technibilt/Cari-All (Fort Worth, Tex), a producer of TSS wire shelving and accessories. The partnership will enable Spacesaver to expand its product offerings in the market of medical storage devices.

With a throughput of 240 films per hour, the DryPix imagers were designed for high-volume, centralized imaging environments that demand high-speed printing, without the need to purchase an additional printer dedicated for FFDM. They can accommodate multiple film sizes specifically required for FFDM printing. The laser imagers feature backup security for high system reliability and high-speed network capabilities, helping to maintain a low cost of ownership.

Cohen served in the medical transcription and HIM field for more than 30 years. He retired in 2003 from his position of president and CEO of MedQuist Inc (Marlton, NJ).

As part of the FORE Merit Scholarship program, the David A. Cohen Scholarship will be offered annually to outstanding undergraduate students pursuing degrees in health information administration and health information technology. Also, the scholarship is available to credentialed professionals pursuing graduate degrees to further their careers in HIM.

The deadline for all applicants is May 31. For additional information, visit www.ahima.org/fore/programs.html.

The FDA’s Radiological Devices Panel of the Medical Devices Advisory Committee has recommended approval of the ImageChecker CT CAD system from R2 Technology (Sunnyvale, Calif). The system is designed to detect lung nodules during review of multidetector CT chest exams.

“Computer-aided detection is useful in the sense that it provides a double read or additional notification to the radiologist of suspicious nodules that might otherwise go unnoticed,” said Pablo Delgado, MD, clinical associate professor of radiology at the University of Missouri, Kansas City.

If approved by the FDA, the ImageChecker CT CAD system would be the first CAD system available in the United States for the detection of lung nodules on CT exams. Although the FDA is not bound by the recommendations of its advisory committees, it generally follows their advice.

James Bilbro has been elected by members of the International Society for Optical Engineering (SPIE of Bellingham, Wash) to serve as the organization’s 2004 president. Serving as a SPIE Fellow since 1992, Bilbro has received numerous performance awards, including the NASA Exceptional Service Medal in 1990 and 1998. SPIE members also elected Malgorzata Kujawinska as VP, Paul McManamon as secretary, and Robert Fischer as treasurer.

Darrel Fuller

Janos Technology Inc (Townshend, Vt) has recruited Darrel Fuller to serve as the new thin film coatings department manager. Fuller has more than 20 years’ experience in the development of infrared and visible thin films for commercial and military applications.

John Monahan has been promoted to VP of corporate accounts for Swissray International (Elizabeth, NJ). With more than 30 years of experience in the healthcare industry—including various positions within Swissray as international project manager, manager of national accounts, and VP of North American customer service—Monahan will support the large-scale DR migration initiatives of GPOs and IHDNs.

John Macko

John Macko has joined Dunlee (Aurora, Ill) as the company’s product marketing manager. Macko brings with him more than 25 years of marketing experience. Prior to joining Dunlee, Macko spent 15 years as product segment manager for Philips Medical Systems.