March 2004

Philips incorporates intelligent design and control with its iU22 ultrasound system.

Philips Medical Systems (Bothell, Wash) has created a resolution for the growing demand with the introduction of its iU22 ultrasound system, the newest addition to the company’s line of ultrasound equipment. The ergonomically designed system consists of intelligent controls and a range of high-performance features, including real-time 4-D imaging, voice-activated control and annotation, and automated image optimization technologies.

The iU22 system was designed to address critical industry issues with a simpler, easy-to-use interface; hands-free voice command; one-button automated optimization controls for quick and consistent imaging acquisition between users of varying skill levels; and data management that allows for more complete patient information, reporting, and trending. These features enable the iU22 to provide higher quality exams, greater consistency, and faster exam times.

“Clinicians have been looking for a leap forward in ultrasound performance and workflow. The iU22 system meets the criteria, going beyond image quality,” said Barbara Franciose, CEO of ultrasound for Philips Medical Systems. “It provides clinicians and administrators with many of the capabilities they have been asking for, like faster patient throughput, more diagnostic capabilities, simplified system control, and broader clinical applications. It humanizes technology.”

Designers of the iU22 didn’t forget the most crucial factor in developing new technology: the patient. The system is designed to help patients better visualize and understand their conditions while reducing the time required for many exams. The iU22 also enhances the physician’s diagnostic capability, thus reducing or eliminating the need for more expensive or invasive tests and procedures.

Varian’s cone-beam CT, newly FDA cleared, creates 3-D images of tumors.

The cone-beam CT generates 3-D images of tumors and surrounding anatomy. Varian has integrated the Acuity imaging system with its software for image management and treatment planning, making it easier for doctors to review, verify, and finalize treatment plans and patient positions prior to commencing treatments.

“The cone-beam enables doctors to dose sharpen, which is a targeting maneuver used to prevent over- or underdosing a particular location,” said Varian PR Manager Meryl Ginsberg. “The size of the beam can be adjusted to accommodate the growth or shrinkage of a targeted area. This versatility drastically reduces the chances of exposing a healthy location to radiation therapy.”

Acuity 3-D imaging will make it possible for clinicians to achieve better outcomes for their patients by sparing more healthy tissues and concentrating more cancer-killing radiation on tumors. The system’s cone-beam imaging also will be used for brachytherapy treatment planning and to guide the placement of catheters and seeds.

Although the response from the market has been favorable for Varian, the acclaim was anticipated. “As soon as we submitted the 510(k) proposal for the 3-D cone-beam, our sales staff was out in the field promoting it,” Ginsberg said. “In essence, the cone-beam has been in the developmental phase since the release of the Acuity years ago. The system has always paralleled the progression and needs of the medical imaging industry. There was no doubt that technology like the 3-D cone-beam would evolve for the system, and we’re excited that it’s finally arrived.”

Conducted by researchers at McLean Hospital (Belmont, Mass), the study tested a form of MRI in 40 patients who were feeling depressed due to bipolar disorder. Of these depressed individuals, 30 underwent a form of MRI using extremely weak magnetic fields that penetrate throughout the brain; 10 patients received a simpler brain scan used as a placebo. The result of the division found that 23 of the 30 individuals (77%) in the treated group noticed an improvement over the way they felt before the scan. Comparatively, only 30% of the placebo group felt the same results.

Although the procedure is still in its developmental phase, researchers at McLean Hospital have designed a low-cost scanner to deliver the magnetic waves. The scan was originally designed as a tool to study brain function, not as a treatment. The idea to try the procedure as a treatment came about after a number of patients claimed to feel better after the scan. The precise reason for the alleviated symptoms is not yet known; however, McLean Hospital President Dr Bruce Cohen stated that the electromagnetic stimulation might change the firing patterns of nerve cells and help the brain balance itself.

McLean Hospital received a patent for the technology in 2003 and plans to make it commercially available in the future. The hypothetical use of the technology would be to provide those who suffer from bipolar disorder with the opportunity to visit a doctor and receive a “zap” in an effort to feel better. Some working on the project have offered the possibility of machines being installed in the homes of those who need the treatment. According to McLean, this idea—if given the opportunity to develop—is many years away from being a reality.

Research into the magnetic stimulation of the brain is not new to the field of brain imaging. Such treatments for mental disorders have been taking place since the 1980s; however, much of the research has been focused on transcranial magnetic stimulation. This procedure differs from the McLean treatment because it delivers strong magnetic pulses directly into specific brain regions.

While the results of the McLean research have proven positive thus far, some doctors claim more work is needed on the project to determine whether the treatment has side effects, such as memory disturbance. Additionally, doctors have raised the issue that it is often difficult when treating bipolar disorder to achieve a long-lasting response.

Retaining its Pixels-on-Demand technology and patents, RTI plans to provide greater emphasis on its iPACS line of medical imaging products. The company’s redirection of its business strategy is in response to the fast-growing iPACS market. Leveraging the industry demand for cost-effective, open, and scalable solutions, RTI says its iPACS system presents a unique venue for image management and distribution solutions as well as expanding conventional imaging workflow.

According to sources representing RTI, the healthcare side of the business has been experiencing intense growth. RTI made the decision to sell its graphics division in order to fund future developments of its intensified healthcare business. Funding for new marketing and research developments, as well as the funding needed to support an enlarged healthcare staff, will rely on the proceeds of the agreement made with Kodak. The transaction between the two companies is expected to close in early 2004.

As stated by the letter of intent with Kodak Polychrome Graphics, RTI’s graphic arts employees will become part of Kodak, continuing to provide service and support to current RTI customers.

Ten years after the relationship was formed, R2 Technology Inc (Sunnyvale, Calif) and the University of Chicago Medical Center have extended their agreement to create CAD applications for mammography. Under the terms of the new agreement, the partners will work together in an effort to accelerate development of a mammographic CAD workstation reference library for the early detection of breast cancer. The investigational CAD reference library contains a database of both malignant and benign lesions, which radiologists can access for comparison and relevancy.

“The University of Chicago has researched computer-aided detection and diagnosis for mammography for many years,” said Maryellen Giger, PhD, professor of radiology at the University of Chicago. “Our group was one of the first to bring computer-assisted reading into the clinical arena nearly a decade ago, and we remain excited about the potential for computer-aided detection and diagnosis to improve mammography.”

According to Michael Klein, president and CEO of R2 Technology, the reference library workstation is designed to display and compare lesions similar to the way most radiologists do in their own minds. “This system is a flexible, intuitive, and interpretative aid, which has the potential to serve as a valuable teaching tool,” Klein said. “Combining the insights of researchers at the University of Chicago, as well as other leaders in mammography, R2 intends to add thousands of lesions to the current database to extend its clinical relevance.”

Clinical trials demonstrated that using the ImageChecker CAD system could result in earlier detection of up to 23.4% of the cancers currently detected with screening mammography in women who had a prior screening mammogram 9 to 24 months earlier.

The American Health Information Management Association (AHIMA of Chicago) released an outlined statement supporting the President’s request for computerized healthcare records. The outline describes four specific needs within the industry:

1. The need for advancing electronic health record (EHR) standards—A standard EHR will help reduce medical errors while providing health information at a lower cost. It also will allow for the sharing of healthcare data, which will improve research, public health monitoring, and bioterrorism response.

2. The need for a standard medical language and improved data—A standard EHR requires standardized medical language, terminology, and coding standards.

3. The need for a national health information infrastructure—This infrastructure will provide accurate and timely information to support decision-making at all levels.

4. The need for jobs and education—Skilled, specially trained health information management professionals will be needed in order to reap the full benefits of information technologies in healthcare.

Bush also called for a more aggressive use of medical technology to reduce the number of medical mistakes, which put lives at stake and increase the cost of healthcare.

Eleanor Kerr, director of government affairs at Siemens Medical Solutions USA Inc (Malvern Pa) released a statement urging Bush as well as medical community members to increase awareness of information technologies that minimize human error within the hospital setting.

“The majority of medical errors do not result from carelessness or individual error,” Kerr said. “Rather, these errors occur from flaws in the delivery system. Simple and readily available information technologies—such as the use of bar codes for medication management and electronic medical records—can address these flaws. Hospitals have to adopt these technologies for our nation to make a dent in the medical error issue, and also to

ultimately improve healthcare costs in America.”

Before Planar’s price reduction, this Dome C3 dual flat-panel display had a list price of $27,995. Today, that price has dropped to $14,995—an almost 54% cut in price.

Planar Systems Inc (Beaverton, Ore) has made it easier for imaging professionals to benefit from high-quality medical imaging displays by reducing the list price of its Dome line of displays by nearly half. The decrease in price enables a wider range of healthcare facilities to deploy the medical displays for improved patient care.

“Our digital imaging strategy is driven by the market,” said Mike Harris, VP of corporate development at Planar. “We’re not trying to push technology out into the marketplace. Instead, we’re spending a lot of time understanding what customers are asking for.”

Planar has spent more than a year studying the demands within in the imaging industry. The company ultimately found a desire in the industry to transition from film-based imaging to digital imaging because of the cost advantages on a per-study basis—digital imaging has proven to be three to five times less expensive than film. However, the capital investment required up front for digital systems makes the decision to take part in the transition much more difficult for many facilities.

“Planar has a significant supply chain and global operations, which enabled us to reap some substantial cost advantages,” Harris added. “Because of this, we also are able to deliver a broader base of customers. We’re able to reach a greater number of smaller firms as well as larger ones that have a desire to obtain digital systems.”

Leveraging Planar’s relationships with IT channels, buyers in healthcare facilities can now purchase Dome displays through resellers they know and trust, such as CDW, Dell, and Richardson Electronics as well as from the industry’s leading medical equipment and software providers.

Planar’s line of Dome displays serves healthcare professionals by enabling diagnostic- and referral-quality images throughout the healthcare enterprise. Available in 2-, 3-, and 5-megapixel resolution, grayscale and full-color, diagnostic- and referral-grade, Dome displays allow for anytime, anywhere viewing of radiological images, overcoming the limitations and costs of film-based images and ultimately leading to improvements in the quality of patient care. The Dome line includes the Dome C2, C3, and C5i as well as the Dome Qx displays (formerly named the Adara Qx line).

“We also found that customers aren’t just looking for a hardware solution,” Harris said. “They are looking for a broader depth of products, software, and services. They want software to manage the hardware as well as services to support the integration of their current systems into a larger system when they make the transition from film to digital.”

Planar Dome displays are available with Dome CXtra software, which ensures that the displays are consistently calibrated and conform to DICOM standards. An important part of a high-quality total solution, this software reduces the total cost of ownership of displays through its enterprise management capabilities, enabling administrators and IT staff to easily monitor display performance and calibration from a central location using industry-standard interfaces.

“We’ve performed a substantial amount of research on what physicians and administrators need in order to make the transition into digital imaging,” Harris said. “In combination with having medical professionals contribute to our research and development process, the fact that our advanced technology is now available at half the standard price has made us very excited about the future diffusion of digital systems within the medical imaging industry.”

Toshiba’s Aquilion 16 CFX helped a Florida facility perform 450 coronary CT angiographies in a 13-month span.

“We were the third site in the country to receive this particular multislice system,” said Steven Strobbe, DO, administrative physician and owner of FIFADI. “We were on Toshiba’s waiting list for more than a year before the system arrived.”

Strobbe adds that after the installation, patients were slow to embrace the new technology. On average, the facility conducted only one or two procedures a day. Cardiol-ogists, too, were slow to respond to the technology being offered by FIFADI. “We had to go out there and inform the doctors of the advanced images that the CFX could produce,” he recalled. “It wasn’t long until the word spread in the area about what kind of technology we were working with.” Today, FIFADI performs an estimated 30 to 40 CT angiography procedures a day, with the majority of patients on referral from area cardiologists.

The Aquilion 16 CFX is a multislice CT system that offers noninvasive cardiovascular diagnostic imaging for early detection of heart disease. The system delivers as many as 16 0.5-mm slices within a 400-millisecond gantry rotation. The 0.4-second scanning capability enhances the image quality of the scanner by effectively reducing any image artifact from internal organs and structure motion. As a result, the 16 CFX delivers more accurate clinical images depicting fine details, including minute coronary arteries, soft plaque, and small vessel structures for superior cardiovascular imaging studies.

FIFADI is an official TAMS show site, an accreditation received by only a few medical facilities throughout the country. Coro-nary computed tomography angiography (CTA) scans performed at FIFADI visually isolate the heart by removing surrounding structures to expose signs of disease through 3-D visualization of coronary arteries, calcified and/or soft plaque, heart chambers, bypass grafts, and stents. In most cases, the primary advantage of a coronary CTA is the ability to visualize soft plaque, which would be invisible during an electrocardiograph, stress testing, calcium scoring, and cardiac catheterization.

According to Strobbe, coronary CTA is one of the most accurate imaging techniques available for detecting the accumulation of soft plaque in the coronary arteries—a leading cause of heart attacks. Using the Aquilion scanner, FIFADI is able to conduct better exams at the earliest stages of heart disease to prevent future heart attacks and lessen patient risk. CTA also reduces the need for costly and often painful invasive procedures, such as catheter angiography and surgery.

“About 50% of cardiac procedures have a negative result,” Strobbe said. “That means, half the patients who experience these painful procedures don’t necessarily have to. The industry is moving away from these types of invasive procedures. These are amazing times. We’re going to stop passing catheters; that’s where the industry is heading, and I think it’s great.”

“When we decided we wanted to provide these kinds of services to our members, we discussed the possibilities of working with many companies,” said Tom Wessling, VP of nutrition and facility services at Amerinet. “However, we ultimately decided on Powerware, because the company is able to provide the exact package we want. Our members can take advantage of [Powerware’s] full range of software, integration, and power services.”

In an effort to help healthcare facilities avoid power disruptions, Powerware provides 24-hour service and technical support, on-site evaluations of power problems, and full-service design and installation unique to the healthcare industry.

“This area of service being provided by Powerware also will create an avenue for our members to increase awareness amongst one another concerning issues or problems they are experiencing,” Wessling added. “Because our members will be receiving the same service, if a question or concern should arise, a solution can be obtained more efficiently within a network of peers.”

To determine the effect on toxicity of adding neoadjuvant hormonal therapy to 3D-CRT, 583 men with prostate cancer enrolled on the first three dose levels of RTOG 94-96. Collectively, 207 men initiated neoadjuvant hormonal therapy between 2 and 3 months before 3D-CRT.

The study found that hormone therapy before radiation did not have a significant independent effect on any acute or late toxicity of the patients. However, the findings do suggest that hormone therapy before radiation significantly increases the likelihood of Grade 2 acute genitourinary complications.

“Although hormone therapy before radiation is not the significant finding, when placed in the multivariate analysis, its interaction with baseline urinary status is an important factor,” said Richard Valicenti, MD, lead author of the study and a member of the Department of Radiation Oncology at Thomas Jefferson University Hospital, Bodine Center for Cancer Treatment (Philadelphia).

Overall, the combined modality therapy significantly increased the risk of acute GU effects compared to 3D-CRT alone in men with poor baseline urinary function.

“We’re interested in the Houston-based company’s reputation of strong experience in the transcription business,” said PracticeXpert CFO Michael Manahan. “The company has a clear and customer-focused operation that serves the exact client mix our company is looking to expand into.

“Our corporate strategy is to acquire companies that have existing relationships with physicians,” he continued. “Once the company is acquired, we have the opportunity to install our medical billing platform.”

The name of the Houston-based company and details of the acquisition are scheduled to be announced when a more final agreement is made between the two companies.

The recent endorsement for the provider of minimally invasive urologic and orthopedic services is well directed. HealthTronics is the creator of OssaTron, the first high-energy ESW device in the United States cleared by the FDA to treat chronic plantar fasciitis and chronic lateral epicondylitis—tennis elbow.

“The endorsement from the medical community further validates the use of high-energy ESW minimally invasive surgery as a clinically effective and safe

noninvasive surgical treatment for a broad range of chronic musculoskeletal conditions,” said Argil Wheelock, chairman and CEO of HealthTronics. “The outcomes from ESW are similar to those achieved with traditional surgery, while the ESW patients have fewer significant complications and return to normal activity much sooner.”

These factors have made ESW the treatment of choice for patients who need surgical intervention if they do not improve with conservative treatment modalities.

According to ECRI, multislice CT angiography will be performed more frequently as a complement or replacement for other cardiac examinations, such as diagnostic cardiac catheterization, MRI, and nuclear imaging. The organization expects the number of diagnostic cardiac catheterization procedures to decrease over the next few years, particularly for assessing plaque, stenoses, and myocardial viability as well as for ruling out atherosclerosis.

Because of the predicted use of the procedure, ECRI also states that high-volume cardiology departments will increasingly consider purchasing dedicated cardiac CT scanners. Healthcare providers and administrators can expect high-end multislice CTs for cardiovascular and angiographic applications to diffuse rapidly over the next several years. According to ECRI, the reasons for this diffusion include the noninvasiveness of the scanning procedure, the increasingly aging population, and an ongoing emphasis on earlier diagnosis and treatment. More advanced CT technology, such as the 32-, 40-, and 64-slice scanners showcased at RSNA 2003, could dramatically increase the range of cardiac imaging applications that can be performed.

In an effort to increase its presence in the tristate area, NovaRad chose Common-wealth X-Ray because it satisfied a number of needs, such as affordability, reliability for customers, and the ability to serve small to mid-size medical facilities. The partnership between the two companies is a result of NovaRad’s strategy to increase its installation size while maintaining affordability. The addition of Commonwealth X-Ray will complement NovaRad’s existing in-house sales efforts.

Also, NovaRad has been selected by Radiology Associates of Macon (Macon, Ga) to aid in the facility’s initiative to become 100% filmless. NovaPACS is anticipated to save the hospital thousands of dollars per month by eliminating the cost of film.

Early in 2004, NovaRad partnered with iPro Inc (Calhoun, Ga), a healthcare technology distributor and consultant company, to market NovaPACS as well as the company’s RIS archived products, servers, and radiology accessories. iPro plans to focus its efforts toward small to mid-size hospitals and radiology centers in the Southeast.

The Community Choice Healthcare Network hospitals (Owenatchee, Wash) selected NovaRad’s NovaPACS, CR technologies, and RIS integration software for its radiological department. The installation of the NovaRad technologies is scheduled for completion in January. The system will replace the hospital’s emulsion film systems and provide the speed and ease of transferring images between hospitals in the network.

Accel Healthcare Communications LLC (New York) has named Orin Kimball as the company’s senior VP, executive creative director. Kimball, who has earned many commendations for art direction and graphics in pharmaceutical advertising, is a graduate of the school of Visual Arts in New York City with a major in advertising.

HealthTek Solutions (Norfolk, Va) has appointed Colin Konschak, RPh, as VP of business development. Konschak is a member of the American Academy of Managed Care Pharmacy, the Virginia Society of Health System Pharmacists, and the American College of Healthcare Executives. He is responsible for creating strategic alliances within the healthcare community as well as overseeing various segments of the company. HealthTek has also named Michael Sanders as divisional director of professional services. With more than 20 years of experience in healthcare services, Sanders is responsible for the development of a new IT consulting practice. He comes to HealthTek after holding several director-level positions at Methodist Healthcare Systems (Houston).

IDX Systems Corp (Burlington, Vt) has promoted Thomas Butts to president and COO of the company. Butts joined IDX in January 2002 as president and general manager of the IDX Flowcast operating unit. In his new position, Butts will have overall responsibility for the IDX operating units, including Flowcast, Groupcast, Carecast, and Image-cast. IDX has also promoted Stephen Gorman to president and general manager of the company’s Groupcast operating unit. Prior to the promotion, Gorman served as the Groupcast national operations manager and southeast region operations manager.

Merge eFilm (Milwaukee) has signed a new $15 million unsecured line of credit agreement with Merchants and Manufactures BanCorp (MMBC of Milwaukee). The previous $15 million line of credit, from which no monies have been drawn, was set to expire in December 2005. The new 3-year agreement provides capital for Merge eFilm’s future growth and strategic investments. The company’s cash balance of $15 million, in conjunction with the $15 million line of credit, provides a $30 million foundation for Merge eFilm in the RIS/PACS marketplace.

CC Soft Computer (Palm Harbor, Fla) has reported increases for fiscal year 2003. The privately held software developer increased total gross revenues in 2003 to $51.5 million, up from $47.3 million in 2002—an increase of 10%. The company is predicting a 20% growth rate for 2004.