HIMSS 2003 offers latest IT products, alliances
The healthcare information technology (IT) showcase that is the annual meeting of the Healthcare Information and Management Systems Society (HIMSS of Chicago) went to San Diego in February.

HIMSS organizers estimated more than 19,000 healthcare professionals and more than 600 vendors and exhibitors attended the forum.

The Health Insurance Portability and Accountability Act (HIPAA) was one of many timely topics for HIMSS 2003. With privacy and security rules coming into effect, many healthcare entities affected by the regulations are working diligently to meet this year’s deadlines.

Health plans, information clearinghouses and healthcare providers have until April 14th to comply with the rule which sets standards for electronic healthcare transactions and protects against the misuse of patient information. Healthcare plans with annual receipts of $5 million or less have until April 14, 2004, to meet the statutes.

Thomas R. Walsh, principal consultant for CTG HealthCare Solutions Inc. (Overland Park, Kan.) said that it is “good business” to implement “certain minimum key things that will need to be done in order to be compliant with the privacy rule, no matter what the final security regulations are.”

He recommended that healthcare entities, among other HIPAA-related measures, assign an employee to the position of privacy or security officer, have the information system’s security audited yearly by an outside entity, and structure the system so security problems easily can be reported. Walsh also advocated creating a procedure to ensure that there will be no retaliation for so-called whistle-blowers.

Vendor news
On the exhibit floor, Agfa HealthCare (Ridgefield Park, N.J.) showed its latest in integrated speech recognition products from Talk Technology Inc. (Bensalem, Pa.), which Agfa acquired in 2001.

The newest features of TalkStation 2.2 include functions that are designed to enhance workflow and help reduce report turnaround time. The Remote Administration Tool is a web-based application that provides administrators with the ability to execute system-wide administrative functions through remote access.

Agfa also demonstrated its Impax DS3000 diagnostic product for radiologists, which facilitates medical image reading and reporting in one step. It includes a single sign-on feature.

Amicas Inc.’s (Boston) Vision Series web-based picture archiving and communications system (PACS) platform has successfully completed interoperability testing with TotalStorage enterprise storage servers from IBM Corp. (Armonk, N.Y.). The IBM TotalStorage Proven program supports the ability of independent software vendors (ISVs), such as Amicas, to design products that can be combined with IBM technology.

The pre-tested configurations can help address a wide range of healthcare institutions’ software and infrastructure needs, including concerns about interoperability, scalability and reliability.

IBM also is partnering with Siemens Medical Solutions USA Inc. (Malvern, Pa.) in the realm of PACS. Siemens is combining its Sienet integrated radiology suite with IBM’s new Management Storage Service (MSS) to offer hospitals more options in their adoption of digital image management technology.

IBM’s MSS is designed to provide healthcare facilities with more storage capacity in conjunction with Siemens’ Sienet, which displays, processes and manages extremely high-resolution electronic radiology images.

IDX Systems Corp. (Burlington, Vt.) and Sentillion Inc. (Andover, Mass.) have aligned to offer IDX’s customers Sentillion’s authentication, single sign-on, context management and privacy auditing products.

Sentillion’s single sign-on feature gives users access to multiple applications with a single secure log-on, even as nurses move from station to station and physicians log on and off various computers during rounds.

IDX will co-brand Sentillion’s product names, extending the IDX brand with names, such as IDX Single Sign-On powered by Sentillion.

Philips Medical Systems North America (Bothell, Wash.) highlighted its Vequion line of clinical IT products and services at HIMSS 2003. Vequion is designed to help healthcare organizations establish and maintain an integrated, streamlined environment to reduce costs, minimize staff training and improve the quality of patient care.

Vequion’s Virtual Patient Record (VPR) application integrates all patient information on a desktop for enhanced information retrieval. Philips’ ViewForum is an example of a Vequion-compatible software product that allows users to configure multi-modality workstation environments.

Sectra Imtec AB (Linkoping, Sweden) is partnering with Eclipsys Corp. (Boca Raton, Fla.) to produce a fully integrated enterprise imaging product that will include a new development called Knowledge-Based Diagnostic Imaging.

The advancement will be designed to provide hospitals with a comprehensive workflow-imaging component in conjunction with Eclipsys’ SunriseXA advanced clinical information product. Sectra Imtec has its largest numbers of installed systems in Sweden, Norway, Finland and Denmark. The partnership is seen as a way to enhance the companies’ presence in North America.

Storage Technology Corp.’s (StorageTek of Louisville, Colo.) and Rorke Data Inc. (Eden Prairie, Minn.) have aligned to improve the healthcare industry’s access to secure, scalable, open and flexible data storage products.

StorageTek is extending its product offerings to a wider customer base within the picture archiving and communications systems (PACS), HIS and radiology information system (RIS) industry segments of the healthcare market. In turn, PACS integrator Rorke Data will provide healthcare facilities with a centralized data storage product using StorageTek technologies.

China to terminate ban on influx of pre-owned medical equipment
The People’s Republic of China has set in motion a series of steps that will culminate in the end of a five-year ban on the importation of pre-owned and refurbished medical equipment into the country.

The Chinese government’s decree reverses a ban that went into effect in January 1998 on the importation of used electro-mechanical equipment, including medical equipment. The decree takes effect on May 1.

Don Bogutski, president of the International Association of Medical Equipment Remarketers and Servicers (IAMERS of Scottsdale, Ariz.), called the action “enormously positive. The People’s Republic of China has tremendous needs to improve on its healthcare. Given the fact that their economy is doing reasonably well, they still don’t have the ability to support new equipment for all the people who require diagnostic or therapeutic capabilities.”

The decree requires that pre-owned equipment be inspected upon arrival in China for compliance with local laws, regulations and other statutes. The action also directs China’s General Administration of Quality Supervision, Inspection and Quarantine to accredit organizations and individuals to perform pre-shipment inspections.

IAMERS said that it is not clear at this time if organizations to be accredited to perform the inspections will be from the Chinese government or third-party organizations.

Bogutski said the mechanisms for pre-inspection prior to loading and shipment could be determined or in place as soon as September. With those guidelines in place, the exportation of medical equipment to China could begin then.

“Depending on how effective the pre-inspections are and how happy the Chinese government is with the process, it [medical equipment exportation] could ramp up very quickly thereafter,” Bogutski speculated.

IAMERS plans to have an update on the China situation at the organization’s annual meeting in New Orleans from April 11th through April 13th.

Delft acquires MDS Nordion Software unit
MDS Nordion (Kanata, Ontario, Canada) in February completed the sale of its Oncology Software Solutions business unit to Delft Instruments N.V. (Delft, Netherlands) for approximately $23 million.

Delft will integrate the oncology software business into its Nucletron B.V. (Veenendaal, Netherlands) radiotherapy company and retain the 150 or so Oncology Software Solutions employees.

The Oncentra line of oncology software products and services heads Oncology Software Solutions’ portfolio. Oncentra’s information management products include integrated treatment planning tools that cover the entire treatment process from image capture to planning to long-term data archiving. Oncentra Electronic Patient Folder provides centralized storage and access for all patient information, while Oncentra Resource Scheduler manages all clinical resources, including staff, equipment and facilities.

With the acquisition, Nucletron maintains that it will be able offer integrated information management products to link data between radiotherapy and oncology departments. Rudolf Scholte, Nucletron’s president and CEO, added that the addition of the Oncology Software Solutions unit also will expand the company’s global service.

MDS Nordion said that the company will continue to focus its resources on radioisotopes, radiation and related technologies to advance healthcare, primarily in nuclear medicine, cancer therapy and sterilization.

MDS Nordion has made recent investments to expand its radioimmunotherapy development capabilities; increase its supply capacity to support growth and new opportunities in the global sterilization business; and bring on new sources of medical isotope supply to meet the growing needs of the global nuclear medicine community.

ARRT exams show second straight increase in candidates
The number of candidates who took American Registry of Radiologic Technologists (ARRT of Albuquerque, N.M.) exams in 2002 increased for the second straight year.

Figures from ARRT’s Annul Report of Examinations show an overall 9.6 percent increase over the number of exams taken in 2001. A total of 9,080 first-time candidates took an ARRT primary examination during 2002, compared with 8,287 in 2001. 2002 is the second straight year the number of first-time candidates taking the exam increased, following several years of decreasing volume during the mid to late 1990s.

d01a.gif (7529 bytes)

AART provides certification in three primary disciplines of radiographic technology: radiography, radiation therapy and nuclear medicine. Both radiation therapy and radiography experienced a significant increase, while the number of nuclear medicine candidates decreased in 2002.   

Radiation therapy increased by 12.6 percent to 652 candidates, while radiography climbed by 10 percent, with 8,168 first-time candidates. Nuclear medicine technology declined 5 percent, with 260 first-time candidates.

ARRT said the upward trend reflects the growing enrollment pattern in educational programs throughout the Unites States. Both educators and employers have been recruiting vigorously in order to fill spots in the profession and ARRT does not think that the increasing trend will turn around in the immediate future.

Konica Medical consolidates operations across the board
Konica Medical Imaging Inc. (Wayne, N.J.) is restructuring and consolidating areas of its sales, business development and service organizations across all of the company’s product lines.

Konica’s product and service offerings cover film, processors, print management, computed radiography (CR) and PACS (picture archiving and communications systems).

Among its initiatives, Konica consolidated sales and business development to increase focus on order creation and order acquisition activities. The company also consolidated all its service-related resources to enhance coordination and focus on order realization and life-cycle support activities.

In a prepared statement, Konica President and COO Wayne Thompson said the company’s goal is to become “more coordinated and decentralized in its decision making and more attentive to local customer and reseller partner needs.”

Konica also has appointed James Champagne to the newly created position of vice president of sales and business development. Champagne has served as Konica’s vice president of business development for the past 18 months. Prior to Konica, he served in business management positions with Philips Medical Systems North America’s (Bothell, Wash.) radiographic, surgery, computed radiography and PACS lines.

Study questions link between experience and ability
A new study suggests that experience may not be the only tool a radiologist needs to interpret mammograms accurately.

Researchers at the H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida (Tampa) concluded that the number of mammograms read might not be the only factor that determines a radiologist’s accuracy rate for identifying breast cancer.

The study, published in the Feb. 19 issue of the Journal of the National Cancer Institute, conflicts with previous experiments, and what may be common sense, regarding volume and accuracy in film reading.

Within the study, Craig A. Beam, M.D., and colleagues found that when 110 randomly selected radiologists screened 148 mammograms for breast cancer, the volume of mammograms that each individual had evaluated the year prior to the test “was not significantly associated with accuracy,” Beam said in a prepared statement.

The discovery is at odds with a previous study that said a radiologist’s accuracy rate for identifying breast cancer was determined by the number of mammograms he or she performed. Last year, another study published in the same journal detailed that radiologists in the United Kingdom, who are required to evaluate more than 5,000 mammograms a year, were more accurate than U.S. radiologists, who must examine only 480 mammograms per year.

In response to the clashing evidence and initial surprise, Beam and his colleagues theorized that the quality of feedback a radiologist receives may be more important in determining one’s level of accuracy.

Since the vast majority of mammograms are negative, radiologists only hear feedback about mammograms that they flagged as positive for breast cancer that were later determined to be negative by further testing — for example with a biopsy — in which suspect breast tissue is removed and examined under a microscope.

“As a result,” explained Beam, “feedback about how well radiologists are doing their job is minimal and negative, because it only calls their attention to false-positive screening results.”

On the heel of their evaluation, researchers also developed additional factors that might be significant predictors for identifying breast cancer accurately.

For one, radiologists who finished their residency training more recently were more accurate than their colleagues trained several years ago. Secondly, radiologists affiliated with specialized breast cancer clinics performed better. Finally, researchers speculated that radiologists who routinely worked in pairs, called double readers, fared better in identifying breast cancer on mammograms than radiologists who worked alone.

All things considered, researchers believe that the topic needs to be explored even further.

FDA awards Varian 510(k) on PaxScan 4030
Varian Medical Systems Inc. (Palo Alto, Calif.) has received 510(k) clearance from the FDA for its new PaxScan 4030 medical digital imaging system, the first end-user configured system developed by Varian Medical’s X-ray Products division.

For its 510(k) submission, Varian Medical combined a workstation, medical imaging software and a flat-panel screen that is already a part of the company’s product line-up. The initial design and configuration of the PaxScan 4030 took nine months to complete and is intended for military application.

 Varian Medical’s PaxScan 4030

“The system came about after preliminary discussions with the military over field type hospital applications, where there are wounded soldiers and other trauma situations that require radiography equipment which is lightweight and portable,” said Chuck Blouir, Varian’s marketing manager.

The system captures x-ray images by using an image detector that is placed behind the patient. X-rays that pass through the patient are captured by an amorphous silicon flat-panel image detector and converted into electronic images, which are displayed on a workstation monitor for diagnosis. The PaxScan 4030 R flat-panel receptor has been used for various industrial and medical applications outside the United States for more than four years.

The digitized images acquired on the battlefield can be stored on a CD or sent via high-speed network or Internet connection to healthcare providers in military field hospitals or remote locations. PaxScan images can be saved and transmitted using standard DICOM-compliant communication protocols.

The portable computer rests in a foam-filled case and has a built-in keyboard and display. The protective case permits the hard drive to be shaken and withstand high temperatures without causing damage.

While the 12-inch by 16-inch panel and 100-pound system are designed for adverse weather conditions and quick set-up, and break-down situations, Varian Medical says adjustments will be made in PaxScan’s design before the system is used in a conventional radiography unit.

“This particular product, as it is constructed, is not going to be used in general radiographic units in a hospital,” said Blouir.

Varian Medical will begin development of a 17-inch by 17-inch square panel starting in the company’s next fiscal year, which begins in September. The company may sell the bigger panel through a system integrator or a third party that lacks an engineering design department.

CT helps in the detection of lung cancer, but not foolproof
A study published in the March issue of Radiology finds that while computed tomography (CT) allows radiologists to detect lung cancer in earlier stages than chest radiography, CT also yields a high number of false positive findings.

Stephen J. Swensen, M.D., lead author and professor and chair of the department of radiology at Mayo Clinic (Rochester, Minn.), said that while CT lung cancer screening “may be a solution for the disease,” caution should be exercised, because CT lung screening involves risks and is yet unproven at saving lives.

The Mayo study found that CT screening of high-risk patients detects lung cancer at a smaller size and earlier stage, as compared with chest radiography and other clinical practice diagnostics. However, CT screening also identifies many benign, uncalcified lung nodules as false positive findings.

The Mayo Clinic research evaluated 1,520 people who were 50 years and older using low-dose, spiral chest CT. The study analyzed lung characteristics, nodules and additional findings and compared the results with previous chest radiograph-based studies and current clinical practice diagnosis.

The study found that 1,049 of the 1,520 people screened (or 69 percent) had uncalcified lung nodules. Using CT, researchers detected 38 cases of lung cancer, including 35 cases of non-small cell lung cancer (NSCLC).

“It is possible that lung cancer has already spread before it can be detected with CT,” Swenson said in a prepared statement. “In that scenario, we may actually be doing more harm than good to patients by removing tumors and involving patients in major surgery that has a measurable mortality rate.”

The study also reported that, over three years, 98 percent of uncalcified lung nodules detected by CT represented false positive findings. In such cases, further testing was required to determine if the imaging findings were lung cancer or benign nodules.

Cerner builds new R&D center
Cerner Corp. (North Kansas City, Mo.) has broken ground on a new six-story Development Center as part of a major expansion initiative at its corporate headquarters.

The new Development Center is part of the information technology (IT) company’s plan to spend $1 billion on research-and-development over the next seven years.

The Development Center will cover 192,000 square feet and could house as many as 1,000 software engineers and designers. The facility is scheduled for completion in October.

Cerner also is in the final stages of construction on its new world headquarters at its North Kansas City site.

Cerner’s R&D projects will target medical imaging systems and consumer-based products, including technology that would allow patients to contact physicians over the world wide web.

Cerner could add 4,000 new jobs over the next two years, with approximately 2,400 at corporate headquarters.

CTI taps Hook to replace Rhoads
CTI Molecular Imaging Inc. (Knoxville, Tenn.) in February announced the resignation of Mark Rhoads as president of CTI subsidiary PETNet Pharmaceuticals Inc. (Knoxville).

To fill the PETNet vacancy, the positron emission tomography (PET) developer and manufacturer appointed Thomas J. Hook, president of CTI Services Inc. (Knoxville), to the post of PETNet president. CTI Molecular Imaging CEO Terry Douglass will assume Hook’s responsibilities at CTI Services.

Rhoads joined PETNet in 2000 and has been commuting from his home in Maryland for the past three years.

Under Rhoads’ tenure, PETNet increased the number of PETNet pharmacies distributing fluorodeoxyglucose (FDG) to PET imaging facilities from 13 pharmacies in 2000 to 36 pharmacies today.

In June 2001, PETNet also established the LA Tech Center in collaboration with the University of California-Los Angeles (UCLA) School of Medicine’s department of molecular and medical pharmacology as a research center for the study of molecular medicine and PET technology.

Hook said it is too early to talk about specific plans for PETNet under his guidance. He and CTI hope to announce PETNet initiatives in late April, when the company releases its financial results for the second quarter of FY03, ending March 31.

“First and foremost, I want to focus on continuing to improve the growth and profitability of PETNet,” Hook said. “Second, I expect to continue Mark’s efforts in the development of new proprietary probes that will ensure PETNet’s leadership in molecular medicine and which will be the driver for CTI’s growth in the years to come.”

Hook joined CTI in July 2002 as president of CTI Services after serving most recently as general manager of global functional and molecular imaging for GE Medical Systems (GEMS of Waukesha, Wis.). Prior to that post, Hook served as GEMS’ general manager of global PET, where he helped guide GEMS’ global nuclear medicine, PET and molecular imaging businesses.

AHS chooses Agfa for $30 million project
The Florida Division of Adventist Health System (AHS of Winter Park, Fla.) has awarded Agfa HealthCare (Ridgefield Park, N.J.) a multi-year, $30 million contract to convert the Florida Division’s current analog radiography system to digital imaging technology.

Agfa will install its digital imaging products in more than 20 AHS facilities, linking AHS’ outpatient facilities and hospitals.

The agreement provides 17 AHS facilities with Agfa’s newest review software, including Agfa’s Impax v4 and ADC Compact computed radiography (CR) system.

Agfa began the project in January and the digital conversion has been completed at nine AHS facilities.

AHS operates a total of 38 hospitals, 24 extended-care facilities, and more than 20 home health, hospice, medical equipment, and infusion entities in 10 states and Puerto Rico.

Cbyon, INI form research alliance
Surgical navigation firm Cbyon Inc. (Mountain View, Calif.) and the International Neuroscience Institute (INI of Hannover, Germany) will partner on the development of the Cbyon Suite for neurosurgical applications.

Cbyon has designated INI, which specializes in the treatment of diseases and disorders of the nervous system, as Cbyon’s European Center of Excellence. Cbyon will support INI with its technology and related resources, while INI serves as a training site for the Cbyon volumetric surgical navigation system for various deep brain approaches.

INI provides a range of neuromedical techniques, including diagnostic and therapeutic neurosurgery, neuroradiotherapy and neuroradiology with an emphasis on the interdisciplinary, surgical and interventional radiological treatment of vascular malformations and tumors of the nervous system.

NASI’s Theseus Imaging to partner with NCI
Theseus Imaging Corp. (Cambridge, Mass.) has entered into a clinical trial agreement with the National Cancer Institute (NCI of Bethesda, Md.) for the co-development of its Hynic-Annexin V agent for imaging cell death.

Hynic-Annexin V is designed for the management of oncology patients, specifically for the early assessment of chemotherapy response.

The collaborative pact pairs Theseus — a subsidiary of North American Scientific Inc. (NASI of Chatsworth, Calif.) — with members of NCI’s Biomedical Imaging Program (BIP). Theseus and the NCI each plan to submit individual investigational new drug (IND) applications to the FDA for clinical studies of Hynic-Annexin V.

The BIP will sponsor clinical trials in oncology patients in cooperation with Theseus and allow Theseus access to data and results from BIP-sponsored studies of Hynic-Annexin V for inclusion in the company’s IND to the FDA.

Theseus expects to sponsor the initial U.S.-based clinical trial of Hynic-Annexin V in lung cancer patients and to develop additional trials in lung cancer and other malignancies, such as breast cancer, gastrointestinal cancer, brain cancer, and lymphoma in cooperation with BIP.

Hynic-Annexin V is based upon NASI’s Apomate technology platform and is a kit for the preparation of Technetium Tc-99m labeled Annexin V. It is administered intravenously and is intended for the in vivo imaging of apoptosis and necrosis.

TechniScan says Phase I trials show promise
TechniScan Inc. (Salt Lake City) is reporting what the company describes as “promising results” from the Phase I clinical trial of its ultrasound imaging technology for breast cancer screening and diagnosis.

In the first series of patient studies at St. Mark’s Hospital (Salt Lake City), preliminary results showed the TechniScan system was able to create high-resolution images showing the speed and absorption of sound in the breast for the first time. The system also was able to indicate the separation of benign and cancerous lesions.

TechniScan said the information could aid radiologists in distinguishing cancers from benign lesions and other tissue structures in the breast earlier and help reduce the need for biopsies.

The Phase I clinical study included women who had undergone routine screening mammography and were asked to undergo a secondary screening using the TechniScan system. TechniScan said the procedure takes approximately 45 to 60 minutes, adding that time per exam should be reduced to approximately 20 minutes with further development of the system.

The TechniScan system is based on technology called inverse scattering, which, the company noted, uses all the data from ultrasound or other waves to provide a more accurate picture than conventional imaging. The technology uses reflection ultrasound tomography that produces sectional slices as in MR and CT imaging.

CAD gains reimbursement for digital mammo
Computer-assisted diagnosis (CAD) for mammography gained some reimbursement strength on April 1st when Medicare payment kicked in for full-field digital mammography in addition to film screen, which has been reimbursed since 2001.

In addition to the primary code for the mammogram, hospitals billing under the Hospital Outpatient Prospective Payment system (HOPPS) can bill using 76085 for CAD with a screening mammogram, in addition to the technical component (76085-TC) and professional fee (76085-26). The revenue code is 403. For billing CAD with a diagnostic mammogram, hospitals can use G0236. The technical component is G0236-TC, the professional fee G0236-26 and 401 is the revenue code. The national average reimbursement is $25.

 A radiologist reviews mammography CAD images on an R2 ImageChecker system.

Freestanding imaging centers also can bill using 76085 for CAD with a screening mammogram in addition to the primary code for the mammogram, and using G0236 with a diagnostic mammogram.

The Medicare Physician Fee Schedule (MPFS), which came into effect on March 1, sets the global payment rate for CAD (unadjusted national) at $19.13 with the professional fee at $3.31 and the technical component at $15.82.

This good reimbursement news comes at a good time for CAD as installations are increasing — with about 900 mammography CAD sites to date divided amongst R2 Technology (Los Altos, Calif.), iCAD (Nashua, N.H.) and CADx Medical Systems (Laval, Quebec, Canada). Experts predict this is just the tip of the iceberg as MQSA sites number about 9,200. CAD became commercially available in 1998.

While CAD’s original purpose was to minimize physician liability by reducing false negatives, it is making great strides in the fight against breast cancer which afflicts more than 256,000 American women (and 1,000 men) annually and kills about 39,800, according to the American Cancer Society.

 A radiologist reviews images from CADx’s Second Look breast CAD unit, which gained regulatory approval in 2002.

CAD with mammography is proving itself through a variety of clinical studies, with the average of a 20 percent-plus increase in breast cancer detection. In addition, one study noted that a larger percentile were early-stage malignancies (78 percent vs. 73 percent detected by radiologists alone). Research shows CAD detects tumors an average of 15 months earlier than humans reading mammograms alone. And who does research say finds more breast cancers? CAD with 90 percent (98.5 percent of microcalcifications and 85 percent of speculated masses) vs. radiologists with 80 percent.

A blinded retrospective review showed that mammographic interpretation by the original radiologists had a false negative rate of 21 percent and the CAD prompting had the potential to reduce that rate by 77 percent. A related study found that of 115 missed cancers on screening mammography, 30 percent were calcifications and 70 percent were mass lesions. CAD software marked 86 percent of the missed calcifications and 73 percent of the missed masses.

CAD’s strength lies in locating microcalcifications in dense breasts, as shown in a study of 18 facilities (906 normal and 153 positive screening mammograms) presented at RSNA 2001 by Rachael F. Brem, M.D. Using CAD, the readers more accurately identified microcalcifications than masses in dense breasts, achieving average sensitivity of 95 percent in dense breasts and 93 percent in non-dense breasts. For fatty breasts, the average sensitivity of mammography alone was 98 percent compared with 88 percent for mammography and CAD.

But how much time does CAD add to an interpretation of a screening exam? On average, 17 seconds, according to a study published in early 2001. It has been pointed out that this is about the same time a magnifying glass review takes as well.

Overall, CAD promises to ease radiologists workflow, namely in reading screening mammograms, as well as increasing the quality of services in spite of the current shortage of radiologists.

Financial Pulse
Revenues at GE Medical Systems (GEMS of Waukesha, Wis.) could exceed $10 billion this year and may top $15 billion within the next four years.

d01f.gif (18632 bytes)

That forecast came from Joseph M. Hogan, GEMS’ president and CEO, at the annual meeting of the Healthcare Information and Management Systems Society (HIMSS of Chicago) in San Diego in February.

In an interview with Reuters news service, Hogan said GEMS’ pending acquisition of Instrumentarium Oy (Helsinki) for $2 billion will be one catalyst for GEMS’ revenue growth this year. If and when the transaction is completed, it would be GEMS’ largest-ever acquisition. The deal could close as soon as the second quarter.

Instrumentarium derives approximately 80 percent of its sales from its anesthesia and critical care operations, which include Datex-Ohmeda Inc. (Madison, Wis.), Deio Oy (Helsinki) and Spacelabs Medical (Redmond, Wash.). The company achieved worldwide sales of approximately $1 billion in 2001. Instrumentarium also develops and manufactures infant care products and mammography equipment. Its U.S. headquarters — Instrumentarium Imaging Inc. — is in Milwaukee.

Hogan told Reuters that while GEMS currently does not have its own hospital information systems (HIS) management unit, the company feels that it does not need one to compete in the market. The strategy is to focus on clinical technology and applications and maintain the flexibility to integrate with an outside vendor’s HIS.

In other comments to Reuters, Hogan said that computerization of healthcare will help enhance patient care, reduce costs and eliminate medical errors. GEMS expects to spend $700 million this year on research and development

Compiled and analyzed by Health Care Markets Inc. (Hilton Head, S.C.), the stock indices above plot the performance of two market segments: Imaging Devices and Imaging Services. The indices are part of WDI’s healthcare database of more than 1,000 companies. For comparison we also plot the progress of the S&P 500. The indices began in January 1991 with a base of 100.

Financial Watch
Alliance Imaging Inc. (Anaheim, Calif.) overcame weak scan volumes during the fourth-quarter holiday period to post revenue and earnings gains in 2002. Revenues increased 10 percent to $412 million last year, compared with from $375.2 million in 2001. Net income advanced to $35.9 million, compared with $10.5 million in 2001. As for its 2003 outlook, the company revised downward its estimates for revenues. Alliance previously estimated revenues of $440 million to $450 million this year. The revised estimate is for full-year revenues of $415 million to $425 million in 2003.

A gain in product development revenues boosted specialty pharmaceutical company Epix Medical Inc. (Cambridge, Mass.) to higher revenues in 2002. Revenues rose to $12.3 million, compared with $9.6 million in 2001. The company’s net loss increased to $22.2 million, compared with a net loss of $19.2 million in 2001. The net loss was due, in part, to a $6.2 million increase in research-and-development expenses related to Phase III clinical trials for Epix’s MS-325 MRI contrast agent.

Acquisitions in 2002 helped Merge Technologies Inc. (Milwaukee) grow its revenues. Net sales advanced to $20.8 million last year, compared with $15.7 million in 2001. Net income almost tripled to $3.6 million in 2002, compared with $1.3 million in the previous calendar year. Merge anticipates that its revenues for 2003 will be in the range of $27 million to $28 million.

Computer-aided detection (CAD) technology firm iCAD Inc. (Nashua, N.H.) achieved greater sales in 2002, as the company continues to transition to CAD products and away from its discontinued graphic arts and photographic lines. Sales for the year — which include CAD sales only since June 28, 2002 — totaled $5 million, compared with medical imaging and total sales of $2.3 million and $4.8 million, respectively, in 2001. iCAD also posted a net loss of $9.4 million for 2002, compared with a net loss of $2.6 million in 2001.

Prime Medical Services Inc. (Austin, Texas) finished 2002 with a 10 percent increase in revenues. Revenues climbed to $169.9 million, compared with $154.9 million in 2001. Net income, excluding non-recurring charges, was $12.3 million in 2002, compared with $8.6 million in 2001. When non-recurring charges are included, the company’s net income was $770,000 in 2002 compared with a net loss of $14.5 million in 2001. Prime Medical Services attributed the growth to acquisitions made within its manufacturing division and urology partnerships. The company expects revenues to reach $225 million in 2003.

Customer adoption of the SonoSite 180PLUS and the trend toward multiple-system sales increased revenues by 36 percent for SonoSite Inc. (Bothell, Wash.) in 2002. Revenues increased to $73 million in 2002, compared with $45.7 million in 2001. The company also posted a net loss of $7.7 million in 2002, compared with a net loss of $16.4 million for 2001. SonoSite’s fourth-quarter revenues increased in each of its major geographic markets, rising 79 percent in the United States and 63 percent in Europe.

Demand for its Stand-Up MRI system increased revenues for Fonar Corp. (Melville, N.Y.) by 51 percent during the first six months of FY03, ending on Dec. 31, 2002. Six-month revenues were $30 million, compared with $19.9 million for the first six months of FY02. The net loss for the six-month period for FY03 was $5.6 million, a 34 percent improvement over a net loss of $8.6 million in the year-ago period. Fonar anticipates that sales from its imaging product will project an increase in revenues during the upcoming two fiscal quarters.

Boosted by its July 2002 acquisition of Spacelabs Medical (Redmond, Wash.), Instrumentarium Oy (Helsinki) reported higher net sales in 2002. Net sales increased 10 percent to approximately $1.2 billion, compared with $1.1 billion in 2001. Net income increased to approximately $166 million, compared with approximately $77 million in 2001. Instrumentarium noted that its growth in operating profit was due to improved profitability in its Anesthesia and Critical Care segment, while the operating profit in the Medical Equipment segment was less than it was in 2001.

Vital Images Inc. (Minneapolis) recorded its first year-end profit in 2002, thanks, in part, to double-digit revenue growth. Revenues increased 39 percent to $21.1 million, compared with $15.2 million in 2001. The company also posted a profit of $790,000, compared with a net loss of $1 million in 2001. The medical imaging software company was buoyed last year by revenues of $7.2 million with a distribution agreement from Toshiba Corp., Medical Systems Group (Tochigi, Japan).

Mobile PET Systems Inc. (San Diego) says it is pleased with its revenue growth in the company’s second fiscal quarter, ending Dec. 31, 2002. Revenues advanced to $5 million, compared with $3.9 million in the second quarter of FY02. The company also posted a net loss of $382,284, compared with a net loss of $1.4 million in the year-ago quarter. For the six-month period, revenues totaled $9.6 million, up 32 percent from $7.3 million in the first half of FY02. MobilePET reported a loss from continuing operations of $1.2 million, compared with a net loss of $2.5 million in the year-ago period. When the company adds a net gain of $2.2 million on the sale of its London (England) PET Centre, MobilePET has net income of $997,210 for the first six months of FY03.