Philips' latest PACS idea allows personalized work environments

Partnership with Sectra Imtec provides technological foundation

The next generation of medical IT systems appeared at the RSNA meeting in December, according to Philips Medical Systems. The Vequion family of products is designed to streamline operations at healthcare facilities by integrating legacy IT systems and multiple modalities, regardless of the manufacturer.

Such homogenization typically carries the risk of reducing technological capabilities to the lowest common denominator, limiting users' ability to customize system functions. Philips believes this is not the case for Vequion.

Vequion is remarkably flexible, featuring a user interface compatible with any modality console or workstation, and software that recognizes users and presents data in the format each user prefers. ViewForum, one of the new software-based products within the Vequion family, lets customers configure multimodality workstations to their own preferences, combining viewing options, clinical applications, and PACS functionality. ViewForum Pro is designed to add interactive 3D volume rendering with direct manipulation, as well as the ability to inspect large data sets.

"It addresses the issue of personalized functionality," said Jos W. Bakker, Ph.D., senior director of Philips strategic marketing and business development in Medical Imaging IT. "It keeps track of your personal profile, which you can access by simply telling it who you are."

A neuroradiologist, for example, does not need or want access to orthopedic studies. The ViewForum aspect of Vequion builds up that information and acts on it.

"It has built-in intelligence to take a profile and produce what you need," he said. "It takes away this problem of throwing a water hose of information at someone who only needs a little sip."

Vequion's adaptability and harmonization support department-specific workflow requirements. They streamline operations and, in the process, reduce costs, minimizing staff training and boosting quality of care, Bakker said.

This next-generation IT achieves wide-ranging compatibility while allowing customized data management based on individual or departmental preferences. Vequion eliminates the boundaries that hamper workflow, increase costs, and impede quality of care, according to the company.

"We create a situation where the classical boundaries between PACS and modalities are blown apart," Bakker said.

The new PACS also blurs the boundaries between companies. The cornerstone of Vequion is technology provided by Sectra Imtec, a wholly owned subsidiary of Sectra, an IT and medical technology company based in Linköping, Sweden.

More than 330 institutions worldwide are running a Sectra PACS, though they may not know it. About 200 PACS installed in European institutions bear the Sectra name, but another 100 or so have been put into hospitals and clinics in the U.S. under the private labels of Sectra partners.

Philips and Sectra have been in partnership for the past five years in the development of PACS, and the relationship will continue for a good while longer. At the RSNA meeting, the two companies signed a five-year extension to their alliance. Together they have evolved a system that fits Philips IT and modality products as well as equipment from other vendors.

Originally founded in 1978 as a high-tech signal processing company, Sectra first dipped a toe into the medical imaging market in 1989. A timely efficiency drive in the Swedish healthcare system, coupled with a need to deliver medical services to a disparate population, helped generate interest and opportunities for digital radiology providers.

"Sweden is a large country, but we don't have a lot of people here," said Staffan Bergström, vice president of marketing for Sectra Imtec. "The northern parts have large distances between hospitals, so there was a real need for teleradiology systems. From there, we entered the PACS market."

Five years later, Sectra celebrated its first film-free radiology department. Technological development and sophistication followed, and the company is now a major international player and building strength.

Sectra got off to a brisk start in fiscal year 2003. Orders for May to October 2002 were up 37% over the same period in 2001, rising to SKr235.5 million (US$27 million) from SKr171.5 million (US$19.7 million). Meanwhile, sales for the six months jumped 85% to SKr266.7 million (US$30.6 million), yielding a healthy pretax profit of SKr 35.7 million (US$4.1 million), compared with just SKr15.9 (US$1.8 million) for the first half of fiscal 2001-2002.

Company president and CEO Jan-Olaf Brüer credits both the finalization of several major hospital projects and an increase in international sales of eavesdrop-secure GSM phones with boosting the six-month results. It is the medical systems sales, however, that currently make up the lion's share of Sectra's business. Secure communication and wireless information systems accounted for less than a quarter (16% and 4%, respectively) of Sectra's total sales in the 12-month period to October 2002. Philips' PACS rendition promises to add to those numbers.

The system's strength is its ability to reflect the character of end users. Vequion can be programmed to provide information for different types of personnel with different levels of training. Profiles may be specific to individual staff or to whole categories of personnel.

"It is the whole notion of personalization," Bakker said. "Vequion makes people feel that the system actually adapts itself to them, rather than making people adapt to the system."

Decisions on programming Vequion are made by radiology administrators or others in authority in the institution. Interfaces can be as detailed or generic or as few or many as desired. If the site prefers the maximum choice, Vequion offers numerous preset protocols.

"It's helpful to have a solid organization within your department or hospital to tune the system to the way you want people to work," Bakker said. "But the freedom is there to make Vequion into whatever you want."

This freedom comes from the underlying character of the system. Vequion is essentially software, Bakker said. This provides not only programming flexibility but the ability to apply Vequion where and when it is needed. Anyone with a PC or PC-compatible device can tap into the system. The device can be hardwired into the network, or access can be achieved through a wireless connection.

"With Vequion, you are not tied in physically to a work spot anymore," he said. "Your ViewForum follows you wherever you go."

The technology underlying Vequion took root in fertile soil. About half of the institutions in Norway and Sweden are film-free. But as the PACS market in these two countries nears saturation, Sectra must expand sales outside the region, if it is to keep up the rapid pace it has recently set.

"We are trying to find more distribution channels to get our products out," Bergström said. "That is the most important thing we are working on right now."

The October opening of a U.K. office to meet increasing demand from British hospitals is regarded as a major step in this direction. A partnership with U.K.-based HIS company Torex Health will allow that company to sell Sectra products in its home country as well.

"We have a very good product. It's a stable product, and it works fine. So we are very confident in increasing the sales and trying to do that through partners," he said. "Of course, the big focus right now is Europe and North America, though we are also looking into Asia."

Sectra often provides trained personnel as support for partners' companies. In some cases, these staff deal directly with the technology-hungry clients. Partners such as Philips may also add depth to the technology, refining its development to ensure compatibility with specific modalities as well as the practice of medicine.

To ensure optimum compatibility, for example, Philips Professional Services provides Vequion customers with integration/interfacing services, systems implementation, clinical consulting, project/program management, and training. And the character of the PACS need not be completely defined by Sectra or its partners.

The open nature of the PACS allows hospitals to add in software from a range of selected third-party vendors, as a key advantage over competing products. Mirada Solutions, specialists in image fusion tools also based in the U.K., and the Swedish company RSA Biomedical Innovations, which produces software packages for radiostereometric analysis, signed cooperation agreements with Sectra in November.

"A lot of hospitals don't want to be locked into one vendor," Bergström said. "They want to be able to work with companies that cooperate with each other."