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Epic takes on large hospitals, Philips focuses on smaller onesMedicine is moving beyond "ology"-centric thinking to embrace a comprehensive view of the patient. PACS, once seen as the key to efficiency within radiology, is being
Epic takes on large hospitals, Philips focuses on smaller ones
Medicine is moving beyond "ology"-centric thinking to embrace a comprehensive view of the patient. PACS, once seen as the key to efficiency within radiology, is being recast as an important but not self-sufficient component of a much larger information network. Traditional vendors of imaging equipment are seeking ways to keep pace with this change. Some have acquired PACS, RIS, and HIS companies; others have built comprehensive systems from the ground up. A few have developed interfaces that link their own PACS to other IT solutions. Philips Medical has chosen a different route.
The Dutch company, which for years has depended on Swedish IT developer Sectra to provide the foundation for its PACS, has struck a separate alliance with Epic Systems of Madison, WI, a major provider of healthcare information systems. The alliance, showcased at the Healthcare Information and Management Systems Society (HIMSS) conference in Orlando, FL, last month, brings together two companies with complementary products and approaches to the market. It combines Epic's strengths in patient-centric, enterprise-wide healthcare information systems with Philips' strengths in medical imaging, PACS, and patient monitoring technology.
At the HIMSS conference, the two companies discussed integrated systems addressing pieces of the puzzle. A radiology-centric system combined Philips' EasyAccess radiology PACS and Epic's Radiant RIS products. A cardiology-centric solution linked Epic's EpicCare electronic medical record (EMR) with Philips' Xcelera CLM catheterization lab management system and its TraceMasterVue ECG management system. Both companies demonstrated patient scenarios in their booths, illustrating the benefits of integrated solutions for healthcare, business, and patients. But these only hinted at what is coming.
Philips is developing an EMR system that encompasses PACS, HIS, and RIS. A prototype of the system is scheduled for installation at a clinical site in October. It will be neither EpicCare nor EasyAccess, but a reformulation of the two.
"There is a joint engineering effort to the extent that Epic is coming from the enterprise space and drilling downward," said Jos W. Bakker, Philips' director of strategic marketing for IT. "With PACS, we are coming from the bottom up."
Uniting the technologies will be Philips' own Vequion, which provides the specific look and feel found in Philips' portfolio of imaging products.
"Vequion is more a synergy than a product-a common characteristic that you can rely on finding in every Philips system," Bakker said.
The goal behind the alliance between Epic and Philips-to provide customers of the two companies what neither company can provide on its own-is driving the development of this new Vequion-based EMR, which has yet to be given a specific name. Epic offers HIS/RIS; Philips offers PACS. Together they can meet the information needs of their customers.
As part of the Epic-Philips alliance, Epic will produce the core RIS that will drive both Epic's Radiant and Philip's Vequion-branded radiology information systems. This core RIS will support integration with Philips' modalities and PACS. It will also provide support for industry-standard interfaces with other vendors' PACS and modalities.
Philips and Epic will work together to rebrand the Epic RIS system to conform to the Vequion standard. This will create a commonality-a specific look and feel-that extends throughout the entire Philips product line.
Just as the technologies of these two companies are complementary, so is their approach to market. Epic will continue selling its IT products principally to large enterprises such as 500-bed and larger hospitals and hospital chains that span several campuses. Philips might sell its modality equipment, such as CT and MR scanners, to these large customers. Philips might even sell Vequion-based PACS to these institutions. But when it comes to a comprehensive IT solution featuring Epic HIS/RIS, Philips will focus on mid-size and smaller customers, the market segment in which Epic does not play.
"We have turned down many proposals from these groups," said Sean Bina, Epic product manager for RIS. "Philips will be able to step in and support that area."
These smaller community hospitals account for more than 75% of all U.S. hospitals, according to the American Hospital Association Annual Survey of Hospitals.
Philips is not an IT company, Bakker said, nor does it intend to become one. It is, however, taking advantage of the alliance with Epic to develop an IT "incubator," which will support its Vequion-based PACS. This incubator will be separate from the rest of the Philips organization. With staff trained and certified by Epic for sales and service, it could serve as the nucleus for an IT program in the future.
"Philips is perceived as an equipment company only, but with this incubator you will see a new entity," he said.
The future will demand an unprecedented degree of connectivity among what are now islands of medical practice, according to Bakker. Philips' new Vequion-based IT will meet that demand by collecting and disseminating patient data obtained from hospital departments including radiology, cardiology, oncology, and ob/gyn, as well as the emergency department, pharmacy, and OR. It will cover registration and scheduling, admission, discharge and transfer, nurse triage, specialty support, ambulatory and inpatient clinical data, even hospital and professional billing.
The efforts to integrate these technologies, while different at Epic and Philips, all seek solutions that will provide enterprise-wide accessibility to clinical data, with physicians and staff accessing patient data among departments. The goal is to make the right information available to the right person any time, any place.
"This enterprise readiness of radiology will produce very practical, tactical benefits inside the modality room," Bakker said. "For example, in a lot of instances, interventional radiologists would love to have a clinical history of the patient."
An EMR may even reroute the flow of information beyond medical staff to include the patients themselves. With access to the Philips EMR, patients could schedule their own appointments, understand their bills, view test results online, and contact providers. The result could be improvements in efficiency and patient satisfaction.
Philips is seeking a Vequion-based system because a single architecture using a common platform promises faster implementation, scalability, and ease of use. This translates into lower labor costs, because staff familiar with Philips equipment will have an easier time learning the IT system.
Eventually, Epic and Philips will offer their integrated products outside the U.S. Before doing so, however, the two partners will have to come up with ways to meet the unique challenges that the myriad medical systems in other countries present to IT systems, as well as establish the infrastructures in other countries needed to support users.
In the meantime, as the premier marketplace for medical products in the world, the U.S. will serve as a proving ground for Philips' and Epic's concepts of comprehensive IT.
"The time for radiology-centric behavior is over," Bakker said. "Radiology is not the center of the universe. It is part of total patient care, and PACS is the vehicle for us to bring it to the enterprise level."