POCUS 101 | PCP Compliance | Handheld Growth

“whether a handheld startup has the master plan, cutting-edge technology, and gusto to take on the likes of GE and Philips is still to be seen.”

IHS Markit’s Adam Davidson on whether the growing field of handheld ultrasound startups can take on the industry’s big names – or maybe if their end-game is to join them.


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  • Carestream – Focused on delivering innovation that is life changing – for patients, customers, employees, communities and other stakeholders.
  • Focused Ultrasound Foundation – Accelerating the development and adoption of focused ultrasound.
  • Medmo – Helping underinsured Americans save on medical scans by connecting them to imaging providers with unfilled schedule time.
  • Pocus Systems – A new Point of Care Ultrasound startup, combining a team of POCUS veterans with next-generation technology to disrupt the industry.



The Imaging Wire

POCUS 101
A team of University of California Irvine researchers put POCUS’ usability and trainability to the test, teaching and then evaluating 40 local 8th grade students on POCUS operation. The students were first trained by an expert sonographer using PowerPoint slides and were then separated into male and female groups (n=20 kids per group, 40 images per group) for hands-on training, with the female students trained by the expert sonographer and the male students trained by another 8th grader that had already attended a two-hour hands-on session. An impressive 78% of the images captured by the expert-trained girls were deemed adequate for clinical use, and perhaps more impressively, 70% the student-trained boys achieved adequate scores. These are some “C” grades the POCUS industry can be proud of. This is also an encouraging sign for healthcare providers in developing areas where relatively untrained clinicians are increasingly responsible for POCUS imaging and where peer-to-peer training is often the go-to option for new POCUS users.

Philips Launches New Vascular and OB-GYN Ultrasounds
Philips expanded its premium ultrasound portfolio with the launch of a pair of new EPIQ Elite vascular and OB-GYN systems. The EPIQ Elite for General Imaging is Philips’ first vascular ultrasound and leads with the company’s new xMATRIX linear transducer (combines 3D and 4D imaging, supports visibility directly into a vessel, and allows viewing of 3D flow data), its proprietary live ‘xPlane’ imaging solution (simultaneously acquires two planes for improved accuracy and 20% faster exam time), and simplified icon-based workflow (reduces clinician steps from 10 to 1). The EPIQ Elite for Obstetrics & Gynecology features the first high-frequency PureWave transducer (V9-2, allows earlier fetal health assessments), Philips’ TrueVue 3D technology (allows clinicians to manipulate a virtual light source around the 3D images), and Philips’ aBiometry Assist application (uses anatomical intelligence to automate measurements).

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Primary Care Interactions Drive Mammogram Compliance
Research from a team of Boston-based radiologists highlighted the key role that primary care physicians (PCPs) play in mammogram screening adherence, finding that patients who regularly interact with their PCPs are more likely to comply with screening recommendations, regardless of race/ethnicity. The retrospective 10-year study of 9,575 50- to 64-year-old women, found that women with a high level of PCP interaction (37% of the sample) complied with their 2-year mammography schedule with a 1.51 odds ratio (1.51x more than low-interaction women), with the greatest impact on black and Hispanic women (1.93 and 1.92 odds ratios), while white and Asian women showed decent improvements (1.51 and 1.55 odds ratios). PCP interaction had the least impact on women covered by Medicare or women who pay for their own scans (0.41 and 0.39 odds ratios). The researchers suggested that radiologists collaborate with PCPs to develop the systems and relationships required to achieve these kind of improvements.

Handheld Ultrasound’s Growth, Diversification
A new IHS Markit post explored handheld ultrasound’s evolution, revealing that the segment achieved 18% revenue growth from 2016 to 2017 due to advancements in portability, affordability, image quality, tech infrastructure, and training, as well as greater adoption in point-of-care and primary care settings. The big handheld ultrasound brands (GE, Philips, Siemens, Sonosite) still held a combined 80% market share in 2017, although handheld startups leveraged low pricing and tech innovations to capture a combined 15% share in the 2016-2017 period (e.g. Clarius, EchoNous, Healcerion), which is notable given the massive advantage that major imaging brands traditionally enjoy. Given the growing buzz around some of these handheld ultrasound startups, it wouldn’t be a surprise if these trends magnify in 2018 and 2019.


Editor’s note: This issue initially included news that Agfa may be winding down its imaging hardware business. This was incorrect. Agfa transitioned its DR/hardware/film business from HealthCare into its industrial/corporate division last year, leaving Agfa HealthCare specifically focused on Health IT.


The Wire

  • A Vanderbilt University Medical Center nurse was indicted for reckless homicide after accidentally injecting a 75-year-old claustrophobic patient with a powerful paralyzing agent (vecuronium) instead of a sedative (Versed) prior to her PET scan, leading to cardiac arrest and brain death during the 30-minute scan. The fatal mistake occurred after the nurse couldn’t find Versed in the automated medication dispensing cabinet, prompting her to override the system and inadvertently access and then inject the vecuronium.

  • A Duke Health study found that cardiac MRI (CMR) could be an effective way to diagnose and predict heart disease, potentially serving as a non-invasive and non-toxic alternative to stress echocardiograms, catheterizations, and stress nuclear exams. The study looked at data from over 9,000 patients that received CMRs, finding that patients with low-risk/no-history of heart disease but had an abnormal CMR scan are 3.4-times more likely to die within 10 years compared to patients with a normal CMR scan. This could be an important finding in support of CMR, which is currently used in less than 1% of all stress tests, due in part to insufficient evidence of its predictive value.

  • Philips Healthcare will expand its IntelliSpace Enterprise Edition platform at this week’s HIMSS conference, adding new IntelliSpace Precision Medicine solutions for oncology and genomics and launching a new clinical information exchange solution. The new IntelliSpace Precision Medicine Oncology solution (workflow solutions used to launch, deploy, and scale precision medicine programs), IntelliSpace Precision Medicine Genomics solution (combines genomic data, disease histology, and patient phenotype for a biomarker-informed diagnostic and therapeutic view), and IntelliSpace Exchange (supports hospital networks’ clinical information exchange) join existing IntelliSpace solutions for radiology and cardiology.

  • IHS Markit reported that the global medical imaging equipment market reached $25 billion in 2017 and will maintain a 3.2% CAGR through 2022 when it reaches $31.7 billion. X-ray, ultrasound, and CT remained the largest equipment segments in 2017, although X-ray continues to decline, while ultrasound (+7.6% in 2017), CT (3.6% CAGR through 2022), and MRI (+3.1% in 2017) are all on the rise. Meanwhile, GE Healthcare, Siemens Healthineers, and Philips Healthcare each increased their share in 2017, reaching a 57.5% combined share.

  • GE Healthcare promoted the results of its SonoCNS ultrasound tool, revealing that the GE Edison AI-powered solution reduces keystrokes during fetal brain measurements by 75%, allowing for more patient interaction and specifically benefitting less experienced gynecologists. SonoCNS quietly debuted at RSNA 2018 and it seems it will be more-prominently featured at GE’s HIMSS booth, suggesting that a formal clinical launch is underway or at least forthcoming.

  • The latest version of Fujifilm’s Synapse 3D Advanced Visualization software will debut at this week’s HIMSS show, adding five new applications (for a total of 55 apps). The new applications include Breast Analyzer MR (analyzes breast tumors and generates BI-RADS reports), Delayed Enhancement MR (analyzes myocardial viability and produces delayed enhancement area and volume measurements), Endoscopic Simulator (trains physicians with laparoscopic surgery simulation), Intravoxel Incoherent Motion MR (IVIM – provides quantitative data from tissue microcapillary perfusion), and Prostate Viewer MR (analyzes prostate gland tumors and generates PI-RADS to support prostate cancer diagnosis),


The Resource Wire

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