Innovative medical technology, leading Healthcare IT, advanced infrastructure and comprehensive service concepts

Siemens is presenting its complete healthcare portfolio at Medica 2008: Fully integrated medical technology, from a single system to the corporate level. Siemens Healthcare has set its sights on being the best integrated healthcare company in the world. By combining diagnostics and therapy, infrastructure concepts, information technology and service concepts, Siemens can offer solutions that encompass the entire healthcare process. Furthermore, these solutions are scalable, from the laboratory up to business management and control. And in all areas the focus at Siemens is on seamless integration.

News at Medica 2008:

Navigating the body without radiation – GPS for interventional radiology

At the Medica Siemens Healthcare will be showing iGuide CAPPA1, a new solution that supports the physician during minimally invasive needle procedures. By combining an angiographic C-arm system with the electromagnetic navigation system iGuide CAPPA, a new method was developed that enables navigation with very low radiation dose. Prior to the intervention, the Siemens software syngo DynaCT provides the 3D soft tissue images required by the physician. The method uses electromagnetic tracking and facilitates interventions such as precise and quick needle placements – for liver biopsies, for vertebroplasties when stabilizing fractured vertebras, or for cancer pain treatment.

Siemens Integrates ARFI Imaging Into Ultrasound

Siemens Healthcare is presenting one of the most innovative technologies for its Acuson S2000 ultrasound system at this year’s Medica. The Virtual Touch Tissue Imaging and Virtual Touch Tissue Quantification applications are the first commercially available implementations of ARFI (Acoustic Radiation Force Impulse). Similar to a physical palpation exam, these leading-edge applications represent a new dimension of diagnostic information by interrogating the mechanical strain properties or stiffness of tissue, which may be correlated with pathology. Both applications are particularly suited to evaluating liver tissue. Additional fields of use – such as in prostate diagnosis – are currently clinically validated.

Siemens sets the next standard for integrated diagnostic imaging

The Biograph Molecular CT (mCT) is the first unit ever to combine the capabilities of a highperformance CT scanner with those of a high-resolution PET (positron emission tomography) system. With conventional PET CT scanners, the CT component can be used only to a limited degree for CT examinations. With the Biograph mCT, Siemens is introducing “molecular computed tomography”. This system includes both a CT for molecular imaging and, at the same time, a PET system offering the comprehensive possibilities of computed tomography. In times characterized by sinking healthcare budgets, this new system is optimally suited for cost-effective performance of high-quality CT as well as PET CT examinations. It also promotes close cooperation between the diagnostic disciplines of radiology and nuclear medicine.

Further highlights at Medica 2008:

Magnetic Resonance Imaging

The unique Tim (Total imaging matrix) technology developed by Siemens offers particularly good image quality, a higher level of patient comfort and an optimized workflow. Studies have shown that, thanks to Tim, patient throughput can be increased up to 50 percent and examination times cut in half. For example, a whole-body examination, which is especially helpful for oncological issues, can be performed in less than ten minutes. Since Tim was introduced in 2003, more than 4,000 MRI (magnetic resonance imaging) systems featuring this technology have been sold worldwide. With its newest MRI system including Tim technology, Siemens strengthens its position as the leader in magnetic resonance imaging. The MAGNETOM ESSENZA, with a field strength of 1.5 Tesla, satisfies customer demands for an innovative yet affordable system that is specially targeted at meeting the needs of hospitals and practices wanting to cover the complete diagnostics area with a limited budget. Within one year over 80 systems worldwide were installed in Europe, Asia, Latin America and the US. The Magnetom Verio is the only 3-Tesla system in the world with an open bore of 70 cm. With this feature, patients can now be examined who could previously not be scanned with conventional 3-Tesla systems, including claustrophobic or obese patients as well as persons who need special positioning.

Computed Tomography

With the Somatom Definition AS (adaptive scanner) Siemens has, for the first time ever, developed a CT scanner which can be adapted to suit all patients and medical requirements. The system is just as suitable for routine diagnostics as it is for complex examinations such as in neurology or cardiology. The system is also ideal in emergency situations, for example when fast diagnoses are required for accident, stroke or heart attack patients. Even the most varied of patient groups, such as obese and claustrophobic persons or children, can be examined speedily and safely. With the adaptive dose shield, clinically irrelevant overradiation before and after a spiral scan can be eliminated. In this way the X-ray dose that is absolutely necessary for an examination can be reduced even further. Because their expertise is so much in demand, physicians often have to be in two places at once during routine clinical work. With syngo WebSpace Software and a basic network connection, medical images can be accessed anywhere. 3D image processing can thus be made available to the radiologist at any PACS workstation within a few seconds. Physicians located at other clinics can also access the results of the radiologist's work. The 3D functionality of syngo WebSpace also helps other clinicians, general surgeons, orthopedists and neurologists demonstrate pathologies better and more comprehensibly.

Radiology

Access to digital radiography is enabled by Multix Swing, an X-ray system with a mobile flat detector, which is just as flexible as a cassette, but is even easier to handle: the detector can be removed from the table and placed directly underneath or next to the patient. Exposures that are difficult or impossible to take using a permanently integrated detector, e.g. lateral exposures of the hip, can now be taken without difficulty. Furthermore, patients with restricted mobility can be Xrayed, e.g. without having to be removed from a wheelchair. With significantly fewer work steps, top quality images that are available quickly and no costs for consumables, this system is economical to use even if the volume of patients is low. Since every practice and hospital has its own individual requirements, with Ysio Siemens now offers an X-ray system that can be custom assembled and configured. Regardless of whether one or two detectors, a system with or without a patient table, a fully automated or a synchronized system is required, Ysio can be individually adapted to meet the clinical requirements at hand. Ysio can be recognized immediately by the large “MaxTouch” color display in its ceiling support. With this touchpad, the customer can control system functions such as examination and exposure parameters or the dose from a tableside position. If a customer decides on the fully automatic ceiling support, he can even choose from over 500 organ programs (anatomically-specific exposure parameters).

Fluoroscopy and Angiography

Visitors interested in fluoroscopy and angiography can test two systems in simulation: Axiom Luminos dRF, a fluoroscopy system that combines fluoroscopy and radiography, thus ensuring high system utilization, and Axiom Artis, a system family which utilizes flat detector technology to examine blood vessels and the heart. The user controls the systems displayed on a monitor with the original operator consoles. All movements initiated at the consoles, including the associated noises, are displayed in real time on the monitor.

Molecular Imaging – Nuclear Medicine

SPECT (Single Photon Emission Computed Tomography) imaging with “intelligence” is the next major trend in nuclear medicine. The Symbia gamma camera from Siemens now comes with a new feature, IQ•SPECT, which in the case of cardiac examinations will supply information concerning perfusion in only five minutes. In addition, the CT attenuation correction can be calculated during the examination and calcium scoring can be performed. At present, perfusion studies of the heart using SPECT systems take approximately 15 to 20 minutes on average.

By introducing high-resolution positron emission tomography (high definition PET, HD•PET) for PET-Computed Tomographs (PET-CT), Siemens Medical Solutions has redefined the quality of molecular imaging. It is making its mark as the only high-resolution PET technology worldwide that ensures greater image sharpness and clarity throughout the entire field of view. The sharpness of HD•PET translates into greater specificity and accuracy. The physician can thus limit small lesions more securely –including those in the lymph nodes, the abdomen, in the head and neck region as well as in the brain. As a result, the system allows for earlier and more targeted treatment sessions. HD•PET builds on the TruePoint technology of Siemens, a unique combination of technical characteristics and workflow solutions for PET-CT imaging designed to optimize patient diagnosis, treatment and care.

Ultrasound

The Acuson S2000 is the first ultrasound system in a completely new product generation. It allows the use of innovative imaging procedures such as Virtual Touch Imaging for qualitative and quantitative assessment of tissue stiffness. As a result, invasive or elaborate procedures in liver or breast diagnostics can be reduced and cost savings achieved. The new generation of the Acuson X300 Premium Edition offers a broad range of services for medical and cardiac diagnostic imaging as well as applications in obstetrics and gynecology, including 4-D volume imaging. For gynecology and obstetrics, the Acuson S2000, Acuson Antares and Acuson X300 Premium Edition systems offer everything that doctors need in their practice: from screening, diagnosis and therapy all the way to aftercare.

Services

Within the scope of its Customer Care Life Program Siemens has extended the pro-active remote monitoring services “Guardian Program” to include “TubeGuard”. TubeGuard can continuously determine the remaining life span of the X-ray tube assembly in the Somatom Definition CT systems and report where an X-ray tube might soon fail. As a result, the risk of system failures is clearly reduced and improved process planning is made possible. With “Uptime Services”, the Customer Care program offers a multitude of innovative services that enable the detection of potential faults in medical systems before malfunctions occur. This minimizes downtimes and decisively improves planning security and workflows in hospitals and medical practices. The Siemens Guardian Program, for example, allows the real-time, online monitoring of medical systems. System errors and potential deviations from the current standard values can be quickly detected and remedied so that reliability and availability of the system are considerably increased. The basis for this is the Siemens Remote Service (SRS) platform, to which Siemens can connect the systems of its customers worldwide. Today, up to 50 percent of all system malfunctions can be remedied by SRS via remote access.

IT in the hospital: Role-based access to RIS and PACS

Siemens is offering a variety of solutions for image processing and image storage at Medica 2008, including the syngo Portal Solutions, which support diagnostic and administrative processes in all aspects of radiology. In the syngo Radiologist Portal, radiologists are offered role-based and relevant work lists, images, reports and more clinical information precisely when they need it. With the help of the syngo Portal Referring Physician, physicians referring a patient can, from the comfort of their own computer, arrange an examination date in a hospital or radiology practice for their patients. The examination results are provided to them digitally, directly after the radiologist's assessment and also in the same portal – and this a number of times on the same day.

Health Information Exchange: Networking across institutional and sectoral boundaries

Health Information Exchange solutions from Siemens allow the treating care providers to communicate seamlessly across institutional and sectoral boundaries. In this way treatment processes can be better adapted to one another or free capacities can be exploited to a greater extent in cooperation ventures. Existing primary systems are not exchanged but instead networked with one another using the Soarian Integrated Care (Soarian IC) software. The core element of Soarian IC is a physician-administrated electronic patient record and case file which allow medical care providers to access all relevant treatment data and documents. A comprehensive authorization and data protection concept is integrated in the solutions; patients must give their prior consent for the use of their data.

Hospital Information and Management Information Systems

Siemens offers a broad range of hospital information systems (HIS): These include international products such as Soarian with an integrated workflow and rules engine and i.s.h.med, which is the only HIS worldwide that is fully integrated in SAP for Healthcare. Another option is medico//s, an HIS with its own administrative component focused on German-speaking regions. Furthermore, at Medica 2008 Siemens will present Management Information Systems (MIS) such as the Management Explorer (MEX) and i.c.m.health. The SAP sector solution “SAP for Healthcare (ISH)” will be introduced as an administrative component for clinical systems. Here, the SAP Ambulatory Care Management solution featuring the amasys billing system, the certified solution for electronic billing with the association of statutory health insurance physicians (Kassenärztlichen Vereinigungen – KV), should be emphasized in particular. With the introduction of the electronic health card as of January 1, 2009, this software will be of particular relevance to the care providers.

Document Management and Archival Solution

Furthermore, Soarian Health Archive, Siemens' document management and archival solution for Healthcare in Europe, will also be demonstrated at the Fair. While Soarian Health Archive stands out particularly due to its deep integration in the Siemens i.s.h.med, medico//s, CLINICOM and Soarian hospital information systems, it also can be used as a standalone solution in all hospital sectors.

Medical Laboratory Diagnostics

With Rapidlab 1200 Version 2.0, a blood gas analyzer is available at the point of care in which quality management in compliance with the new guideline of the German Federal Chamber of Physicians, RiliBÄK 2008, is already integrated. Rapidlab 1200 was developed especially for use in ICUs or emergency rooms. It features extensive test menus for blood gases, electrolytes, metabolites and the complete CO oxymetry. Whereas many blood gas analyzers require daily service and care, the Rapidlab 1200 requires extremely little maintenance and, is easy to master and operate due to its intuitive user interface.

Stratus CS is a point-of-care system for those parameters which are important in the emergency room of a cardiology department. Troponin I, NT pro BNP, myoglobin and D-dimer levels are determined with high sensitivity and specifically in just a few minutes from a single blood sample tube.

Dimension Vista 1500 belongs to a new class of intelligent laboratory systems in which several measurement technologies are combined in a single system. It integrates photometry, nephelometry, V-LYTE electrolyte measurement and modern LOCI chemiluminescence and generates up to 1500 test results per hour in up to 200 samples per hour. Dimension Vista supports the diagnosis of many indication areas including anemia, cardiological diseases, thyroid function, therapeutic medication monitoring and urine drug screening. The Dimension Vista system is used as an integrated platform for routine and emergency analysis.

Environmental concepts for medical engineering systems

To reuse pre-owned systems as much as possible is an important component of Siemens' corporate philosophy: Resources are conserved by extending the life cycle of a product. For example, computed and magnetic resonance tomographs, ultrasound, radiation therapy and radiography systems are repurchased by Siemens Med and then reconditioned by the Refurbished Systems Division. This is accomplished in an extensive five-level quality process (system selection, qualified disassembly, refurbishing process, installation, liability for material defects) that matches the same high quality standards as are applied to new systems. This integrated approach eliminates a yearly discharge of 10,000 tons of CO2. These energy savings correspond to the yearly electrical energy demands of 3,000 3-person households.

Building Automation

In the area of building automation, Siemens will focus on its integral Total Building Solutions at Medica 2008. Included in the exhibit are an automation solution for operating rooms which, for example, includes an integrated medical gas management system, a system for the distribution of gases in the operating room, provided by a third party. This enables, for example, comfortable and safe operation of the system and reduces interfaces. In the Digital Hospital showcase, trade fair visitors can obtain information on how patient rooms can be designed using building technology to provide more comfort. The exhibition also shows how, for example, mobile devices such as notebooks or machines used to monitor vital signs can be tracked by means of RFID technology. This provides anti-theft protection and saves time as the staff know the whereabouts of the devices at all times.

Mobile Information and Communication Device

The Esprimo MA is a mobile information and communication device designed specifically for the hospital environment. The robust tablet PC, which weighs only 1.3 kg, not only can be used at the hospital bedside or in the examination room, but also for the general optimization of all hospital processes. The fanless housing, which is certified to IP 54 and can easily be disinfected, offers an ideal working environment and protects sensitive data against external influences. Conceived both for right-handed and left-handed users, the 10.4-inch touchscreen display enables uncomplicated data entry with a stylus Al applications can be accessed quickly using the predefined application keys. Thanks to integrated high-speed connectivity (WLAN, 3G/UMTS) examination data is available at any time: The patient's condition can thus be documented fast and efficiently on-site and compared with earlier findings. The data can also be updated via barcode and RFID readers. Using the integrated auto focus camera, the treating physician can even photographically record the patient's condition and forward this information to medical colleagues for evaluation.

Hospital Communication Solution

With the motto “Unified Communications@Healthcare” Siemens presents several solutions to facilitate communication at the hospital. This includes HiMed V.8, a new version of the tried and tested hospital communication solution. HiMed V.8 can be operated with OpenScape Voice (previously HiPath 8000). With this solution, hospitals can benefit from the structural and economic advantages of software-based communication via IP (internet protocol) and have access to all the options offered by Unified Communications. HiMed offers personnel communication applications which are tailored to the processes in hospitals. In addition the solution allows entertainment and communication services for patients to be easily administrated.

E-Health Solutions

Integrated Care Monitoring comprises the IT infrastructure and platform for the exchange of information between physicians or hospitals and the cost bearers such as the health insurance company. This solution leads to more transparency in integrated care contracts with respect to treatments, patients and budgets. In this regard, Siemens demonstrates live at Medica three options for the connection of practice administration systems, all compliant with data protection regulations: off-line, with the electronic health card and on-line with biometrics. With the patient's consent, the treating physician or pharmacist can check the patient's medication and prevent double prescriptions as well as undesirable interactions. For the E-Medication Solution, the so-called e-card is the key to a database in which the information is stored. When the patient submits his or her e-card, the required medicines are compared with a database and stored, regardless of whether they are only available on prescription. When medications are prescribed twice or undesirable interactions occur, the system sounds an alarm. The E-Health Portal of Siemens IT Solutions and Services ensures secure and fast communication between healthcare participants. It serves as a central information and communication platform on the internet and addresses common citizens as well as physicians, medical chambers, health insurance companies and pharmacies. Common citizens can inform themselves on general health topics and obtain overviews of physicians, hospitals or health insurance companies. In the future, it is also conceivable that appointments, transfers, or prescriptions can be performed electronically as well. Care providers can present themselves in the Portal and exchange information as in a forum. Of course, all available security functions are also employed for the user.

Financial solutions

Being one of the leading providers of financial solutions in the health care sector, Siemens finances equipment, infrastructure and associated services from one source. Flexible models provide the leeway necessary for investments and projects of any scale. Tailor-made leasing offers are available not only for systems and solutions of Siemens AG, but also for those of third parties.

The Siemens Healthcare Sector is one of the world’s largest suppliers to the healthcare industry. The company is a renowned medical solutions provider with core competence and innovative strength in diagnostic and therapeutic technologies as well as in knowledge engineering, including information technology and system integration. With its laboratory diagnostics acquisitions, Siemens Healthcare is the first integrated healthcare company, bringing together imaging and lab diagnostics, therapy, and healthcare information technology solutions, supplemented by consulting and support services. Siemens Healthcare delivers solutions across the entire continuum of care – from prevention and early detection, to diagnosis, therapy and care. Additionally, Siemens Healthcare is the global market leader in innovative hearing instruments. The company employs more than 49,000 people worldwide and operates in 130 countries. In the fiscal year 2008 (Sept. 30), Siemens Healthcare reported sales of €11.17 billion, orders of €11.78 billion, and group profit of €1.23 billion. (Preliminary figures)