When it comes to breast cancer screening, one solution does not fit all
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The Future of Breast Cancer Screening is Here p. 96
Your Industry Source for Health Care and Equipment Coverage
July 2016
When it comes to
breast cancer screening,
one solution does not fit all
See p. 60, p. 64, p. 74, p. 78
In this issue
BONE DENSITOMETRY
• A fractured system: Why detecting
and preventing bone loss needs more
reimbursement p. 60
MAMMOGRAPHY
• Will breast tomosynthesis completely
replace 2-D mammography? p. 64
BREAST IMAGING
• More choices than ever as concerns
remain regarding radiation dose p. 74
ULTRASOUND
• From breast exams to childbirth,
ultrasound is gaining momentum p. 78
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CONTENTS
July 2016
THIS MONTH’S EXCLUSIVE Q&As
28 56
Bruce Slawitsky, Senior Vice President of Human
Resources, Hospital for Special Surgery
40
Mary Beth Lang, Chair of the Association for Healthcare
Resource & Materials Management (AHRMM)
42
Ernie Cerdena, President of AHRA
64
FEATURES
56
Imaging Department Management
Changes come faster than ever for imaging professionals.
60
Bone Densitometry
A fractured system: Why detecting and preventing
bone loss needs more reimbursement.
64
Mammography and Tomosynthesis
Will breast tomosynthesis completely replace 2-D mammography?
74
Breast Imaging Choices
More choices than ever as concerns remain regarding
radiation dose.
78
Ultrasound
From breast exams to childbirth, ultrasound is gaining
78
momentum.
Visit DOTmed.com/news for breaking
news daily, to comment on stories in this
issue, to participate in surveys and more.
HealthCareBusiness news I july 2016 3
PUBLISHER DOTmed.com, Inc.
26 PRESIDENT
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40 42 STAFF WRITERS Lauren Dubinsky
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COLUMNS Scott Dodson
Paul Dubiel
Robert Gagel
8 HealthCare Business Online News Tsuneo Imai
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26 Hospital Spotlight Csaba Polgar
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Vratislav Strnad
30
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Critical Test Management Gets the Attention it Deserves DESIGN
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ShearWave Elastography: Clinical Practice and Patient Outcomes HealthCare Business News is published by DOTmed.com, Inc.,
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Copyright 2016 DOTmed.com, Inc. All rights reserved.
90 Medical Museum
91 This Month in Medical History
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96 The Future of Health Care the accuracy or timeliness of its content. DOTmedSM may suspend or cancel this
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Letter from the Editor
Women’s health: Trending in the right direction
In this issue of HealthCare Business News On the therapeutic side, we have Dr. Vratislav Strnad and Dr.
you will find a number of interesting re- Csaba Polgár (p. 73) of the European Society for Therapeutic Radiol-
ports and articles on the topics most impor- ogy and Oncology (ESTRO) making the case for accelerated partial
tant to women’s health. Women are standing breast irradiation with brachytherapy (APBI brachytherapy) over
up and standing together today to ensure their whole breast irradiation (WBI).
health care needs are addressed and met. We To round out our coverage of all things related to breast health,
chose the image on the cover because, in fact, Scott Dodson (p. 69) discusses breast reconstruction, noting that a
we believe it graphically depicts this solidarity. lack of information and understanding by patients has resulted in an
In our story on mammography and the future of tomosynthesis underutilization of available reconstruction procedures.
(p. 60), you’ll find interviews with some of the leading practitioners in the The other major issue today for women’s health is bone densitom-
field, practically declaring that, because of the diagnostic clarity of tomo- etry scans — or the lack thereof. In an article by Dr. Robert Gagel (p.
therapy, it should be the default procedure for all women — and that 56), he makes an impassioned case for restoring higher reimburse-
reimbursement for it should be embraced by all insurance underwriters. ment rates for DEXA scans. His first paragraph is quite an eye-opener:
In our report, “More choices than ever for breast imaging” (p. 70) “On Mother’s Day and throughout Breast Cancer Awareness
there is a second school of thought: that tomography is not neces- Month [of May], people across the U.S. don pink ribbons and walk
sarily the optimal choice, and that molecular imaging or MR exams in stride in the fight against breast cancer. Yet far more women die
should be in the mammographer’s toolbox, to be used if appropriate, of complications from a hip fracture than they do breast cancer, and
on a case-by-case basis. National Osteoporosis Month — recognized in May — flies largely
We also take a look at the latest evaluation of ultrasound as a breast under the public’s radar.”
imaging modality in a story we call “From breast exams to childbirth, We’re sure you will want to read where Dr. Gagel goes from here.
ultrasound is gaining momentum” (p. 74). The article delves into the We believe, in fact, that you’ll find all the content in this issue
pros and cons of ultrasound breast exams — the jury is definitely still well worth your time — including our regular monthly columns —
out on the efficacy of the procedure — but it clearly has its proponents. and when you are done, we trust you’ll agree we’ve given women’s
Don’t miss our report on the latest in ShearWave Elastography health the coverage it deserves.
(SWE) (p. 84) by Dr. Kamilia Kozlowski. She cites research that
claims SWE provides critical data that has resulted in a reduction in Robert Garment
the number of unnecessary biopsies, has helped prevent false nega- Executive Editor
tive diagnoses and has improved overall diagnostic confidence. rgarment@dotmed.com
editorial advisory board
Abass Alavi, MD, professor of Michael Friebe, PhD, an affiliate Katie Regan, clinical publishing
radiology and director of research professor at the Technical University manager, MD Buyline
education in the Perelman School Munich in Germany
of Medicine at the University of Bipin Thomas, chairman, ICURO
Pennsylvania School of Medicine Heidi Horn, vice president of SSM
Health Care’s Clinical Engineering Wayne Webster, principal,
Leonard Arzt, executive director, Service (CES) department Proactics Consulting
National Association for Proton
Therapy Jason Launders, medical physicist, Sharon A. VanWicklin, MSN, RN,
ECRI Institute CNOR/CRNFA, CPSN, PLNC,
Norman E. Bolus, MSPH, MPH, perioperative nursing specialist,
CNMT, editor-in-chief, JNMT, Jill Rathbun, president, Galileo Association of periOperative
director, assistant professor Nuclear Consulting Group Inc. Registered Nurses (AORN)
Medicine Technology Program Clinical
& Diagnostic Sciences Department, Barbara G. Rebold, RN, MS, CPHQ Marty Zimmerman, president
UAB School of Health Profession director, Operations, and chief executive officer of
ECRI Institute PSO LFC Capital, Inc.
6 HealthCareBusiness news I july 2016 www.dotmed.com
HealthCareBusiness Daily News Online
Top trending headlines
As we went to print:
Welcome to Our News M USPSTF approves CT colonography
screening, sets stage for better coverage
Center dotmed.com/news/story/31442
• Insurers allege Intuitive Surgical hid over
700 claims of da Vinci-related injuries
dotmed.com/news/story/31212
daily news online • Three things you may have missed at
AAMI 2016
When health care industry news dotmed.com/news/story/31299
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assesses global readiness for a care
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Visit daily and sign up for our dotmed.com/news/story/31270
convenient weekly news digest. • White House rep sees 'tremendous
progress' in Mo-99 availability
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M S odium fluoride PET/CT can detect
bone metastases in prostate cancer
in print patients
dotmed.com/news/story/31303
• New evidence that eating nuts de-
Get a free subscription and creases prostate cancer mortality
sign up for the digital version dotmed.com/news/story/31457
• Researchers publish free open-source-
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dotmed.com/news/story/31165
• Apple is turning heads with job listings
for biomedical engineers and HIPAA
lawyers
dotmed.com/news/story/31192
MR
esearcher awarded $7.5 million to
evaluate mammography alternatives
dotmed.com/news/story/31185
Subscribe to our Magazine and • Researchers develop flexible MR coil to
improve comfort and decrease scan time
weekly Online News digest now. dotmed.com/news/story/31159
• Royal Philips looking to new deals post
lighting business spinoff: van Houten
dotmed.com/news/story/31359
• New prostate scan finds cancer
sooner, quicker and more safely
dotmed.com/news/story/31247
• Fujifilm's new President Kenji Sukeno:
'various deals on the table'
The Future of Breast Cancer Screening is Here p. 96
Your Industry Source for Health Care and Equipment Coverage
July 2016
dotmed.com/news/story/31235
When it comes to
breast cancer screening,
one solution does not fit all
• Philips and Cordaan partner to offer
remote care to dementia patients liv-
See p. 60, p. 64, p. 74, p. 78
ing at home
In this issue
BONE DENSITOMETRY
• A fractured system: Why detecting
and preventing bone loss needs more
reimbursement p. 60
dotmed.com/news/story/31327
MAMMOGRAPHY
• Will breast tomosynthesis completely
replace 2-D mammography? p. 64
BREAST IMAGING
• More choices than ever as concerns
remain regarding radiation dose p. 74
ULTRASOUND
• From breast exams to childbirth,
ultrasound is gaining momentum p. 78
Visit HCB Daily News online for
breaking stories every day.
M Editor’s Choice
HealthCareBusiness news I july 2016 7
Letter from the Daily News Editor
Top five reasons to visit our daily news
In case you didn’t know, the magazine in ests? For example, if you only want to read about molecular imaging
your hands is only a small portion of the and don’t want to see stories about health IT, you can do that now.
news content DOTmed HealthCare Busi- 3) Year-over-year, our traffic has increased by over 47 percent.
ness News provides. We also have a daily We credit this to having a larger staff of full-time and freelance writers
news operation where we cover the breaking who are writing better and more interesting stories than ever before.
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Although the next few pages of the maga- company news with us and we can post it for all our visitors to see? Our
zine offer a collection of some of the most in- carefully curated press room features statements from roughly 10-20 or-
teresting stories we wrote in May, they only represent a small fraction ganizations daily — in May we hosted almost 400 such announcements.
of the over 100 stories we actually posted that month. 1) Top Ten Most Read Stories List — Perhaps the inspiration for
Instead of my usual letter from the editor, this month I want to this letter, we have finally rolled out this long overdue feature on our
share with you what our writers and I believe are the top five reasons site which allows you to see what stories people have been clicking
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cesco Sardanelli being chosen to oversee a new radiology journal, or Dr.
Andrew E. Gurman being selected as the new president of the AMA — Gus Iversen
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GE delegates all U.S. bone densitometry
service to Milwaukee-based Alpha Source
Posted online June 17, 2016 by Lauren Dubinsky
In May, Alpha Source became the au- gineers will be supplemented with depot ity parts procurement and service manage-
thorized service provider for GE Health- repair operations in Milwaukee to support ment for 28 years."
care's bone mineral densitometry (BMD) this growing multi-modal installed base of Despite ongoing reimbursement cuts
equipment in the U.S. — meaning the imaging equipment." since 2007, the global bone densitometer
manufacturer will be delegating all ser- Lytle counts the company's core objec- market is thriving. A Transparency Market
vicing needs to the Milwaukee-based tives as helping health care organizations Research report found that the market is ex-
care technology management company. by offering solutions that extend the life of pected to jump from $778 million in 2012
GE will continue to develop and manu- medical equipment, reduce equipment costs to $909 million by 2019, mostly due to the
facture BMD solutions and also service of ownership and support improved patient growing geriatric population.
systems for customers outside of the U.S. care — but some customers are concerned Other factors fueling the market are the
Meanwhile, overseeing BMD equipment in that the new arrangement will have a nega- increased risk of osteoporosis among meno-
the U.S. will complement the service Alpha tive financial impact on them. pausal women, the high occurrence of vita-
Source has been providing on select GE ul- Todd Singleton, director of strategic min D deficiency diseases and advanced tech-
trasound products since 2014. initiative services, U.S. and Canada service nology that is expected to contribute to the
"Alpha Source provides a trusted ser- at GE, stated in a letter to customers that growth of the market in the next few years.
vice solution for GE Healthcare's BMD and contracts and service coverage — including The full transaction of GE's BMD service
selected ultrasound products," Rick Lytle, price, entitlements, and end date — will not to Alpha Source is expected to be finalized
CEO of Alpha Source, told HCB News. "The be changed. He also praised Alpha Source before the end of the year.
national network of trained field service en- for providing "innovative solutions for qual- Share this story: dotmed.com/news/31477
8 HealthCareBusiness news I july 2016 www.dotmed.comHealthCareBusiness Daily News Online > dotmed.com/news
Researcher says head CT radiation dose for
stroke patients can be reduced by 90 percent
Posted online May 31, 2016 by John W. Mitchell
Working with radiologists at Weill Cor- random fashion side-by-side, and cannot tell lar disease and kidney patients as well. It
nell Medicine, Dr. Ruogu Fang, Ph.D., the difference with statistical significance," also has the potential for application in MR
has applied machine learning and math- she said. patient scans. The tenfold reduction in ra-
ematical algorithms to manipulate low- Fang recently received $175,000 in fund- diation could also greatly reduce the 15,000
dose CT perfusion images on stroke pa- ing from the National Science Foundation deaths a year that are attributed to CT perfu-
tients. When reconstructed, these low-dose and other sources. The grants will be primar- sion scans, according to FIU.
images provide comparable image quality ily used to study blood flow in the brain as it In explaining the science behind her re-
with just eight percent of the radiation need- relates to radiation exposure, as well as help search, Fang noted that she uses machine
ed to produce traditional, high-dose images. validate her technique in patients learning called dictionary learning and
Although the technique needs to be clini- Fang began her study while working on sparse representation to learn from big med-
cally validated on real patients, Fang, assis- her Ph.D. at Cornell. She said that while at ical data, or high quality radiation images.
tant professor of computer science at Florida Cornell, she learned of physician concern This data is used to restore the low-quality
International University (FIU), told HCB News about radiation exposure, especially in con- images with the clarity needed to study cere-
that the radiologists she is collaborating with ducting CT perfusion (head) scans. bral blood flow in stroke patients. The imag-
are very excited about the promise it may According to FIU sources, Fang’s work es provided by CT, combined with reduced
hold for improving care. “They view the may also reduce radiation exposure not just radiation, could result in safer patient care.
high-dose and restored low-dose images in in stroke patients, but also in cardiovascu- Share this story: dotmed.com/news/31164
Catching cancer early with Endra and GE collaborate on
LDCT lung screening increases new ultrasound technology
survival by 73 percent Posted online May 26, 2016 by Christina Hwang
Posted online May 31, 2016 by Lauren Dubinsky
Endra Life Sciences and GE Healthcare are teaming up for
the development of Endra’s Thermo Acoustic Enhanced Ul-
If patients with a high risk of developing lung cancer are
trasound (TAEUS), a system that will detect tiny amounts of
diagnosed at an early stage, they have a 73 percent chance
pressure changes deep within tissues and generate diagnos-
of surviving for five or more years, according to the UK Lung
tic insight currently only available on CT or MR exams.
cancer screening trial (UKLS). The next step is to decide if a na-
The technology will allow physicians to use their existing ultra-
tional screening program is needed in the U.K.
sound systems to visualize tissue health, function, composition, and
For the UKLS trial, the researchers had 4,055 individuals be-
monitor therapeutic interventions at the point of care without the
tween the ages of 50 and 75 undergo a population-based ques-
use of ionizing radiation or contrast agents.
tionnaire to identify if they were at high risk for lung cancer. They
According to Endra, it will also improve access, clinical effective-
recruited 2,028 for the low-dose CT (LDCT) group and the other
ness and safety while bringing down hospital expenses. It believes
2,027 for the control group.
that TAEUS could have broad potential clinical applications, includ-
A total of 1,994 patients underwent LDCT and 42 were diag-
ing noninvasively quantifying fat in the liver for diagnosis of fatty
nosed with lung cancer. The researchers found that 36 out of the
liver disease.
42 cancers were stage 1 or 2, and 35 of the patients underwent
As part of the collaboration, GE will support Endra’s efforts to
surgical resection as their primary treatment.
commercialize the technology, provide equipment and technical
The researchers concluded that the UKLS trial has successfully
advice and also facilitate introductions to the technology to GE
demonstrated a way to screen for lung cancer in high-risk individu-
ultrasound customers. In turn, Endra will give GE certain rights of
als in the U.K. But since it was a pilot trial, they are waiting for the
first offer with respect to manufacturing and licensing rights for the
outcomes of a CT screening trial underway in the Netherlands that
target application, according to the announcement.
may provide mortality data supporting the program.
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As total colorectal cancer rates go down,
an unsettling increase in young cases
Posted online May 31, 2016 by Christina Hwang
The colorectal cancer (CRC) rate has years or older, the percentage fell by 2.5 per- The team also discovered that the
been increasing in individuals under 50 cent. They also found that the young-onset younger group had a higher incidence of
despite the fact that the overall rate of cases were more prevalent in non-white pa- more advanced cancer. Stage 3 was at 30.6
the disease has been declining in recent tients than late-onset cases. percent while the older patients were at 25.1
years, a new study has shown. “While the health care system has done percent.
Researchers, led by Dr. Eli Sutton, re- a great deal to address colorectal cancer Stage 4 had a bigger difference between
search fellow at Mount Sinai West Hospital, in people over 50 — heightening patient the two groups, 25.6 percent compared to
examined 1,010,530 CRC cases in the Na- awareness and increasing screenings — our 18.2 percent.
tional Cancer Database from 2004 to 2013 findings show that much more needs to be Based on their findings, the researchers
to determine the proportion of patients who done to fight this cancer in people under 50, suggest that health care facilities should be
were identified as young-onset to those that a group not normally considered at risk,” more vigilant about detecting symptoms in
were late-onset. said Sutton, in a statement. younger patients.
The study found that the number of Variables between the two groups were While the findings show that CRC is on
young-onset cases increased by 11.4 per- recorded, which included factors such as the the rise in individuals under 50, Sutton does
cent, which is approximately 1.28 percent or stage the cancer was found, the length of note that most CRC cases are still patients
136 additional new cases every year. For the the patient’s hospital stay, demographics, over 50.
late-onset patients, who are grouped as 50 and 30-day and 90-day mortality rates. Share this story: dotmed.com/news/31114
Radiation may complement Mitsubishi, 2 Japanese
immunotherapy for melanoma universities develop
outcomes: mounting evidence helium-free 3T MR
Posted online May 26, 2016 by Christina Hwang Posted online May 25, 2016 by Lauren Dubinsky
Radiation along with immunotherapy may help fight melanoma, In a partnership with Kyoto University and Tohoku Univer-
a new report in the Journal of Radiation Oncology has shown. sity, Mitsubishi Electric has developed a small model 3T MR
Dr. James Welsh, professor in the department of radiation oncol- with a high-temperature superconducting coil that doesn’t
ogy at Loyola University Chicago Stritch School of Medicine, and need to be cooled — and therefore requires no helium.
colleagues analyzed previous studies to summarize what the research The high-temperature superconducting wires measure .2 mil-
to date has shown. limeters thick and four to five millimeters wide, and are typically
Dr. Welsh had treated a patient with radiation to shrink the tumor wound several hundred times to create a "pancake coil," which
in the patient’s thigh bone, according to the announcement, in order the developers wound precisely to generate a strong and stable
to reduce pain and risk of fracture. Three months later, however, a magnetic field.
CT scan found no trace of the cancer cells — an extremely rare, but Tiny differences in the thickness and width of the wire can
not unheard-of, result. cause the coil’s height to be uneven, which can disrupt the mag-
Additionally, doctors reported that radiation is increasingly being netic field and distort the images. To solve that, Mitsubishi used
used alongside “checkpoint inhibitors," which allow molecules to be laser displacement meters to carefully measure the coil height and
activated on specific immune cells to start an attack on foreign cells, then adjust it with correction sheets.
and the combination of these treatments have had notable results. The researchers used the helium-free system — which has a
However, even with the success rates of radiation and immuno- bore measuring 320 millimeters and an axial length of 450 mil-
therapy, not all patients are able to fight off the melanoma cancer limeters — to successfully image a 25-millimeter mouse fetus.
cells. The doctors believe that it is important to discover proteins or The developers have plans to increase the size of the system by
other biomarkers since they can help quantify how well experimental one-half the size of a full-size MR by 2020, and to commercialize
therapies are working. it by 2021.
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What can spherical brain mapping of MR
images teach us about Alzheimer's Disease?
Posted online May 31, 2016 by Christina Hwang
A new framework for the detection of Al- oped the SBM framework. After establishing white, grey or black, and a textural measure
zheimer’s using spherical brain mapping the framework, they then tested SBM on the called local binary patterns.
(SBM), a technique that allows physicians images ADNI provided. According to Martínez-Murcia, the av-
to visualize a 3-D MR image as a 2-D im- “We analyzed the discriminative power erage or local binary patterns maps have
age, has been proposed by researchers of the projected maps using both visual and approximately 90 percent accuracy while
from the University of Grenada, Spain. classification analysis,” Francisco Jesús Mar- other maps such as surface or kurtosis have
In SBM, each pixel of the image repre- tínez-Murcia, a researcher from the study, a lower performance of about 70 percent.
sents a certain measurement in a specific department of signal theory, telematics and “SBM provides visual maps that repre-
direction, and in the study the researchers communications at the University of Grana- sent internal features of the brain, and there-
had focused on six types of measurement. da, told HCB News. fore could be very useful to obtain that kind
Three statistical: average, entropy and kurto- The team had tested this technique of high-level knowledge at a glance, without
sis; and three morphological: cortical thick- against an MR database of 180 Alzheimer’s having to navigate the different coordinates
ness, topology of the brain’s surface and the patients and 180 individuals without the of the 3-D images,” said Martínez-Murcia.
number of folds, were measured. disease, and found that the most appropri- The maps also reduce computation load
The researchers obtained structural imag- ate maps to be used in Alzheimer’s were while maintaining a large amount of the origi-
es of the brain from the Alzheimer’s Disease the ones that measured the average of the nal information provided by the 3-D image.
Neuroimaging Initiative (ADNI) and devel- intensities of the MR image, which can be Share this story: dotmed.com/news/31077
GE Healthcare ups the Carestream Health is reportedly
ante in $2 billion medical being put up for sale
claim denials market Posted online May 25, 2016 by Gus Iversen
Posted online May 25, 2016 by John W. Mitchell
Carestream Health may be on the auction block, with owning
investment firm Onex Corp. exploring a breakup of the medi-
A new venture will join GE’s analytics with Accenture’s fo-
cal imaging company that could bring in upward of $3 billion,
cused consulting to increase cash flow and reduce the one-in-
including debt, according to unnamed sources.
five claims denial rate for health care providers.
The report comes from a Reuters exclusive based on information
“Denials come in many flavors,” Jon Zimmerman, vice president
provided by people familiar with the matter.
and general manager at GE Healthcare IT and Clinical Business Solu-
Reuters stated that this latest move underscores the diverging
tions, told HCB News. “But the ones our customers are focusing on
fortunes of Carestream's business — rising sales in its smaller digital
the most are related to eligibility, coding, prior authorization and
dental equipment division and challenges to the film X-ray business.
timely filing.”
As the health care industry moves away from a film business
According to GE, medical claims denials represent one of the
that was once highly lucrative, legislation such as the Consolidated
largest lost revenue areas in health care. In total, lost revenue from
Appropriations Act of 2016 is expected to incentivize facilities to
denied claims costs hospitals and physicians about $2 billion a year,
upgrade their X-ray systems to digital radiography (DR) by impacting
according to Zimmerman. He said that one of their users was able
reimbursement.
to reduce claims denials by 47 percent in the first month with a cost
Film aside, Carestream also offers a range of advanced medical
savings of $93,000. DenialsIQ is based on an algorithm that was
imaging solutions for computed radiography (CR), DR, cone beam
originally developed to identify anomalies in jet engines.
CT and ultrasound — as well as health IT solutions aimed at improv-
Under the agreement, Accenture will offer services to help sup-
ing hospital workflow.
port three types of revenue cycle engagements. These include: a de-
The Reuters report said Carestream is working with investment
nials management assessment; a more extensive consulting engage-
firm Goldman Sachs Group for its film and digital medical imaging
ment that uses DenialsIQ data to help redesign claims workflow; and
business, while another investment firm, Jefferies Group, has been
claims management and operations support services using DenialsIQ.
retained to shop its dental imaging business.
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Tata Consultancy Services and GE collaborate
to develop solutions on GE Health Cloud
Posted online May 27, 2016 by Christina Hwang
Tata Consultancy Services (TCS), a global teams collaborate on care planning; Centricity TCS will use its consulting experience
IT services, consulting and business so- Case Exchange, which allows affiliated and to ensure quality control and regulatory
lutions organization, is partnering with non-affiliated systems to share images and compliance of the GE Health Cloud and
GE Healthcare and GE Digital to develop reports; and Centricity Image Access Portal, its solutions.
digital solutions on the GE Health Cloud. where affiliated and non-affiliated physicians "TCS sees great opportunities to improve
Health Cloud connects to more than can view longitudinal patient imaging data. care pathways for patients through its digital
500,000 GE imaging systems from which “The GE Health Cloud can help unlock solutions, enriching the GE Health Cloud
the images processed on-site can be moved the value of data, quickly and seamlessly ecosystem to improve outcomes for health
to the cloud, allowing radiologists and clini- for better patient care,” said John Flannery, care providers," said Anupam Singhal, vice
cians to collaborate across care pathways president and CEO of GE Healthcare, last president of Tata Consultancy Services, in a
and departments both inside and outside November when the Health Cloud was first statement.
the hospital setting. announced. “[It] will help clinicians turn According to the announcement, TCS has
Health Cloud also has four new radiology data into insights, and insights into tangible significant expertise on the GE Predix platform
apps that will run in the cloud: Centricity Cloud actions for decision-makers to drive better — aimed at industrial factories and plants —
Advanced Visualization, to manage image outcomes.” which released Internet of Things solutions
post-processing and allow viewings of the 3-D Flannery said the amount of data health such as supply chain monitoring, prognostics
images at any time; Centricity Multi-Disciplin- care devices are generating is expected to maintenance and engine telematics.
ary Team Virtual Meeting, aimed at helping increase 50-fold by 2024. Share this story: dotmed.com/news/31106
FDA approves Siemens system Hospitals face a compliance
for 3-D-only mammography crackdown on credit card
Posted online May 18, 2016 by Lauren Dubinsky security from PCI Council
Posted online May 17, 2016 by Dan Conley
The Mammomat Inspiration with Tomosynthesis Option is
the first 3-D digital breast tomosynthesis system to receive
Hospitals are aware of the financial and reputational threats
FDA approval as a stand-alone screening and diagnostic tool.
posed by non-compliance with HIPAA. They’re generally less
The approval was based on a pivotal reader study in which the
informed about another major player in the compliance game: the
participating radiologists read 3-D-only images and then 2-D and
PCI Security Standards Council (PCI SSC).
3-D images to determine how well they could detect cancer. The
This council, originally formed by the major credit card com-
study found that the radiologists were able to decrease average
panies, monitors “merchants” for adherence to PCI Data Security
recall rates by an average of 19 percent without a 2-D image.
Standards (PCI-DSS), the safeguards intended to protect credit card
Even though the Mammomat Inspiration is the first breast tomo-
data. Because any location where a credit card is swiped or keyed in,
synthesis solution on the market to demonstrate superior results to
and any network on which data is transmitted or kept in storage, is
2-D as a stand-alone exam, the company is aware that many physi-
considered a “merchant," hospitals are subject to their standards.
cians will continue to use it as an adjunct to 2-D exams.
The traditional approaches to achieving PCI compliance for pro-
Siemens’ Tomosynthesis Only Option is available on both its
cessing and storing credit card data are expensive to implement and
Mammomat Inspiration and Mammomat Inspiration Prime Edition
maintain. They also require regular lengthy audits. A new solution
digital mammography systems. No changes have been made to the
introduced by OnPlan Health and Bluefin Payment Systems may be
systems, so physicians can still continue performing breast tomosyn-
a cost-effective alternative to those methods, and is the first system
thesis as an adjunct to 2-D mammography.
that combines PCI-validated Point-to-Point Encryption (P2PE) by
The Mammomat Inspiration with Tomosynthesis Option was
Bluefin with OnPlan’s tokenization technology to vastly reduce the
FDA approved in April 2015 for being used in conjunction with the
annual PCI-DSS audit and scope for health care providers.
2-D mammography option.
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16 HealthCareBusiness news I july 2016 www.dotmed.comUMC Utrecht Johnson & Johnson and HP partner for
installs third Elekta 'game changing' 3-D printed solutions
MR-guided linear Posted online May 25, 2016 by Gail Kalinoski
accelerator Johnson & Johnson and a subsidiary of alization of instrumentation and software
Posted online May 27, 2016 HP Inc. are teaming up to provide per- for patient-specific health care devices,”
by Christina Hwang sonalized health care solutions for pa- according to Johnson & Johnson. But it is
tients, with 3-D printing. The goal is to anticipated that the 3-D technology will
University Medical Centre (UMC) Utrecht create customized products that will improve also eventually lead to innovations in uses
recently installed its third Elekta high-field outcomes and reduce costs for patients. for orthopedics, eye health and consumer
MR-guided linear acceleration (MR-linac) The collaboration, which has already be- products.
system, a 1.5T system that allows physicians gun, is focusing immediately on “person- Share this story: dotmed.com/news/31027
to capture images of a patient’s tumor and
surrounding tissue at the time of treatment.
Allowing the radiologist to monitor the tu-
mor during treatment or between treatment
sessions as it changes shape and size is a key
benefit that sets the technology apart from
conventional linac systems.
"Although MR-linac is not yet approved for
use in patients, the system will be used for all
types of cancers that are being treated today
with radiotherapy while opening the door to
anatomies that have previously been consid-
ered unsuitable for radiotherapy," a spokesper-
son for Elekta told HCB News.
"It will be particularly advantageous for those
anatomies that are in constant motion, such as
the lung, and [those] surrounded by critical struc-
tures and intricate complexities," Elekta said.
According to Bas Raaymakers, Ph.D., professor
of experimental clinical physics in the department
of radiotherapy at UMC Utrecht, in a statement,
the ability to visualize radiation therapy during
treatment and to adapt treatment in real time
based on MR images would allow radiologists
to treat cancer with precision and accuracy while
improving efficacy and reducing side effects.
UMC Utrecht is the founding member of
Elekta’s MR-linac consortium, which is currently
composed of seven institutions and was estab-
lished in 2012 by Elekta and Philips.
"After the significant technology hurdles that
the teams have successfully overcome in order to
combine advanced high-field digital magnetic
resonance imaging with a state-of-the-art linear
accelerator, and then validate and test the sys-
tem, we are now about to enter the next phase
of our important journey," said Rob Cascella,
CEO Diagnosis and Treatment at Philips.
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Missouri calls $37 billion Aetna-Humana
merger anti-competitive for the state
Posted online May 26, 2016 by Lauren Dubinsky
In a blow to the proposed $37 billion to Missouri regulators. director of media relations at Aetna, said in
Aetna and Humana merger, the Mis- The merger would have substantially a statement. “We’re disappointed but ex-
souri Department of Insurance, under compromised competition in the state's pect to have a constructive dialogue with the
the leadership of director John M. Huff, Medicare Advantage market, according to state to address their concerns.”
ruled that it would be anti-competitive the AMA, particularly with negative conse- Other states have taken a different view of
for the state. quences for elderly patients. the merger. The Connecticut Department of
The companies have 30 days to submit The merger is currently being reviewed by Insurance is among 15 states that have already
a plan to fix the anti-competitive impact or the U.S. Department of Justice, state regula- approved it. A spokesperson from the depart-
they will not be permitted to operate in 65 tors and antitrust authorities, and they are ment told the Hartford Courant that the merg-
Missouri counties, including St. Louis City and also reviewing the Anthem and Cigna merg- er wouldn't affect competition locally because
St. Louis County, according to a preliminary er. Since the deals will reduce major health in- Humana has almost no customers in the state.
order issued by the state's insurance officials. surers to three from five, investors are unsure However, the Anthem and Cigna merg-
Several organizations applauded Mis- if they will close, according to Reuters. er is still under review in Connecticut. The
souri's stance on the merger. Dr. Steven J. But Aetna isn't expecting this order to department will evaluate the competitive
Stack, president of the American Medical affect the merger at the federal level. impact and the impact to Cigna after it's
Association (AMA), stated that this "strongly “The Missouri order does not impede the combined into Anthem.
validates" the concerns that AMA expressed DOJ approval process,” T.J. Crawford, senior Share this story: dotmed.com/news/31138
NorthStar's new filling line Functional SBRT prostate
will quadruple its capacity imaging treatment advances
to dispense Mo-99 to world’s first clinical trials
Posted online May 13, 2016 by Lauren Dubinsky at Case Medical Center
Posted online May 3, 2016 by John W. Mitchell
NorthStar Medical Radioisotopes announced that it's add-
ing a new filling line at the University of Missouri Research
Doctors at the University Hospitals Case Medical Center Seid-
Reactor (MURR) production operations that will quadruple
man Cancer Center in Cleveland have launched a trial to evalu-
the company's capacity to produce molybdenum-99 (Mo-99)
ate a new stereotactic body radiotherapy that may greatly
— the parent isotope of technetium-99 (Tc-99m)
reduce treatment time, costs and serious side effects.
NorthStar and Von Gahlen International, a radiation shielding
SBRT targets just part of the prostate, rather than the entire gland.
manufacturer, are working together to design and install the new
“If successful this study may lead to a routine option to treat only
system. When it's complete, it will include a high-capacity DPharm
part of the prostate containing cancer, instead of treating the entire
unit to fill source vessels quickly along with companion hot cells for
prostate initially,” Dr. Rodney Ellis, lead author and associate professor
radiation containment.
of radiation oncology and urology at Seidman, told HCB News.
In addition to increasing the dispensing capacity at MURR,
In 1998, Ellis was the first clinician to use functional imaging to
the new filling line will also be able to prepare source vessels with
escalate dose in the prostate gland using brachytherapy and SPECT/
Mo-99 generated from natural or enriched Mo-98 targets. The en-
CT images, according to Seidman Cancer Clinic. The methodology
riched targets have higher concentrations of Mo-98 and produce
for the current SBRT trial method was conceived in 2004 from his
about three times more Mo-99 than natural targets.
prior research.
Tc-99m is derived from Mo-99 and is used in the majority of
The initial trial will include 12 patients. Ellis said that if they can
SPECT imaging exams. Currently, the parent isotope is only pro-
confirm the SBRT findings, the team would seek additional funding
duced in aging reactors that use weapons-usable highly enriched
to include more patients.
uranium (HEU).
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18 HealthCareBusiness news I july 2016 www.dotmed.comECRI launches Is GE Healthcare done with
solution to track plans for dealmaking?
equipment recalls Posted online May 17, 2016 by Thomas Dworetzky
and alerts for Internal earnings growth through new Electric, according to a recent Bloomberg
hospitals deal structures — not straight acquisi- News interview.
tions — appears to be the new mantra The health care giant has pledged to
Posted online May 27, 2016 at GE Healthcare. boost profit margins 50 basis points in the
by Lauren Dubinsky At least that's the latest word from its next year, with a target of 18 percent in
CEO John Flannery, who totaled $26 bil- 2018.
Sometimes it can feel like every time you lion in acquisition deals as the rainmaking Share this story: dotmed.com/news/30930
turn around a new device recall or alert is head of business development at General
being announced. Whether it comes from
the FDA, manufacturers or other organizations
— it can be a challenge for hospitals to keep
track of the alerts that are relevant to them and
their equipment.
For that reason, ECRI Institute has launched
a new feature for its existing Alerts Tracker au-
tomated recall management solution called
Automatch for Equipment, which identifies
equipment models and supplies within a facility
that have been alerted or recalled.
ECRI developed Automatch because of the
large number of safety alerts related to medi-
cal equipment, which can reach 20 to 25 per
week, and the unreliability of inventory data-
bases.
"As a result of these factors, it is difficult for
hospitals and health systems to reliably identify
all alerts that affect them and to reliably identify
all affected devices throughout the hospital,"
Eric Sacks, director of health care product alerts
at ECRI, told HCB News. "Automatch stream-
lines the process and makes it much more reli-
able and complete.”
Clinical engineers typically have to manually
search through the inventory database to find
the affected equipment. Automatch gener-
ates a list of affected assets and automatically
distributes it to every potentially affected de-
partment.
Alerts Tracker, the system on which Au-
tomatch functions, is ECRI's solution for elec-
tronically distributing safety information about
medical devices, blood products, food products
and pharmaceuticals to the appropriate staff
member.
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Medicare reimbursement cuts to push providers
using film and CR toward DR systems
Posted online May 26, 2016 by Gail Kalinoski
Hospital outpatient facilities and physi- But facilities currently not using DR for The biggest reduction in reimbursements
cians’ offices still using analog and CR their imaging needs were not so lucky. The will be for those using analog equipment.
X-ray equipment need to begin think- law sets out a series of Medicare reimburse- They will see Medicare reimbursements cut
ing about making the switch to DR in ment cuts that begin next year and will be by 20 percent beginning in 2017. Medicare
order to avoid Medicare reimbursement phased in through 2023. reimbursements for practices using CR will
reductions starting next year. “The policy permits physicians to con- have a 7 percent cut starting in 2018 and a
As part of the $1.1 trillion omnibus tinue to use X-ray equipment used for film 10 percent cut in 2023.
spending bill passed by Congress and signed radiography and computer radiography. Certain outpatient facilities and free-
into law by President Barack Obama in mid- Physicians who elect to continue to use standing imaging centers submitting Current
December, provisions in the Consolidated these modalities are subject to per-scan re- Procedural Terminology (CPT) Codes such as
Appropriations Act of 2016 contained in Sec- imbursement reductions within the Medi- 71010 (Radiologic examination, chest, single
tion 502 are designed to speed up the transi- care program,” according to the American view, frontal) and 71020 (Radiologic exami-
tion from traditional X-ray imaging to DR. College of Radiology. nation, chest, 2 views, frontal and lateral)
The provisions are part of the wide- ACR notes that the policy changes apply are expected to be impacted, according to
ranging, 2,000-page bill that did have some only to analog radiography and CR that is MITA. Acute care hospitals are exempt from
good news for medical equipment manu- reimbursed through the Medicare Physician payment changes as they are reimbursed
facturers and suppliers — it postponed the Fee Schedule (MPFS) and Hospital Outpa- under a different payment system.
medical device tax for the next two years. tient Prospective Payment System (HOPPS). Share this story: dotmed.com/news/30959
Varian to shed imaging Bloomberg News: Pfizer
components business, poised taking bids for Hospira
for growth in cancer care pumps and devices business
Posted online May 24, 2016 by Lauren Dubinsky Posted online May 4, 2016 by Lauren Dubinsky
Varian Medical Systems announced plans to spin off its imag- Pfizer is reportedly taking bids for its pumps and devices busi-
ing components business to have two independent compa- ness, which it acquired from Hospira in September 2015.
nies. The stand-alone company will be created through a tax-free Smiths Group Plc, an engineering business in the U.K. and Frese-
distribution to Varian's stockholders and is expected to be completed nius SE, a diversified health care company in Germany, are a couple
by the end of the year. of the bidders, Bloomberg News reported. Pamplona Capital Man-
This transaction will allow Varian to solely focus on advancing its agement, a private equity firm, also made a second-round bid.
technology and services for cancer treatment. The new company will If the unit is sold, Pfizer could make about $2 billion through the
handle components, software and services for expanded imaging deal.
applications and markets. Back in January, there was talk that Pfizer was considering selling
Varian believes that making these two separate businesses will the unit.
provide them more freedom to invest in and pursue new growth Analysts have speculated that after Hospira's assets were inte-
strategies in their different markets. The investors will also get better grated into the company, Pfizer may split off its entire drugs unit
transparency and understanding of each business. from the faster-growing business that includes many of its newer,
The new company will be a high-volume manufacturer of X-ray brand-name drugs, Bloomberg reported at that time.
tubes, flat-panel detectors, connectors and accessories for imaging. Hospira has struggled over the years with regulatory issues and
It will also sell workstations and software for computer-aided diag- most recently, cybersecurity dangers.
nostics and image processing. In August 2015, the FDA issued a statement strongly encourag-
Varian anticipates that it will generate about $575 million in an- ing health care facilities to stop using Hospira's Symbiq infusion
nual revenues. pump because they were vulnerable to cyber attacks.
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20 HealthCareBusiness news I july 2016 www.dotmed.comIsrael-based Medic Vision's SafeCT-29 is the first
third-party XR-29 solution to get FDA nod
Posted online May 24, 2016 by Gus Iversen
With XR-29 raising the bar on what a affect one-third of the CT scanners being ance — and it is precisely what SafeCT-29
CT scanner should be capable of, many used in the U.S. provides.
hospitals have found themselves forced It's not the only third-party XR-29 solution, Scanner OEMs like Philips, Siemens and
to choose between a costly capital in- but it is the only one regulated by the FDA. GE have established upgrade pathways for
vestment and penalized reimbursement And with nothing comparable ever hav- many of their CT scanners to ensure com-
— but there may be a third option on ing been on the market, getting clearance pliance — but older models are being left
the table. wasn't easy. "In the beginning one of the behind, as well as the majority of PET/CT
After over a year of working with the major challenges for us as well as the FDA systems.
FDA and redesigning their product, Israel- was finding some kind of similarity we can Unlike the proprietary software pack-
based Medic Vision has received clearance compare against," said Aharon. ages that the manufacturers install on the
for a patent-pending XR-29 solution called Under XR-29, a facility will be docked 5 scanners themselves, SafeCT-29 is an add-on
SafeCT-29. percent of its reimbursement on certain CT system that is fully automatic and does not
"We eliminated the need to replace exams if their scanner does not meet four interfere with the scanner. It analyzes dose
thousands of fully-operational scanners and specific requirements. In 2017, that cut data in real time and alerts the operator if
saved the health care industry billions of dol- jumps to 15 percent. the dose is too high, while preventing the
lars in the process," Eyal Aharon, CEO of According to Aharon, published reports patient from being scanned until dose levels
Medic Vision, told HCB News, referring to have pointed to Dose Check as the XR-29 are changed or confirmed and justified.
NEMA's estimate that non-compliance could standard that costs most scanners compli- Share this story: dotmed.com/news/31057
Philips and MUSC Health
Complete Hitachi® MRI Solutions
enter $36 million, 8-year
strategic partnership
• Altaire ® Coldhead Service
Posted online May 23, 2016 by Lauren Dubinsky
• Helium Fills
Royal Philips has entered into a handful of strategic partner-
ships in recent months, and another one was announced, but • ACR & IAC Calibrations & Shimming
this time it's solely focused on patient monitoring. The deal
• Flexible Service Plans
with Medical University of South Carolina Health (MUSC Health) is
worth $36 million and will span eight years.
• Image Quality Tune-ups
The partnership is based on the enterprise managed services
model in which Philips will install, integrate and manage the health • Coil Repairs
system's patient monitoring systems and software. Philips will also
provide maintenance, training and consulting services within a struc- • Installations & System Moves
tured monthly payment model.
This will help MUSC Health implement standardized clinical prac- • Quality, Refurbished OEM Parts
tices that are based on defined monitoring configurations and inte-
grate with other clinical IT systems. They will also be able to collect ...And, a reputation you can trust!
and manage patient data more effectively.
MUSC Health is a 750-bed medical center located in Charleston,
South Carolina, with about 13,000 clinicians, faculty and staff. The
partnership is aiming to improve patient monitoring for 1 million
patients per year.
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