Monday, January 02, 2006

An AuntMinnie Thread about Siemens Syngo PACS

Sometimes, discussion threads on become a little contentious. Take in point this thread about Siemens Syngo PACS. I won't copy it here, but suffice it to say that a question about this product morphed into a rather long discussion with an entrepreneur by the name of Stephen Levkoff, PhD.

Dr. Levkoff started out in the financial world, and amassed a great deal of expertise in computers and databases. His fame was tarnished somewhat by a famous failure, Decision 2000, which he created for Reuters. The Observer notes:

But Reuters' attempts to compete with Bloomberg led to financial disaster and a series of lawsuits. In 1989 the company hired a former Smith Barney executive, Stephen Levkoff, to devise a bonds analysis database to rival Bloomberg. But the product, released as Decision 2000, was regarded as a technological disaster and cost $10m after Levkoff sued.
Another lawsuit, from brokerage house Cantor Fitzgerald, followed over a failed joint venture through which Cantors would provide Reuters with a live feed of US Treasury securities prices.
Even worse was to follow with Reuters' next project, codenamed 'Armstrong', an ambitious attempt to correct what it had failed to achieve with Decision 2000 - fusing real-time market data with legacy information. Armstrong proved to be another huge disaster and cost the company some $20m.

In the interest of fair and balanced reporting, Dr. Levkoff responded thusly when I posted this snippet:

In response, I saw the Observer many years ago. It was an attempt to hammer Reuters for its incompetence in financial markets other than foreign exchange. Reuters failed in two major deals with two industry experts: Cantor Fitzgerald (government bonds) and me (multicurrency analytic systems). In my case, they wanted to integrate D2000 functionality into ALL Reuter terminals –but with no royalty payments. The business landscape is littered with numerous other IP vendor lawsuits against Reuters for various material breaches of contracts, bad, faith and lack of fair dealing. Cantor Fitz and I had the wherewithal, strong legal position and balls to fight back. We won – more than you will make in a lifetime as a radiologist in private practice.
I didn't respond to the Observer nor will I now. I consider the Observer article libelous – incorrect and uninformed. D2000 was extremely successful. Clients in 30 countries were serviced by 6 redundant data centers via a failsafe global network. It significantly undercut the "Reuters Terminal (RT)" - a proprietary PC platform that delivered nothing but real time data that was only a small part of D2000.
Decision 2000, a highly viable multi-lingual Bloomberg competitor with operations in 30 countries, subsumed the RT functionality and offered more advanced real-time analytics than Bloomberg has today - in an industrial strength platform. D 2000 became a $250 million disaster for Reuters AFTER I sold it to them - they mistakenly did not understand the financial markets or the expertise necessary to compete. They hired 1000+ (semi-competent) people to attempt to do what I had done with 150. They bombed badly and attempted to blame me long after I left the company. If you can read, you should review the federal case that we brought against and books written by insiders at Reuters. D2000 comes out very well.

Dr. Levkoff's goal is to "develop and acquires very high end multi-modality imaging centers." What differentiates him from a hundred other similar operations is that he wishes to apply his years of expertise to the world of health-care informatics, PACS, RIS, and so forth. His analysis

"...found that Siemens Syngo Suite offers the only fully integrated, industrial strength RIS/PACS solution in the market. The platform - Fujistu Siemens servers, Sun Solaris (UNIX), Oracle (db), EMC (storage) - is the only one in the industry capable of supporting multiple, fully redundant data centers with real-time database replication and synchronization. At the June 2005 SCAR meeting in Orlando, most vendors not only completely failed our platform requirements but scoffed at our requirements for a completely fail-safe, multi-data center integrated health care information environment. However, post-Katrina, the need should be obvious to all health care executives."

Interesting analysis, but when I posted this, Dr. Levkoff decompensated:

If bullet-proof, uncrashable hardware was the end-all to end-all, we would all still be using UNIX on Sun boxes. Somehow, Katrina or no, that has not been first and foremost in everyone's mind. Wintel boxes are considerably less expensive, and with off-site storage, you should be covered. The best Unix box hooked up to the best SAN becomes inoperative when immersed in water, last time I checked.
The Siemens Syngo/eSoft approach is very esoteric (read: strange) although it does work well once you get used to it. They have unified the appearance of their modality controls and workstations, and from a very brief peek at RSNA, their PACS uses the very same interface. That is a good thing to some extent, but how many rads are going back into the control room and running the CT scanner? I personally don't think this interface is the easiest or the most straight forward for PACS use. It has certainly been a long time in coming. I would be curious to hear from any rad who is using this product.

His response:

Hello Dalai Lama - You sound like a weak Siemens competitor. Your Wintel comments are extraordinarily naive - typical of the industry. Microsoft does not offer an industrial strength operating system for zero-downtime environments - particularly across data centers. Further, you obviously don't understand the concept of running multiple, fully redundant data centers with real time database replication....On the user interface issue, you may find it "strange" because you are accustomed to doing things a certain way. Loosen up - it’s very intuitive and flexible. Additionally, commonality of user interface across applications and modality is essential for training, cross-training, quality control, and leveraging personnel for operating efficiency. As a CEO, I would not make a purchase decision that did not offer all of the characteristics of the Siemens Syngo Suite, given its availability. Also, I wouldn’t hire a radiologist who couldn’t scan.

Just a little bit over the top. I won't keep quoting the thread, but suffice it to say that things went straight downhill. He became more and more angry and condescending with every post. I finally gave up and invoked the "Dalai Shroud", declaring Dr. Levkoff deceased with respect to my future interaction with him.

Daniel Braga, another AuntMinnie poster, has the last word so far on the thread, asking the most pertinent questions of all:

How many radiologists did you meet with to discuss their impressions of the viewer? How many hospitals did you visit using the product that you would be buying?
Dr. Levkoff is obviously a very brilliant man, and has done a great deal research in PACS and healthcare informatics. Unfortunately, his wisdom has manifested itself into tunnel vision, and he has sandbaged himself into a particular corner. Even more sadly, he cannot tolerate the disagreement over his choice of, well, corners, and he has lashed out to the point of destroying his credibility, at least to me. He had much to contribute, but in trying to change the entire industry in one fell swoop, he lost his chance to do so meaningfully. RIP.


Blue Cross of California said...

Great blog I hope we can work to build a better health care system as we are in a major crisis and health insurance is a major aspect to many.

Dr. Sardonicus said...

This guy has my BS detector going into the red.
You say that Levkoff is obviously a brilliant man. Not obvious, and I would not accept that he is brilliant.
He fits the mold of many I have met who talk a good game, who are quick to tell you in many subtle and not so subtle ways that they are brilliant. Alpha male behavior. Usually (maybe always) these guys are not close to the level the pretend to be. Hiding insecurities with bluster.
There are a few truly stupid statements in his posts. One is he wouldn't hire a radiologist who couldn't run a scanner. Clearly he is not a big one for knowing his industry before he forges ahead. He also seems to fail to understand that he must actually work with people and get those people who work with him who have skills he does not (radiologists) to enthusiastically endorse what he is doing. No - this guy is a scorched earth sort of administrator.
He may or may not be a good engineer. At least Reuters would disagree. But, reading his ideas here, he knows pretty much zero about working with people successfully.
The truly brilliant, IMHO are the few who quietly assemble an organization of people who are sold on an idea, and pursue it with passion. They are, without exception, open to the ideas of others, and meld their ideas into the entire organizaion. They are never the person that you would see in a room conversing with others and think: "he is brilliant"

BS artist - yes. Normally these people have a short moment of glory and are gone pretty quickly.