Monday, July 11, 2005

Northwest Redux and Other Random Musings From The North Woods

(My Temporary Shingle)

I try to be flexible when possible, and this week I am playing Pediatrician at my son's camp in northern Wisconsin. The territory up here is nothing short of spectacular, lots of trees and lakes and clear blue skies. The camp itself is a rustic paradise, about as far from a Ritz Carlton as you can get, but still peaceful, placid, and comfortable. Maybe I'll stay up here for a while....

Northwest redeemed itself in getting me here. There were absolutely no glitches whatsoever. Flights were ontime and smooth, and personel were friendly. Special thanks to Sergio at our originating airport, who went out of his way to help us redistribute items in an overweight bag, thus avoiding a penalty. Sergio's behaviour compensated for that of the other Northwest employees to a very significant degree. He "got it" as they say. All I ask is that I be treated with kindness, understanding, and dignity; this is how Sergio treated me, and how I hope I treat my patients.

On the PACS front, the big news is the purchase of Stentor by Philips, for $280 Million. That's a lot of cash, folks. The big question I have is this: What happens to all of those Sectra installs? The Sectra folks seem to be assuming the worst:

Since 1997, Sectra has had a global cooperation with Philips Medical Systems, which has sold Sectra's software for processing digital X-ray images worldwide.

"We have several project agreements with Philips that extend up to ten years and our cooperation will successively be terminated," relates Sectra's President and CEO Jan-Olof Brüer. "We assess that the termination will impact on our sales and earnings in the current fiscal year. At this time, however, it is difficult to provide any reliable view of the financial effects, since this depends on how much time the termination will require."

The change provides Sectra the opportunity to review its sales channels. Sectra's sales of PACS are handled on a proprietary basis in Scandinavia and other selected markets as well as through partners, of which Philips was the largest. Sectra's largest sales together with Philips have been in the US.

"Part of the sales for which Philips is currently responsible will be taken over by other partners that today are active in the same markets as Philips," says Jan-Olof Brüer. "At the same time, we gain the opportunity to advance our positions and will increase our focus on own sales in important key markets, as we do today in Scandinavia, where we have captured more than half of the total PACS market."

Sounds to me like Philips is dropping Sectra (or maybe it will turn out to be the other way around) like a hot potatoe, and Sectra will find some "other way" to service its sites. Uh Oh. I've lived through that sort of thing with our Elscint CT scanners. Elscint sold its CT division to Picker (actually happened while I was visiting their main offices in Haifa, Israel), which then was gobbled up by none other than Philips. Service was pretty good, considering, but it just isn't an optimal situation. In this case, Sectra will have to bring in some other outfit to do its service. Perhaps they should contact Banctec, the outsourced Dell service provider, or maybe the Geek Squad from Best Buy.

I know of several sites that had purchased Philips/Sectra, or were close to doing so. Wouldn't go there at this point, at least until the market stabilizes. If they were buying because of the Philips name, they would of course still get that, but a completely different product. To buy Sectra means diving into a very murky future. I personally wouldn't go near either one for the time being, but that's just me. Your milage may vary.

I had the chance to play with the Philips/Sectra system, and it isn't bad. It was neither my most or least favorite. The team was (and I emphasize was) a formidible player in the PACS field. I've asked people why they liked the PS system so, and invariably I get one of the following answers:
  1. It's made or marketed by a company that makes scanners, so it must be good.
  2. It has an easy pull-down preliminary report menu.
  3. Their embedded 3D lets you select exact slice thickness on MPR.

My answers to the above are probably predictable. First, GE and Siemens make scanners too...I don't consider the PACS product from either company, um, great at the moment. Secondly, one should never, ever make a major purchase based upon one or two perks. Would you buy a Peugot over a Mercedes because it has, say, a prettier hood-ornament? You have to take all factors into account, not the least of which is the overall usability of the entire system. Having the hots for one specific component has the potential to send you down the completely wrong path. Pull-down preliminary report generators are dandy, and I have a rudimentary version on Agfa Impax 4.5. I rarely use it, because I can type my prelim much faster without any help. As far as MPR slice thickness, I don't know anyone who finds knowing the exact numerical value of the thickness that valuable in actual use. Frankly, I suspect a lot of potential PACS purchasers, especially those who are new to the game, are so overwhelmed by whizbang gadgets, they don't stop to think about how they might actually use said toys.

My advice remains this: use the product as much as you can before making a purchase. Web-based systems lend themselves very well to trial-runs in your own office or home setting. Vendors...can you accomidate this?

Anyway. For the moment, all is well in the North Woods. That is until Sick-Call, which is right after dinner.........

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