Cardiovascular Business News sat down with Michael Reitermann, CEO of Siemens Healthcare in the U.S., at ACC.10 to discuss the challenges and solutions regarding the U.S. healthcare market.
Cardiovascular Business News ( CVB): What is the most pressing challenge facing U.S. cardiologists and how has Siemens addressed it?
Michael Reitermann: One challenge that everybody faces in healthcare is the pressure to contain costs and how that can be translated to doing more procedures with less resources. We address it with workflow improvements, whether it's ultrasound where we have ways to accelerate the acquisition of echocardiography exams or with CT where we have fast-acquisition technology that allows patients to be scanned without beta blockers.
Regarding coronary CT angiography (CCTA), we are in the process of releasing a product that reduces post-processing of the images to about five minutes.
CVB: What solutions do you offer on the information management side?
Reitermann: We have a web-enabled CVIS that does not require practices and departments to invest in a lot of hardware. We have streamlined our reporting templates to reduce reporting time and have made it easier for department managers to record and collate departmental metrics, such as door-to-balloon times and procedure times. We call it our executive portal and it requires no intervention from the departmental manager.
CVB: One of the ways practices and hospitals are looking to expand their service line is by incorporating a hybrid OR into their workflow. What can you offer hospitals who want to build a hybrid OR?
Reitermann: We believe that one of the primary applications for our Artis zeego robotic c-arm is for the OR. If during a valve replacement, for example, the surgeons need to take over, the system slides out of the way. We also have harnessed the tubing apparatus in a retractable device that can be moved out of the way, so there is nothing mounted on the ceiling.
Also, our Dyna CT is the hybrid solution to biplane imaging. Particularly with children, it is possible with Dyna CT to give one injection of 30 ml of contrast and have as many angles imaged as you want.
Going forward, we will see many more patients with complex disease states. The hybrid OR will be integral for interventionalists to work together with surgeons.
CVB: There has been a lot of talk about radiation exposure, particularly from CT imaging. Can you tell me about some of the initiatives by Siemens to address this issue?
Reitermann: We are focused on minimizing radiation dose during each exam. With the Somotom Definition Flash CT scanner, for example, we can routinely perform exams at sub-1 mSv exposure—less than one second and less than 1 mSv. There are many technological advancements that led to those values. One is the dual-source technology where you have two tubes and two detector elements combined into one, which allows the capture of the heart without motion artifacts and without giving patients beta blockers.
Routinely, everybody can under certain circumstances produce cardiac CTA exams with less than one mSv. One question is: Can I do it with 70 percent of my patients? We make it easy to achieve sub-mSv scanning by allowing our RIS to send optimal dose settings to the CT scanner based on the patient information.
We are convinced we can do it routinely. In fact, we have a web site www.siemens.com/low-dose called “Worldwide Dose Counter – Live Statistics for the Somatom Definition Flash CT scanner” where the dose of each cardiac scan from the Flash scanner is recorded. The last time I checked, we had more than 10,000 cardiac scans with an average dose or 0.85 mSv. We truly believe in our technology, otherwise we wouldn't put that information on a website for everyone to see.