Tag Archives: Interventional

Signify Premium Insight: MediView Set to Augment Surgeons with $15m Funding

Earlier this month interventional augmented reality start-up MediView XR secured $15m in strategic funding from a number of well-respected backers, including GE HealthCare, Mayo Clinic and Cleveland Clinic, among others.

MediView’s solutions combine surgical navigation with augmented reality, to give surgeons what it calls “3D X-ray vision”, in a bid to equip them with greater surgical visualisation and navigation tools, and ultimately offer better care. In addition, the vendor says the tools can also facilitate remote collaboration, and in doing so, improve access to care in underserved populations.

MediView has now raised approximately $29.5m in funding. With its latest funding it plans to continue to establish and expand its multi-tier platform. This, it says, includes generating additional clinical evidence, developing products and achieving milestones in intellectual property, regulation, commercialisation and product launches

Signify Premium Insight: Philips Takes Spectral CT to the Heart of the Matter

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Earlier this month, Philips announced that it has brought the company’s spectral CT imaging technology into an integrated hybrid angiography CT suite. The vendor hopes to improve the clinical utility of its Azurion image guided therapy system, by using spectral CT technology. This combination will give physicians access to two key modalities in a single room, which the Dutch company hopes will facilitate improved minimally invasive procedures in areas such as oncology, stroke and trauma care.

The Signify View

Philips is not the only vendor to offer a hybrid angiography CT interventional system, but, by bestowing its Azurion angiography platform with spectral CT functionality, making it the first to market with an angio-spectral CT offering, it hopes it can elevate the system further, and increase its usefulness in more critical applications such as oncology, stroke care and trauma care.

Such development and innovation is important. Not only will it help Philips maintain its reputation as one of the vendors delivering the most technologically advanced interventional imaging systems, and continue to solidify its position as one of the premier vendors of such systems, it also matches increasingly sophisticated clinical needs.

Interventional procedures are becoming more complex over time. This is, in part, facilitated by increasingly sophisticated interventional imaging equipment which enables more complex procedures to be performed in a minimally invasive way, but, as surgeons undertake such complex procedures, the need for more sophisticated imaging equipment is also magnified. Given that the complexity of procedures and the sophistication of interventional imaging equipment therefore progresses in lockstep, technological advancements made could have significant clinical benefits. In the case of spectral CT, the ability to better distinguish between different tissue types can improve the detection and quantification of lesions and can help improve planning to benefit minimally invasive procedures. This is particularly true in oncology, where spectral CT imaging can offer significant advantages in detection and treatment of malignant tumours.

This has been demonstrated with several collaborations with research hospitals which have shown the ability of spectral CT-based temperature mapping provides real time feedback during tumour ablation procedures. A process which is expected to reduce the risk of localised tumour reoccurrence.

Price and Value

Spectral CT also offers other advantages in oncology. One of the use cases for the technology could be improving biopsies and allowing doctors to better distinguish between active and non-active regions of a tumour. When using conventional CT, many of these masses appear uniform so conducting a targeted biopsy can be difficult but the extra detail offered by spectral CT means that different tissues can be more reliably identified.

Such capability will not come cheaply to providers. The spectral CT equipped Azurion system is the very pinnacle of Philips’ interventional offering, so its customers, in the near term at least will primarily be research institutions and academic hospitals in very mature markets such as the US and Western Europe. There are also several other reasons why Philips tool could be attractive.

There is, at present at least, no direct competition for the device. As well as being the first spectral CT-enhanced angiography system, there is also, as yet, no equivalent device utilising photon counting CT; the other major innovation in CT imaging in recent years. While Philips has chosen to use spectral CT on the image guided therapy market, vendors which have made the most progress in photon counting CT so far have chosen to focus on the diagnostic procedures. This may change in the future as the technology becomes more commercialised, but at present Philips has an edge in the interventional space.

Lifetime Rewards

Another reason providers could be interested is that the spectral CT system could also actually prove to be good value in terms of a patient’s entire care pathway. Although the initial cost of the spectral CT Azurion system may be high, if its use in cancer care is effective as expected, and it can help reduce the recurrence of localised tumours, providers could avoid some longer-term costs associated with chronic and terminal conditions, expenses which can quickly escalate.

Such savings could be very significant over the lifecycle of an interventional imaging system, although Philips needs to provide clinical evidence of its claims for more mainstream providers to adopt the systems.

This development of spectral CT angiography is also occurring against the broader backdrop of an increasing transition of interventional imaging to outpatient sites. A trend which brings benefits to patients, which can take advantage of a greater range or procedures within a closer radius and providers, which can, in some markets, benefit from more favourable reimbursement at some outpatient sites. While Philips’ latest CT angiography system is not considered to be used in outpatient sites, it will help providers differentiate between outpatient and inpatient sites, with lower complexity procedures, which require less sophisticated equipment being conducted at outpatient sites, while more complex procedures can be conducted in hospitals using more sophisticated equipment.

Surgeon’s Choice

Utilising its latest CT technology in an interventional angiography suite also makes sense for Philips for other reasons. While medical imaging modalities are increasingly sold as part of broader deals that extend across imaging departments, premium interventional systems are still frequently purchased as individual pieces of equipment. For critical use cases, surgeons are often given more input into purchasing decisions, and while the more general concerns of cost of ownership and return on investment are considered, decisions are often heavily weighted towards clinical capabilities and a piece of equipment’s benefits it can offer surgeons.

As such it represents a sensible setting for Philips to showcase its most cutting-edge CT technology. In other settings, and in less advanced imaging applications, there is frequently less differentiation between companies in terms of the imaging capabilities that are offered by different vendors. While one vendor may have an advantage in certain scenarios, in many cases these differences are slight and will likely be negated or reversed as competing vendors bring out new models. However, in interventional systems, which are used for highly complex, critical procedures, more advanced features are frequently better able to be showcased.

However, while the system may offer advantages, and a few providers might be tempted to adopt Philips’ hardware over that of a competitor, well established preferences for a particular vendor’s products will still make it more likely that Philips will primarily be targeting replacement sales with its new spectral CT angiography system. By offering a new system which harbours significant potential for improved clinical performance, Philips will hope to entice their existent customer base to take the plunge and update their medical imaging hardware.

Such sales will occur over an extended time frame, although this will be expedited if clinical guidelines change over time to recommend use of spectral CT angiography, as they have in the past to stipulate use of hybrid operating rooms for some complex cardiac procedures, for example. This would quickly increase demand for Philips’ latest system and encourage many providers to upgrade.

Even without such guidance, Philips has made a sensible move. By entering the interventional market with spectral CT, the vendor has placed itself in prime position to shape the next generation of interventional solutions that become available. There is still work to be done, identifying more key use cases for the technology and investing in clinical studies to demonstrate the benefits will help translate product announcements into sales, but in the interim, Philips has shown a pragmatic approach to the application of its latest technology.

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Signify Premium Insight: Strong Growth and Increased Competition – The Key Trends in the Interventional and Surgical X-ray Markets

This Insight is part of your subscription to Signify Premium Insights – Medical ImagingThis content is only available to individuals with an active account for this paid-for service and is the copyright of Signify Research. Content cannot be shared or distributed to non-subscribers or other third parties without express written consent from Signify ResearchTo view other recent Premium Insights that are part of the service please click here.

Research Manager Bhvita Jani

Signify Research has recently released its Interventional & Surgical X-ray – World Market Analysis which details the nuance of the market in the face of turbulence brought by the global Covid pandemic, and its subsequent recovery. The interventional and surgical markets were growing reasonably strongly in 2019 before the pandemic, consistently posting growth of mid-single digits. But, these were some of the markets most affected by the pandemic, with restrictions brought in to combat the virus leading to the cancellation of 30%-40% of elective procedures in some countries during the height of the pandemic.

Such a significant fall in procedures led to anticipation of a similar market decline, however, as the report’s author, Research Manager Bhvita Jani, points out, this wasn’t necessarily the case.

The Signify View

“On the Interventional side, the decline wasn’t as drastic as anticipated,” she explains. “There was softening but the drop, given the situation, was moderate with a high-single-digit to low-double-digit declines.

“On top of this we also saw the market bounce back quickly in 2021, so 2022 so far has been very much like a typical pre-covid year. The markets are stable and within the normal range.”

There have been several drivers of this return to normality. “It was in part a recovery after the pandemic, with a return to elective procedures and the fulfilling of pent-up demand, but, what is actually driving a lot of the growth is demographic factors.

“There is an ageing population, obesity is on the rise and the subsequent incidence of related diseases and conditions, such as cardiovascular disease and stroke among other things. All this means that procedures are becoming more complex and hospitals require more complex equipment to carry out these procedures.

“One of the biggest growth segments in interventional imaging is neurology, for example. Lots of developed countries are placing increased importance in dedicated stroke pathways and increasing the number of stroke centres accordingly.”

Perfecting Products

Such factors are not only driving the market forward, they are also shaping the product trends within the market. The increased demand for complex neurology procedures, oncology procedures and cardiovascular procedures means that hospitals are increasingly prioritising advanced multidisciplinary equipment. As such sophisticated biplane systems, for example, are proving increasingly popular in developed markets.

There are also other considerations for vendors looking to capitalise on the growth in the interventional radiology market. Increasingly providers are looking beyond simple transactions for a piece of hardware, and instead are looking to purchase complete patient care pathway solutions.

“So now, when stroke interventional neurology systems are sold, providers want the entire stroke treatment pathway, including the IT environment that can streamline the process,” Jani adds. “So, we expect more of those type of solutions to become available.”

Another factor contributing to market growth is the changes in settings in which interventional systems are used.

“In certain developed markets, one of the biggest growth factors is office-based labs. This growth stems from such labs being more profitable to the interventional radiologist or cardiologist, as it is a lower cost setting, which results in higher reimbursement.

“So, from a business perspective, these settings represent a higher return on investment. These settings are driving new demand, which is growing the market, compared to inpatient settings, where demand for equipment is almost entirely on a replacement basis.”

Global Changes

As well as meeting the distinct requirements of different customer groups, vendors are also having to react to the changing needs of different geographic markets.

“Vendors in India and China are among those disrupting the market, as they are driving down prices and continuing to increase the affordability and access to interventional technology,” Jani notes.

“In some markets, including China and India, governments are actively pushing more local vendors. This prioritisation of local companies and the incentives that are in place, could begin to threaten some of the international players’ share in those markets.”

For these international vendors, this challenge from lower-priced competitors could also exacerbate pressures closer to home stemming from changing purchasing practices.

“Hospitals are increasingly becoming part of bigger hospital chains. This means that the buying power now sits with group purchasing organisations, and that means there is more competition for these deals and more consolidation. Another more direct impact of this is that, with these bulk deals, the average selling price of systems is going down.”

Carry on Regardless

While such trends will have an impact, and there may be some pricing pressures in the market, according to Jani it remains an attractive area for vendors to serve.

“Despite these changes, providers are still keen to invest in very high-end equipment,” she explains.

“I’d say that compared to other areas of X-ray, decisions about interventional equipment are less driven by price. There is still a significant focus given to a system’s specifications, how the equipment can directly impact clinical outcomes, and the preference of the end user.

“This means, that in developed markets, it is a very hard market to disrupt, with hospitals and clinicians unlikely to want to go through the hassle of shifting from one brand’s equipment to another. Providers tend to replace the equipment from one vendor with equipment from the same brand, so it is very difficult for one brand to steal share from another.”

New technologies could, however, make such shifts more likely, with innovations within AI, for example, which focus on features such as radiation dose management or treatment planning potentially giving providers more of a reason to switch to another vendor’s products.

Future Preparation

As well as focusing on these new technologies, there are also other priorities that vendors in the interventional and surgical X-ray markets should concentrate on to best capitalise on market trends.

“While the high end is very important, if vendors want to maintain a market presence in some of the highest growth markets like China and India, they need to have a performance offering as well. This will allow them to continue to compete against the lower-cost system offerings from those countries.

“Another opportunity for vendors is to focus on more sustainable solutions,” Jani continues. “So, for example vendors offering providers software updates when they are launched by the vendor instead of providers being stuck with the software that was current when they purchased the system.

“This goes hand in hand with the increase in smart subscriptions that we are also seeing in the market, which makes the solutions more stable and improves their longevity, giving the vendors that offer these subscriptions an advantage.”

Strength in Surgical

Many of these trends seen in the interventional imaging market are mirrored in the surgical market, although there are some differences. For instance, one of the major trends in that market is the shift from image intensifier-based systems to systems that use flat panel detectors (FPD). There is also an increasing shift to 3D imaging, a transition that began gathering pace after 3D mobile C-arms were released by the likes of Ziehm Imaging, Siemens Healthineers and GE Healthcare. This has changed the complexion of the market somewhat. Before these releases most growth was expected in Europe, in countries like Germany, for example, but with the release of 3D systems, China is increasingly looking like a big driver of growth. This is particularly important given the levels of competition in the 2D C-arm market.

“Competition is much higher in the 2D mobile C-arm market,” Jani explains. “We are seeing a lot more domestic manufacturers in China and India which are offering systems at a lower price and making it more difficult for multinational companies to grow in those markets. However, there are some opportunities in developing markets, with 2D C-arms providing access to basic imaging in rural areas.

“In developed markets, mobile C-arms are also being used for overspill procedures and as backup to the fixed C-arm, although typically the purchase of an interventional system is prioritised over a mobile system.”

Possibilities and Market Potential

Despite these nuances the interventional and surgical X-ray markets both represent strong growth markets, with a great deal of potential in both developed and developing markets.

“There are going to be disruptive new entrants to the market,” Jani continues, “that is really going to cause a shake up.”

“The affordability of systems is going to increase, which means there is going to a much faster roll out with domestic vendors in India and China particularly accelerating growth in the market.

“Growth will also come from hybrid operating rooms, which are a fast-growing segment. That growth is set to continue in the coming years in both developed and emerging markets, just because of the multi-disciplinary clinical usage and the return on investment.”

“However, the US and China will remain the key growth drivers,” Jani concludes. “There is simply more demand for interventional and surgical X-ray systems due to the increased numbers of procedures that are being carried out, and an increased focus on interventions.

“This, ultimately, is the key driver of growth going forward.”

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Signify Premium Insight: GE’s Allia Platform: An Intervention in a Lucrative Segment

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GE Healthcare has recently debuted its latest interventional platform, dubbed Allia, which it hopes will allow it to capitalise on the growing demand for minimally invasive procedures.

The new suite centres around a wide-bore C-arm, and, according to GE Healthcare, has been developed in conjunction with surgeons and interventionalists to better support their needs during surgery. This, the vendor says, will improve the accessibility of the system’s user interface, as well as allowing the suite to be customised to individual surgeon’s needs. The Allia Platform is also offered with GE’s AI-based AutoRight interventional imaging chain, and GE’s AI-based parenchymography software solution.

The Signify View

Because of the high-pressure situations in which it is used, and the inseparable link between imaging and treatment, interventional imaging is unique. Despite these peculiarities that set it apart from other kinds of imaging, it does share one almost universal challenge with its imaging kin: the need for greater workflow efficiency. Improving the efficiency of surgeries and reducing operational challenges are among the guiding tenets of GE Healthcare’s Allia platform. Ergonomics is one area where GE Healthcare has worked to improve surgeries, with one of the key developments being a wide-bore C-arm that is neither floor nor ceiling-mounted, a change which is hoped to make interventional rooms more navigable for clinicians.

In a similar vein, GE Healthcare boasts that it has worked to ensure interfaces, functions and displays – the touchpoints that clinicians interact with on a daily basis, are all easily accessible, enabling surgeons to operate more efficiently. There are also more outwardly sophisticated, if more specialised developments, with GE Healthcare looking to leverage AI to assist with liver embolization procedures as well as manage the dose that patients are subjected to.

All of these tools and capabilities should, assuming they perform as well as GE Healthcare expects, be useful to surgeons. Whether that will be enough to convince providers to buy or upgrade their systems to have access to this new clinician-focused platform is another question entirely.

Users vs Buyers

As large medical imaging vendors are increasingly looking to enter into more comprehensive managed service agreements with providers, effectively becoming partners rather than simply suppliers, decisions are being made higher up in the hierarchy of a hospital network. As such, focusing so myopically on the needs of clinicians, rather than the requirements of the C-suite or finance department could be a risk. However, interventional X-ray is unusual in this regard. Its high-risk nature compared to other areas of medical imaging means that the opinions and preferences of the clinicians that will eventually be using the platform will be given more weight than might be the case for other imaging purchases.

Given this clinician focus, it makes sense for GE Healthcare to focus on, and emphasise in its marketing, the benefits that such a system could bring to surgeons, with improved workflow, enhanced clinical outcome, improved usability, and advanced image guidance all aiming to make interventional teams more efficient.

Despite these improvements being roundly appreciated, the Allia platform does represent the top end of GE Healthcare’s interventional imaging range, and as such comes with a price premium. While this may deter some potential customers, it does offer the halo effect, raising GE’s profile in a segment in which its two chief competitors, Philips and Siemens Healthineers, tend to outperform, especially in developed markets. This alone is unlikely to make a provider switch its allegiance and suddenly adopt GE Healthcares interventional imaging suite, but, by addressing one of the gaps in its portfolio, GE Healthcare is increasing the broader appeal of its overall medical imaging offering and therefore standing it in better stead to become the vendor of choice for a provider entering into a holistic imaging deal. By a similar token, offering a system that rivals the best from Siemens Healthineers and Philips also ensures that interventional won’t be a reason it misses out on such deals.

Competing Interest

This is an important factor. GE Healthcare’s Allia platform does not stand in a field of one, with both Philips and Siemens offering products that have comparable functionality, albeit with their own unique focus, however, the timing of GE Healthcare’s launch will also benefit the vendor. During the Covid-19 pandemic countless elective procedures were canceled because of restrictions to hospitals. This has left providers facing an enormous backlog of postponed procedures which they need to clear. Given this pressure on hospitals, any interventional solution which can improve the efficiencies of interventions, reduce bottlenecks in procedures and improve the workflow efficiency of surgical departments will be warmly received.

There are, however, some differences that do set GE Healthcare’s new solution apart from its chief competitors. One such factor is the inclusion of an AI tool it calls Liver Assist, which is a 3D visualisation solution that GE Healthcare says will provide virtual parenchymography and help clinicians simulate injections dynamically and perform liver embolization procedures. Unlike other vendors which have tended to focus on hardware innovation, and supplementing that with software that is applicable across a variety of different use cases, GE has sought to combine its hardware and software capabilities into one product which addresses a growing clinical use case.

Market Pressure

GE’s approach is, more broadly, also appropriate given the wider trends in the medical imaging markets. Unlike many of the segments in which GE plays, there is limited competition in the interventional market. In some of GE’s biggest adjacent markets, competition has increased rapidly. In general radiography, for example, explosive growth in the number of Chinese vendors targeting both the budget segments and players such as United Imaging targeting ever more premium markets, will start to weigh on GE’s results. With new competitors and lower costs eroding market share and margin. In contrast, interventional imaging is a much more sophisticated segment with much higher barriers to entry for potential competitors. What’s more, given the more critical nature of interventional imaging, providers will be less likely to take a chance on a lesser-known vendor if there is an alternative from a more established player with a robust reputation available.

Against this backdrop, focusing on maintaining and building share in the interventional space is an appropriate strategy. Growth in interventional imaging will also be international. Both demographic factors such as aging populations, higher rates of obesity, heart disease, stroke and other conditions rising, along with the increasing availability of medical imaging in developing markets allowing conditions requiring surgical interventions to be diagnosed, the need for interventional imaging platforms will grow in lockstep.

Ultimately, GE Healthcare’s release of its Allia platform will not dramatically change the complexion of the interventional X-ray market. Providers will not rush to replace their existing systems to take advantage of GE Healthcare’s new workflow improvements or its AI capabilities, and it may not, in the short term, necessarily push providers toward a large comprehensive contract with GE Healthcare. However, some clinicians will notice the release, they will visit GE’s booth at RSNA and assess the consideration that they, and their needs have been given in the update, and, perhaps will start to notice some shortcomings in their own systems. Then, when the time comes, these clinicians tasked with performing some of the most direct tasks in medicine could advocate for a GE system in future. Such patterns may not allow GE Healthcare to overthrow Philips and Siemens, and over time those vendors will also release new systems that will once again swing the balance. But, by focusing both hardware and software innovation on the platform’s users, GE Healthcare may well have boosted its chances in a difficult, yet rewarding, segment.

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Signify Premium Insight: GE Healthcare looks to Keep Patients out of Hospital with Medtronic Partnership

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GE Healthcare and Medtronic recently announced a partnership which will see the two health tech vendors increasingly target the US’s growing outpatient segment.

The deal will see the firms collaborate on the specific requirements and needs of Ambulatory Surgery Centres (ASC) and Office Based Labs (OBL), allowing customers to benefit from their combined product sets, and financial solutions.

The partners will also offer these outpatient customers services, to, as the vendors note, navigate the costs and complexity associated with expanding an existing site or establishing a new one. These services include planning construction, medical hardware and digital solutions.

The Signify View

In a growing number of cases, it is clear that patients no longer need to visit an acute hospital to receive interventional treatment. In a shift that is quickly accelerating, ambulatory centres are becoming a much more attractive location for simpler, lower risk procedures. It is, after all, a cheaper option for some operations, a factor that has become ever more important in the wake of the global coronavirus pandemic which has hit the budgets of many acute centres. Further increasing the attractiveness of such sites are changes to reimbursement, which can, in some instances, render procedures carried out at outpatient sites more profitable than those carried out within a hospital’s walls.

However, this rising demand for outpatient surgical centres presents something of a challenge for leading medical imaging vendors such as GE Healthcare. On the one hand, such vendors will be keen to capitalise on the growth of the segment, looking to take advantage of any additional investment in medical imaging equipment that is forthcoming. On the other, however, selling into such settings represents a departure from these vendors’ established practices, and offers a new set of problems that they must overcome. Large vendors are used to forging huge, comprehensive, multi-year deals with entire provider networks, but this will not directly translate to the growing outpatient segment. Instead, these smaller, more specialist ambulatory centres need a different mixture of products, services and support. Furthermore, purchasing decision makers will be different, with surgeons themselves having more influence over a decision, enabling features such as clinical precision to come to the forefront, compared to larger networks where decisions are increasingly being made at a C-suite, rather than departmental, level.

Making Customers Bigger Customers

These considerations will have guided GE in making such a partnership, with the arrangement, and the possibilities it offers customers, helping GE Healthcare and Medtronic to capitalise on the growth of that sector. What’s more, it will be doing this while helping to facilitate the growth of the market itself. This will be achieved by helping these smaller sites to develop their capability and procure the necessary equipment. Through the agreement GE Healthcare and Medtronic will help by offering guidance on the setting up of these sites and their construction. The vendors will also provide necessary equipment, along with the digital solutions to go alongside it, as well as remote support and expertise in matters such as reimbursement. OBLs and ASCs lack the same level of peer support which healthcare professionals have access to in larger hospital facilities, making it more imperative that OEMs form a long-standing partnership, including ongoing training and support, as opposed to delivering a transactional sale.

This latter point could be particularly important given that, at present, reimbursement rates are being used as a tool to incentivise the creation of outpatient surgical centres. For surgeons used to working in large acute centres, having to file for reimbursement themselves could prove challenging and potentially disruptive to a fledgling business. By providing support to these surgeons, the GE Healthcare and Medtronic partnership will help them overcome one of the key challenges they face in establishing their own centres.

This is a sound plan. Beyond helping the outpatient surgical market grow, the inclusion of services will help the vendors retain customers, offer new opportunities for upselling and allow for better margins. OBLs and ASCs are more likely than large providers to purchase single pieces of equipment at a time and be more open to utilising pieces from different vendors. However, the inclusion of a service element will better entrench GE Healthcare at an outpatient provider, fostering brand loyalty and giving it a reason to stick with GE Healthcare even if a competitor offers incentives for it to change suppliers, offering a rival piece of imaging equipment at a lower price for example.

This will be particularly important as GE Healthcare, along with Medtronic, seek to compete with other vendors. Philips is the strongest vendor in the acute interventional space, a market which it stubbornly retains. The growing outpatient setting offers new potential customers and a chance to establish a strong position in a burgeoning market. Philips, as well as other large imaging vendors, are also trying to target these customers, so for the likes of GE Healthcare, ensuring that customers’ eyes don’t wander after they have made their purchase is critically important. For instance, Philips tweaked its traditional inpatient products to address the workflow and infrastructure limitations of outpatient settings, as well as evolving its strategy to provide a more holistic full-service OBL offering.

Pulling the Right Lever

There are also other tools that GE Healthcare and other vendors looking to capitalise on the increase in outpatient interventional procedures can leverage. One of these is business models. Most large providers purchase their medical imaging equipment on a capital expenditure model. This is suitable for these large providers which have large budgets and are used to capex purchasing. However, smaller surgery centres could benefit from other types of purchasing options such as ongoing operational costs or financing packages. By offering such packages that allow customers to purchase equipment over a period of months or years, GE Healthcare can make its equipment more accessible to more outpatient sites.

Another tool GE Healthcare can use is to adapt its product range. The challenges of tackling a more disparate outpatient market, as well as the generally lower budgets of those customers mean that it could be hard to maintain margins. One of the solutions to this is developing a range of products designed specifically for outpatient sites. As well as meeting the financial constraints of such customers while remaining profitable, product adaptations could help create systems that are more aligned with the needs of these outpatient surgical sites and eschewing features unnecessary in ASCs, or bespoke packages of imaging hardware and software that cuts costs for GE Healthcare, a portion of which can be passed on, rendering them attractive to a potential customer.

The Organisation of Opportunity

GE Healthcare is not alone in targeting this blossoming section of the market, but the depth of portfolio offered by the combination of GE Healthcare and Medtronic, makes it a formidable entrant. It will not be an easy segment to exploit, particularly as GE Healthcare and Medtronic are not organisationally optimised to sell to such a diffuse and decentralised customer base effectively and profitably. Sales networks, support teams and supply lines, not to mention business models, have all been refined over decades to better meet the needs of acute hospitals. Unpicking and rebuilding these channels to serve the needs of a different customer group is not the work of a minute and will require investment and dedication over an extended period to be fully completed.

But work toward this goal has to start somewhere. A partnership with Medtronic, which addresses some of the pragmatic needs of surgeons in budding ambulatory sites, while allowing GE Healthcare to promote other products within its portfolio and build a loyal customer base represent solid first steps. Whether it is enough to head off rivals in the space or withstand an external shock such as changes to reimbursement is unclear, but at present, GE Healthcare is making progress in tilling a very fertile field.

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