Imaging for Optimal Therapy and Patient Outcomes: Siemens Healthineers

How is Siemens Healthineers changing its focus with respect to the fields of cardiology and therapy?

We are a leading diagnostics company, and our portfolio of imaging systems is used across the care continuum, from screening and diagnosis through therapy and monitoring. Historically, we haven’t thought as much as we could have about the actual implications of the therapies that we guide. We are now taking a different approach and are focusing on the clinical requirements of therapy, including the importance of image guidance during the therapy procedure.

The big focus is on cardiology. There have been great advancements in cardiology, in structural heart, with transcatheter aortic valve repair (TAVR), mitral valve repair, left atrial appendage repair, and potentially down the road, tricuspid repair (which is not yet performed in the U.S.). All of these procedures rely on image guidance. The beauty of these procedures is that they are less invasive, which gets patients out of the hospital sooner, and hopefully their recovery is shorter and they feel better, sooner. From an imaging standpoint, we think that we can help ensure that therapy is delivered in a very specific, precise manner, and most importantly, that we can help impact a better outcome. We are extremely focused on cardiology and on partnering with other companies — particularly medical device companies — to ensure that we help them deliver optimal image-guided therapy. Having a cardiology background and having worked at Abbott Vascular for many years, I have seen the impact of these devices on people’s lives. We want to do everything we can to help physicians and healthcare facilities improve overall patient outcomes.

You mentioned partnering with other companies. Can you expand on that?

Our goal is to work with device companies — for example, companies that provide TAVR devices, companies that supply mitral valve or repair devices, or companies in the field of left atrial appendage closure. While we are not yet in a position to name specific companies, we have had discussions with many of them that are far beyond the preliminary stage. In each case, our stated goal is to focus on the optimization and delivery of therapy.

Which emerging trends are you identifying in the cath lab?

Certainly there have been major advances in the treatment of structural heart disease, but these approaches are still in their relative infancy. I foresee great advancements for therapies like mitral valve replacement and tricuspid valve repair and/or replacement. Great work is also being done in angioplasty. In the U.S., a growing area is complex percutaneous coronary interventions (PCIs), including chronic total occlusions (CTOs) and the ability to address that complex disease state in people with coronary artery disease. These lengthy procedures require better visualization, and that plays back into the imaging and diagnostics component. We can help physicians visualize these procedures, with the goal of shortening them and helping physicians deliver an improved outcome. We want to work with both physicians and medical device companies to realize that goal.

How is the increasing focus on meaningful use and quality measures influencing the role of cardiac IT?

We live in a digital world now, and physicians want to electronically locate their reports and imaging in one place. Today when they perform these complex procedures, physicians use multi-modality images acquired with ultrasound, computed tomography (CT), and fluoroscopy, and they want to see all of those images in one location, so they have everything in front of them to help them make informed decisions — most importantly, about how to treat the patient and ultimately how to report the outcome. An IT solution is required to meaningfully aggregate all of those images with the purpose of driving a better outcome. As a company, we would be remiss if we weren’t thinking about outcomes. We know that in U.S. healthcare systems, outcomes will be a major focus. We play a role in helping with that, both through IT innovations and through the imaging equipment that we manufacture.

What are the cost implications of the more imaging-intensive “cath lab of the future”?

It’s all about the overall cost. If we have the right type of imaging that is much more precise — and that extremely high level of precision is what we are working toward and, in many cases, already have achieved with our imaging systems — we can help physicians improve the outcome, which means that not only does the cost go down, but the procedure time is reduced, as well. As a responsible company in the healthcare space, we want to help physicians and facilities shorten that procedure time and impact a better outcome, so that overall costs are reduced. Part of helping institutions address rising costs and mitigate cost is improving the outcome, because hospitals will be measured on the outcome, the quality score, and how a patient feels following the procedure. We believe we play a role in helping with that because, while we don’t deliver the therapy, we do provide systems that aid physicians in delivering that therapy.

How does a facility implement this cath lab of the future — and how can Siemens Healthineers help? 

The very complex procedures being performed today require multi-modality imaging. Unfortunately, many of those imaging modalities — ultrasound, CT, or the cath lab itself — reside in different sections of the hospital. One area we are focusing on is helping healthcare facilities redesign their cath labs so they can have all of these modalities in one location. We have cath labs now with CT systems that slide in and out of the room, because structural heart procedures may require both pre- and post-procedure CT scans. This is just one example of an opportunity to incorporate an imaging modality so we can get everything done at one time, in a more timely and cost-effective manner. Combining systems in one location and facilitating a much more efficient procedure is an area of focus for us in helping to usher in what we call “the cath lab of the future.” Part of that cath lab of the future involves enhancing the images. We help cath labs obtain the right image for the right procedure at the right time, as well as help them fuse all of those images in one location, which was not easily accomplished in the past. When a physician looks at an echo image, he wants to see it on the monitor in front of him, and he also may want to see the image from the CT scan performed earlier that day, along with his fluoro images. This is all about helping physicians make better, more informed decisions, hopefully for a better patient outcome.

Has consolidation in healthcare affected how customers approach the cath lab of the future? 

Consolidation in healthcare is not going away. As healthcare providers consolidate, standardization — utilizing the same equipment the same way to obtain the same result — is an important component. We see several advantages in aiding with protocol management to standardize how people perform certain procedures from an imaging perspective, and help them with their imaging techniques. When we work with an integrated health network, our goal is to work across that network to help each member institution perform a procedure in an appropriate, standardized manner, and hopefully impact a better outcome.

What makes you proud of Siemens Healthineers?

We have incredibly proud and passionate employees. Their passion not only makes me proud, but it also fuels our entire organization.  Our employees take pride in the products that we make, because these products represent outstanding technology that helps to improve patient outcomes. We are focused on these outcomes and on ensuring that we bring the best possible quality to the market so that we are able to help physicians and hospitals provide treatment for their patients in an appropriate and cost-effective manner. 

Any final thoughts?

We have seen so many incredible advancements in cardiology over the last few years that have improved patients’ lives. I have spent considerable time in cath labs, and I speak from firsthand experience when I say that it is an amazing environment that is highly focused on caring for patients. I have witnessed great work by cath lab personnel – the physicians, cath lab technologists, and nurses all perform a tremendous service. My family and I have seen this personally with my father, who is 86 years old, has over 10 stents, and is doing great. I am deeply thankful for the important work being done in cardiology.

David Pacitti is President of Siemens Medical Solutions USA, Inc. and Head of Siemens Healthineers North America. Based at the U.S. headquarters of Siemens Healthineers in Malvern, Pennsylvania, Pacitti is responsible for leading the marketing, sales, service, and support functions in the U.S., with additional oversight of Canada, across the entire healthcare portfolio, including medical imaging, laboratory diagnostics, therapy solutions, clinical IT, and services.

Prior to joining Siemens in 2015 in his current role, Pacitti was Division Vice President of U.S. Commercial Operations, Sales, and Marketing at Abbott Vascular for two years, overseeing the company’s business in North America. As a member of the Senior Executive Staff, he worked with the CEO, CFO, and Research & Development team on business development initiatives and played pivotal roles in key launches, including Abbott Vascular’s first drug-eluting stent franchise and structural heart franchise. Prior to this position, Pacitti was Vice President of Abbott Vascular’s Commercial Operations from 2009 to 2013, and Vice President of Global Marketing from 2006 to 2009. He joined Abbott Vascular with its acquisition of Guidant Corp, where he served in positions of increasing responsibility from 1995 to 2006. Early in Pacitti’s career, he was a sales representative in Siemens’ Molecular Imaging business.