Interview

'We Will Focus On Growing the Market through a Multi-Pronged Approach'

Carestream Health, Inc is a dynamic new company that leverages 100-plus years of market leadership and an innovative suite of solutions to meet the critical needs of the markets it serves. Globally, Carestream health has thousands of healthcare information management solutions installed worldwide. The company sells nearly 40 per cent of all new computed radiography (CR) systems in the US and Canada, and is a key player in the digital radiography (DR) systems market. The Carestream dental digital radiography equipment and practice management software installed bases, respectively, are the largest in the world. Prabir Chatterjee, MD of Carestream Health India Private Limited, talks about company's exciting plans in India to Express Healthcare. Excerpts:

Prabir Chatterjee MD, Carestream Health India Private Limited

What are your latest products and service offerings to the Indian market and the target market for the same?

Carestream continues to introduce innovative and market-leading imaging products in all the various segments. Among our powerful recent introductions in India have been -

• The Carestream DRX-1, the world's first cassette sized wireless digital DR detector, which fits in to existing systems. An extremely cost-effective digital solution, the imaging labs can shift to digital radiography without a complete revamp of their existing system.
• The Carestream DRX Evolution, the world's first integrated DR suite powered by the innovative Carestream DRX -1 system. This remarkable system matches the world's first cassette sized DR detector DRX-1 with fully automated suit of precision X-ray equipment. The DRX Evolution is designed with a solution that can grow to fit the needs of radiology facilities over a longer period. The DRX-1 and the DRX Evolution systems address the needs of large healthcare facilities with heavy workloads.
• The most advanced 3D Dental Imaging machine - the Kodak 9500 3D. Reflecting Carstream's industry leading position in the field of dental imaging too, the 9500 3D is a flexible and easy to use 3D dental imaging system that enables dental professionals to obtain localised, high-resolution three-dimensional images, as well as panoramic examinations, at a very affordable price point - making the power and utility of 3D technology available to general practitioners and specialists alike. In India, three focused field units (Kodak 9000 3D) and a Cone Beam CT (Kodak 9500) have been installed. This system is targeted at endodontists, implantologists, and other dental specialists performing complex procedures.

What is your view on the after-sales services or customer support being provided by Carestream Health?

Carestream recognises the need of busy imaging facilities for high-level of service that enables minimal disruption of their patient-care and diagnostic operations. Among the features of Carestream's service supports are:

• An experienced and highly qualified team of over 60 service engineers in the country, who have been trained at overseas manufacturing facilities directly on equipment they are required to support.
• Easy access to service and registration of service requests through a country-wide toll-free telephone number (1 800 209 0190), as well as e-mail (service-india@carestreamhealth.com).
• Practice of using only genuine spare parts with spares being dispatched from mother warehouse only after QC checks.
• To minimise down-time, there are 15 stocking points for spares (warehouses) across India. Regularly required spares are maintained in sufficient quantities at the warehouses to enable prompt response. The spares management network is a dedicated operation, separate from manufacturing and sales, to ensure prompt delivery.
• Global Technical Support operates round-the-clock through the Carestream Technology and innovation centres located in China, Geneva and the US.
• Our current & upcoming products come with Remote management service.
• Application specialists on different product lines train users for optimum practices to assure best image quality and equipment care for trouble-free long-term operation.

Please elaborate your growth plans.

Carestream Health, Inc., originated in 2007 when Onex Corporation purchased Eastman Kodak Company's Health Group and established it as an independent company. Since then, Carestream Health has grown consistently and we are planning substantial growth in coming years in India as well as worldwide. The Company's 2008 revenue was approximately $2.5 billion. Carestream Health's wholly-owned subsidiary company in India - Carestream Health India - also has a comprehensive portfolio of medical imaging and healthcare IT products, services, and solutions, as well as the latest in X-ray films, laser films, Computed Radiography (CR) systems, Digital Radiography system, PACS, dental imaging products and medical laser printers. Starting of as the erstwhile Health Group of Kodak India which commenced operations in 90's, Carestream Health India had revenue of about Rs 200 crore in 2008. We will continue to introduce innovative new products and bring the latest technology to India as fast as possible. We will provide scalable solutions that enable growth and connectivity and thus the expandability built into our products itself will lead to growth. Carestream Health will also be flexible in communicating with customers to understand their needs and develop solutions that meet those needs. The emerging markets from second-third tier towns will provide the drivers for further market expansion.

In which segments of radiology, does your company focus on?

Carestream Health markets a broad portfolio of CR and DR systems that equips hospitals, outpatient imaging centres, orthopaedic practices and other healthcare providers with digital image capture for X-ray imaging studies. Carestream Health's laser imagers range from desktop systems designed for imaging centres, small hospitals and clinics to fully featured units designed for high volume, multi-modality output at hospitals of all sizes. These imagers offer output from PACS, CT, MRI, computed radiography and digital radiography systems, and other grayscale imaging applications.

Any technology that you pioneered in radiology?

Carestream Health has a proud history inherited from its previous identity as the Health Group of Eastman Kodak Company, comprising over 100 years of innovation dating from almost the time of discovery of X-Rays by WE Roentgen. A recent example of pioneering technology from Carestream has been the DRX-1 - the world's first cassette sized wireless digital DR detector. It fits in to existing systems without any modifications so that the users can conveniently shift to Digital Radiography at an affordable cost.

What is the USP of your company in India?

Carestream Health has several USPs in India,

• The only company in India offering a complete range of medical imaging products ranging from CR, DR, PACS, dental imaging and medical printing.
• Direct presence in India with employee strength of 75.
• A history of over 100-years of market leadership and an innovative suite of solutions to meet market needs.
• Market-leading laser imagers for printing medical images of all types - CT, MRI, ultrasound, CR and DR.
• Flexible CR and DR solutions that solve workflow, budget and space challenges while reducing procedure times.

What market opportunities and trends do you witness in Indian radiology market? How do you plan to tap it?

The overall growth in healthcare sector presents a great opportunity. The standards of healthcare and related diagnostics services have shown a sharp improvement in recent years. Modern hospitals in bigger cities adopt the latest innovations in imaging so as to be able to provide world-standard care to their patients. Such medicare facilities are in fact driving the increasing flow of overseas patients coming to India in the often-discussed phenomena being commonly referred to as medical tourism.

Now, we are witnessing another trend with the next level cities and towns (B&C category locations) displaying a more mature and aware market and shifting to digital imaging solutions.

How do you plan to tap it?

Carestream Health has leaded the market with its innovations and cutting edge technology products in the imaging market almost since the very birth of X-Rays over a hundred years ago. We carry a highly respected name in the medical imaging community and it will be our effort to continue to build on that brand, by,

• Providing innovative and high quality imaging solutions that help healthcare facilities do their jobs better, faster and more cost effectively.
• Providing world class service and support for our entire product range.
• Bringing the latest technology to India almost simultaneously with worldwide launch of products with minimum time lag.

In how many countries is Carestream present?

Carestream Health serves a global customer base in 150 countries.

What is the company's strength?

Carestream is the acknowledged world leader in all categories of film: digital output, radiology, mammography, dental and molecular imaging. With an installation base of more than 60,000 laser imaging systems around the world, and more than 1,000 patents for medical and dental imaging and information technology, Carestream Health can be found in approximately 90 per cent of hospitals and dental practices around the world.

Carestream Health India leverages the strengths of its global parent to offer the same standard of product, technology and service to medical imaging community in India.

How many sales offices do you have in India?

The India Corporate Office of Carestream Health is located at Mumbai. There are three other regional sales offices - at Delhi, Kolkata and Chennai. The sales organisation is buttressed with a network of about 155 channel partners across the country.

How has the company grown over the years in India in the radiology segment?

Carestream Health, Inc., the leading provider of medical imaging systems and healthcare IT solutions, was formed in 2007 when Onex Corporation purchased Eastman Kodak Company's Health Group. Simultaneously, the Indian company Carestream Health India Private Limited was formed from the erstwhile Health Imaging Group of Kodak India. Since then, the company has grown substantially. In coming years we are geared up for aggressive growth in India and worldwide.

What are your expansion plans? What strategies you plan to adopt for expansion?

Carestream Health in India will focus on growing the market through a multi-pronged approach. On the one hand we will continue to introduce innovative new products and bring the latest technology to India as fast as possible. We will provide scalable solutions that enable growth and connectivity and thus the expandability built into our products itself will lead to growth. Carestream Health will also be flexible in communicating with customers to understand their needs and develop solutions that meet those needs. The emerging markets from second-third tier towns will provide the drivers for further market expansion.

As a leader in the medical Imaging industry, Carestream Health believes in growing together with the customers. We proactively contribute to the growth of medical imaging market by developing and introducing innovative and state-of-the-art products improving the quality of patient care. As a knowledge sharing initiative Carestream Health carries out several training and development initiatives for radiology professionals in the country, including orientation programmes, student workshops, patient awareness campaigns such as for breast cancer awareness etc.

healthcare@expressindia.com

Interview

'Agfa Offers Everything You Need for High-quality Imaging & Streamlined, Cost-effective Workflow Management'

Agfa HealthCare, a member of the Agfa-Gevaert Group, is a leading provider of IT-enabled clinical workflow and diagnostic image management solutions, and state-of-the-art systems for capturing and processing images in hospitals and healthcare facilities. Suresh Ranganathan, Managing Director, Agfa Healthcare spoke to Express Healthcare. Excerpts:

Suresh Ranganathan Managing Director, Agfa Healthcare

In which segments of radiology does your company focus on?

Agfa HealthCare today offers its customers an extensive portfolio of solutions:

1)Within Imaging Business Division - Computed Radiography Systems, Digital Radiography Systems, the Drystar range of Hardcopy Print solutions, hardcopy film for all diagnostic modalities as well as analog X ray film. Agfa Healthcare India is a leading player in this segment.

2)within Information Technology Business Division - Hospital Information Systems (HIS), Clinical Information Systems (CIS), Radiology Information Systems (RIS), Laboratory Information Systems (LIS), Cardiology Information and Image Management Systems (CVIS), solutions for reporting, enterprise scheduling, decision support, and data storage. In India, this business division has focused on Picture Archiving and Communications Systems (PACS).

What is the uniqueness of the technology used for these products?

Key benefits of Agfa CR solutions are:

1)From image acquisition, patient identification and digitising to image quality control and processing, Agfa offers everything you need for high quality imaging and streamlined, cost-effective workflow management.

2)Our digitisers suit customer throughput, are scalable for centralised and decentralised workflow, can grow and adapt to the changing medical imaging environment, and offer the best price/performance ratio. Based on the latest Agfa technology platform, we offer improved cassette throughput, provide a high-level and homogeneous image quality, and support a wide range of applications.

3)Combining features like reliability, durability, comfort and minimum weight, our cassettes and image plates are easy to handle and comfortable for the patient. The cassettes provide excellent diagnostic results and are long-lasting and shockproof.

This is the reason why Agfa HealthCare's Computed Radiography and Hardcopy Print solutions have a wide installed base among the entire spectrum of radiology set-ups in India - from the large teaching Government institutions & prestigious Corporate hospitals on the one hand to the private diagnostic centres spread all across India on the other.

Key benefits of Agfa Impax are:

1) Matches unique users' needs for maximum user acceptance and reduced transition time - IMPAX Enterprise uses highly innovative persona-based user interfaces. Each unique 'persona' represents the exact needs of an individual using IMPAX Enterprise: Hospital Administrator, Clinician, IT Manager, Radiologist, PACS Administrator, and Technician. The system recognizes the persona during log-on and displays the appropriate product features, navigation, and information for that individual's unique workflow. Users can further customise their screen layout based upon their own preferences

2) Integrates complex workflow for improved patient care - IMPAX Enterprise includes fully integrated RIS/PACS/Reporting technology - to simplify information access and reduce unnecessary manual steps. Whether in the office, in the ward or offsite, authorised users can see patient images, past studies, key RIS information, and procedure reports - all from a single desktop. And, for clinical users, speech recognition and digital dictation tools are just one mouse click away, with exam review a

3) Simplifies technology management for maximum uptime and availability of functionality - IMPAX Enterprise provides the benefits of a web-based client with the functionality of a client-server application. It can be securely deployed, updated and centrally managed via the web. And, allows IT management the ability to provide offsite healthcare professionals full application functionality, like integrated RIS/PACS/Reporting.

4) With an innovative service-oriented architecture that allows new applications to be plugged in with minimal resources or downtime, and IMPAX Connectivity Manager providing the technology to connect with legacy data, the really smart part is that it makes managing complex technology a whole lot easier.

5) IMPAX Enterprise provides facilities with 24x7 global system monitoring and reporting services.

6) Connects clinical areas for a fully integrated healthcare enterprise - IMPAX Enterprise facilitates information sharing across the enterprise. It links clinical and administrative areas, both onsite and offsite, so that the stakeholders participating in the care of a patient can share key information quickly and effectively. With IMPAX MPI (Master Patiient Index) and solutions for Radiology, Women's Care, Orthopaedics, Cardiology and others, IMPAX Enterprise offers clinically specific components that integrate into the overall enterprise solution - balancing the needs of individual clinical and administrative workflows with the benefits of a fully integrated healthcare enterprise.

Any technology that you pioneered in radiology?

The next-generation in CR for general radiography departments, the DX-G digitiser unites superb image quality with the convenience of supporting both standard phosphor plates and needle-based detectors. The exclusive DirectriX detector technology offers the potential for a significant patient dose reduction. With a user-friendly drop-and-go buffer, workflow is smoother and more productive. The DX-G can be used as a centralised or decentralised digitiser in the radiography department, supporting a broad range of applications. In a centralized environment, it can serve multiple rooms. At the same time, its small footprint means it can be placed in any available space.

For intelligent digital X-ray image processing, Agfa HealthCare's MUSICA (Multi-Scale Image Contrast Amplification) offers even better image visualisation and greater autonomy and robustness than its predecessor, the market's gold standard, the original MUSICA image processing software.

The Multi-scale Image Contrast Amplification algorithm, MUSICA, composes the digital image in a number of different frequency ranges (or detail sizes) and modulates the signal amplitudes (or contrast) within each of these ranges. This results in an exceptional perceptibility, enhancing details. Making use of one-dimension: the frequency, MUSICA is still today's market golden standard and is included in NX, Agfa's operator workstation for digital imaging.

MUSICA, however, takes image processing even further with two-dimensional image processing, for both frequency and density (or grey levels). This delivers even more detailed image quality.

All Drystar imagers feature A#Sharp technology to provide high throughput and long-life, controlled, consistent diagnostic image quality. Agfa has enhanced its Direct Digital Imaging print technology with a new algorithm that will improve the reading comfort of the diagnostic hardcopy images adding to the productivity and ensures easy printer maintenance and repair

The basic idea behind Direct Digital Imaging is a solid-state - and hence highly reliable - 14'' print head that writes line-by-line onto heat-sensitive DRYSTAR film in a single-step process. Images of the same quality level are printed without the use of a complex laser and optical system. The only moving parts in the printer are the film and film drum itself. The straightforward design greatly increases reliability. The unique direct digital printing process guarantees high consistency of exposure.

Agfa's DRYSTAR imagers incorporate a built-in on-line macro-densitometer, controlling crosstalk via an intelligent thermal model that takes environment, image contents, thermal head condition and other factors all fully into account. The result is that every pixel in the image is completely software-controlled. This makes the thermal process more flexible than alternative laser engine technologies.

Direct Digital Imaging technology with A#Sharp Enhancement offers a number of advantages in addition to the enhanced image quality offered by A#Sharp technology. DDI technology is a single step process, with no separation of exposure and heat processing. Its simple mechanism makes it compact and highly reliable. Daylight insensitivity facilitates maintenance and reduces running costs, while solid-state imaging ensures long life and controlled, consistent image quality. Lastly, DDI with A#Sharp offers an excellent price/performance ratio.

What is the USP of your company?

From image acquisition, patient identification and digitising to image quality control and processing, Agfa offers everything you need for high quality imaging and streamlined, cost-effective workflow management.

What market opportunities and trends do you witness in Indian radiology market? How do you plan to tap it?

India is one of the fastest growing markets in the world for radiography systems (both CR as well as DR). Given that the diagnostic imaging segment is expanding both in width as well as depth in India, the growth opportunities for hardcopy print solutions will also be immense. As with the developed world, the Indian radiology market will also adopt IT solutions to improve workflow, productivity and quality. Agfa has an enviable track record in addressing such customer requirements and we look forward to participating in the growth story.

In how many countries are you present and what is the company's strength in India?

Agfa is present in 40 countries and has agents in another 100 countries around the globe.

How many sales offices do you have in India?

In India, we have four regional offices (HO being Mumbai), and represented in the entire country through our associates.

How has the company grown over the years in India and worldwide in the radiology segment?

In India, the company has had steep growth in business and enjoys good brand equity in the radiology segment.

What are your expansion plans? What strategies you plan to adopt for expansion?

While the details of our plans and strategies cannot be revealed, it is quite clear that we will endeavour to bring the latest technologies and advancements in the area of Imaging as well as IT solutions for radiology progressively to the Indian market.

healthcare@expressindia.com