Recenly, Siemens Medical Engineering Group acquired the ultrasound sytems manufacturer Acuson Corporation. Following this merger, John Pavlidis, President of Siemens Ultrasound Division, was appointed Chief Executive Officer of Acuson, a Siemens Company. He recenly spoke with Applied Radiology about the future of this new company and ultrasound technology.
Recently, Siemens Medical Engineering Group (Erlangen, Germany)
acquired the ultrasound systems manufacturer Acuson Corporation of
Mountain View, CA. This merger, valued at approximately $700
million, comes on the heels of Siemens' acquisition of the
information technology (IT) company, Shared Medical Systems.
Through these transactions, Siemens Medical Engineering Group hopes
to position itself as an IT-driven, high-tech company and further
its transformation to an e-company.
Following this merger, John Pavlidis, President of Siemens
Ultrasound Division, was appointed Chief Executive Officer of
Acuson, a Siemens Company. He recently spoke with Applied Radiology
about the future of this new company and ultrasound technology.
What are the short- and long-terms plans for integrating Acuson and
There are many aspects to integrating the companies. We have
identified areas ranging from sales and marketing through service,
logistics, legal issues, procurement, etc., and we have teams
working on all those aspects. We started as soon as we got the "go
ahead" to merge in early November and we expect the planning phase
to last until about the end of March. The implementation phase will
begin sometime at the end of March and, in some cases, will clearly
take up to 24 months or more, because, as you can imagine, there
are some things that will take longer than others.
Do you expect the companies to be fully integrated under one
The company clearly is one company focused on ultrasound; however,
there is unquestionable value to the Acuson brand. So, we will
definitely keep the Acuson brand prominent not only in the product
name--it will still remain Acuson Sequoia, Acuson Aspen, etc.--but
for the foreseeable future we will also keep the company name, so
it will be Acuson, a Siemens Company.
Will the sales forces be merged as well?
Yes. The sales forces will be one, and the unified sales force will
be able to sell both Acuson and SONOLINE products.
Will there continue to be new developments under the Acuson brand
Absolutely. There will continue to be new development on both the
SONOLINE brand, which is the Siemens' ultrasound brand, and the
Acuson brand. Clearly, one of the areas we are looking at is "cross
pollination" of technology and product features.
How do you envision the two product lines dovetailing?
Each brand has its own particular strengths in the marketplace. The
Acuson brand, for example, is very well known in cardiology, where
the SONOLINE brand has really not had much of a presence at all.
When it comes to, for example, general imaging, if you look at the
Sequoia as the 'super premium' brand in gastrointestinal imaging
with cardiology capabilities as well, that would be the 'super
premium' level. Then you have the Elegra at the 'premium' level and
the Aspen at 'high end.' So at every point, with the two brands
combined, we can cover all the price points and customer needs.
How will the merger with Shared Medical Systems influence your
It's not so much ultrasound related, but that merger is very
important because it focuses on the IT component of health care. In
many ways, it is the connecting glue to hospital information
systems. Shared Medical Systems offers several additional services,
including--very importantly because we see it as a growing
trend--application service provider (ASP) capabilities. Shared
Medical is the world's largest ASP provider in health care. There
is no question that, over time, with increasing focus on disease
management, a key driver for implementing such programs will be the
right IT, having access to patient outcome studies, and
understanding the work flow; for example, a patient with X disease
has this kind of exam first, this kind of exam second, etc. You
can't develop and implement best practice guidelines without the
right IT structure. Shared Medical plays more of a strategic IT
role within all of medical as opposed to ultrasound directly.
: Acuson is also involved in Picture Archiving and Communications
Systems (PACS) as well, are they not?
Absolutely. Actually, since the merger, Acuson's KinetDx Networking
Solution has become the Acuson and Siemens ultrasound networking
What role does Acuson's WebPro play in the field of ultrasound?
WebPro is part of the e-ultrasound focus and the connectivity
solution of KinetDx. It is an important element of connectivity;
not so much at the highest possible speed setting, but from a
teleradiology perspective. If a physician at a remote location
needs to look at images over a regular phone line, they are
accessible on a regular PC. It also adds flexibility because many
customers are migrating toward "centers of excellence," where
basically the images go to the expert physicians wherever they may
happen to be while the acquisition is done at a range of
facilities. So the "super expertise" lies in one location and the
images come to them rather than the patients.
What is the future focus for Acuson and Siemens?
In the past, Siemens' ultrasound has been more successful outside
the United States, with almost 70% of our revenue coming from
outside the U.S. The reverse was true for Acuson, with about 70%
coming from within the U.S. So, it was clear that each company by
itself was not able to leverage research and development methods on
a global basis because we had pockets of strength and pockets of
weakness. So, in terms of the logic of the merger, it is clear that
one of the key drivers that we are looking forward to is making
sure that our research and development investments have a global
appeal. The Acuson part of the equation certainly helps the U.S.
presence and Siemens' part of the equation helps Acuson's previous
We definitely see ultrasound being more and more focused on
workflow issues: making sure the exam can be faster; producing more
results per unit of time; and allowing the exams to be more
consistent. One of the points that is sometimes mentioned as a
negative of ultrasound is that it is user-dependent and has
variability depending on the skill of the user. Technology such as
tissue equalization, pioneered by Acuson, is shaping the way toward
more consistency, easier training for sonographers, and ease of
use. That is the kind of technology clearly that we will explore
planning to incorporate into the SONOLINE platform.
Another example that appears to be very exciting from a research
and development perspective is strain imaging; that is, measuring
the elasticity of tissue with ultrasound. It is being tested for a
number of applications: breast cancer, prostate disease, thyroid,
and peripheral vascular disease. It has been talked about for a
long time, but the ability to really show such exciting results was
not there until we showed some examples at the RSNA.
Contrast agents are another area. Although they are not FDA
cleared in the United States, we see tremendous potential for their
use; for example, detection and characterization of liver disease,
and treatment monitoring such as radiofrequency ablation. That
whole area of contrast imaging, we see as a potential area of
significant growth in ultrasound.
In general, in talking with our customers, they say that because
of the continued and rapid improvement in ultrasound they have seen
their procedure volumes increase significantly, and that is one of
the key drivers for growth in ultrasound. Taking another step back,
that is one of the key reasons that Siemens invested in Acuson,
because ultrasound is a growth area. It's the same with IT in
healthcare; it really makes no sense not to invest in growth
What other general trends are you seeing in ultrasound?
Another general trend is the one toward connectivity. Ultrasound is
a dynamic modality and, as such, it is best expressed not by still
images, but by moving images. Up until recently, it has not been
easy or straightforward to handle dynamic clips in ultrasound, so
most people accepted dealing with static images. The whole KinetDx
platform makes dealing with dynamic clips easy and
straightforward--transporting them quickly over long distances over
a network. What we are finding are more and more customers who used
to rely very heavily on sonographer training and making sure that
they had very, very specific protocols to capture a specific view,
who now basically can request a sweep of a certain organ and have
the whole clip sent over so they don't have to depend on snapshots
and pre-selection. The physician can really look at the complete
study without being concerned that something was missed. That is a
tremendous productivity driver and it increases diagnostic
Another trend is toward miniaturization. Like other things
around us, such as cell phones and computers, everything is
becoming smaller and more powerful. That trend will certainly also
continue. Mobility and portability are becoming key drivers in
ultrasound. The technology is now available to make highly
portable, highly mobile systems that also have high quality. That
also means that customers expect more and more for the same price
and also expect much more compact and powerful packages. AR