Kathleen M. Dallessio

Philips Medical Systems (Best, The Netherlands), a division of Royal Philips Electronics, has undergone several significant changes in recent years. In December 2000, the company acquired ADAC Laboratories. This was followed by acquisitions of Agilent's Healthcare Solutions Group in August 2001 and Marconi Medical Systems in October 2001. In October 2002, Jouko Karvinen was appointed as president and CEO.

A native of Finland, Mr. Karvinen came to Philips from the ABB Group Ltd. (Zurich, Switzerland), where he headed the Automation Technology Products Division. He holds a Master of Science degree in Electronics and Industrial Economics from Tampere University of Technology in Finland.

With the integration of the acquired companies now complete, Philips Medical Systems' business units include general and cardiac X-ray, ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), nuclear medicine, positron emission tomography (PET), radiation oncology systems, image and information management, customer support, healthcare consulting and financial/leasing services, and cardiac and monitoring systems. The company employs more than 22,000 people worldwide with representation in over 100 countries and annual sales of approximately EUR 6.5 billion ($5.8 billion).

Mr. Karvinen recently sat down with Applied Radiology to talk about the changes at Philips and the future of radiology technology in general.

Applied Radiology: What is the biggest news from Philips this year?

Jouko Karvinen: The first news is that we are Philips Medical Systems now; we are not a company trying to integrate five companies. If you looked at our booth at RSNA 2002, if you talk to our people, if you look at platforms like Vequion, if you look at other new products based on a combination of technologies, that is the proof of what we have had. We have had a year of integration, now we are getting out of it. We are fully, absolutely 150% focused on serving our customers and learning with them. That is what I think you could see at RSNA 2002. We are no longer a combination of Philips, Agilent, Marconi, and so on. We are Philips Medical Systems, and this is how we go forward. Then you can start address all of the various modalities, such as the new Vequion, which is unique, I think, in that it is hardware independent. I think it will build a scalable platform for the customers.

I have spent quite a bit of my time in front of the customers--more than I ever thought I would--and I will keep doing that, not only at RSNA but overall.

AR: What have you found that customers want most?

Karvinen: I'll use a quote from the dean of the nursing school at Michigan State University as an example. They are looking for "supplier partners who first listen, and then say that they are the best anyway." They want partners who are willing to share their future plans, willing to interact in the development process, and, clearly, do not say, "I have a solution for you," before they ask what the problem is.

For example, look at information technology specifically. Many suppliers promise, "I have the solution." Yes they might, but if you want to work with your customer today, next year, and 5 years out, you'd better listen first. I think Vequion addresses that very specifically with its open platform, hardware-independent scalability, and interoperability, not only within the Philips modalities, but with competitors' products as well. That is what customers tell us that they want from us: to be a partner, to be there on all levels from CEO to the field support, on the day we get the order, the day we ship, and for many years after that.

AR: What do you think are the most important factors currently driving the radiology technology market?

Karvinen: There is an endless race going on. Who has how many slice CT? We had the first FDA approval, but I'm sure there are many people who claim to be number one. With MRI, with the Teslas we have, we also believe that we are very unique. That's the way it's going to keep going. But as an industry, we need to talk less about how much money we invest and much more about how much we get out of it so that we can advance the technology that we have. You can go through the list for almost any modality: PET/CT combination, live 3D ultrasound, and 16-slice CT, with more to come.

I think the real trend is going to be that the race will keep going and we are all going to have to concentrate a little more on the applications. Less and less is it just about this or that modality in radiology; it's about the family of applications. It's not just the technology. If you go to the extreme, we say, "Our technology on its own is useless; technology depends on how you use it." That is the spirit we are trying to build on. That is what we need to steer more and more toward: what we do with the technology.

I have one benefit as an industry outsider; I don't get as excited over the number of slices on CT as do the people who have been here 30 years. I always ask, "So what? Where do we need to go with CT to have a dramatic impact on the early diagnosis of lung cancer, where the death rate is still 80%? What do we need to do in partnership with whom to make a real breakthrough in molecular imaging that everyone is talking about?"

That is the other trend that I think is going have a great impact: molecular imaging. We at Philips may talk less than others about it, but we are doing more than many others in that area today, not just 5 years from now. No longer is it going to be so much about coming up with a new modality or a little more speed, it's going to be a lot more of a true partnership. It's not an automatic thing. It has to begin very early in the game. Listen much more than you do. Then you have to start trusting outside people. The same is true, I think, with software, partnering with the number one source.

AR: So when you begin looking for new technologies to develop, you are looking more at the application than at the technology itself?

Karvinen: That is always the number one question: So what? What is it going to do to the customer community, the workflow efficiency, or information management efficiency, safety, or security? Or if you take the clinical applications, for example, cardiology or any other area, what does it do? That is the question I always ask our customers. Where do we need to go to take CT or MRI? What will it take to make the breakthrough in cardiac imaging? I think that is a very healthy question for any of the players in this field.

AR: Which new technologies do you think will have the greatest influence on the day-to-day life of the clinical radiologist?

Karvinen: Let me turn your question a bit. When you talk to radiologists at a typical modern American hospital, you find that an enormous amount of their time is spent trying to locate information; up to 20%. So that is a problem in the reality of life: we can't stop the customers, they have to take care of patients every day, and there is an existing infrastructure that they cannot throw away. But there is not going to be a single solution just because we have a technology. It's going to be different in different hospitals. If you go to a government-run hospital in Rome, their challenges are very different from here in the U.S. That is a big one; I see a big improvement opportunity.

But there it is back to my earlier statement: don't start with technology, start with what it can do.

In molecular imaging diagnostics, for example, we cannot change the world on our own. We and our imaging customers can't change the world. But it's us, our customers, and some very key partners that we already have in some applications. That's a different game.

AR: What do you think will be highlighted at RSNA 2005?

Karvinen: It will be very much a "customer-in" tone, where at our booth or anybody's booth, you will see the X-rays, the ultrasounds, etc. In 2005, the focus will be on applications, such as "Cardiology: this is what our company can do for you," including one or two modalities. It's going to try to say to the cardiology interventionalist "these are the tools you need to help the patient." That would be the overall approach.

I'm not going to tell you how many slices we are going to have on our CT or what Tesla our MRI will have. We announced at RSNA 2002, however, plans to develop a 7.0-T whole-body MRI system with the University of Nottingham in the U.K. What I hear from our customers is "Help us to change the future." I think this 7-T work with the researchers from the University of Nottingham is a sign of that.

Everybody keeps saying that they are the best, but I say "Don't tell me. Show me what you have been doing in real clinical applications today." Because I think the topic of "molecular imaging diagnostics" tends to be like something far away--and in some ways it is--but there are things we can do today to help patients. That is the message I would like to bring to my own organization and to the customers. The future starts today. AR