2015 European Cardiovascular Image Management Technology Leadership Award

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1 2015 European Cardiovascular Image Management Technology Leadership Award 2015

2 Contents Background and Company Performance... 3 Industry Challenges... 3 Technology Leverage and Business Impact... 4 Conclusion... 6 Significance of Technology Leadership... 7 Understanding Technology Leadership... 7 Key Benchmarking Criteria... 8 Best Practice Award Analysis for Pie Medical Imaging B.V Decision Support Scorecard... 8 Technology Leverage... 9 Business Impact... 9 Decision Support Matrix The Intersection between 360-Degree Research and Best Practices Awards Research Methodology Best Practices Recognition: 10 Steps to Researching, Identifying, and Recognizing Best Practices About Frost & Sullivan Frost & Sullivan 2 We Accelerate Growth

3 Background and Company Performance Industry Challenges A variety of cardiac diagnostic and imaging tests are used to detect heart disease conditions and thereby help treat patients with cardiac and cardiovascular (CV) diseases. Some of the most popular and frequently used imaging procedures are cardiac ultrasound, cath-lab X-ray, intravascular ultrasound (IUS), optical computed tomography (OCT), to name a few and the less frequently used systems include single-photon emission computed tomography (SPECT) and positron emission tomography (PET). The dynamic character of the heart increases the size of the image data. At times, a combination of imaging tools is recommended to accurately diagnose the condition and this in turn generates a huge volume of data in the form of images. The adoption of information technology (IT) in radiology has helped the practice to become paperless and enhance timely imaging and diagnosis. Frost & Sullivan points out that cardiovascular image management solution have been adopted slowly into clinical practice primarily due to reimbursement issues. Frost & Sullivan also points out that the other challenge that contributes to slow adoption is that cardiology customers are quite demanding, yet resistant to changes in their workflow. A significant amount of cardiology picture archiving and communication system (C-PACS) technology is being used in catheterisation and echocardiography labs in the United States. C-PACS can only integrate images from different stand-alone single-modality and these solutions do not aid clinicians with any quantitative diagnosis. Realising the significance of quantitative diagnosis, companies are focussing on introducing quantitative analysis in cardiovascular imaging and diagnosis to acquire more accurate and fine numeric data than is possible from the results of qualitative observation. With the use of quantitative analysis, prediction of cardiovascular risk and detection of subtle changes in CV systems have become more reliable. Based on technical advancements, quantitative clinical analysis on a research basis was initially implemented in cardiovascular CT and MRI for the evaluation of cardiovascular structures. The positive results from the research studies encouraged industry participants to further take up the platform for commercialization. The quantitative analyses from imaging modalities where cardiovascular information systems (CVIS) have been incorporated have aided clinicians in accurate diagnosis, thus improving treatment outcome. Analysis software also plays an important role in interventional cardiology to prepare and assist during interventional treatment. E.g. analysis of CCT to select patient that will benefit from TAVR (trans aortic valve replacement) and indicate optimal visualization angles for X-ray during the intervention, 3D reconstructions of coronary arteries will assist during interventional treatment of chronic total occlusions (CTO). Frost & Sullivan 3 We Accelerate Growth

4 Technology Leverage and Business Impact Criterion 1: Commitment to Innovation Among the existing imaging modalities, CMR plays an increasingly important role especially in the assessment of patients with heart failure (HF). For example, the assessment of myocardial perfusion status in HF can be challenging due to left ventricular (LV) remodelling and wall thinning, coexistent scar, and respiratory artefacts. All of this makes the timely detection of the condition difficult. State-of-the-art imaging modalities (along with software algorithms) are required to diagnose the disease accurately and at an early stage, so that the best treatment options are available for the patient. The incidence of cardiac HF in the United States and Europe has increased steadily in recent years, and cardiovascular diseases are posing serious health problems. Netherlands-based Pie Medical Imaging (PMI) develops and markets software for the diagnosis and treatment of cardiovascular diseases from the quantitative analysis of cardiovascular images. Frost & Sullivan appreciates the fact that the company s mission is to improve the quality of cardiovascular diagnostics and interventions by providing innovative and easy-to-use software solutions that offer accurate and reproducible results. Criterion 2: Commitment to Creativity CAAS, Pie Medical s cardiovascular quantitative solution, offers precise and reproducible measurement results, and the outputs are simple to read and use. Pie Medical s analysis software is used in more than 50% of all catheterisation labs globally, either with the company s brand name or integrated into the X-ray products of its OEM partners. The CAAS software also supports medical professionals in diagnostic processes and during patient intervention and treatments. Additionally, it can also be used in research studies on the efficacy of novel intervention methods. Criterion 3: Technology Incubation Coronary angiography is routinely used for the diagnosis and treatment of patients who have or are at risk of developing coronary artery disease. In clinical practice, visual estimation is the most common way of evaluating coronary angiograms. Visual estimation, however, has several limitations, such as intra- and inter-observer variability. Even experienced operators can only provide generalized estimation of vessel dimensions. QCA, a quantitative coronary analysis tool, is accurate and reproducible, can refine the visual estimate, and is capable of providing several important measurements of the coronary anatomy. To develop the platform further, Pie Medical employs more than 60 full time research and development (R&D) employees dedicated to developing and optimizing the advanced visualization and analysis software. It also offers unique products such as regurgitation analysis based on X-ray images, plaque content determination and analysis software for Magnetic Resonance Angiography (MRA), pre-op mitral valve analysis Frost & Sullivan 4 We Accelerate Growth

5 software based on CT imaging, 3D QCA for X-ray imaging, and 4D flow analyses for MR cardiovascular studies. Criterion 4: Commercialization Success In clinical practice, cardiologists have to make decisions about the type of intervention required and the most appropriate devices, sizes, etc. to be used for treatment. Due to the limitations of visual estimation, quantitative measurements are required. Clinicians usually prefer easy-to-use solutions that improve their patient treatment possibilities. For complex interventional treatment procedures, clinical workflow needs to be optimised and, at the same time, procedure reliability issues need to be addressed. End-user feedback indicates that Pie Medical s products are preferred by interventional cardiologists and the company is presently focusing on expanding its product portfolio to cover more diagnostic application areas as well as to assist cardiologists during more interventional treatments in cardiovascular diseases. Pie Medical has granted patents and patent applications on image processing technology used in its software products. It also has close co-operation with research institutions in Europe, the United States, Japan, and Australia. This partnership includes evaluation studies and co-development of a product/solution. The company also works with core labs such as CRF New York and Cardialysis in Rotterdam to study the efficacy of new treatment methods. Criterion 5: Application Diversity Pie Medical s CAAS Workstation is designed as a stand-alone modular software product for the viewing and quantification of X-ray angiographic images on a desktop running on a Windows operating system. Semi-automatic contour detection forms the basis of the quantitative analysis. The quantitative results of the CAAS Workstation aid in the diagnosis and intervention of cardiovascular conditions. Analysis can be carried out and then exported in various formats across different consoles independent of the type of vendor acquisition equipment. The CAAS Workstation offers segmentation of different cardiovascular structures, 3D reconstruction of vessel segments based on multiple sliced images, as well as measurement and reporting tools. The platform aids in calculating the dimensions of cardiovascular structures, in quantifying stenosis in coronary and peripheral vessels, in the motion quantification of left and right ventricular walls, and in stent visualization and dimension measurement. Criterion 6: Growth Potential Pie Medical Imaging is the market leader in cardiovascular analysis software for cardiology and radiology and is well known for its Cardiovascular Angiographic Analysis System Frost & Sullivan 5 We Accelerate Growth

6 (CAAS) as well as its 3mensio products. The CAAS and 3mensio brands offer a broad product range for the analysis of X-ray, CT, MRI, IVUS, and OCT images. The high success rate of the platform won the company an award for the Best High Tech Company of The Netherlands in the De Succes Award The high adoption rate of its previous CAAS modules has encouraged the company to further develop its modules. The Asian Pacific Interventional Cardiology Educational trust centre selected Pie Medical Imaging as the software provider for its core laboratory. The centre will use the CAAS Workstation and CAAS IntraVascular software for angiograms and the IVUS/OCT software for research. Furthermore, Pie Medical has presented its solution in numerous trade fairs across the globe and received positive peer reviews. Conclusion Pie Medical Imaging designs and delivers quantitative solution software for cardiovascular analysis that can facilitate next-generation research and diagnostics. The company s mission is to improve the quality of cardiovascular diagnostics and interventions by providing innovative and easy-to-use software solutions with accurate and reproducible results. The products offer highly accurate and reproducible measurement results. Due to its strong overall performance, Pie Medical Imaging has earned the 2015 Frost & Sullivan Technology Leadership Award. Frost & Sullivan 6 We Accelerate Growth

7 Significance of Technology Leadership Technology-rich companies with strong commercialization strategies benefit from the increased demand for high-quality, technologically innovative products. Those products help shape the brand, leading to a strong differentiated market position. Understanding Technology Leadership Technology Leadership recognizes companies that lead the development and successful introduction of high-tech solutions to customers most pressing needs, altering the industry or business landscape in the process. These companies shape the future of technology and its uses. Ultimately, success is measured by the degree to which a technology is leveraged, and the impact that technology has on growing the business. Frost & Sullivan 7 We Accelerate Growth

8 Key Benchmarking Criteria For the Technology Leadership Award, Frost & Sullivan analysts independently evaluated two key factors Technology Leverage and Business Impact according to the criteria identified below. Technology Leverage Criterion 1: Commitment to Innovation Criterion 2: Commitment to Creativity Criterion 3: Technology Incubation Criterion 4: Commercialization Success Criterion 5: Application Diversity Business Impact Criterion 1: Financial Performance Criterion 2: Customer Acquisition Criterion 3: Operational Efficiency Criterion 4: Growth Potential Criterion 5: Human Capital Best Practice Award Analysis for Pie Medical Imaging Decision Support Scorecard To support its evaluation of best practices across multiple business performance categories, Frost & Sullivan employs a customized Decision Support Scorecard. This tool allows our research and consulting teams to objectively analyze performance, according to the key benchmarking criteria listed in the previous section, and to assign ratings on that basis. The tool follows a 10-point scale that allows for nuances in performance evaluation; ratings guidelines are illustrated below. RATINGS GUIDELINES The Decision Support Scorecard is organized by Technology Leverage and Business Impact (i.e., the overarching categories for all 10 benchmarking criteria; the definitions for each criteria are provided beneath the scorecard). The research team confirms the veracity of this weighted scorecard through sensitivity analysis, which confirms that small changes to Frost & Sullivan 8 We Accelerate Growth

9 the ratings for a specific criterion do not lead to a significant change in the overall relative rankings of the companies. The results of this analysis are shown below. To remain unbiased and to protect the interests of all organizations reviewed, we have chosen to refer to the other key players as Competitor 2 and Competitor 3. DECISION SUPPORT SCORECARD FOR TECHNOLOGY LEADERSHIP AWARD Measurement of 1 10 (1 = poor; 10 = excellent) Technology Leadership Technology Leverage Business Impact Average Rating Pie Medical Imaging, B.V Competitor Competitor Technology Leverage Criterion 1: Commitment to Innovation Requirement: Conscious, ongoing development of an organization culture that supports the pursuit of groundbreaking ideas through the leverage of technology Criterion 2: Commitment to Creativity Requirement: Employees rewarded for pushing the limits of form and function, by integrating the latest technologies to enhance products Criterion 3: Technology Incubation Requirement: A structured process with adequate investment to incubate new technologies developed internally or through strategic partnerships Criterion 4: Commercialization Success Requirement: A proven track record of successfully commercializing new technologies, by enabling new products and/or through licensing strategies Criterion 5: Application Diversity Requirement: The development of technologies that serve multiple products, multiple applications, and multiple user environments Business Impact Criterion 1: Financial Performance Requirement: Strong overall financial performance in terms of revenues, revenue growth, operating margin and other key financial metrics Criterion 2: Customer Acquisition Frost & Sullivan 9 We Accelerate Growth

10 Requirement: Overall technology strength enables acquisition of new customers, even as it enhances retention of current customers Criterion 3: Operational Efficiency Requirement: Staff is able to perform assigned tasks productively, quickly, and to a high quality standard Criterion 4: Growth Potential Requirements: Technology focus strengthens brand, reinforces customer loyalty and enhances growth potential Criterion 5: Human Capital Requirement: Company culture is characterized by a strong commitment to customer impact through technology leverage, which in turn enhances employee morale and retention Decision Support Matrix Once all companies have been evaluated according to the Decision Support Scorecard, analysts can then position the candidates on the matrix shown below, enabling them to visualize which companies are truly breakthrough and which ones are not yet operating at best-in-class levels. DECISION SUPPORT MATRIX FOR TECHNOLOGY LEADERSHIP AWARD High Pie Medical Competitor 2 Business Impact Competitor 3 Low Low Technology Leverage High Frost & Sullivan 10 We Accelerate Growth

11 The Intersection between 360-Degree Research and Best Practices Awards Research Methodology Frost & Sullivan s 360-degree research methodology represents the analytical rigor of our research process. It offers a 360-degree-view of industry challenges, trends, and issues by integrating all 7 of Frost & Sullivan's research methodologies. Too often, companies make important growth decisions based on a narrow understanding of their environment, leading to errors of both omission and commission. Successful growth strategies are founded on a thorough understanding of market, technical, economic, financial, customer, best practices, and demographic analyses. The integration of these research disciplines into the 360-degree research methodology provides an evaluation platform for benchmarking industry players and for identifying those performing at bestin-class levels. 360-DEGREE RESEARCH: SEEING ORDER IN THE CHAOS Competitive Benchmarking Availability of Capital Demographics Buying Behavior Growth Strategies Economic Trends Industry Expansion Industry Evolution New Vertical Markets GeoPolitical Stability Growth Implementation Technology Obsolescence Emerging Technologies CEO Sustainability Disruptive Technologies New Business Cultures Smart Cities Career Development New Applications Segmentation Industry Convergence Country Risk Branding and Positioning Crowd Sourcing Competitive Strategy Needs and Perceptions Capital Investments Emerging Competition Frost & Sullivan 11 We Accelerate Growth

12 Best Practices Recognition: 10 Steps to Researching, Identifying, and Recognizing Best Practices Frost & Sullivan Awards follow a 10-step process to evaluate Award candidates and assess their fit with select best practice criteria. The reputation and integrity of the Awards are based on close adherence to this process. STEP OBJECTIVE KEY ACTIVITIES OUTPUT 1 Monitor, target, and screen Identify Award recipient candidates from around the globe Conduct in-depth industry research Identify emerging sectors Scan multiple geographies Pipeline of candidates who potentially meet all bestpractice criteria 2 Perform 360-degree research Perform comprehensive, 360-degree research on all candidates in the pipeline Interview thought leaders and industry practitioners Assess candidates fit with best-practice criteria Rank all candidates Matrix positioning all candidates performance relative to one another 3 Invite thought leadership in best practices Perform in-depth examination of all candidates Confirm best-practice criteria Examine eligibility of all candidates Identify any information gaps Detailed profiles of all ranked candidates 4 Initiate research director review Conduct an unbiased evaluation of all candidate profiles Brainstorm ranking options Invite multiple perspectives on candidates performance Update candidate profiles Final prioritization of all eligible candidates and companion best-practice positioning paper 5 Assemble panel of industry experts Present findings to an expert panel of industry thought leaders Share findings Strengthen cases for candidate eligibility Prioritize candidates Refined list of prioritized Award candidates 6 Conduct global industry review Build consensus on Award candidates eligibility Hold global team meeting to review all candidates Pressure-test fit with criteria Confirm inclusion of all eligible candidates Final list of eligible Award candidates, representing success stories worldwide 7 Perform quality check Develop official Award consideration materials Perform final performance benchmarking activities Write nominations Perform quality review High-quality, accurate, and creative presentation of nominees successes 8 Reconnect with panel of industry experts Finalize the selection of the best-practice Award recipient Review analysis with panel Build consensus Select winner Decision on which company performs best against all best-practice criteria 9 Communicate recognition Inform Award recipient of Award recognition Present Award to the CEO Inspire the organization for continued success Celebrate the recipient s performance Announcement of Award and plan for how recipient can use the Award to enhance the brand 10 Take strategic action Upon licensing, company may share Award news with stakeholders and customers Coordinate media outreach Design a marketing plan Assess Award s role in future strategic planning Widespread awareness of recipient s Award status among investors, media personnel, and employees Frost & Sullivan 12 We Accelerate Growth

13 About Frost & Sullivan Frost & Sullivan, the Growth Partnership Company, enables clients to accelerate growth and achieve best in class positions in growth, innovation and leadership. The company's Growth Partnership Service provides the CEO and the CEO's Growth Team with disciplined research and best practice models to drive the generation, evaluation and implementation of powerful growth strategies. Frost & Sullivan leverages almost 50 years of experience in partnering with Global 1000 companies, emerging businesses and the investment community from 31 offices on six continents. To join our Growth Partnership, please visit Frost & Sullivan 13 We Accelerate Growth

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