In an exclusive interview, Frans van Houten, CEO of Royal Philips, spoke to HCB News about a wide range of topics pertaining to RSNA and the future of medical imaging.

From the evolving role of radiologists to a comparison between software innovation and hardware innovation, to the political situation in the U.S. and its global implications for value-based care. Here, lightly modified for cohesiveness and clarity, is our conversation:

HCB News: For Philips, in what ways was this year's RSNA different from previous years?

Frans van Houten: For us, RSNA this year was very much focused on clinical informatics that bring the health continuum together.

We introduced solutions for more integrated care pathways supported by clinical analytics, and showed how artificial intelligence applications can make radiologists much more productive. For example, to do longitudinal cancer tumor assessment over multiple modalities — whether PET, CT, X-ray, MR or ultrasound, from any vendor — we can go through the longitudinal records of a patient and automatically quantify how the tumor is evolving.

It was an RSNA where we showed that data can be made actionable. In the past, RSNA has been about image acquisition through scanners. We still do that but besides great acquisition devices, we’ve demonstrated we can also generate data specific to a patient and make the doctor more productive, and free-up time to be more patient-centric.

The reaction from radiologists can vary. Some fear that machines will take over their tasks while others can see that these innovations are helping to determine the best way to treat the patient. Obviously we believe the latter — and that this will be the norm in the future.

HCB News: What do you tell those radiologists who are worried about becoming obsolete?

FVH: I think that fear is wrong. Clinical informatics can take over routine tasks and quantification, and free up time so radiologists can be more productive and see more patients. The picture we paint is one where there will be an emerging role for a chief clinical data scientist.

Who is bringing together the data from these various fields? You need custodianship and stewardship over all that data and then to interpret it, in order to come to a definitive diagnosis.

What is statistically the treatment pathway that has the best possible outcome? I think that is where doctors will spend more time in the future, rather then in the dark room manually measuring how many millimeters the tumor has evolved.

HCB News: How did this emphasis on software innovation come around?

FVH: Health care is a fairly siloed world and Philips has had the notion of patient-centric care for a long time. If you want to connect doctors and patients in a different way — more focused on an ongoing constant relationship rather than an acute and episodic relationship where maybe it comes too late and at a great cost — then you need to leverage software and the cloud.

Jeroen Tas (CEO of Connected Care & Health Informatics at Philips) and myself both have informatics backgrounds and come out of the financial service industry, and we joke: Why do people trust financial health to the cloud but not their physical health? The world of health care has not fully embraced digital technology – in pockets, yes, but broadly no, not yet.

I know many people have spent a ton of money on EHRs but let's not forget that those were primarily focused on claims rather than patient-centric care delivery. So we felt that as Philips is positioned very much in the care pathway — we have the smart systems, we touch patients, we support doctors, that’s what I call in the last yard of the care pathway — we can make our data much more actionable through clinical decision support systems.

We don’t want to replace the doctor. We want to make the doctor more effective and we want to give patients the tools to also manage their own health, so software was an obvious direction for us. We’re quite proud to say 60 percent of our R&D people are in software, and we’ve made a big stride over the last few years reinventing ourselves as a digital company.

HCB News: In what ways is innovating software a different venture than innovating hardware?

FVH: Indeed, the product development process is different. We use Scaled Agile for software development, it’s a methodology where groups of people work together in so-called "sprints" and there’s always a customer rep in those sprints to make sure we develop the right functionality and applications.

In hardware development, systems development, the whole path for a new product is much longer than in software. In software you can have a minimal viable product then an augmented product, and you can release new versions incrementally over a period of months, for example, whereas in systems development the cycle for breakthrough technology could easily be four years and it comes with a huge systems integration effort.

The IQon Spectral CT, for example, had a long development cycle.

For application software you can start with something simple and then build it out. We have standardized all our software development.

HCB News: How do capital equipment imaging systems such as MR and CT scanners fit into the push for software innovation?

FVH: That continues. We talked about the 40/60 – a large portion of the $1.7 billion we invest into R&D goes into hardware and systems development.



For example, take the innovations we've made with spectral CT — the dual imaging acquisition is the great advance of our IQon product — where you can reconstruct that image in software after the fact and in any way you like. In other words, you can do post-processing and identify much better cancer diagnostics from the raw images acquired by the IQon.

To what extent are those diagnostics obtained by the system and to what extent is that done in post-processing in an image on your PACS? That becomes fluid so, in a way, you could say that we are liberating the image acquisition device from the necessity to process that image. That’s quite a breakthrough and I think we are making great strides with that.

HCB News: Is there any sense of how the new U.S. presidential administration could impact the trends we're seeing in health care technology?

FVH: I find it difficult to interpret but I will say that value based care — whatever name we give it — is going to be the future. Patients want precision health and first-time-right outcomes, so outcomes will be measured and some form of bundled payments will also happen. That combination means hospitals will drive outcomes and productivity.

We can put any label on it but I’ve seen it all over the world: value based care and higher productivity are the two drivers that are happening.

HCB News: With RSNA in the books, what is the next health care event Philips is gearing up for?

FVH: We will have a big showing at Arab Health in January and we're also looking forward to HIMSS in February.

HCB News: What can we expect from Philips at HIMSS?

FVH: For one thing, we are planning to open up HealthSuite — our cloud-based health care platform which we now use for all our internal products from sleep and respiratory care to acute care — to third-party developers to get other companies creating applications for diagnosis or treatment, or home care programs for our platform.