Imatron: Speed Saves
Executive Summary
Imatron's electron beam tomography, or EBT, offers clinicians a valuable tool to detect the early presence of heart disease, by looking for calcium deposits that are a surrogate for plaque build-up, and to help them begin treatment or lifestyle changes before heart attacks occur. But adoption or acceptance of EBT has been slow in coming, the result of physician skepticism, consumer ignorance, and most importantly, insurer resistance. Some physicians are skeptical because EBT measures neither restenosis no so-called vulnerable plaque. Things are looking up for Imatron, however. Sales of EBT systems are increasing rapidly due to greater acceptance in the medical community and the launch of the company's own sales force.
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The Unstable State of Plaque Detection
Recent research points to unstable, rather than stenotic plaque, as a major cause of heart attacks. Cardiologists, as much as entrepreneurs and large companies, are therefore driving the creation of new cardiac detection platforms based on characterizing arterial plaque in order to identify patients that are unaware that they are at risk of suffering a myocardial infarction. First-generation detection tools are well along in development, but the scientific understanding about plaque is evolving so rapidly, technologies may be obsolete by the time they are ready for commercialization. Finally, looking for heart attack risk in symptomless patients means screening apparently healthy patients based on risk factors. Clinicians aren't yet prepared for the treatment implications and payers aren't ready for the economic burden of widespread screening, and this presents one of the greatest challenges for companies introducing new plaque detection technologies.
The Coming of Age of Vulnerable Plaque
Traditional scientific wisdom holds that heart attacks originate from severe blockages of the artery created by atherosclerosis, the progressive build up of plaque in the coronary arteries. Recent research indicates, however, that certain kinds of "vulnerable plaque" may trigger acute coronary events, creating demand for new diagnostic tools to identify and characterize the plaque and new treatments. The field is moving at a dizzying pace and is beginning to attract a handful of start-ups and venture capitalists; these see a huge opportunity, but also recognize the challenges inherent in changing entrenched approaches to treatment.
Applying the GE Mantra to Medical Systems
To keep pace with market changes and the slow growth in many of its core businesses, GE Medical Systems (GEMS) has been expanding its role as a maker of diagnostic modalities and monitoring equipment to include clinical systems and productivity solutions for its customers. In keeping with GE's overall business philosophy, emphasizing information technology, GEMS is using the Internet to improve productivity for itself and its customers. By establishing itself as the best-in-class provider of products and services, GEMS expects to take market share from its competitors. But as GEMS moves into new hospital departments and up the hospital hierarchy to the CIO and CEO, it must not lose touch with what got it where it is--selling radiology, and more recently, cardiology, systems. The extent that GEMS can effectively grow its business using that model is unclear. Such systems and services may be limited to being an adjunct to the core business of selling imaging equipment, not the cornerstone for growth of a billion-dollar, information-propelled business.