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Philips Azurion with FlexArm: Delivering the Healthcare Quadruple Aim imperative

18 Jun 2019
At the 7th Philips Interventional Symposium held in Singapore on 4 May 2019, interventional cardiologists, vascular surgeons, nurses and allied health professionals from the ASEAN Pacific region were invited to the launch of Azurion with FlexArm, a new standard for patient imaging and positioning flexibility for image-guided procedures. Mr Bert Van Meurs, Executive Vice President and Chief Business Leader (Image Guided Therapy), and Dr Atul Gupta, Chief Medical Officer (Image Guided Therapy), shared details on how Philips’ endeavour to innovate healthcare solutions has led to the conception of the Azurion with FlexArm.

Recent trends in image-guided therapy
Given the well-established clinical benefits of minimally invasive procedures, the demand for these procedures, such as that in the coronary and vascular fields, have increased steadily in recent times.1 Additionally, the range and complexity of diseases that can be treated with minimally invasive procedures also continue to expand2 These complex procedures usually require a huge multi-disciplinary team of physicians to be at the patient's tableside, working together in a highly coordinated manner. Philips recognises the need for more meaningful clinical and technological innovations in image-guided therapy to meet the rising patient volumes, whilst ensuring cost-efficient care delivery.

Centred on healthcare’s quadruple aim – to enhance patient experience, improve health outcomes, lower cost of care, and improve the work life of healthcare providers – Philips is a leading innovator in image-guided therapy,4 and its portfolio of integrated solutions for image-guided therapy are fast expanding across multiple clinical domains. Since its launch in February 2017, the Philips interventional platform has been used to treat over half a million patients across 80 countries worldwide.5 On how Philips strives to develop impactful healthcare innovations, Mr Bert Van Meurs, Executive President and Chief Business Leader of Philips Image Guided Therapy shared, “We believe that the process of developing meaningful technical and clinical innovations is an iterative one that should involve feedback from the clinical experts who will be using these solutions. We have therefore adopted a co-creation strategy and work closely with experts in various clinical fields in developing our integrated healthcare solutions.”

Mr Bert Van Meurs, Executive Vice President and Chief Business Leader of Philips Image Guided Therapy.
Mr Bert Van Meurs, Executive Vice President and Chief Business Leader of Philips Image Guided Therapy.


Azurion with FlexArm sets a new standard for patient positioning flexibility and imaging
Labs in Asia are generally smaller than those in the West. As a result, the multi-disciplinary team often find themselves working on extremely challenging procedures in a highly constrained environment. With a compact design, the FlexArm’s patient oriented movement not only frees up space around the table so that staff are able to work in the most ergonomic position, it also improves patient positioning flexibility, enhances patient quality of care and ensures consistency of surgical procedures.6 Empowered by a unique smart kinematic engine, the Azurion with FlexArm moves on 8 different axes that can be rotated and moved longitudinally and laterally, allowing patient access from three sides of the table without pivoting or panning the table. This further eliminates the need for frequent table movements and reduces the risk of dislodging wires and tubes from the patient or disrupting the equipment and instrument setup.

Aside from increasing patient positioning flexibility, the fast 2D and 3D image acquisition of the FlexArm in just under 6 seconds, drastically reduces the occurrence of  motion artefacts and greatly enhances visualisation of critical anatomy for complex procedures.6,7 By providing off-centre imaging along both sides of the table, the FlexArm allows physicians to perform radial access cases on both the left or right arm in full or partial extension, without moving the patient table.7 “The flexibility in patient positioning and imaging accorded by the FlexArm overcomes typical ‘no-fly’ zones around the treatment area, helping to improve workflow consistency and contributing to enhanced patient outcomes,” said Dr Atul Gupta, Chief Medical Officer, Philips Image Guided Therapy.

The Azurion 7 C20 with FlexArm.
The Azurion 7 C20 with FlexArm.


High system usability of the Azurion with FlexArm leads to improved workflow efficiency
“In line with the co-creation strategy adopted by Philips, the Axsys motion control system and the Axsys joystick controller were developed with deep insights and experiences shared by clinical experts who utilise these interventional suites,” explained Dr Gupta. Consequently, a survey conducted amongst clinical users showed that viewed the system as highly intuitive, easy to use and easy to learn, giving them more independent control during interventions and surgical procedures.6  The Axsys controller was designed to deliver predictable and precise system movements that minimise disturbances and increase clinical staff concentration.7 With greater side table control, the intuitive motion control system enables procedures to flow naturally and reduce the need for physicians and other members of the clinical team to move out of the sterile field during a procedure, hence, improving workflow efficiency. The Azurion with FlexArm system scored 92 on the System Usability Scale, higher than the industry average score of 68.6

The Image Beam Rotation feature of the FlexArm system is another innovation that was developed to help physicians and clinical team members maintain their focus on the procedure and patient. With this feature, the X-ray tube continually aligns and rotates so that the image beam remains centred over the region of interest as the C-arm is angulated and rotated, abolishing the need to constantly re-adjust the position of the image.6,7

A user study to evaluate the FlexArm’s 270-degree range of movement showed that the system has led to a 27% average reduction in time spent positioning the system during procedures.6 This decrease in time spent positioning the system is attributed to its flexibility and high usability which overcame excess patient movements during procedures in the past.6 In addition, 88% of physicians agreed that the FlexArm system would help them save time, while 76% of physicians acknowledged that by using this system they could make more efficient use of their time spent in the catheterisation laboratory.6

Mr Van Meurs further shared that the high usability of the FlexArm system also allows rooms to be rapidly reconfigured for a variety of procedures, making it ideal for use in hybrid operating rooms that cater to a variety of procedures. As a ceiling-mounted system, the Azurion with FlexArm is compact and takes up less room, therefore, reducing floor space requirements and contributing to more efficient use of space.

Dr Gupta and Mr Van Meurs shared that innovating minimally invasive procedures is an ongoing commitment. In another example, Philips recently announced a collaboration with Microsoft to combine the HoloLens 2 holographic computing platform with the Azurion platform to develop augmented-reality applications that will take image-guided minimally invasive procedures to the next level, creating a new concept for the operating theatre of the future.4

Conclusions
The Azurion with FlexArm combines clinical and operational benefits to improve patient care, potentially reduce healthcare costs, and enhance user experience. This is the latest innovation in Philips’ unique portfolio of systems, smart devices, software and services in image-guided therapy, which work in synergy to equip healthcare providers with sophisticated, procedure-oriented solutions.
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Most Read Articles
09 Jul 2019
Patients who had undergone aortic valve replacement (AVR) have shorter life expectancy than the general population, a study has found. Apart from being substantial, this loss in life expectancy increases with younger age.
6 days ago
The consumption of red and processed meats does not seem to affect the likelihood of symptom relapse among Crohn’s disease (CD) patients in relapse, reports a recent study.
Pearl Toh, 6 days ago
Restarting antiplatelet therapy in survivors of intracranial haemorrhage (ICH)-related stroke is safe without raising their risk of a recurrent ICH, contrary to the commonly perceived risk of a recurrence with an antithrombotic drug, the RESTART* trial has shown.
Elaine Soliven, 4 days ago

Disease-free survival (DFS) at 3 years was comparable between patients with locally advanced gastric cancer who underwent laparoscopic distal gastrectomy and open distal gastrectomy, pointing to the noninferiority of the laparoscopic procedure to the open one, according to the CLASS-01* study.