Philips password 34 by Martijn

Issue 34 â&#x20AC;&#x201C; February 2009 Philips Research technology magazine

Password Support tools may give doctors a helping hand

The information age Redesigning hospitals helps put patients at ease

A more scenic scan Thinking outside the bulb OLEDs are set to revolutionize lighting design

A more scenic scan Research shows that hospital design can influence how patients feel during procedures. A new ‘ambient’ approach is helping patients – and doctors – feel better.

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Password February 2009

Contents Thinking outside the bulb

OLEDs use a revolutionary new lighting technology that does away with the traditional bulb. You may never look at lights the same way again.

The information age

Doctors have never before had access to so much information to help them diagnose and treat patients. But with the time pressures they face, how can they make the best use of it?

A breath of fresh air

Recent studies have raised health concerns about unregulated ultrafine particles in air pollution. But a new monitoring technology is a step towards clearing the air.

14 Did you know...

Interesting facts and figures at your fingertips.

20 Point and control

Imagine controlling all your living room technology – from the television to the lights – with a slight wave of your hand. The new Philips uWand lets you do exactly that.

28 Did you know... Interesting facts and figures at your fingertips.

30 A collaborative approach If you have an idea, Eliav Haskal, Director of Strategic Partnerships for the Technology program at Philips Research, is a good man to know.

Giving ideas life

Even the most revolutionary of products and technologies begin in the same simple way – with an idea. But for it to grow, it needs a nurturing environment, something Philips knows all about.

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by Brandy Vaughan Images: Philips

A more scenic scan You hear the sound of waves crashing and a breeze blowing. You’re looking at a white sandy beach complete with a swaying palm tree… hard to believe that you’re actually in a medical imaging room. A new approach to hospital visits is helping patients – and doctors – feel better.

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Expert opinions

“I would envision that the patient would feel just as I felt when I walked into the room the first time: my mouth opened and all I could say was ‘wow’.” Gary Marshall, Radiology Outpatient Coordinator, Laughlin Memorial Hospital, USA

Going to the hospital is not normally something people look forward to. But it doesn’t always have to be a negative experience. Research shows that the way a hospital is designed can influence how patients feel during procedures. And if the environment is more relaxing and pleasant, patients will be more at ease and feel better about the overall experience.

Combining design expertise with technology, Philips has found a way to achieve this by turning the exam room into an Ambient Experience suite. The concept uses customized design solutions and calming visuals set to music to make scan rooms as relaxing and low stress as possible – for patients and staff.

This rings true for those undergoing medical imaging scans, such as computed tomography (CT) or magnetic resonance imaging (MRI). For patients, the scan experience is often

Being in an unfamiliar situation without any control over what’s happening, patients tend to be anxious and uncomfortable. So to give them a sense of control and confidence, a key aspect of the Ambient Experience suite is allowing them to set the scene – literally – even before they step foot in the exam room. Using a wireless touch pad, patients select one of the various scenes – such as a beach, mountain scenery or cartoons. Related images then cover the walls and ceiling of the exam room. They can also choose the music that accompanies the scene to complete the ambient atmosphere of the room.

Confidence and control

The calming themes put people at ease and provide a much needed distraction during the exams. And by selecting the theme and the music themselves, patients have a greater sense of involvement in the situation, which can then help them relax. The more relaxed and comfortable they are in the scanner means less time staff have to spend soothing, or even sedating, them. And relaxed patients tend move less and breathe slower – both of which can help doctors get a better image.

stressful and intimidating. For doctors, getting a good image can be an exercise in patience. So as the number of imaging scans steadily rises – doctors in the USA ordered a record 68.7 million CT scans in 2007 – the search is on for ways to improve the experience for everyone involved. 6

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“The more pleasant sensory information you can send your brain, the more it blocks out frightening sensations that come from the situation you’re in,” explains Kenneth Gorfinkle, Assistant Clinical Professor of Medical Psychology at Columbia University in New York, and part of the Ambient Healthcare project team. “Ambient Experience is all about putting control in the patient’s hands and making them an active participant.”

“Both for our younger patients and older ones, who might be claustrophobic or anxious, we went with Ambient Experience.” Bernie Schmidt, CEO, Soldiers’ Memorial Hospital, Canada

More than pretty pictures But there’s much more to it than just pretty pictures and music. The entire concept is based on a customized set of design solutions that add to the feeling of calm. It begins with a site-specific evaluation and consultation with design and architecture specialists. Next, the team organizes and de-clutters the room using innovative storage solutions and by separating the ‘control room’ from the treatment room, giving both the patient and the doctor privacy. The result: a tailored solution that improves workflow, organization and efficiency while providing a more relaxed and comfor ting environment for patients. “Atmosphere plays a big role in the overall experience a patient has,” explains Janet Ensign, head of the Ambient Experience marketing team in North America for Philips Healthcare. “So when we do a design consultation, we look at the how the patients feel in the current space, workflow issues, staff efficiency and the way the room and

The birth of Ambient Experience… Ambient Experience grew out of the Philips’ Ambient Intelligence initiative, which began in the 1980s at the Philips Research HomeLab – now known as ExperienceLab. The forward-looking Ambient Intelligence concept is based on the idea that electronics can be miniaturized to such an extent that they can be easily integrated into our everyday lives including in homes, furniture and clothing. Ambient Intelligent products include the popular Ambilight television, which to date has sold more than a million sets.

“The CT staff really enjoys taking patients into the CT suite – seeing the reaction on the patients’ faces and hearing the comments afterwards.” Paul Mezacapa, Chief Operating Officer, Desert Medical Imaging, USA

equipment are set up. All of these aspects are important. Then we bring together architects, psychologists, sound specialists and designers with one aim in mind: to create a better experience for the patients.”

From HomeLab to healthcare The project grew out of Ambient Experience research done at the Philips Research HomeLab, where the initial focus was on consumer applications in the home. But the potential value of using Ambient Experience in healthcare settings – to help reduce patient anxiety and discomfor t – soon became apparent. Philips went straight to Gorfinkle, an exper t in medical psychology, and asked him to collaborate on the new project. He didn’t hesitate. “Hospitals and diagnostic procedures are scary for adults and children,” says Gorfinkle. “I joined the Philips team to help find ways to make the overall patient experience not only safer and more tolerable but also more pleasant.”

Rave reviews Since the first Ambient Experience suite opened in 2005, its popularity has steadily risen and can now be found in more than 50 hospitals worldwide. And it’s getting rave reviews. “Patients who have had Ambient Experience in our survey said that they felt very relaxed and very comfortable,” says Paul Mezacapa, Chief Operating Officer at Desert Medical Imaging, Palm Springs, USA. Maida Jerej, head of MRI technology at Soldiers’ Memorial Hospital in Ontario, Canada agrees: “When they can pick a scene and walk into it, whether it is a beach scene or cartoons for kids, it makes patients feel like they’re going to be okay and that they can make it through.” But not everyone was convinced right away. Mark Swanson, chief radiologist at Soldiers’ Memorial Hospital, Password February 2009

“Ambient Experience fits right in with our aim to make the hospital much more patient-focused.” David Lafleche, Director of Diagnostic Imaging, Soldiers’ Memorial Hospital, Canada

admits before seeing it in action, he wasn’t sure the Ambient Experience suite was a worthy investment. “In the beginning I asked: ‘Why would we want to spend money on something that’s just decoration?’ But as I soon discovered, it is much more than that,” he notes. “A lot of the people we examine, especially the elderly, are either sick or anxious. But we know now that if they are made to feel better, we can get better images.”

Feeling the crunch It’s not just the patients that benefit. Since using Ambient Experience helps relax patients, it could lead to improved efficiency and allow for more scans in less time – always good news for time-crunched hospital staff and doctors. It also makes for a more enjoyable working environment. “I hear from everybody who works in the Ambient Experience room – both nurses and doctors – that it’s just a pleasure to be able to work in there,” notes Jacques Koolen, Head of Cardiology at Catharina Hospital in the Netherlands. “We have three other rooms but everyone wants to work in the Ambient Experience room if possible.”

Not just for scans The Ambient Experience isn’t just for scan rooms – patients anywhere in the hospital could benefit from a more relaxed visit. The design concept can be applied to any clinical space, including waiting rooms and emergency rooms. In fact, the team is currently creating a large-scale ambient environment in a pediatric emergency area as well as exploring new solutions for neo-natal wards, intensive care areas and oncology treatment rooms. Catheterization (cath) labs are also a popular choice for Ambient Experience. “Entering the cath lab for a heart procedure can be very scary for patients, so allowing them to create an 8

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“In our first 8 weeks [with an Ambient Experience MRI suite], we experienced a 10% growth in referrals. Patients are going back to their referring physicians saying how positive their MRI exam was. There is no better marketing than that.” John Feller, Desert Medical Imaging, USA

environment, such as a beach setting, can help put them at ease,” says Victor Hall, Vice President of cardiac services at Fairview Hospital in Cleveland, USA. “The lighting actually makes our lab appear bigger, which helps to calm patients and alleviate feelings of claustrophobia. The Ambient lab has also created a more comfortable and soothing environment for our doctors and nurses to perform procedures.”

Cartoons for kids

“It’s bad enough to be sick – you shouldn’t have to be scared, too,” says Cindy Law, mother to three-year-old Jack. Suffering from an immune deficiency that requires repeated CT scans, Jack’s fear of hospitals had grown to the point of being unbearable. But that changed when the two arrived at Advocate Lutheran General Hospital in Illinois, USA – home to the world’s first Ambient Experience CT suite, opened in 2005. Much like with adult patients, Ambient Experience used in pediatric settings has allowed hospitals to create soothing environments that can help children relax during exams. But in the case of pediatric patients, the suite fills with cartoon animations that give them something else to focus on while making the atmosphere

Here kitty, kitty

A smoother scan

The Ambient Experience begins as

Just a year after installing Ambient Experience

Ambient Experience has been

soon as the patient arrives in the

in its pediatric CT suite, Advocate Lutheran

particularly helpful during imaging

waiting room at Advocate Lutheran

General Hospital reported a reduced

procedures like CT scans when nervous

Children’s Hospital as children have the

sedation rate of 16% in children under the age

children have a hard time staying still long

opportunity to play with the ‘Kitten Scan’

of 18 and 28% in children under the age of four.

enough for doctors to get a good image.

– a miniature CT scanner used as an

And now the entire scan process is smoother.

In these situations, the main goal of using

educational resource for children. When

“Our Ambient Experience CT suite has really

Ambient Experience is to potentially

children select a toy and put it through

helped us eliminate the most time-consuming

reduce the need for sedation and

the Kitten Scan, an animation appears on

part of our day: getting a child to lie still and

repeat exams.

the screen showing them how doctors

breathe on cue,” explains Chris Semler, a

look inside the toy at the various parts.

radiology nurse at Advocate Lutheran.

less clinical and more comfortable.

“About one-third of children require

By playing with the scanner and seeing

sedation because they are unable to relax

how it works, children are often less

In fact, Semler says her team has realized

enough for a successful diagnostic exam,”

anxious about their own exam.

tremendous success with their pediatric

explains John Anastos, Chairman of the

lung and cardiac patients. “Sedation isn’t a

Radiology Department at Advocate

And this has multiple benefits. “When

viable option with these kids. So Ambient

Lutheran General Hospital. “That’s

the child is relaxed and comfortable in

Experience has made a world of difference.

pretty significant when you consider

their environment, the need for sedation

We’ve reduced the number of repeat scans

that sedation adds six to eight hours of

or repeat exams is reduced, which helps

and subsequent radiation – and our kids love

recovery time to a procedure that could

keep a young patient’s radiation doses to a

coming in for their exams almost as much as

be completed in 15 minutes.”

minimum,” notes Anastos.

our nurses enjoy facilitating them.”

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by Stuart Cherry Images: Philips. Illustration: Roland Blokhuizen

OLED windows are transparent during the day but can light up the room at night.

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Thinking outside the bulb Ever seen a window that gives natural-looking daylight in the middle of the night? Or a glowing ceiling that evenly lights your workspace without glare or flicker? Well you could soon, thanks to a revolutionary new lighting technology that may also slash your electricity bills and carbon emissions. The organic light emitting diode (OLED) is not just another lighting technology. And it’s not another version of the chipbased LED. It’s something fundamentally different. For a start, OLEDs aren’t bulbs or point sources, but thin, glowing sheets that produce diffuse, constant light of almost any color. You’re unlikely to ever see OLED bulbs in the shops. Rather, OLEDs are all-in-one lighting systems or luminaires – complete with built-in reflectors and diffusers for directed yet gentle light. This makes OLEDs ideal for applications that evenly illuminate a wide area – something current lighting options don’t easily cover. By contrast, their chipbased cousins, LEDs, are perfect for spotlight effects and as replacements for traditional bulbs.

Unique effects Although the technology is still in development and very few products are currently available, lighting designers are already excited about the never-before-seen applications that OLEDs enable. Renowned German lighting designer Ingo Maurer, one of the first to use OLEDs in the industrial arena, is fascinated by how different they are from traditional light sources. “OLEDs have a completely different look. They don’t require large sockets or external reflectors for directing light,” he says. “They are very light, allowing me to realize some long-

standing visions of mine.” These include a coffee table that appears to float magically in the air, and a suspended light fitting he describes as like “a flock of extraterrestrial beings, hovering and moving in the passing wind.” Jeff Gerwing of the US-based SmithGroup is equally excited: “For lighting designers, OLEDs present amazing new opportunities. In fact, OLEDs could revolutionize how we use light to shape architecture. The sky’s the limit!” For example, being very thin (typically less than two millimeters), OLEDs can be embedded into surfaces like walls, table tops or ceilings. Ambient lighting could then become an integral part of a building’s look and feel – giving it real ‘hidden lighting’ without intrusive fittings.

Look and feel Because of their small size, OLEDs have the potential to be embedded into objects and surfaces of almost any shape. Like most lighting technologies, the light-emitting part needs to be protected from the environment. Incandescent and fluorescent lamps use glass bulbs and tubes. For OLEDs, you need a protective substrate, and currently glass is the best option. But since OLED technology isn’t tied to a certain form, designers have an almost limitless scope to create new scenes and features. Password February 2009

Transparent OLEDs can turn normal windows, which let natural sunlight in during the day, into diffuse indoor lighting sources at night.

Looking ahead, plastic substrates are being developed that could potentially replace glass by providing the same level of protection against moisture and air but with less constraints. When these become available, OLEDs could become curved, moldable and even flexible. Users could reshape light sources to suit their mood – or fold them up and carry them in their pockets. Perhaps most intriguingly, OLEDs could one day be made using completely clear substrates, light-emitting materials and electrodes. These transparent OLEDs would enable glowing mirrors, or even windows that let natural sunlight through during the day and deliver pleasant, diffuse indoor lighting when the sun goes down – the options are almost limitless. “For a lighting designer, this is really exciting,” Gerwing says.

Green lighting It’s not just OLEDs’ design possibilities that excite potential users. The technology could also dramatically cut lighting’s environmental impact. Like their chip-based cousins, OLEDs directly convert electricity into light via ‘electroluminescence’. So both technologies have the potential to be extremely energy efficient. In fact, OLEDs could be as much as ten times more efficient than standard incandescent bulbs and around three times more efficient than today’s energy-saving compact fluorescents (CFLs). As lighting currently consumes about 19% of the world’s electricity, technologies such as LEDs and OLEDs could significantly reduce global energy consumption and fossil fuel usage. That, in turn, would slash carbon dioxide emissions. What’s more, unlike CFLs, OLEDs don’t contain mercury or other environmentally sensitive materials, and can be easily 12

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and safely disposed of at the end of their life. Nor do they suffer other issues sometimes associated with current energysaving lamps: they are instant-on, don’t flicker, can be dimmed and emit a crisp, clear color.

A technology on the rise OLEDs are clearly a globally important technology. Consequently, they are attracting attention from research groups around the world. In line with its goal to reduce CO2 emissions by 20% by 2020, the European Union has partially funded two public-private research projects focused on OLED technology through its Research Framework Programme. The first was the recently concluded OLLA project. The 24-member consortium behind the project was made up of universities, research institutes and companies including Philips. Covering the whole value chain, the project laid the technology foundations for OLED devices and investigated materials, manufacturing techniques, device technologies and application requirements. Efficiency was a key project objective given that previous OLEDs had limitations in this area. A light source’s efficiency is often expressed in terms of its ‘luminous efficacy’ – the amount of light (in lumens) emitted for a given input power (usually in watts). In June 2008, the project announced it had achieved an impressive feat: a white-light prototype with a luminous efficacy of 50.7 lumens per watt (lm/W) and an initial brightness of 1000 candelas per square meter, with a lifetime above 10,000 hours. This is comparable to today’s CFLs but is just the beginning for OLEDs.

A worthy goal On September 1, 2008, the baton passed to the OLED100.eu project, focusing on devices and applications. According to OLED100.eu project manager Stefan Grabowski of Philips Research, the key aims are “twice the efficiency, ten times the operational lifetime and a factor-of-ten increase in panel size to one square meter.” Project members believe these ambitious goals are achievable with current light-emitting materials. Grabowski predicts that optimizing the OLED device structure and the way light is channeled could double the luminous efficacy. In achieving its 100 lm/W goal, the OLED100.eu project will take OLED efficiency past that of fluorescent tubes – currently the most efficient commercial white light source. But the project team has even bigger dreams, as Philips Lighting’s Dietrich Bertram, a member of both the OLLA and OLED100.eu projects, explains. “Energy prices won’t fall, so we’ll keep pushing efficiency as long as it’s commercially

worthwhile. Nobody knows what the limit is, but 150 lm/W should be possible.” With the technology developing rapidly, new performance records are constantly being reported. But since different groups often use different reporting standards, it’s hard to keep track of progress and compare products. In a move to hasten market uptake, the OLED100.eu project is working on exactly this: a set of industry-recognized standards.

Coming soon? So when should we see OLEDs lighting up our homes and workplaces? Bertram believes it won’t be too long. “OLEDs will have an impact on the general lighting market within eight to ten years,” he predicts. “But we should see some of these new, breakthrough applications appearing within three to five years.” As yet, no one dares to say what those first OLED applications will look like. In fact, the OLED100.eu project team is keen to hear ideas and suggestions from potential users. But one thing is certain: it won’t be a boring old bulb.

Making OLEDs glow

Cut through an OLED and it looks like a tiny

of the photon, and hence the color of

multi-layer sandwich. There is a thin cathode,

the light emitted, varies for different

typically aluminum, on the bottom and an

semiconductors.

OLED

Light emission

anode made from a transparent oxide, such as indium tin oxide, on the top. The filling

As the process directly converts

consists of layers of organic semiconductors.

electricity into light, electroluminescence

Glass substrate

is inherently more efficient than Just like chip-based LEDs, OLEDs produce

incandescent bulbs where a wire is

light through electroluminescence.

heated until it glows, leaving as much

When a voltage is applied across the

as 90% of the energy consumed to be

Hole injection layer

electrodes, electrons are injected into the

diffused as heat. Careful device design

Organic emitters

semiconductor layer near the cathode and

can increase efficiency even further,

removed at the anode – leaving behind

either by improving the ‘electron-hole’

positively charged ‘holes’. The electrons and

process or by ensuring more of the light

the holes travel through the semiconductor

produced leaves the device in the optimal

layer until they meet and re-combine,

direction. This latter process is known as

emitting a photon of light. The energy

‘light outcoupling’.

Anode

Electron transport layer Metal cathode

2-10V DC Visit www.research.philips.com/password for more information.

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Did you know... Going nowhere

“Nothing will ever be attempted if all possible objections must first be overcome.”

Samuel Johnson, English critic, essayist and lexicographer

Sanitation shocker

The number of people in the world without access to basic sanitation facilities reached a staggering 2.6 billion in 2006.

Not safe inside

Every year, indoor air pollution kills 1.6 million people – that’s one death every 20 seconds.

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Retrofit reduction When the Empire State Building wanted to reduce its energy consumption, Philips was on hand to make it happen. As part of the award-winning lighting retrofit, more than 30,000 light fixtures were replaced with energy-efficient equivalents – without decreasing light levels.

Info overload “Everybody gets so much information, all day long, that they lose their common sense.” Gertrude Stein, American author

Join the queue In 2006, patients in the United States waited an average of 56 minutes to see a doctor in the emergency room – up from 38 minutes in 1996.

On the rise In the United States, the number of people aged 65 and over with Alzheimer’s disease is estimated to reach 7.7 million in 2030, up from the 5 million currently affected.

% 11

26%

more patients The number of medical visits made in the United States increased 26% between 19962006, significantly higher than the 11% growth in population during the same period. Password February 2009

by Susan Wild Images: Philips

The information age From medical imaging to online databases, doctors have never before had access to so much information to help them diagnose and treat patients. They have also never had so many patients and so little time. So when every minute counts, how can doctors make the best use of it all?

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Whether it’s a life or death diagnosis or a long-term health management program, computer-based decision support tools could lend doctors a helping hand. The concept is not a new one. In the early 1970s, a team of doctors led by Edward Shortliffe at US-based Stanford University developed a computer program called MYCIN. The software helped doctors choose which antibiotic to prescribe based on their replies to a series of yes/no questions. After identifying possible culprit bacteria, the program then ranked the probability of each diagnosis ranging from high to low. MYCIN was one of the earliest attempts to develop a computer-based decision support tool (or “therapy advice system” as Shortliffe described it) for doctors. Since then, commercial tools aimed at specific tasks, such as supporting diagnostic decisions, have emerged but progress has been patchy and slow (see More section). Yet there are plenty of reasons why computer-based decision support could now be more valuable than ever.

A pressing need You don’t need to be a medical specialist to know the healthcare industry is under pressure. One reason is that we’re living longer than ever before. The average lifespan at the beginning of the 20th century was 30-40 years – today it’s over 65. And thanks to medical science, diseases like cancer, diabetes and cardiovascular disorders that were once certain killers are now often chronic conditions that people live with for months or years. But these advances come at a price – literally. Looking after aging populations is sending healthcare costs soaring everywhere. And costs are likely to increase further as the baby boomer generation hits retirement. What’s more, baby boomers typify a new kind of patient: ones with high expectations of the quality of care they receive. Today, many patients are knowledgeable about their illnesses and want to play an active role in their treatment. Doctors equally aspire to patient-centric care that puts the focus on quality of life and well-being. They also want more time to spend with each patient that comes through the door. But because of skyrocketing patient numbers and costs, doctors are often under significant pressure to speed through consultations and make quick diagnoses. And, as Mark Linzer, Professor and Chief of General Internal Medicine at the University of Wisconsin USA points out, it’s

ultimately the patients that suffer. “The bottom line is that quality of care may suffer when doctors don’t have enough time to treat patients.”

The information irony Ironically, the very tools that help doctors make better diagnoses and deliver better treatment are part of the problem. Today’s highly sophisticated imaging devices produce masses of valuable information, but it all takes time to review. On top of this, there is the accelerating growth of ‘evidencebased medicine’, which combines a focus on the patient and their desires with a systematic review of the evidence for a proposed treatment and its benefits. The goal is higher-quality care and better results for patients. But doctors need to continually keep abreast of new developments, therapies and techniques. In a time when research is constantly evolving and new studies come out nearly every day, this can be increasingly difficult. Information overload is a real risk. And the worldwide shortage of skilled medical professionals only serves to exacerbate the problems while putting even more pressure on those in practice. And what of genomic and molecular medicine, which may in future enable diagnoses and therapies tailored to our unique genetic make-ups? According to an American Health Information Community (AHIC) report: “The increased complexity presented through the applications of geneticbased tests, coupled with predictive risk assessments provided by family and health history information, exemplifies the need for services, tools, and technologies to assist in consumerclinician interactions.”

Life-saving decisions So how could computer-based decision support tools help? They could provide doctors with clinical knowledge and patient information in an easily accessible form. They could also identify patients that are due for follow-up or overdue interventions. Moreover, these tools have the potential to increase patient safety by checking against other patient information and clinical knowledge, and then alerting doctors to contraindications or potential problems with different medications. Imagine if a general practitioner could pull up a new patient’s electronic healthcare record (including her full medical history from the town where she used to live). Then suppose the doctor could access the patient’s latest PET scan images, Password February 2009

annotated to help a non-specialist interpret what they see – all done with a decision support tool. It could also highlight potential diagnoses that the doctor may not have considered previously and give advice on the adverse effects of drug combinations. Or imagine doctors racing to treat a stroke victim in an emergency room. Every second counts, and it’s vital to know whether the stroke is caused by a blood clot or a ruptured vessel, since the treatment for one can be life-threatening for the other. A system that helps integrate the data from various sources, as well as from the various staff seeing the patient, could allow doctors to make decisions faster – and in a situation like this it could truly be a life-saver.

Interpreting images This world of universally accessible electronic patient records and seamless integration of all kinds of medical data is still a long way off. Nonetheless, decision support tools are being developed for specific areas. Dementia diagnosis is one of these areas. Dementia currently affects over 25 million people worldwide and, as the global population ages, the numbers could reach epidemic proportions. Identifying which of the many forms of dementia the patient has at an early stage can ensure they receive the most appropriate therapies – improving the benefits of treatment and the patient’s quality of life. NUMBER OF INHABITANTS PER DOCTOR, PER COUNTRY

Source: World Health Organization, The World Health Report 2006.

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Currently, one of the most effective ways of diagnosing dementia in its earlier stages is by performing a positron emission tomography (PET) brain scan. Areas of the brain causing dementia typically exhibit reduced activity, which can be imaged by PET. But the visual features doctors look for to distinguish the various forms of the disease are often extremely subtle – appearing as variations in shades of gray. So diagnosis requires highly trained specialists.

Brighter colors The new decision support software being developed by Philips Research and the University Medical Center Hamburg-Eppendorf in Germany addresses this issue. First, it ‘normalizes’ the patient’s unique brain image. This allows it to then compare the image with a set of disease-specific patterns (for Alzheimer’s, Lewy Body and frontotemporal dementia) and draw the user’s attention to changes that may be significant by highlighting them in a bright color. In a retrospective study, the software achieved a better than 98% correspondence with a specialist’s interpretation when it was programmed to differentiate between brain scans showing no signs of dementia, those showing characteristics of Alzheimer’s disease, and those showing characteristics of Frontotemporal Dementia. “The results of the study have been truly excellent,” says Ralph Buchert, doctor of nuclear medicine at the University Medical Center Hamburg-Eppendorf. “When, as part

Meaningful input Tools like these are still in the research phase, but their potential is clear. First, they could reduce the time specialists need to arrive at decisions or even allow less experienced colleagues to make accurate assessments of image data. At a time when skilled professionals are in short supply, this could be an important benefit. Buchert sees possible advantages for both groups. “Decision support systems might be useful to support the less skilled practitioners. However, in our experience, the system is likely to be useful for skilled practitioners too – speeding up the reading of images and increasing diagnostic confidence in many cases. Of course, this needs to be confirmed in prognostic clinical trials.” of our study, we made the software available to referring physicians who were not skilled in reading PET and MRI images, they were able to analyze images and interpret the results within a few minutes.” In addition to research on decision support for dementia, Philips Research is working on software to assist radiologists in quickly identifying rare and early-stage abnormalities in brain and optic nerve scans using similar cases to aid in their diagnosis. The software combines specialized image-processing technologies to pinpoint and measure even very small features. It then searches online reference material to find information and images from potentially similar cases, which the radiologist could take into account when making the diagnosis.

Also, as Stewart Young, project leader for Philips’ dementia decision support tool, says, “Providing support in interpreting images could enable other doctors working on the same case, such as neurologists or psychiatrists, to make use of the image data. They would have additional, meaningful input for their decision-making.” Ultimately, that may be the most important point. And as decision support tools evolve, their role is about putting more meaningful information into doctors’ hands – in a form they can easily and quickly understand and use. And with this, diagnoses, treatments and the focus on the precious doctor-patient relationship could all stand to benefit.

A supporting role

Although the idea of decision suppor t

Equally obvious: decision support tools

security and the sheer practicalities of

systems for use in medical environments

should improve patient outcomes.

standardizing a widespread industry.

by no means in widespread use. The

This requires high-quality knowledge

Nonetheless, as the age of personalized

reasons are complex, but one issue is

bases that are both evidence-based and

medicine dawns, the need to make progress

simple to identify. The early tools were

‘evidence adaptive’ that continuously

is clear. Elias Zerhouni, Director of the

slow and often required doctors to

update to reflect the latest scientific

US-based National Institutes of Health, says,

answer long lists of questions. But for

advances and clinical practice. Yet creating

“As opposed to the doctor-centric, curative

a tool to be of use to busy doctors –

such databases raises thorny issues

model of the past, the future is going to be

whether in general practice or hospital

such as the standardization of medical

patient-centric and proactive. It must be

environments – it must fit into their

data formats and the development of

based on education and communication.”

existing workflow and actually facilitate

electronic patient records. With these

And that takes information, evidence and

their work.

come issues such as cost, infrastructure,

well-founded decisions.

came about in the 1970s, they are still

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Point and control

Password February 2009

Imagine controlling your living room technology – from the television to the lights – with a slight wave of your hand. Sounds simple, right? That’s exactly the point behind the Philips uWand. A simple gesture with the uWand is all that’s needed to move an on-screen pointer that controls your entire TV and multimedia content in one place. Even with very few buttons, uWand easily performs more sophisticated actions than typical multi-button remote controls. uWand users can also ‘point and control’ lighting in the room to achieve the perfect atmosphere with a simple twist of the wrist.

uWand was developed after research showed that most people were not happy with the current options. “We discovered that many people find remote controls overly complex and also say that they have too many remotes in the house,” says Navin Natoewal, General Manager of the uWand venture. “uWand helps simplify the process and, in that aspect, makes the entertainment experience more enjoyable.” Password February 2009

by Brandy Vaughan Images: Getty Images, Infographic: Roland Blokhuizen

A breath of fresh air It’s everywhere. But just how safe is the air we breathe? There’s no one answer. However, in many areas, air pollution is an invisible yet serious threat to our health that causes some two million premature deaths each year. But it’s not easy to regulate something we cannot even see, especially when it comes to the smallest, and potentially most dangerous, of air particles: the ultra-fines. Fortunately, a new monitoring technology called Aerasense may bring us a step closer to clean air.

Password February 2009

About 99% of particles in the air we breathe are too tiny to see. And whether you’re in your car, at home or at work, chances are the air you’re breathing holds a wealth of invisible parts that may be working against you. The dangers of air pollution are well documented. It’s been linked to respiratory ailments such as asthma, bronchitis, even lung cancer as well as heart disease and increased mortality rates. Until recently, research has primarily looked at the effects of air pollution as a whole. But not all air particles are created equal. Particle size varies as do the effects of different particles. And recent studies suggest that it’s the smallest, currently unregulated ultra-fine particles – or nanoparticles – that wreak the most havoc on our health.

Tiny but toxic Large clusters of ultra-fine particles (UFPs) can be seen with the naked eye but alone they’re less than 0.1 micrometer, about one-thousandth the size of a human hair. And apparently, size does matter, at least with air particles. It seems that it’s mostly their small size that makes them so troublesome. “There is certainly reason to be concerned about ultrafine particles. When looked at separately, they show a substantial, and possibly specific, role for the overall toxicity of particles in the air we breathe,” explains Matthias Amrein, Professor, Cell Biology and Anatomy at the University of Calgary in Canada, who’s currently working on a study, funded by the Canadian Institutes of Health Research, tracking the biophysical interaction between UFPs and the lung. “And ultra-fines cause a greater inflammatory response than do larger particles of the same type,” he adds.

Researchers have a number of theories as to why this could be. UFPs seem to be rich in potentially toxic chemicals, and the smaller the particle, the deeper it can penetrate into the lung cavity and cause serious damage. Because of their small size, UFPs may also bypass some of the body’s natural defense systems and slip into the bloodstream. There are even signs that ultra-fines can squeeze through the blood/ brain barrier, allowing them to enter into the central nervous system and other organs. But inhaled UFPs may not even have to travel far to do widespread damage. “When the lung becomes inflamed, lung tissue releases pro-inflammatory substances into the bloodstream and this is how inflammation spreads throughout the body,” explains Amrein. “This is quite likely the mechanism by which ultra-fine particles increase the risk of a heart attack – a known fact.”

Fueling suspicions Although research on the specific effects of UFPs on health is still in the early stages, there are an increasing number of studies that are backing up the theories and fueling suspicions. One such study done at the University of California Los Angeles, USA discovered that ultra-fine particles may well be the main culprit behind the build-up of plaque in the arteries, which can lead to heart attack and stroke. “It appears that the smallest air pollutant particles, which are the most abundant in an urban environment, are the most toxic,” notes study author Jesus Araujo, Director of Environmental Cardiology at the UCLA’s School of Medicine. A study from the University of Edinburgh in the UK seems to confirm suspicions that ultra-fines are particularly Password February 2009

unhealthy. It found that men who exercised while exposed to normal levels of diesel fumes, which are full of UFPs, experienced a rapid reduction in blood flow to the heart and a significant drop in a protective protein that prevents dangerous clotting.

for ways to improve air ventilation systems in its cars by reducing the amount of UFPs drivers inhale. The idea is that when Aerasense signals a high level of UFPs in outside air, the ventilation system would kick into recirculation mode using less contaminated inside air.

Not so simple

Open the window

So why aren’t ultra-fine particles regulated in the same way as the larger particles that also contribute to air pollution? The simple answer: more evidence is needed.

But one of the most important settings for Aerasense may come as a surprise to many: indoors. Most of us associate air pollution with outdoor environments but, according to the US-based Environmental Protection Agency, the air quality inside buildings is most often two to five times worse than outside. And considering most people spend on average 80% of their time indoors, this is definitely a good place to start.

“New research needs to expose the mechanisms that allow certain particles to enter and penetrate the body whereas others are exhaled or efficiently cleared,” says Amrein. “Current regulations permit exposures to particles which are known to pose a significant health risk, even at levels allowed by those standards. However, researchers must provide the ‘how’ data before the government can act upon it.” But research has been slow, in part, because measuring and monitoring ultra-fine particles is problematic, explains Francis Allard, a research scientist and president of the European heating and air-conditioning association REHVA. “Research suggests that ultra-fine particles may be more dangerous than people realize. But we need better evidence as to how harmful they can be,” he notes. “This has been difficult because the real-time monitoring of ultra-fines is not easy.”

Real time, real quick Since ultra-fine particles are too small to catch in most air filters, measuring them is highly complex – involving costly equipment operated by specialized technicians. That is until now. Philips Research has come up with an easier way to detect and monitor ultra-fine particles in the air around us – and people in the industry are excited. The new technology, called Aerasense, is much smaller and easier-to-use than current monitoring methods. It also measures particle levels accurately and instantly, with realtime results. And since it’s hard to regulate something if you cannot easily measure it, Aerasense is an important step towards learning more about the health effects of UFPs. Although not yet widely available, Aerasense is finding its way into a number of different testing scenarios. Experts say on average around a third of ultra-fine exposure comes from driving. So it’s fitting that one test user is looking

Password February 2009

“If building ventilation is poor, especially in urban areas, outdoor air pollution can make its way inside and become trapped,” explains Willem van den Brink, General Manager, Aerasense. “Add to this all the indoor-based UFPs – coming from building materials, copies and printers, furniture and activities such as cooking and burning candles – and it’s a recipe for dirty air.”

Working worries Air quality can be particularly bad in office buildings, which are often close to major roads or in urban settings. And businesses are beginning to wake up to risks of bad indoor air – which can impact the health, comfort and productivity of those working in the building. These factors, in turn, affect the bottom line as employees lose work hours and have higher medical costs and sick days. “There’s a growing concern about the air quality in offices because it’s where most people spend a good chunk of their time,” notes Henk Goossens, Marketing Manager, Aerasense. “It’s the perfect place for Aerasense monitoring because if high levels of UFPs are discovered, improvements can be made fairly easily through better air ventilation or filtration systems.” Studies regularly show that improvements in indoor air quality up employee productivity levels by 2% to 10%. There’s also strong evidence that it reduces the number of sick days employees take.

Proactive about particles

One test user from a large Dutch bank, based in

Amsterdam, the Netherlands, found out about Aerasense at a conference on indoor air systems. As a building facilities manager, he’d received complaints about the air quality in certain areas of the building. “Before Aerasense, there was no way to test UFP levels easily or quickly. I had to hire in a specialized company and it could take weeks,” he explains. “But using Aerasense, I was able to see if the complaints were valid within minutes, using the portable monitor.” He also wondered just how well his air filtration systems worked. “When based in a big city, as our building is, ultra-fine particles have to be on your agenda. Aerasense showed me that some of our filtration systems weren’t working up to guidelines and important changes were

made. We are now much more proactive about improving our indoor air quality.” Eventually, Aerasense could even be incorporated into ‘intelligent’ ventilation systems, signaling when air quality falls below certain levels. This would help ensure clean air and save energy as the filters would only be activated as needed. Since ultra-fine particles are invisible, it’s hard for us to avoid them. But when it comes to regulating something that cannot be seen, knowing what’s there is at least half the battle. And with Aerasense technology on the horizon, it doesn’t look quite so hazy.

Aerasense: how it works

Ultra-fine particles are drawn into the

The electrical charge that builds up in the

ensuring that air filters are working

sensor via air flow generated by a small

filter is then measured with an advanced,

properly and can easily be connected

fan at the top of the sensor. Then a

high-precision current meter. The higher

to a building management system for

high-voltage ion source generates ions

the current, the more ultra-fine particles

continuous measurement of pollution

that stick to the particles giving them an

are in the air. Aerasense not only records

levels.

electrical charge. The particles, together

concentration but also the average diameter

with the attached ions, are then caught in

of the particles (from 10 to 300 nm).

a small filter. This detection technique has important advantages over existing monitoring Fan

systems. It’s far less sensitive to contamination, is much easier to operate and can monitor air quality for a very long time without maintenance.

Electric charge in the filter is measured

Ultra-fine particles

Polluted Pollu ut air ute

High-voltage ion source

The Aerasense NanoMonitor, a small,

The Aerasense NanoTracer, a small,

wall-mountable device,

portable device, enables real-time

enables a continuous

detection of ultra-fine particles in ambient

real-time detection

air. In fast mode, it registers the particle

of airborne ultra-fine

concentrations in real time. In advanced

particles. It’s easy to

mode, it captures concentrations and

operate and does not require special

average particle sizes in a slightly longer

training. The NanoMonitor is ideal for

sample time.

Password February 2009

by Brandy Vaughan and Monica Esslin Image: Getty Images

Giving ideas life

What do the internet, the television and the x-ray all have in common? Even the most revolutionary of products and technologies begin in the same simple way â&#x20AC;&#x201C; with an idea. But for the seeds of innovation to grow, they need a nurturing environment, something Philips knows all about. 26

Password February 2009

Taking an idea from its infancy to something substantial takes patience, persistence and, most often, experience. And at Philips, ideas are taken seriously. So seriously, in fact, that it has developed a concept called ‘incubation’ to turn good ideas into great technologies.

portfolio is new. “What has changed from the past is that we are branching out from our traditional research model that focused on developing new products within already established Philips segments,” says Harwig. “We now start with an idea and a champion. The idea might be closely linked to an existing portfolio, or it might address a totally new market.”

“Incubation is all about passion,” explains Rick Harwig, Chief Technology Officer at Philips. “It’s about people with an idea and then bringing that idea to fruition within a global business. Through incubation, we link colleagues around the world, customers and financiers, either internal or external.”

The Philips’ Incubator team uses guidance from the Business Development Board – drawn from managers across the company as well as Managing Board members – to sift through the possibilities and identify the best ideas at an early stage. Then a small team is tasked with driving and developing the idea into a viable business. But making the cut is not easy. As Harwig points out, “The first question is always: ‘Can we develop this idea into a business that addresses a market worth between €200 million and €1 billion annually?’”

Incubation started at the High Tech Campus in Eindhoven, the Netherlands back in 2002 with the creation of the Technology Incubator (now known as the Lighting and Clean Technology Incubator). In 2006, incubators for Healthcare and Lifestyle followed. Today, at any given time, there’s an average of 25-30 ventures within the three incubators.

New ways of thinking Incubators also benefit from growing up in an open and innovative environment surrounded by other small ventures trying to find their place in the world. The High Tech Campus Eindhoven is now home to more than 80 companies, most of which are technology related. It’s the ideal location for Philips incubators and other businesses to exchange ideas, expertise and inspire one another.

Spin in, spin out The incubation process can take anywhere from eight to ten years, and most of the ideas come from within the Philips organization. The ultimate goal is to create a new multi-million euro business within Philips, or if the technology has the potential for a wide range of applications across industries, venture capital funding comes into play. Philips partners with venture capitalists, who take a majority stake, and the business grows outside the company. It’s a move that still leaves Philips holding a minority share, but also allows businesses to achieve greater economies of scale while serving a broader customer base.

The international dimension is even more important. “We have an open innovation ‘eco-system’ linking teams in Shanghai, New York, Cambridge, Eindhoven and Amsterdam – just to name a few,” notes Harwig. “We have ideas from Eindhoven put into practice in China, and ideas from China used in our work in the Americas and in Europe. People from 50 nationalities work together in this unique set-up to stimulate ideas, share expertise and come up with new ways of thinking.”

Each incubator project begins in the same way: with a spark (or idea). It sounds obvious, but the concept of an incubator venture growing out of an idea instead of a gap in the existing product

IDEATION

1. Pre-seed

2. Seed

3. Alpha

4. Beta

5. Market Calibration

CAPTURING THE VALUE

Here are the five steps of a successful incubation idea at Philips: IDEATION Ideas are generated and sponsors are gathered. 1. Pre-seed A concept plan is created that outlines the possible applications, value chain and competitive market.

2. Seed The business plan is developed and the product/service specifications and partner strategy are defined. 3. Alpha Creation of the marketing plan based on prototype feedback. Customer care models are decided.

4. Beta Launch plan developed and key partners are on board. 5. Market Calibration The business model is now stable, sales revenues grow and the business is ready for expansion.

CAPTURING THE VALUE Now fully grown, the business moves out of incubation.

This model is based on a systematic approach developed by the Bell Mason Group and tested in about 1,000 venture diagnostics.

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Did you know... Coal killer

The UK suffered its worst ever air pollution event in December 1952 when a thick, cold fog (or smog) formed over London, partially as a result of burning coal for home heating. During the four-day period, at least 4,000 people died as a direct result of the weather.

Simple truth

â&#x20AC;&#x153;The great seal of truth is simplicity.â&#x20AC;? Herman Boerhaave, Dutch botanist and physician

Six liters

The average pair of human lungs can hold about six liters of air but only a small amount of this capacity is used during normal breathing.

Password February 2009

Every breath you take An average human breathes about ten times per minute, 600 times per hour, 14,400 times per day and 5.25 million times per year.

More demand, less supply

The demand for emergency care in the Netherlands is estimated to grow by almost 7% per year, while medical staff and resources in the country only increase by 3.5% annually.

Scanner friendly There’s an estimated 81 CT scanners in the United States for every million people – almost three times the average for the rest of the industrialized world. Only Japan has a higher density of machines, at 93 per million people.

Make no mistakes

“Anyone who has never made a mistake has never tried anything new.” Albert Einstein, theoretical physicist and Nobel Prize winner

Northern lights In Canada, the average household has 26.4 light bulbs.

Password February 2009

by Brandy Vaughan Images: Philips, Getty Images

A collaborative approach If you have an idea, Eliav Haskal is a good man to know. As Director of Strategic Partnerships for the Technology program at Philips Research, he is part of a three-man team that helps get ideas out of the lab and into the world. With technology advancing at unheard-of speeds, Philips Research stays ahead of the competition by using an ‘open innovation’ concept that calls for bringing in outside sources of expertise, distribution or funding – when necessary – to take ideas to the next level. So what’s the secret to matchmaking in the research field? “It’s not only what you know, but who you know,” explains Haskal. And he is a good person to listen to. In 2003, he was part of a polymer LED project team that beat hundreds of candidates to win the European Commission’s prestigious Descartes Prize for collaborative research. Here Haskal talks about what he does and why open innovation is important.

Tell us about your current role. Basically, I’m the liaison between our Technology program, external partners and funding sources that can help us take our projects further – the ultimate goal of our open innovation policy. My two colleagues represent the Lifestyle and Healthcare programs. Each program has a different strategic vision and based on this we distinguish between the projects we keep entirely in-house and those that could really benefit from external partners. 30

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Then I’m involved in identifying, setting up and managing these partnerships in just about every aspect. This means I do a variety of things from helping to develop and drive the open innovation part of our strategy, to meeting with potential partners and working out the conditions. I even help guide the project’s proposal development activities – from the idea phase to execution – and negotiate with funding sources. We currently have around 40 projects running with outside partners, so everyday is a juggling act!

Why is open innovation important? Not so long ago we handled almost every aspect of a research project in-house. Back then there was less pressure for a quick turnaround of ideas and projects, as well as a fear of losing control over our ideas. So we took the time to learn new things and find new ways to fill gaps in our expertise internally. This was possible because the market wasn’t as crowded and the competition wasn’t as fierce. But these days, with technology advancing at such a rapid rate, we have to get our ideas to market quickly to stay ahead of the game. And to do this efficiently, we need to be open to teaming up with partners who can complement our skills and help us achieve our goals.

Eliav Haskal (middle) in discussion with Philips Research colleagues Hans Hofstraat (left, responsible for Healthcare partnerships) and Jean Gelissen (responsible for Lifestyle partnerships).

With funding, it’s the same scenario. There’s only so much funding to go around and to really capitalize on all of our ideas, we also need to look externally for ways to fund research. In the last few years, external funding has gone from a nice-to-have to a need-to-have. Times are changing.

What is a typical day like for you?

What do you like best about your role? I like putting different pieces of the puzzle together and watching a project go from a small idea to a real, tangible technology. Since I’m involved from an early stage, I have some influence in terms of how an idea takes shape. And I feel a sense of pride when I see projects that I’ve been involved with succeed – everything from building management solutions to high-powered devices for x-ray generators to OLED technology. The variety keeps things interesting.

“I like putting different pieces of the puzzle together.”

There is none! I may start off the day by writing a lobbying document to a government research program, in an effort to influence the direction that funding will take over the next few years. I also spend time looking over partner and funding contracts. Often I meet with researchers and project leaders to brainstorm for new ideas, follow up on project progress and help them prepare proposals. I also help them focus on the broader perspective of the research and the potential added value of bringing others on board to get the idea out into a bigger world.

It’s also exciting, after months of hard work, to find that we’ve created a coordinated ensemble of partners that complement each other, allowing us to achieve something great. I also enjoy being involved in the strategic vision of the Technology program – helping to define it and improve it as we go along. From the big-picture strategy to the technical details – it’s never dull. Password February 2009

* because * because some people some people can only dream can only dream of getting of getting a good night’s a good night’s sleep. sleep. Philips Respironics products are designed to give people with debilitating sleep disorders the essential sleep they need to be healthy. By investing time in peoples’ needs, we’ve created a por tfolio of 60,000 innovative understanding people’s Philips Respironics products are designed to give people with debilitating sleep patents that will enhance the quality disorders the essential sleep they need to be healthy. By investing time in of life for people everywhere. There’s understanding people’s needs, we’ve created a por tfolio of 60,000 innovative more where that came from at patents that will enhance the quality www.philips.com/because of life for people everywhere. There’s

more where that came from at www.philips.com/because