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Simplicity is a clear view of patient care and how our ... Simplicity is a clear view of patient care and how our ... Document Transcript

  • Simplicity is a clear view of patient care and how our customers use technology
  • Philips: sense and simplicity At Philips Medical Systems Canada, good service and support do not end when the decision to choose Philips is made. The relationship Philips seeks with its clients stretches beneficially for both, far beyond the traditional bounds of vendor and customer. “It’s a philosophy we’ve consciously embraced over the past few years, at all levels of Philips,” says Vice President John Cieslowski. “We concern ourselves from day one – not just with providing a hospital or clinic or other healthcare facility client with state of the art equipment, but also with how that equipment is supported. That philosophy is based on the awareness that hospital needs are constantly changing and so, too, is technology. Consequently, the relationship we strive to have with our clients is a very flexible one.” Philips has been fostering adaptable relationships that have customers responding in growing numbers, vaulting Philips towards the Number One position in the Canadian medical systems marketplace. “We’ve enjoyed that success, I think, partly because being partner oriented and flexible builds trust. And that has benefits both to us and to the hospital,” says Cieslowski. “If you trust someone, then that tends to lead to a long-term relationship. So for us, having comfortable, lengthy connections with clients helps Philips John Cieslowski, Vice President, attract better quality employees who are not worried that a short, up and down, market cycle is going to Philips Medical Systems Canada result in loss of employment. They can spend the time it takes to properly look after the changing needs of our customers.” Philips provides its support not just to a customer’s operational and technical people, but also to management – from the chief financial officer and the head of human resources, to the CEO and the board of directors. “We are prepared to help clients at all levels modernize their medical systems,” says Cieslowski. – John Cieslowski, Vice President, Philips Medical Systems Canada
  • Simplicity is results where and when you need them because with Brilliance, better patient care is everywhere Thin-client computing for the PACS user improves performance Computed tomography (CT) imaging at The Credit Valley Hospital, near Toronto, has emerged from a systems upgrade in the caring hands of Philips Medical Systems Canada. Like many a discharged patient, it’s in thinner, but far better condition. “Credit Valley has two Philips Brilliance CTs – one a 16-slice and the other a 64-slice – but now we have linked both to what’s known as a thin-client portal server,” explains Philips CT product specialist Michael Regan. “That server holds all of the CT clinical software applications that used to be loaded on every workstation, in effect leaving the workstations as ‘thin’ clients of the server.” That means the much more powerful server is now doing all the Dr. Matt Downey, Rita Downhill, Techs ‘heavy lifting’ of processing the CT images. This greatly facilitates Shannon Rodgers and Cathy Tomaso. clinician access to the images from any computer, laptop, tablet, or other remote device they can connect to the hospital information A helping hand system. Dr. Matt Downey, medical director of From just about anywhere, including home, they can go online via the diagnostic imaging for Quinte Health internet and open up the portal, which functions as a gateway to Care, in Belleville, Ont., says that more Dr. Stephen Florence, Medical those images – and all the other features they could find before only than three years of solid after-sales Director CT, Credit Valley Hospital. by sitting at the workstations. “Because the portal server is doing the support by Philips has enabled the bulk of the work, it also means that the visualization or appearance of clear CT images on those remote thin four-hospital regional institution to clients happens much faster,” says Regan. “And that solves the problem of older, remote-access systems. both streamline its workflow and They were quite slow at reconstructing the images.” greatly expand the use of CT in Radiologist Dr. Stephen Florence, the medical director of CT in Credit Valley’s diagnostic imaging Eastern Ontario. department, likes all that new accessibility and speed. “We’re the Philips beta test site for this portal concept. “Philips has been extremely helpful We’ve been using it now for more than a year and it is working very well,” says Dr. Florence. “The biggest – first with the CT equipment advantage is that the portal has the Philips comprehensive cardiac package on it, so now we can look at the installation itself and then with the use heart without having to go way down the hall and maybe line up to use the workstation. I can access all the of our CT applications. And in the cardiac package’s features right from my desktop. And as we add more and more packages to the system, process they have also kept us on the like virtual colonoscopy, for example, that will become even more of an advantage.” leading-edge of CT technology.” Dr. Downey cites the approach Philips took when it helped Quinte Health Care install a second Brilliance CT at its Trenton site to complement the 64-slice Brilliance machine in Belleville. “When we negotiated our original deal three years ago, it was to be a basic 6-slice CT. What we received from Philips for Trenton was a 16-slice CT that’s far more sophisticated and functional than other machines that were leading-edge when we conducted our orginal due diligence for these CT purchases.” Philips Brilliance CT
  • Simplicity is confidence you're getting complete and accurate diagnostic for every patient every time Count on Philips for top-level technology, along with planning and installation services When choosing ultrasound machines, Canada’s largest partnership of radiologists went with Philips. Medical Imaging Consultants (MIC) consists of approximately 70 radiologists and is Canada’s largest private radiology partnership. MIC owns and operates five major clinics that provide “imaging excellence” in a full range of modalities to patients and physicians in the Edmonton area. In ultrasound alone, MIC performs approximately 100,000 exams annually. So when MIC makes an ultrasound purchasing decision it will likely get the attention of others in the radiological community. “A few years ago, after a comprehensive review of ultrasound Dr. Trevor Horwitz, Radiologist, technology available in the marketplace, we purchased 16 general Medical Imaging Consultants. ultrasound (iU22) and 5 cardiac ultrasound (iE33) machines, certainly one of the largest ultrasound sales Philips has made,” says Ivan Olsen, CEO of MIC. “Since then, our radiologists have indicated they are very happy with the performance of the Philips machines. We certainly have the confidence to deal with Philips for additional equipment when the need arises.” What’s keeping Philips popular with MIC, however, is not just its ultrasound technology but its whole Leading-edge 3D echocardiology approach to doing business. Transesophageal echocardiography, or “Over the course of the first six months of 2007, MIC converted its enterprise to digital imaging TEE for short, a method of examining technology, so we could eliminate film and put all our imaging on PACS. Philips was one of the the heart with ultrasound, became a vendors who played a very significant role in making that happen,” says Olsen. “We bought our fluoroscopy lot more attractive in June, when and other digital equipment from Philips, and they were also very much on the ball when it came to planning Philips announced its new Live 3D TEE the installation of the equipment and meeting deadlines. probe. “This new development has the “To their credit, their sales people don’t abandon you as soon as the sale is secured,” adds Olsen. “If potential to give us a quantum leap in something needs fixing throughout the product’s life cycle, they don’t argue; they just step right in and get it information – and then become the done. When your organization is investing millions of dollars in imaging equipment, those are the kind of standard of cardiac care,” says Dr. people you want to do business with.” Harry Rakowski, a senior cardiologist at the Toronto General Hospital, and the development director of the Peter Munk Imaging Centre. “With this technique, the TEE probe is put in the esophagus (the swallowing tube) of a sleeping patient in the operating room, and that allows you to get high resolution pictures of the heart because you do not have intervening chest and lungs in the way,” explains Dr. Rakowski. “Until now, those pictures were only two-dimensional. But the new probe will give you live, three-dimensional images in spectacular detail – to the point, for example, of being able to see where the small sutures are in an implanted mechanical heart valve.” Philips iU22 Ultrasound System
  • Simplicity is treating more patients with superior interventional imaging and live 3D guidance Interventional Staff, Saint John Regional Hospital. Expanding the medical envelope Precise, 3D imaging is enabling physicians to perform new and innovative procedures. An example includes a minimally invasive bone- cementing procedure known as kyphoplasty. Kyphoplasty is used when someone has suffered bone deterioration of the vertebrae – often through osteoporosis or bone cancer. To remedy the condition, the physician, guided by the 3D-RA images, navigates a needle into the centre of the collapsed vertebrae and then inflates a small balloon, which pries the collapsed bones open like it would a clamshell. The space is then filled with cement. “What’s crucial during the 3D imaging results in faster, safer procedures procedure is to accurately assess the Three-dimensional imaging is helping radiologists expand the range of procedures they do – resulting in position of that cement and prevent it quicker treatment and better outcomes. “Our older patients, in particular, are benefiting because by using from touching the spinal cord, as this the new 3D applications we have on our imaging equipment, we are finding new ways to do more can cause pain, altered sensation, or complicated treatment procedures and to do them faster,” says Dr. Ferguson, divisional head of vascular & even very rarely, paralysis,” explains interventional radiology at Atlantic Health Sciences Corp., based in Saint John, N.B. Dr. Ferguson. “What the 3D-RA The imaging tools Dr. Ferguson and his Atlantic Health colleagues have at hand include the Philips Allura allows is a three-dimensional, real-time FD20, an advanced x-ray machine that comes with “three-dimensional rotational angiography,” or 3D-RA for digital re-construction during the short. This 3D-RA capability improves significantly on the two-dimensional, or 2D imaging, that has procedure, so we can see from every traditionally guided angiographic interventions. In vessel-reinforcing stenting procedures for instance, 3D gives angle exactly where that cement is clinicians a much more complete picture of what life-threatening embolisms or blockages in the vessels look going–and not going.” like and where they are. So interventions can be mapped out and planned more accurately – with the result that interventionalists can usually go in, remove the threat, insert the stent, and get out far sooner, all with less risk to the patient. “What we can say for sure is that technologies like 3D-RA are allowing us to expand the boundaries of patients that we can treat – especially older patients who have complex morbidities and histories,” says Dr. Ferguson. “It’s a known fact that the longer a procedure takes, the higher the risk is of complications setting in. The 3D technology helps us make procedures faster and safer with the usual result of a shorter hospital stay. So in that sense we are definitely improving outcomes.”
  • Simplicity is improved efficiency and produ Flexibility makes a world of difference in General X-ray You’re more likely to make a team if you can play more than one position. That’s an old sports adage that’s quickly gaining currency with diagnostic imaging decision makers too. Indeed, selectors at Markham Stouffville Hospital, just northeast of Toronto, put the new Philips MultiDiagnost (MD) Eleva flat detector x-ray machine on the hospital roster, very much because it is a flexible player. “The MD Eleva is called MultiDiagnost for good reason,” says Michael Rice, Philips’ general x-ray sales specialist. “The reality in Canada is that what customers are called to do in their R&F rooms (radiology and fluoroscopy) is really changing. The number of gastric examinations is diminishing, while the spectrum of other procedures is widening. That flexibility is really the forté of this equipment.” That’s not to say that Markham-Stouffville made a snap judgment. “We did our due diligence process Philips MD Eleva
  • ctivity through digital workflow solutions involving our whole team in making the decision and picking Philips,” says Andrea MacKenzie, Markham Stouffville’s manager of diagnostic imaging.” Much like a professional baseball team might size up its new players, MacKenzie says her team applied four major criteria to decide which x-ray player would win the nod: “Vendor characteristics, financial and contractual, service and support, and finally, product strength, were the four factors we considered.” The ‘we’ making the call for Markham-Stouffville included not just hospital management, but also the hospital’s radiologists, x-ray technologists, information Bill Brodie with Technologist Lisa Sharp. technology staff, radiological information specialists, and PACS operators. “We had input from everybody and from When the going gets hot, the cool keep going every perspective, and that’s how we came It was a hotly contested request for proposal. But in the end, to choose Philips,” says MacKenzie. Philips’ powerful mobile fluoroscopy system, the BV Pulsera One perspective that counted most in and its rotating anode technology with the power to see Philips’ favour was Eleva’s digital capability. through virtually any patient, won the nod. “One of the major competitive advantages “We chose Philips, number one because of the image Philips had was that with the Eleva, we could quality,” says Bill Brodie, technical director of diagnostic send fluoroscopy images digitally and directly Dr. Michael Steirman, Penny Kaminski, imaging at Halton Healthcare Services based in Oakville, to our PACS system for distribution,” says and Andrea Larman-MacKenzie. Ontario. “But number two was definitely the ease of Lynne Campkin, director of diagnostic and operating it and learning how to use it. Our technologists respiratory services at Markham Stouffville. “The Philips Eleva, is a multipurpose room found it simple and easily understood. Also, it has a small with a flat detector and we could reduce the amount of radiation that’s needed, footprint, so it fits with our ergonomics.” without compromising the image quality.” “It uses a very low level of radiation,” explains Brodie. For its part, Philips sent its own installation team onto a field of play that was Equally important, Brodie says the Pulsera’s capabilities are bounded by tight deadlines. a good fit with the surgical procedures often done at Halton, “Our project management team pulled out all the stops in order to meet their which require careful guidance, including hip and other joint time lines,” says Rice. We have a project manager replacements, cardiac pacemakers, and “PICC” lines who can call all the necessary Philips resources to (peripherally inserted central catheters) that deliver the table: the staff who co-ordinate the delivery of chemotherapy or other drugs to specific organs. the equipment, the engineers who do the installation, On the integration front, the Pulsera was readily and then come our application people who do the training on connected to the PACS. “Pulsera meets the DICOM the site. So what we’re really providing is a quarterback for the team.” communication standard, and its images are digital, so that With an attitude that’s as flexible as the Philips equipment. integrating it and building our PACS became that “Philips has the resources and the customer focus to meet the commitments much easier.” they make,” says MacKenzie. “They bent over backwards to help us with a very All those benefits have pleased not only Brodie and his difficult situation that we ourselves had created. We weren’t just installing the MD radiology colleagues, but other departments, too. Eleva, we were doing multiple installations and renovations to the hospital at the “It’s been really well accepted by the surgeons. They are same time. So Philips worked hard with us to co-ordinate all that effort and our very happy with the quality of the imaging, the maneuverability, facilities folks loved to work with them as a result.” and the field of vision they see in the operating room,” says And not just during the week. Brodie. “I even had an orthopaedic surgeon stop me in the “The one weekend in particular that I recall most, the Philips installation people hall to compliment me. And that doesn’t happen every day.” worked almost 24 hours on the last night, right around the clock in order to meet our deadline,” says Campkin. There are no more versatile and dedicated team players than that.
  • Simplicity is making hospitals feel less like hospitals Dr. Paul Babyn, Radiologist-in-Chief at The Hospital for Sick Children. Calming for kids As comforting as the Ambient Experience can be for adults, fidgety or fearful children can be quite a different matter. “The children we examine are Ambient Experience projection either those who we need to put under general anesthetic in order to Patient visits brighten with Ambient Experience keep them still enough to capture clear Soldiers’ Memorial Hospital in Orillia, Ont., is shining a new light on the Philips Ambient Experience. In June, images, or those we sedate, or those the hospital opened its new MRI suite, the first in the country to fully embrace the Ambient Experience – who are perhaps older and can lie still with patient-calming interior design, ambient lighting, and patient selected images and soothing scenes. at least for a short period of time,” The new MRI suite at Soldiers’ has added another dimension to its patients’ visits. The hospital’s explains Dr. Paul Babyn, radiologist-in- Ambient Experience MRI suite, which sits adjacent to the chief at The Hospital for Sick Children new six-storey patient care tower, lets in sunshine from (SickKids) in Toronto. above through a suite-encompassing skylight. So, with two out of three patient But it is inside the examining room where the patient categories needing drugs before experience changes the most. As never before, patients can examination, Dr. Babyn and SickKids, control the environment of the examination room – by naturally, were interested in an selecting its lighting from a range of soothing pastels, picking alternative approach. music to accompany calming seascapes, mountain vistas, and “We realized that a more Children, like Kenny McIssac of Orillia, feel more other scenes or even cartoon animation, all projected on the relaxed in the Ambient Experience environment. welcoming and interesting environment walls and ceiling. could distract them and make children “Thanks to this suite, we’ve become a state of the art diagnostic centre,” says Gini Stringer, board chair less concerned. We found the MR of Soldiers’ Memorial Hospital Foundation and cancer survivor, who has experienced firsthand the diagnostic Ambient Experience met all our needs.” capabilities of Soldiers’ MRI. Consequently, SickKids is the The promise of working in such an advanced environment is what Maida Jeraj, MRI charge technologist second Canadian site, along with and overseer of the Ambient suite, admits attracted her to Soldiers’. “In 25 years I’ve seen a lot of MRI Soldiers’ Memorial Hospital in Orillia, centres and by far this is the prettiest one.” to go Ambient. Already converted is “With its muted tones and lighting, patients tell me it doesn’t feel clinical. Also this new scanner and how SickKids’ 1.5 Tesla MR suite. Soon to it will be linked in with our radiological information and PACS systems, makes for a happy staff too. So it is a join it will be the new 3 Tesla suite real privilege to work here.” expected to be operational later “We chose Philips first of all because of the excellence of their equipment, but the Ambient Experience this year. aspect of it was also very important because it fit right in with our aim to be patient focused in everything we do,” says David LaFleche, the director of diagnostic imaging.
  • Simplicity is providing enterprise-wide clinical information to optimize patient care North Bay General’s iSite PACS provides anytime, anywhere viewing Unlike the waves that sometimes churn the waters of nearby Lake Nipissing, wavelet-based iSite PACS technology from Philips has swept through North Bay General Hospital (NBGH) without rocking the boat. “We’ve been live with iSite for over a year now and overall it has been a very smooth transition,” says Brenda Monahan, the PACS/RIS co-ordinator at NBGH. “Our physicians, in particular, have really embraced the technology. They now have instant access to all the images they want at their fingertips – in their offices, in the clinics they work in, and just about anywhere else in the hospital.” Quick access to the PACS (Picture Archiving and Communications System) results from an ingenious method of distributing the images. Instead of trying to move whole or even compressed, network-choking images around, the Xcelera, for extra efficiency Brenda Monahan, PACS/RIS iSite system breaks images down into small, mathematically encoded in cardiology Co-ordinator at NBGH. The Philips portfolio of Xcelera, wavelets. These are re-assembled for quick viewing at the other end, even on regular PC desktops and laptops, with no loss of data. Cardiology Image Management System, “We’ve seen improvements, as a result, not only in the workflow of our diagnostic imaging department is now bringing new cardiac and our radiologists, but also outside the hospital, as we are a district referral centre,” says Monahan, a department efficiencies to more than former nuclear medicine technologist. “It was really quite surprising how fast the benefits started to roll in 1,500 installations worldwide. from iSite.” Among them, the Xcelera But those quick returns are the result of some earlier painstaking help from Philips. Cardiology PACS system installed at St. “When we became the vendor of choice through North Bay’s RFP (request for proposal) process, we Michael’s Hospital, in Toronto, has spent a lot of time working on their technical needs, but also working with the community and within the been enabling its users for the past hospital to help them gain acceptance for their PACS,” says Stephen Mayer, account manager for healthcare three years to quickly create, review, informatics at Philips. and distribute echo, cardiac, and soon vascular ultrasound reports – all from a single workstation. “It is easy to see why Xcelera is so popular,” says cardiologist Dr. Stuart Hutchison, St. Michael’s director of the echocardiography and vascular ultrasound labs. “We were able to generate reports before using a digital network, but it was time consuming. Xcelera is considerably more efficient, and its connectivity with the hospital’s IT system is truly seamless.” Summing up his relationship with Philips, Dr. Hutchison simply says: “It’s excellent; never had a bad day.” Philips Healthcare Informatics
  • Simplicity is the shortest distance to diagnosis Clear images, exact locations, using SPECT/CT “Nuclear” medicine is no longer “Unclear” medicine, as nuclear medicine’s detractors used to wryly observe. Not for an estimated 2,600 patients a year in Edmonton’s Capital Health region, at least. Since early this year, radiologists at Capital Health’s Royal Alexandra Hospital have been spotting tumours – and other hard- to-see abnormalities – with greater precision than ever before. They’re doing it through the remarkably keen eyes of a Philips nuclear medicine machine, the first of its kind in Canada. It combines a special SPECT (single photon emission computed tomography) gamma ray camera with an adapted 16-slice CT scanner. The gamma camera visualizes the workings of an organ or an area Light at the end of the tunnel of tissues, while the CT scanner pinpoints their location in the patient’s Not quite so clear is what the future body. Together, the technologies provide for better diagnosis and holds for Capital Health’s SPECT/CT – swifter, more appropriate treatment. Patient Danny Steeves and Karen and that’s a good thing, says Dr. Bill “Anybody who has seen this technology is overwhelmed by how Allred, SPECT/CT Supervisor. Anderson, the region’s clinical director clear the images are and how cool it is to use,” says radiologist Dr. of diagnostic imaging. Michael Hoskinson, clinical specialty coordinator for nuclear medicine at Capital Health. “You can hold a little “The future possibilities are hot dot over something on the image, and show surgeons and other physicians exactly where that thyroid endless,” says Dr. Anderson, pointing tumour is, and they say oooh, we had no idea it was there.” out that the Philips SPECT/CT “SPECT images do a fine job of showing how that organ and abnormality is functioning, their resolution machine, as one of just a few in the isn’t very high,” explains Hoskinson. “But when you apply high-resolution CT to those images, you in effect world, will also go to work for the correct them. You still get to see the SPECT functionality, but now you see very clearly what you’re looking Molecular Imaging Institute, a joint at and where it is.” initiative between Capital Health and the University of Alberta, where plans call for it to help researchers “...further advance diagnostic imaging, improving diagnosis and patient care for years to come.” But it will remain rooted in the daily realities of clinical care. “The SPECT/CT is doing regular clinical work right now, and pretty much every day we are finding areas where it shows new benefits,” says Anderson. “One of them is how patients react. Because they can come in with little preparation, be examined quickly, and usually don’t have to come back in to be examined with another modality, it seems almost magical to them. It’s as if what they’ve seen on Star Trek has arrived.” Philips SPECT/CT
  • Simplicity is SmartExam: one click to plan, scan and process your MR exam Wayne Wilson, Charge Technologist at Joseph Brant Memorial Hospital. MR tools improve workflow Joseph Brant Memorial Hospital in Burlington may not be huge, but it has a big reputation for imaging excellence. “The hospital has become a reference site for us,” says Philips account manager Marcel Trentelman. “We bring people to Joseph Brant so they can see how well imaging workflow can be managed.” Achieva 1.5T For MRI department boss, charge technologist Wayne Wilson, what impressed right from the outset were Improved breast cancer diagnosis, using MR the Achieva MR’s reliability and user There’s one simple fact about breast cancer that gives us more hope at the moment than any other. friendliness. “We have absolutely “The only means today of reducing breast cancer mortality is an early diagnosis,” says breast surgeon Dr. minimal downtime, and we don’t have Jocelyne Hébert, unequivocally. Dr. Hébert is a member of a Philips-equipped, multi-talented clinical team to spend months and months getting devoted to breast cancer patients at a remarkable clinic in Moncton, New Brunswick. In what could well be someone up to speed on a cryptic a model for similar sized hospitals across the country, the Multidisciplinary Breast interface,” says Wilson. “I believe the Clinic, based at the 320-bed Georges-L. Dumont Regional Hospital, not only Philips interface is one of the most involves Hébert and two surgical colleagues full time, but also calls on medical intuitive.” But it is the Achieva’s recipe- oncologists, radiation oncologists, pathologists, radiologists, nurse navigators, and card-like SmartExam protocols that family physicians. All are dedicated to early detection, thorough diagnosis, and truly inspire him. They automate steps swift, effective treatment of the breast cancer scourge. for imaging specific parts of the body. The Breast Clinic has managed to reduce wait-times of up to six months for “This product really does as advertised. a final diagnosis by more than 75 percent. Once patients are in the clinic doors, When you use the SmartBrain card, for there’s no time wasted either. “A patient at our clinic usually has a complete instance, it doesn’t matter what workup done within two weeks,” says Dr. Marcel Caissie, the hospital and position the patient’s head is in, the Breast Clinic’s chief radiologist. “By then there’s a diagnosis established. The Dr. Jocelyne Hébert and Dr. Marcel Caissie. system automatically detects the patients have seen the surgeon and they are ready for treatment, if needed.” anatomy and compensates for the Since the clinic started doing Breast MRI and Breast MRI biopsies in 2004, over 1,000 patients have had angles. The cards standardize the work MRI scans or biopsies. And the demand is growing very rapidly – spurred by good results, improving and yet are very simple to use.” technology, and most recently by a study in the New England Journal of Medicine that shows MRI scans can spot tumours that conventional mammograms and Ultrasound miss. “With the upgraded Philips MRI equipment and diagnosis system, we acquire images with thinner cross-sectional views faster, and this improves both temporal and spatial resolution,” explains Dr. Caissie. The upshot is that the Breast Clinic is catching more cancers. And most amazingly, of all cancers found, the number of Stage 1 tumours detected has risen from spotting them in 43% of examinations done in 2000-2002 to 53% in 2006-2007. This means patients have a much better outcome and chance of survival.
  • On the web www.medical.philips.com The future is bright… Via email salesandmarketing@Philips.com Interested? Would you like to see your healthcare facility featured in future publications? By mail Philips Medical Systems Canada Please submit your customer stories to us. Division of Philips Electronics Ltd. We would be glad to hear from you. 281 Hillmount Road Markham ON L6C 2S3 Canada By phone Canada Tel: 1 877 744 5633 ext. 2046 Philips Medical Systems is part of Royal Philips Electronics © 2007 Philips Electronics Ltd. All rights reserved. Philips Medical Systems Nederland B.V. and its affiliates reserve the right to make changes in specifications and/or to discontinue any product at any time without notice or obligation and will not be liable for any consequences resulting from the use of this publication. Printed in Canada August 2007.