Six design principles that work for both the clinic and management
Not a “sell-and-forget” device: from add-on installation on existing machines to clinical operation, our design works for the people on the floor and for management.
01
Retrofit to installed machines
Not only for new facilities: our software can be added to machines already in operation. Roughly 16,000 photon and 250 particle therapy machines worldwide are candidates. Hospitals gain the function without new capital investment.
02
PIL supports the regulatory amendment
For the device manufacturer’s partial-change application, PIL prepares the product documentation and supports the submission, applying the approach established with a Japanese device manufacturer.
03
In-house X-ray imaging control
We have developed our own synchronizer that precisely controls two X-ray tubes and flat-panel detectors, minimizing modifications on the machine side and shortening integration and verification.
04
Less training, less stress for staff
Automatic template generation and self-optimizing machine-learning dictionaries standardize the preparation steps. The system takes over the worry of “can we track this patient?”
05
Remote maintenance and continuous user feedback
During the small-scale introduction phase, maintenance is handled remotely and through the manufacturer. Issues and requests are collected continuously and returned as software updates.
06
Device-independent, easy to replace
Across photon, proton and carbon-ion therapy. With a Japanese device manufacturer we fully replaced the existing positioning and CBCT with PIL products, so we support both replacement and integration.
How does an expensive machine affect the bottom line?
Particle therapy facilities carry large construction costs, and revenue is determined by fixed reimbursement points. Management therefore focuses on utilization and turnover rather than on treatment outcomes.
→ The key management metric becomes “treatments per room per year”
Annual new-patient numbers vary widely between radiotherapy facilities in Japan
JASTRO 2019 structure survey, 734 facilities
Patient turnover
Room occupancy time and the number of fractions cap the annual case volume. At QST, two rooms treated about 600 cases per year with an average room occupancy of 9–10 minutes (non-gated).
Waiting time
Cases requiring metal marker implantation go through implantation, a fixation waiting period and then treatment start, extending lead time and causing lost opportunities for both patients and hospitals.
Staff burden
Respiratory gating and positioning tend to depend on skilled operators, making staffing and training a bottleneck for utilization.
Introduction and maintenance cost
Large facility costs mean long payback periods. Additional functions are more readily evaluated as “added value for the installed machine” than as new capital investment.
Sources: Japanese medical fee schedule M001-4 / Mori S, et al. Phys Med 2018;52:18-26 / JASTRO National Structure Survey of Radiotherapy Facilities 2019 (Report 1)
A sustainable package, not a one-time device sale
Introduction is not the end. We present, as part of the contract, a cycle in which operation → user feedback → improvement and updates → patient referral keep reinforcing each other.
Introduction and start-up
Regulatory documentation and submission support, implementation, training
Operational support and maintenance
Remote maintenance plus first-line response via the OEM keeps maintenance costs down
Voice of the user
Issues and requests collected continuously
Improvement and software updates
Tracking algorithms, UI and workflow improved and returned as updates
Referrals and facility network
Results, papers and know-how shared between user facilities and the device manufacturer
Consideration for financial planning
- Staged introduction, module by module
- License and maintenance billed separately
- Payment designed around the hospital’s investment decision and the OEM’s sales plan
- Update and maintenance revenue shared with the device manufacturer
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