"We used workflow features that are common in everyday life and adapted them to medical technology so the consumer doesn't see the difference. It blends seamlessly," said Philips' Gopalakrishnan.

Using just four patient leads (plus ground) the unit reports the equivalent of 12 leads of derived ECG data. Proprietary algorithms in PC-based software provide excellent clinical decision support. The device is extremely easy to use with a lead map displayed for the technician right on the unit. It will even auto-start if someone forgets to start the recorder.


Another promising breakthrough in holter is its application for sleep studies with the addition of a pulse oximeter and special software manufactured by NorthEast Monitoring.

"It's a holter monitor just like in cardiology. One way of accurately determining sleep apnea is to examine ECG levels corresponding to pulse oximetry," explained Garret Purrington, president, Medical Equipment Dynamics, Inc., New Bedford, Mass. The two-year-old company sells a variety of new and used medical equipment. "It's a great application because if you're an ENT facility or general practice you can send the patient home instead of sending them to a sleep lab which costs insurance thousands of dollars. The referring physician can pay the unit off quickly. It's a good reimbursement rate."

In the ECG space, Philips offers its latest product, the touch screen PageWriter TC-70 also known for super ease-of-use as well as advanced clinical decision support and workflow benefits.

"The technology has unique things to make patient care more effective and safer," said Kevin Geary, global product manager, Pagewriter Cardiographs, Philips Healthcare. It provides analysis of up to 16 leads instead of the usual 12, looking at a wider area of the heart including the right ventricle or posterior wall of the heart.

"If you go to the ER with shortness of breath [a vague symptom] and they put on a standard 12-lead, it won't find a heart attack in your right ventricle; it comes out normal," Geary said. "Because we look at the right ventricle and posterior wall, our equipment shows a positive ECG test." This might speed a patient to the cath lab for treatment before she suffers permanent damage.

Not to be overlooked are some low-priced new technologies from China including Mindray and Edan.

"It hurts the refurbished market a bit because you can get a brand new Mindray patient monitor for the price of a refurbished one. It comes with a two-year parts and labor warranty. If I were a doctor's office or surgery center, why would I buy a used monitor? It doesn't make sense," Purrington said. However, he noted that the need for compatibility with installed systems drives an ongoing used equipment market. "Refurbished [equipment] will always be strong because you've got standardization problems. You need to standardize patient monitors."

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