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Dr. Eric Schulze | Lifetrack

A Problem Worth Solving

According to the World Health Organization, nearly two thirds of the world lack access to diagnostic imaging. The problem is compounded by three main challenges: a global shortage of trained radiologists, a skewed concentration of radiologists in urban vs. rural, remote areas, and expensive and limited legacy radiology software (RIS/PACS) that prevent wider usage in emerging markets.

Technology in healthcare has benefited healthcare professionals by addressing challenges of access. Radiology has embraced cloud technology, allowing medical professionals accessible, more efficient, and cost-effective solutions. With this innovation, trained radiologists, although few and concentrated in certain areas, will be able to work efficiently with a managed inflow of cases from remote areas, anywhere, anytime.

But technology does not erase the inherent problem brought about by the scarcity of radiologists. There is a need to train more radiologists, which, in combination with technological solutions, may be a more sustainable approach to address these challenges.

A Singapore-headquartered healthtech enterprise has led this initiative by providing a simple, elegant, powerful and intuitive platform for the healthcare ecosystem. 

Purpose Linked to the Founder’s Journey 

Lack of access to diagnostic imaging and inefficiencies with current legacy RIS/PACS systems are well-known problems to Lifetrack’s founder, Dr. Eric Schulze. In 2003, Dr. Schulze co-founded, 24/7 Radiology, one of the first teleradiology companies in the United States. It grew to serve the requirements of 85 sites in the US with radiologist reading centers in Manila, Singapore, Bangalore, and Kolkata.

Using the standard radiology software of the time, each reading center required an on-site data center filled with multiple rack-mounted blade servers and expensive Cisco routers and network appliances- representing over US$100,000 in sunk cost per site. Several full-time IT personnel had to be employed at each site to ensure reliable 24/7 uptime.

In 2011, Dr. Schulze sold 24/7 Radiology to Alliance Imaging, a New York Stock Exchange-listed company. He started Lifetrack Medical Systems and dedicated himself to rethinking how radiology software could be architected from the ground up to do truly distributed enterprise radiology while eliminating all the operational pain and financial costs he encountered at 24/7 Radiology.

As a practicing radiologist, he was determined to create the most flexible but efficient platform that radiologists could use to support any workflow. With the advent of the cloud and browser era, Dr. Schulze architected the next-generation LifeSys™ RIS/PACS.

LifeSys: Software with a Mission 

To give perspective, in the Philippines, there are only about 1,000 radiologists catering to the entire country’s diagnostic imaging needs. That’s 100,000 individuals per radiologist. Even if only around 1/3 of the Philippine’s population (estimated at a total of 110 million) will ever need just one (1) diagnostic imaging test in a given year, every radiologist would have to work 8 hours straight every day for 360 days averaging only about 6 minutes per study.

This problem is aggravated by the disproportionate distribution of radiologists in major cities, leaving smaller cities and especially rural areas and communities without access. In urban areas, it usually takes 2-5 working days from the day of image capture to get a final report. In rural areas, it can take as long as two weeks, with printed x-ray films being shipped from one island to the next where a radiologist is located. Some healthcare institutions will have a radiologist come only once a week.

But with the rapid expansion of internet connectivity, much of what used to be restricted to clinical settings can now, from a purely technical perspective, be handled remotely. This includes diagnostic imaging.

The LifeSys platform enables a distributed radiology model for an entire provider network that supports diagnostic healthcare in emerging markets at a fraction of the cost. Its architecture allows for rapid transmission, aggregation, and access of diagnostic images through the cloud from multiple clinics in remote areas for Lifetrack partners, using consumer DSL or even 4G.

Using off-the-shelf consumer hardware such as standard monitors and computers to allow for affordable adoption in emerging market environments, offering up to 10x savings in upfront setup costs is highly compatible with the LifeSys platform. In resource-constrained emerging markets, this allows healthcare providers operating in the affordable segment of the market to upgrade their medical imaging to a fully digital workflow.

This helps them harvest cost savings from removing x-ray film production, get more productivity out of their radiologists, and expand to more areas thereby enhancing access to high-quality medical imaging.

In addition to extending the reach of existing radiologists, LifeSys was designed to be a cost-effective platform for radiologist training and capacity building.

LifeSys includes the Active Templates, an advanced radiology reporting mechanism, and RadNav, a fully-integrated decision support system, for efficient referencing, education, and diagnostic standardization. RadNav is particularly useful in emerging markets where the standard of specialty training varies and exposure to new modalities such as CT and MRI may still be limited. 

Improving Patient Lives

One of Lifetrack’s partners, the Philippine Tuberculosis Society (PTSI), a non-profit organization dedicated to the prevention, control, and treatment of tuberculosis, had to undergo major renovation for its tuberculosis screening clinic on the island of Leyte, which had been ravaged by Typhoon Haiyan a few years previously.

PTSI wanted to upgrade its clinic into a state-of-the-art modern facility, equipped with a digital x-ray machine. But with most electrical and telecommunication infrastructure destroyed by Typhoon Haiyan, they could only send images using a mobile phone’s 4G connection.

Fortunately, Lifetrack’s LifeSys RIS PACS platform was architected to accommodate low-bandwidth environments without compromising image quality and transmission speed. The clinic is now able to upload diagnostic-grade x-rays using 4G to the LifeSys cloud server where a radiologist 900km away is able to access it within five minutes – cutting the time to diagnosis and treatment of tuberculosis in a remote, underserved area.

Lifetrack has also improved a customer’s healthcare outcomes and delivery. Since launching with LifeSys, FamilyDOC, a chain of community-based primary-care clinics serving lower middle-class semi-urban areas in the Philippines, now provides diagnosis within 30 minutes of an X-Ray. This is a radical improvement on typical waiting times for x-rays in the Philippines of 2-5 days, saving a working-class patient from missing one day’s worth of wages to pick up his report. This is done without any radiologists on-site.

Diagnostic imaging is done by radiographers on-site and upload their x-rays to our cloud server using consumer DSL, where a radiologist working remotely is able to access it in real-time. This has allowed FamilyDOC to rapidly scale from an initial two clinics to over 70 clinics in the last five years.

Awards and Recognition

Lifetrack holds several awards over the past years. In 2016, Lifetrack was the only Philippine representative to win the Red Herring Top 100 Asia Award. In 2017, Lifetrack was awarded in the ASEAN Rice Bowl Startup Awards Philippines leg as Best Life Sciences/Medtech Startup. In 2018, Lifetrack won the overall award for Excellence in Disruptive Technologies by the Financial Times Transformational Business Conference and Awards. Most recently in 2019, Lifetrack was recognized as one of the Top 150 Digital Health Startups Redefining Healthcare by CB Insights.

Future of Lifetrack Medical Systems

Lifetrack aims to be the clear leader in medical imaging for emerging markets, connecting healthcare institutions, medical professionals, and patients from Manila to Marrakech to Medellin. In the next decade we aspire to have helped diagnose tens of millions of patients, a sizeable number of which would not have been able to access medical imaging if not for our technology.

This access to medical imaging becomes key in improving overall health outcomes for populations in the developing world, leading to earlier screening of cancer, less invasive procedures later on, and savings for the healthcare system as well as longer, healthier lives for people.