SIEMENS AG Matthias Kraemer | Head of Media Relations
Siemens Healthcare GmbH
Unrestricted © Siemens Healthcare GmbH, 2015
Notes and forward-looking statements
This document contains statements related to our future business and financial performance and future events or developments involving Siemens that may constitute forward-looking statements. These statements may be identified by words such as 'expect', 'look forward to', 'anticipate', 'intend', 'plan', 'believe', 'seek', 'estimate', 'will', 'project' or words of similar meaning. We may also make forward-looking statements in other reports, in presentations, in material delivered to shareholders and in press releases. In addition, our representatives may from time to time make oral forward-looking statements. Such statements are based on the current expectations and certain assumptions of Siemens' management, of which many are beyond Siemens' control. These are subject to a number of risks, uncertainties and factors, including, but not limited to those described in disclosures, in particular in the chapter Risks in the Annual Report. Should one or more of these risks or uncertainties materialize, or should underlying expectations not occur or assumptions prove incorrect, actual results, performance or achievements of Siemens may (negatively or positively) vary materially from those described explicitly or implicitly in the relevant forward-looking statement. Siemens neither intends, nor assumes any obligation, to update or revise these forward-looking statements in light of developments which differ from those anticipated.
This document includes - in IFRS not clearly defined - supplemental financial measures that are or may be non-GAAP financial measures. These supplemental financial measures should not be viewed in isolation or as alternatives to measures of Siemens' net assets and financial positions or results of operations as presented in accordance with IFRS in its Consolidated Financial Statements. Other companies that report or describe similarly titled financial measures may calculate them differently.
Due to rounding, numbers presented throughout this and other documents may not add up precisely to the totals provided and percentages may not precisely reflect the absolute figures.
New management of Siemens Healthcare effective from May 1, 2015
Bernd Montag | |
Chairman of the Executive | |
Thomas Rathmann | |
Member of the Executive | |
Michael Reitermann | |
Member of the Executive | |
Management
and CEO
Management
and CFO
Management
Separation of Siemens Healthcare's business activities into legal entities under the Siemens umbrella
Foundation of Siemens Healthcare GmbH in Germany
Buffalo Grove
Elkhart, Mishawaka
Dublin Llanberis Oxford
Hoffman Estates Flanders,
Glasgow
Edgewater
Walpole, Brookfield
Issaquah
Tarrytown
Sudbury
Erlangen, Forchheim
Kemnath Rudolstadt
SeongNam GyeonJu PoHang
Sacramento
Berkeley
Mountain
View Los Angeles
Getafe
Malvern Plymouth Cary Knoxville
Joinville
Marburg
Bangalore Goa
Wuxi Shanghai Shenzhen
Headquarters
Major manufacturing/engineering sites
We innovate to advance human health
R&D spending1) Ratio of R&D expenses as a percentage of revenue1)
Inventions per year Patents per working day
patents in total
Fiscal Year 2014
Unrestricted © Siemens Healthcare GmbH, 2015
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Erlangen, September 29, 2015
Matthias Kraemer | Healthcare
Key Financials
Key financials
Revenue by Region2)
FY 2014
€ 12.1 bn
€ 11.7 bn
€ 2.1 bn
17.7%
Orders Revenue
Profit (w/o PPA amortization) in % of revenue
Asia, Australia
27%
Germany
7%
28%
Europe, CIS3), Africa, Middle East (excl. Germany)
€ 2.0 bn
17.1%
Underlying Profit1)
in % of revenue
38%
€ 1.9 bn
Free Cash Flow
Americas
Profit excl. PPA amortization, transformation charges and other one-time effects Note: All data Healthcare excluding Hospital Information Systems and Audiology
FY 2014 external revenue by location of customer
Commonwealth of Independent States
MRI relies on the principle that the hydrogen atoms in the human body possess magnetic properties: Exposed to the magnet in the MRI system, the nuclei of these atoms align with the magnetic field, like the needle of a compass with the earth's magnetic field
The MRI system generates a second electro- magnetic field by transmitting high-frequency radio waves. These waves meet the nuclei of the atoms and set them in motion
If the waves are turned off, the atoms return to their initial position within the magnetic field.
A computer converts the data and uses them to generate tomograms, or slice images
CT measures the attenuation of X-rays within the tissue, visualizing the inside of the body as tomograms - slice images - on a screen
A measurement system consisting of the X-ray tube and the opposite detector is located inside the gantry, which is circling the patient. During this process, the tube transmits a fan-shaped X-ray beam, which is weakened less by soft tissue than by firmer tissue (bones) as it passes through the body
When they reach the detector, the X-rays hit a 'scintillator' - Siemens uses a highly
The computer translates the measurements into individual section images or even a three-
Syngo makes reading, storing, archiving and sharing clinical images easier and more efficient
Its innovative technology transforms the power
of imaging equipment into tangible clinical benefits
A common user interface across all modalities streamlines radiologists' work
Mobile access capabilities make it possible to view images and findings anywhere
and on many devices
Syngo.via for 3D and advanced visualization software
Syngo Dynamics as Cardiovascular Imaging and Information System
Syngo Workflow as Radiology Information System (RIS)
Syngo.plaza as Picture Archiving
and Communication Software (PACS)
Syngo.share as versatile Vendor Neutral Archive (VNA)
Sense
Teamplay as first cloud-based healthcare network
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•
Pros Increased efficiency Increased diagnostic quality
•
Common user interface across all modalities
•
Cons None
Results
Access to image data, increased usability
Use cases
Software for imaging scanners in Angiography, Computed Tomo- graphy, Mammography, Magnetic Resonance, Molecular Imaging etc.
Software to connect to current data, comparing benchmarks, and collaborating with healthcare professionals worldwide
Software for effective management and sharing of clinical image data, multimedia data, radiological studies and clinical documents
Software to support integrated, cross-enterprise healthcare networks by providing medical information
Technology
Like light, X-rays are electromagnetic waves
Radiation is generated in an X-ray tube when electrons from an incandescent wire, the cathode, are beamed at a specific metal part known as the anode
When the electrons strike the anode,
X-ray radiation is generated. As they pass
•
Pros Low cost
•
•
Available almost in every clinic Still most often used
•
No physician needed to produce X-ray images
•
Bone density is measurable
Results
2D and even 3D pictures
Use cases
Cardiovascular diseases e.g. heart attack (angiography), fractures (radiography and mobile radiography), ortho, trauma,
through the body, the rays are absorbed to different degrees
Bones are so dense that they weaken the rays, leaving a bright, clear image
Other kinds of tissue allow more of the radiation to pass through
The X-ray image is either captured on film or an electronic sensor converts it into
a digital image
The short-wavelength rays are invisible to the human eye
Cons
•
Ionizing radiation
•
•
Image quality less compared to CT or MR Not suitable for pregnant women
•
Copyright: Siemens MedMuseum
Soft tissue is not seen properly
surgery, CT, mammography (women's
health), urology, fluoroscopy
Technology
Ultrasound uses high-frequency sound waves
The transducer emits waves and receives their echo reflected from the tissue
This echo is calculated into grey values
for real-time images also for moving organs like the heart
Using Doppler sonography, blood flow velocity may be determined and the flow relationship in vessels displayed. As a result, information can be obtained regarding constrictions, occlusions, and standard variants in vessels and the heart
Wide-area panoramic displays and three- and four- dimensional images can be generated on the computer in order to better analyze complex anatomical structures
Pros
Cons
•
No radiation (can be used for children and pregnant women)
•
Affordable and in most clinics available technology
Easy to use
Can't percolate bone or air (lung) Difficult to percolate technically difficult patients
Results
Ultrasound delivers real-time images in 2D, 3D or 4D
Use cases
Pregnancy, fetus scans (Gynecology); heart examinations; thyroid glands; gallstones; kidneys, nerves, blood vessels
almost all organs, except lung and bones
Technology
Performed to view blood vessels after injecting them with a radiopaque dye that outlines them on X-Ray. This helps to detect abnormalities including narrowing (stenosis) or blockages in the blood vessels (occlusions)
Angiography is used for diagnosis and treatment of arteries, veins, and lymphatic vessels,
as well as the heart chambers
If a vessel is constricted, the contrast agent helps in locating the stenosis and detecting to which percentage the lumen of the vessel is occluded
When diagnosing tumors, angiography can be used to show the blood supply of the tumor
The origin of internal bleeding, such as a damaged vessel, can be precisely located
In interventional angiography imaging tools are used for minimally invasive procedures including angioplasty and embolization
Pros
Cons
•
Image guidance in interventional procedures
•
Diseases can be diagnosed and treated using minimally invasive procedures
•
•
•
Enables treatment even for very old or sick people Less scar tissue
Faster healing
•
Ionizing radiation
•
•
•
Contrast media can further damage e.g. the kidney Known allergies to contrast media with some diseases
Internal bleedings as complications of puncturing an artery
Results
Digital subtraction angiography (DSA) to 'subtract' bones and other organs to better see the vessels
Image guidance in interventional procedures
Check for successful treatment
Use cases
Cardiac catheterization during coronary angiography (e.g. chronical heart disease); aortography
(e.g. aortic aneurysms/dissection); cerebral angiography to visualize vessels in the brain (e.g. stroke, aneurysms, thrombectomy); Angiography of the leg and pelvic vessels (e.g. diabetes); Chemo- embolization of tumor feeding vessels
Copyright:
Dr. Azam Ahmed, University of Wisconsin, Madison, USA
Technology
Single Photon Emission Computed Tomography (SPECT), Positron Emission
Pros
•
Detecting diseases at very early stage e.g. cancer or Alzheimer's
Results
Molecular imaging procedures are able to
Tomography (PET), Magnetic Resonance,
Optical Imaging and Ultrasound
•
Monitoring cancer therapy image different biological processes of organs at the cellular level and thus can
Probes known as imaging biomarkers (i.e., peptides, radiopharmaceuticals, fluorescents) are injected into the body to help display particular targets or pathways
Through chemical interactions with their surroundings, imaging biomarkers alter the image according to molecular changes that occur within the area of interest
This level of functional imaging displays, for instance, increased metabolic activity that is typical for malignant tumors like recurrent prostate cancer
The addition of CT to either PET or SPECT provides the anatomical 'map' for pinpointing the exact location of disease in the body, to match their metabolic or functional information
Cons
•
Without CT or MR no anatomical structure visible
•
Very expensive and limited availability
•
Injection of imaging biomarkers such as radiopharmaceuticals
provide earlier and more precise evaluation of disease
Use cases
PET imaging is used for cardiac indications like coronary artery disease and helps detect most types of cancers and how much they have spread in the body. PET also provides diagnostic information on neurological disease.
The main indications for SPECT are detection of tumors at a very early stage, sentinel nodes and infections, as well as cardiac and coronary vessel pathologies
Point-of-Care (POC)
Chemistry/Immunoassay, Hematology, Hemostasis
Automation, Diagnostics IT
(Blood) samples testing is performed close to the patient
Tests outside the traditional central laboratory and in a very short time
Pocket ultrasound systems as Point-of-Care system, mostly used in obstetrics
No need to wait for results from a lab
Easy to handle and cost efficient
Improving the workflow in physician's offices
Testing of body liquids such as urine or blood tests as well as the measurement of specific chemicals
Immunoassays as biochemical tests that measure the presence or concentration of molecules in the blood through the use of an antibody or immunoglobulin
Early proof of a broad range of diseases without invasive examinations
Reliable, fast and cost efficient analysis and ongoing observation of the course of diseases
Systems that can do multiple tests at once and then extrapolate the information
Moving samples to and from multiple analyzers, automatically performing additional tests or cancelling previously ordered tests according
to pre-programmed protocols
Allows caregivers to make faster and more timely treatment decisions for patients
High initial capital investment, but immediate returns on investment from improved lab efficiency, throughput and capacity
Customers and patients Market
Demographics:
Ageing and age-related diseases
Healthcare business
Cost pressure, industrialization of healthcare
Shortage of qualified HC professionals
Consolidation
Consumerization, patient centricity
Regulatory environment
Accountable care, outcome focus
Knowledge-based healthcare: Connectivity, big data
Technology
Pace of scientific advance
Expected impact on Siemens HC business: Positive Negative
Interventional
Angiography Mammography Molecular Imaging Imaging Software
Computed Ultrasound
Tomography Imaging
Women's health
Radiation therapy
Oncology Neurology
Radiology
Urology
Cardiology
Surgery
Intensive care unit
Molecular Testing
Point-of-Care Testing
Magnetic
EmergencyLaboratory
X-ray Imaging
Resonance Imaging Hemostasis and Hematology Testing
Technology | |
As they do so, they release some of the energy that they have absorbed from exposure to the high-frequency waves. This released energy is measured by highly sensitive receiver coils, and suitable techniques can be used to pinpoint its origin | |
Pros
•
•
•
•
•
•
•
No ionizing radiation Painless
Results
High resolution 2D or 3D imaging
Good soft tissue contrast ofhuge body parts Multiplanar Use cases Difficult fractures, joint problems, Cons Time effort soft tissue examinations, tumors, Mightneed contrast media MRI-Angiography, Brain MRI Noise | |
Copyright: Siemens MedArchiv | |
Market position #1 globally | |
Copyright: Siemens MedArchiv
Unrestricted © Siemens Healthcare GmbH, 2015
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Matthias Kraemer | Healthcare
•
•
Technology | |
specialized ceramic mixture - that converts the detected X-rays into light. Photodiodes then convert the light into electricity, and a converter produces digital data from the analog signals and transmits them to the computer for analysis dimensional model of the entire body, all | |
Pros Free of superimpositions compared to classical X-ray examinations
Results
•
•
•
High-contrast 3D pictures of the tissue
without a noticeable delay
Fast examinations compared to MR - thorax scan in less than one second Use cases Heart scan in one heart beat, painless Stroke(Neurology), head or spine injuries, internal injuries, diseases of Cons Ionizing radiation the respiratory system, tumor follow-up Mightafford injection examinations (Oncology), heart ofcontrast medium examinations (Angiography) | |
Copyright: Siemens MedArchiv © St. Louis Children's Hospital Barnes-Jewish Hospital, United States Copyright: Siemens MedArchiv | |
Market position #1 globally | |
Unrestricted © Siemens Healthcare GmbH, 2015
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Matthias Kraemer | Healthcare
Technology
Use cases
Routine physical exam (urine analysis),
diabetes management (blood glucose monitoring), emergencies or during an operation (blood gas analysis), gynecology
Use cases
Fertility testing, allergy, anemia, cardiac and tumor markers, diabetes management,
control of kidney function, urinary tract infections, bone metabolism, inflammations
Use cases
All four diagnostic disciplines of chemistry, immunoassay, hematology and hemostasis on a single automated track
More than 200,000 instruments installed worldwide, from hospitals to physician offices to the most remote locations in the world like the Australian Outback
More than 900 million patients tested per year, more than 7 billion tests provided per year
More than 1,300 installed track-based automation systems world-wide, more than any other company
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