Inside the May 2006 print
edition of Canadian Healthcare Technology:
Feature Report: Developments in surgical
Toronto hospitals collaborate on
Three Toronto organizations – Mount Sinai Hospital, the University
Health Network, and Sunnybrook Health Sciences Centre – have joined
forces to develop an e-Learning system that allows for collaborative
creation and sharing of courseware and training materials.
Survey ranks top IT projects in hospitals across Canada
Canadian Healthcare Technology magazine’s most recent survey of IT
trends in hospitals found that technology spending is on the
upswing. The average hospital IT budget increased to 2.5 percent of
the operating budget in 2005, a hefty increase from 1.4 percent two
years earlier, in 2003.
READ THE STORY
Lakeridge Health, a hospital group based in Oshawa, Ont., has
successfully combined voice technology with radiology reporting. It
has also integrated its PACS with the hospital information system.
New X-ray technology
Physicians and researchers in Montreal, working in conjunction with
teams in Paris, France, have devised a new X-ray system that takes
high-res, 3D images with dramatically far less radiation for
patients. The system is designed for orthopedic applications.
READ THE STORY
Effective nurse-call systems
New technologies for alerting nurses, and for intra-hospital
communication, have recently appeared. They’re driving the use of
wireless solutions in hospitals.
Canadian Forces PACS
The Canadian Forces have implemented a Picture Archiving and
Communication System that will soon allow for remote diagnoses to be
completed in 60 minutes, as opposed to six weeks. The system has
been implemented at bases in Canada, ships at sea and foreign
PLUS news stories, analysis, and features and more.
Toronto hospitals collaborate on ambitious
By Andy Shaw
TORONTO – Reading, ‘Riting, and ‘Rithmatic sure ain’t what they used to
be in the healthcare setting – judging by the ‘e-learning’ initiative
undertaken jointly by Mount Sinai, the University Health Network (UHN),
and Sunnybrook Health Sciences Centre.
The three Toronto hospitals have been collaborating since 2004 with the
aim of doing nothing less than transforming how, both individually and
collectively, they certify, educate, train, retain, and recruit their
In doing so, they plan to eliminate the inefficiencies of traditional
instructor-based classroom teaching (while not doing away with it
entirely), and to capitalize on the convenience and cost savings of
self-conducted, internet-based e-learning.
So far, they have: surmounted their technical differences; jointly
purchased a common yet highly adaptable learning management system (LMS)
that initially can track the progress of 10,000 trainees; individually
deployed a number of LMS-driven courses internally; and are readying to
roll out a first training course that is common to all three.
The LMS, now a product of Mountain View, California-based SumTotal
Systems, provides a common database that all three hospitals can draw
on. The SumTotal platform is the foundation for creating and sharing
courses not only among themselves, but eventually among a wider circle
“This all started as an internal UHN nursing initiative,” says Brenda
Laurie-Shaw, UHN’s director of nursing informatics. “Our vice president
and chief nursing executive, Mary Ferguson-Paré, had asked us to see how
we could use technology to improve the education of our clinical nurses.
And that need sprang out of a number of things, including SARS, where we
learned how difficult it is to communicate new information quickly.
“Also, we do a lot of repetitive training for both annual certification
requirements and for new hires. We’re a multi-site facility, so we
recognized that even within our own hospital, we had duplication of
effort by educators developing similar training courses, which were not
standard across the organization.”
The appeal to UHN of applying educational technology, specifically a
learning management system, is that the hospital can escape most of the
costs and constraints of the physical classroom and make standardized
courses available to nurses on their own time, 24 hours a day, seven
days a week, from the hospital or from home.
An LMS can therefore free up clinical educators to spend more time
helping their charges apply their knowledge. What’s more, it enables
users to institute life-long learning practices that increase job
satisfaction, thereby helping to retain hospital employees and attract
Those possibilities, of course, were not unique to UHN. When Ferguson-Paré
presented UHN’s project to her chief nurse peers at other Toronto
teaching hospitals, she found a lot of interest among them.
“Our joint project really began in 2004, when all the teaching hospitals
in the Toronto area were invited (by the UHN) to come and discuss what
we might do together, since we all have to deal with so many of the same
training and courses,” says Marilyn Sanli, who is the manager of
information systems at Mount Sinai. “A number of those hospitals remain
interested, but in the end it was Mount Sinai, UHN, and Sunnybrook, who
made the commitment after we asked ourselves: Can we share content? Can
we share skills? And can we share costs?”
Saying “Yes” to all three by all three was made easier, adds Sanli, by
the sheer economics of collaboration.
“Together, we were able to purchase (with some Ontario Ministry of
Health help) a large volume of seats (10,000) at a far cheaper rate than
we could have individually. And with every system you buy, there are
implementation charges and project management charges and other one-time
expenses. So we were able to split all those three ways as well.”
Most importantly, given the idiosyncrasies of each hospital, the
tri-partite group also purchased authoring tools. The TrainerSoft tools
enable each hospital to create e-learning courses specific to their
“We each have a section in the database where we can store our
individual content,” explains Sanli. “And we set up security such that
we can each have our own say in placing restrictions on the database and
defining who gets access to what.”
But it is the common ground that’s most compelling.
“Every hospital has to do the same infection control, the same
occupational health, the same safety and other training courses that are
basically all the same,” says Sanli. “So no one hospital has to take on
the task any longer of developing something completely on their own.”
What the three hospitals have been doing on their own is not only
developing internal online courses, but also adding applications that
complement the shared LMS.
Sunnybrook, for example, is building Canada’s first clinical multimedia
library. With the help of Sonic Foundry’s Mediasite technology, the
hospital is automating the capture, retrieval, and sharing worldwide of
rich-media content – ranging from videos, audio tapes, webcasts, and
press conferences, to professional development tutorials – that can all
be used in a wide variety of ways, including as subject matter for
formal training courses.
“That was made possible from a Bell Canada research grant, and we’ve
used that in partnership with Sonic Foundry to develop the library,”
says Sam Marafioti, vice president of eHealth and chief technology
officer at Sunnybrook. “But it does fit with what we are doing jointly
with UHN and Mount Sinai in e-learning. The richer the content of our
library, the better off everyone’s training and education can be. It
adds value both to anywhere, anytime learning for individuals, and also
it helps foster the needed communication and teamwork that sustains that
learning. And here we have the library and our e-learning up and
running. All we are doing now is adding content to both.”
Mount Sinai, an old hand at e-learning, knows both its advantages and
its limitations. As a result, the hospital’s strategic approach to
education and training is a mix of new e-learning and traditional
“In fact that’s what we call our approach, ‘Blended Learning’, says
Sanli. “And what that means is that we take the best of technology-based
training and we take the best of classroom training and we blend them.
It’s a bit like belonging to a book club. You read the book first on
your own, and then you get together to discuss it, and compare with
other people what you learned from it.
“So the e-learning the nurses do from an online course on wound and skin
care, for example, that’s the knowledge acquiring part. But the second
part, when they actually take that knowledge and start applying the
know-how they’ve picked up about cleaning wounds, that’s when we get
them together in a clinic or a classroom, with other nurses and with an
expert instructor. Similarly, we have 500 of our physicians using the
LMS to learn about clinical applications, including our computerized
order entry system.”
All three hospitals are taking this blended learning approach, says
Sanli, and are working on common standards along with other interested
hospitals on how precisely they will share that learning.
“We have several collaborative e-learning committees that also involve
the hospitals who weren’t operationally or financially ready at the time
to help purchase the LMS system,” explains Sanli. “For instance, we have
one committee looking at technical standards, so that physicians who
work in more than one hospital can see just about the same screen,
except for the different hospital logos, no matter where they go. We
have another hospital that is looking at common content we can develop.”
Eventually, she predicts course content and types of trainees will
expand beyond its current focus on nursing interests at three hospitals.
Sanli sees as many as 100 or more courses on every aspect of acute
healthcare being available for healthcare workers of any stripe and in
more hospitals – as the hospitals see the benefits and buy their share
of seats in the SumTotal LMS.
Survey ranks top IT projects in hospitals across Canada
By Jerry Zeidenberg
TORONTO – Canadian Healthcare Technology magazine’s most recent
survey of IT trends in hospitals found that technology spending is on
the upswing. The average hospital IT budget increased to 2.5 percent of
the operating budget in 2005, a hefty increase from 1.4 percent two
years earlier, in 2003.
The survey, titled the 2005-2006 Report on IT in Canadian Hospitals:
Current Capabilities and Upcoming Acquisitions, was conducted in 2005
under the leadership of research director Richard Irving, PhD, a
professor of management science at the Schulich School of Business, York
University, in Toronto. The results were published in 2006.
The study obtained extensive responses from 51 hospital and
health-region CIOs about their plans for 26 different clinical
applications and 15 administrative or ‘infrastructure’ applications.
When respondents were asked to rank the ‘Top Clinical IT Project’
currently under way in their organizations, the breakout was as follows:
2. e-Charting for Nursing Staff
3. Computerized Physician Order Entry
Similarly, we asked the CIOs and IT directors to rank
their top projects on the infrastructure side. The breakdown was as
1. Single Sign-on
2. Enterprise-wide Disaster Recovery Plan
3. Integration Engine
PACS: PACS was far and away the leading clinical IT project
currently under development, most likely because the systems provide a
rapid return on investment (ROI), both from a financial and clinical
point of view.
As one radiology department chief told Canadian Healthcare Technology
magazine, “PACS lead to a 15 to 25 percent increase in the efficiency of
radiologists, and a 10 to 15 percent increase for technologists and
Recently, several sub-themes have emerged in the PACS marketplace. First
and foremost, hospitals are attempting to integrate cardiology
department images in their PACS. For historical reasons, and often as a
result of differing corporate cultures, cardiology and radiology
departments have in the past tended to establish standalone imaging
systems. It only makes sense, however, for radiologists and
cardiologists to have fast access to studies from both departments.
According to the survey, the typical PACS project costs $2 million or
more, takes 13 to 24 months to complete, and requires 400 to 500 person
days for implementation.
Electronic charting for nurses: Since it is nurses, not doctors,
who are checking on patients most often and monitoring vital signs, it’s
not surprising that hospitals are making electronic charting for nurses
a high priority. Once information is entered electronically in this way,
it’s much easier for physicians to read and analyze as they make their
It should be noted that some vendors, such as medical device specialist
Welch Allyn and communications giant Cisco Systems, are now releasing
solutions that collect vital signs and automatically feed the results
into electronic medical records. The systems not only ease the workload
of nurses and improve the accuracy of record-keeping, but they also
provide alerts for abnormal results and indicators – an advance on the
CPOE: Computerized Physician Order Entry systems are designed to
eliminate many sources of medical error. As such, they offer huge
potential benefits. In recent years, a good deal of troubling
information has emerged about the level of medical error in the
healthcare system. For example:
• In 1999, the landmark U.S. study by the Institutes of Medicine, To Err
is Human, estimated that 44,000 to 98,000 Americans annually die of
preventable medical errors;
• In 2004, Canadian researchers Ross Baker and Peter Norton released
Patient Safety and Healthcare Error in the Canadian Healthcare Sector,
finding that one out of every 13 hospital patients experiences an
adverse event, and that 37 percent of these are ‘preventable’. Moreover,
an estimated 16,000 hospital patients die each year in Canada as a
result of these mistakes. Adverse events add five to six days to the
hospital of stay of patients.
Until recently, few hospitals attempted to employ a CPOE system. Early
solutions tended to slow down the work of doctors – in order to process
an order that formerly took a few seconds on paper, some initial systems
forced physicians to complete a dozen or more screens, inputting data
and waiting for responses. This took between several minutes to a
half-hour – an unacceptable period of time for a busy physician. A CPOE
of this sort at Cedars-Sinai Medical Center, in Los Angeles, infamously
caused physicians there to revolt, resulting in the system to be
scrapped in January 2003.
While the Cedars-Sinai Medical Center CPOE is often pointed to as a
high-profile failure, the implementation deserves to be put into
context. The system was developed in-house, and management admits the
CPOE was ‘clunky and slow’. They also note that physicians were not part
of the development process. Nevertheless, during its short lifespan of
three months, the Cedars-Sinai CPOE generated 39,000 medication alerts,
35 percent of which led physicians to change their orders.
The median CPOE project costs $2 million plus, takes 13-24 months to
complete, and requires 500+ person-days.
Single Sign-On: Single sign-on systems enable users to
automatically enter various applications without logging out of one and
into another. Single sign-on can be a huge boost to productivity, by
dramatically reducing the time for a clinician to move from one
computerized application to another. Indeed, in the past, the time and
trouble to switch between computerized systems have created
disincentives for doctors and nurses to use them.
The size and scope of the problem is illustrated by the number of
systems that many hospitals currently have implemented. Ontario
hospitals, for example, typically run different systems for ADT, lab,
pharmacy, RIS, PACS, medication alerts and finance. They often tap into
adjunct systems, like the Electronic Child Health Network (eCHN), the
NORTH telehealth network, Cancer Care Ontario, and the Ministry of
Health and Long-term Care. Said Jamie Bowie, CIO at the Credit Valley
Hospital, in Mississauga, Ont.: “It is becoming more and more complex.
Currently, we have about 60 interfaces to support.” For its part, Credit
Valley Hospital has recently implemented a leading-edge single sign-on
system that’s designed to resolve this issue.
The median single sign-on project costs between $200,000 and $400,000,
and requires seven to 12 months to implement.
Enterprise-wide disaster recovery: When we asked CIOs about this
problem in previous years, some said they simply didn’t have the budgets
for both the applications they needed and off-site storage for back-up
purposes. As a result, they went ahead with application development, and
kept their fingers crossed when it came to disaster recovery.
Much more planning appears to be going on now – perhaps health regions
have been chastened by the experiences of medical centres that have
experienced actual disasters – such as Hurricane Katrina in the United
According to our survey, the median DRP project costs $50,000 to
$100,000 and takes seven to 12 months to implement.
Integration engines: We’ve pointed to the multiplicity of
discrete applications and computer systems operated by most hospitals –
typically dozens of different systems are used.
Not only is obtaining quick access a challenge; so is interchanging
data. For example, a clinician or administrator might want to update
fields in a patient record from an ambulatory clinic into those of the
hospital’s ADT or pharmacy system.
To do so, hospitals have been implementing integration engines – systems
that copy the right data into the appropriate fields of corresponding
Our survey found that the median Integration Engine project costs
$600,000 to $1 million and requires 7 to 12 months to implement.
While many of the hospitals and health regions already possess a good
number of clinical IT applications, many solutions are just starting to
appear in the healthcare system.
As a major part of the study, we identified the information technologies
that hospitals and health regions planned to acquire in the next 24
months. The top ranked systems were as follows:
• Data mining
• Computerized ER
• e-Medical charting for nurses
• Computerized discharge planning
• Computerized OR charting
• Scanned charts in EPR
• Barcode tracking systems
• Computerized charting for allied health professionals
• e-Medical charting for physicians
• Computerized ICU charting
• Computerized voice recognition
• Radio-frequency Identification (RFID)
Similarly, when it comes to the adoption of infrastructure applications,
the following will be acquired by many or most organizations in the next
• Web portals
• Wireless access to patient records
• Enterprise-wide continuity plan
• Enterprise-wide disaster recovery plan
• Single sign-on
• Biometric sign-on
• Patient self-scheduling
• RFID equipment tracking
In an earlier study, CIOs told Canadian Healthcare Technology
that 4 percent of the operating budget would be the amount needed to
successfully implement their plans. Despite the recent surge in
spending, that’s significantly more than what’s currently being
According to Dr. Irving, “Canadian hospitals have been under-spending on
IT for years and must now play catch-up.
“Moreover, substantial under-funding increases the risk of failure for
major IT projects,” added Dr. Irving. “One way the risk of failure is
increased is by extending the duration of the project to the point where
the technology becomes obsolete or at best, relatively ineffective and
“Another factor that increases the risk of project failure is the
temptation to take shortcuts that may cut costs, but which also reduce
the operational value of the project to the point where it is only
Dr. Irving emphasized that it’s important to have enough funding to
ensure that projects can be completed quickly, without cutting corners.
The 2005-2006 Report on IT in Canadian Hospitals: Current
Capabilities and Upcoming Acquisitions, is available from Canadian
Healthcare Technology. The full 74-page report, including 59 tables,
Voice-enabled PACS makes images and
reports available more quickly
OSHAWA, ONT. – A picture archiving and communication
system (PACS) at Lakeridge Health has made diagnostic imaging
essentially paperless – but not voiceless.
The Lakeridge Health PACS is among the first in the country to
successfully integrate a voice recognition system with what Lakeridge
now calls its Enterprise Imaging Management System (EIMS).
The voice recognition component of the EIMS automatically transcribes
the dictated reports of Lakeridge Health radiologists and appends them
to diagnostic images that are in turn made part of the electronic health
record (EHR) of the patient.
The voice-enabled EIMS links the four hospitals of Lakeridge Health, all
in Durham Region, just east of Toronto. Tied together are three acute
care facilities – a base hospital in Oshawa and two others in outlying
Port Perry and Bowmanville – as well as a specialty care hospital in
“It’s one of the few systems in the country that has integrated speech
recognition with PACS Radiology Information System (RIS) and an EHR,”
says Leon Chew, market development manager at GE Healthcare (Canada).
“Others have tried, but there’s only been limited success. And it’s a
particularly impressive accomplishment when you consider that the
Lakeridge Health PACS is running over lines between some sites that are
According to Lakeridge Health officials, not only has their
voice-capable PACS been a technical triumph, it’s been a business-case
winner as well. Their studies show that report turnaround times have
dropped dramatically. In the case of reports connected with Emergency
and In-Patient imaging, for example, the time it takes on average for
them to be available has dropped from 50 hours (pre-EIMS) to 15.9 hours
That speed improvement has translated into enhanced patient care.
“The fracture clinic is a great place to go for patient reaction,” says
EIMS system administrator, William Field. “You can tell that the patient
feels more involved, and is getting better care, because the orthopaedic
physician can call up the image of a broken foot or ankle, show it to
the patient and discuss it with them, all within five minutes of the
image being taken.”
Field adds that not having to store tens of thousands of film sheets is
a great cost and space saver within the hospital. Not to mention the
impact on the environment outside of it.
“We no longer have to get rid of the chemicals used to produce the
film,” adds Maria Hilts, EIMS manager. No more film, of course, means no
more chemicals. Equally impressive are the workflow efficiencies that
have been gained by radiologists. As they examine patient images on the
screens of their workstations, they dictate their findings. The words
they are speaking are instantly turned into text by the embedded
PowerScribe voice dictation application from Dictaphone.
Once recorded and signed off by the radiologists, any authorized
caregiver can view that text whenever a patient image is retrieved. “Our
PACS is a terrific system,” says Dr. Jay Dahman, a Lakeridge Health
pediatrician. “We can call up the radiologist reports along with the
images. The images are so crystal clear and so easy to manipulate and
measure. There is just no comparison with the old film and paper report
It’s important to note that the system spans the entire hospital and its
physicians. “We gave it that ‘Enterprise Imaging Management System ’
name because we wanted to make it clear that it meant more to the
hospital than just another diagnostic imaging project,” says Lydia
Antalfy, Lakeridge Health’s director of diagnostic imaging.
“We had interviewed our users and they told us they wanted to be able to
go into their Meditech patient care inquiry application and not only
find lab results and pharmacy results, but also to be able to click on
that record and bring up the patients’ images and attached reports,
too,” says Antalfy. “They didn’t want to have to enter a whole new
system, nor have to remember a different password.”
A simple enough concept, but back in 2004, when the EIMS got under way
at Lakeridge Health, there was no great confidence that the marketplace
could deliver it. “In response to our RFP (request for proposal), most
vendors told us they thought that kind of integration was possible, but
they admitted they hadn’t actually done it before,” says Antalfy.
“However, GE demonstrated to us, and to senior management at the
hospital, that they could bring it all together; that physicians could
enter the Meditech system and get all their images and reports.”
Consequently, GE Healthcare became prime contractor for the EIMS
project, supplying not just the PACS system itself but pulling in
Dictaphone and other suppliers. And the partners didn’t waste much time
setting up the system.
“We took a modality by modality approach and moved quickly,” recalls
EIMS manager Maria Hilts. “At the main Oshawa site we first went live
with two imaging modalities, CT and MR. And right from the outset with
those we were paperless and had speech recognition built in. Then,
within the next six months, we had the rest of our modalities, save for
nuclear medicine and mammography, similarly operational at each site.”
And now, the image-toting EIMS also extends off-site to Lakeridge Health
physicians’ individual offices and homes.
“Most of our physicians have VPN (virtual private network) access to our
EIMS via the internet,” explains Ehab Fanous, information technology
(IT) systems consultant at Lakeridge Health. “After they log on to the
VPN, they can securely go to the Meditech Hospital Information System.
It has a link to a GE Centricity web server from which they can call up
the images and the reports.”
Similarly, physicians on rounds at the hospitals can view the same data
from Lakeridge health’s unique ‘COWs’ (computers on wheels) at the
The EIMS stores its diagnostic images and reports for immediate
retrieval on an HP Storage Area Network (SAN). For long-term storage, GE
gave the EIMS two-tier archiving that files one copy of each image and
report to a DVD jukebox from Plasmon and another copy to a tape storage
unit from StorageTek.
Antalfy says Lakeridge Health is now working on expanding EIMS’s
functionality and reach: “It’s an image management system, so we can add
almost any other kind of digital images to it. We’re looking in future
at adding images produced by mammography, cardiology, opthalmology, or
endoscopy – really any image that can be taken of a patient and added to
the patient’s electronic health record.”
Innovative X-ray takes fast, whole-body images, at low dosages
Two Montreal hospitals have installed prototypes of a
new X-ray scanning machine that can produce whole-body images, with
patients standing upright, in just 15 seconds.
Called EOS, and co-developed by teams in Montreal and Paris, France, the
device takes high-resolution, 2D or 3D images using 8 to 10 times less
radiation than standard X-ray machines and 300 to 1,000 times less than
a CT scanner.
“The EOS radiograph of the whole body is very fast,” commented Dr.
Jacques de Guise, professor at Montreal’s Ecole de technologie
superieure and director of the Imagery and Orthopaedic Research
Laboratory at the CHUM. In comparison, “if you use standard X-ray
equipment and films, it could take 45 minutes to image the entire
Dr. de Guise, a leader of the teams that have devised the new
technology, commented that today’s multi-slice CT scanners can also take
very fast images, but they emit high doses of radiation. “To make 3D
reconstructions from the transverse slices will require 500 to 600
images,” he said. “That’s a lot of images to store and process, and a
lot of radiation is produced.”
By contrast, the EOS scanner requires just two images – one from the
front, one from the side. From that information, special software is
used to create the 3D images that are needed.
That being said, Dr. de Guise stressed that EOS is not meant to replace
CT scanning, but is a complementary technology, especially in the
The EOS devices were installed in March at the Centre hospitalier de
l’Universite de Montreal (CHUM) and the Centre hospitalier universitaire
They will be used primarily for research purposes, but patients will
benefit dramatically on the clinical front.
For example, Dr. de Guise noted that every patient requiring attention
for scoliosis at the Hopital Ste. Justine, a pediatric hospital, will be
enrolled in the research program using the EOS scanner.
That means children who require multiple X-rays to check their
condition, plan surgery and treatment, and to conduct follow-ups, will
obtain imaging with dramatically reduced levels of radiation.
“There will be 50 to 60 subjects a week,” commented Dr. de Guise. “The
lower dosage is a superb benefit for them.”
Similarly, many patients at the CHUM will attain the same kind of
advantage when enrolled in the various research projects surrounding the
At the same time, the images produced by the scanner are expected to
enable surgeons and other physicians to provide better diagnoses and
treatments, due to the more detailed 3D images they will obtain.
The dual-ray EOS scanner, it should be noted, has a unique upright
design, allowing patients to be scanned while standing.
This is extremely important to orthopedic specialists, as it allows them
to see the effects of weight and pressure on bones and joints. As a
result, they can better prepare for treatments – such as braces – and
The EOS scanners at the two Montreal hospitals were acquired at a cost
of $1.2 million. Of that, 40 percent was provided by the Canada
Foundation for Innovation; 40 percent was from the government of Quebec;
and the remaining 20 percent came from the partner institutions.
The systems will be commercialized by the lead French partner, Biospace,
based in Paris. Dr. de Guise was unsure of how many could be sold in the
years to come, but he said orthopedic surgeons and other musculoskeletal
specialists who have seen the system have been impressed.
“They like it very much,” he said. In particular, they like the
standing-up orientation of the images, the fast head-to-toe scanning,
and the simultaneously available front and side images.
While it’s a specialized system that’s aimed at orthopedics, Dr. de
Guise noted that with the aging of the general population, orthopedic
issues are becoming increasingly important.
Dr. de Guise explained that two major innovations are responsible for
the dramatically lowered X-ray dosage in the EOS.
First, a unique X-ray detector is used, based on cutting-edge research
by French professor Georges Charpak, the 1992 Nobel Prize winner in
physics and founder of Biospace.
In addition, very thin beams are used by the X-ray generators, which
were designed and built in Quebec.
Dr. de Guise estimated that the software used in the device was
developed equally by teams in Quebec and France – a 50-50 effort.