Findings

Insights into the Portable Ultrasounds Market

• There is no information on how licensed practitioners learn about new devices in the portable ultrasound market or on sources trusted for such device purchases specifically.
• Several medical device providers and business media sites provide guides on how to choose an ultrasound machine. They include articles by Integra Medical Systems, Medical Expo, National Ultrasound, and Business News Daily.
• There are also case studies of portable ultrasounds, including Sonosite by FujiFilm. Based on the data on the trustworthy sources of information for new medical device purchase decisions, it is likely that they are important for licensed practitioners looking to purchase a portable ultrasound device.
• However, there is no data to confirm the above assumption.
• In the absence of information specific to the portable ultrasound market, the research focused on providing additional insights into the medical device market.

Online Sources of Information on New Medical Devices

• According to Penrod, a company that provides sales and marketing expertise in the healthcare industry, 50% of professionals who don't see sales representatives still take interest in digital promotions of medical devices.
• Additionally, 80% of physicians use the Internet for professional reasons.
• While email is the obvious choice for medical device companies to reach to licensed practitioners, it is quickly becoming overused.
• Penrod believes that online professional networks are the places where practitioners may be the most responsive to information on new devices. They include WebMD MedSpace and LinkedIn.
• Curtis Coulter also believes that regular social media networks are increasingly popular among healthcare practitioners. It cites research by QuantiaMD, according to which 60% of physicians think that social media improves the quality of care they provide and 24% use it daily for new medical information.
• The company mentions that many medical device companies have already capitalized on this trend, including Medtronic, which successfully promotes itself on Facebook, YouTube, Twitter, and LinkedIn.

Trusted Information Sources

• According to Evidera, hospitals and physicians have a system to evaluate new medical devices. They create value analysis teams (VATs) that include physicians, clinicians, and purchasing staff.
• Those teams base their assessments on sources such as papers published in peer-reviewed journals. They are trustworthy because they provide an independent, evidence-based opinion.
• Other sources include manufacturer's white papers, brochures, and evidence briefs, economic models that assess cost-effectiveness, and data collected through electronic medical records.
• The Digital MedTech Survey found that physicians overwhelmingly prefer to learn about new medical devices through educational resources such as case studies.
• Case studies are among the preferred types of educational materials. They can either serve as a source of information for physicians or for their patients. They typically include key data on the device, including "positive patient outcomes, reduce operational costs, increase productivity, lower readmission rates, increased quality of care, and staff and administrative efficiencies."
• Additionally, Definitive Healthcare believes that medical device sales can be influenced by Key Opinion Leaders (KOLs). They are physicians that have experience and respect within the specific health network or in a particular discipline or market. If device manufacturers manage to connect with them, they can not only advise on the go-to-market strategy but also act as intermediaries between medical device companies and physicians.
• One survey found that recommendations from KOLs are the top reason for choosing a medical device for 62% of healthcare providers.
• While it was not a winning factor, other choices weren't connected to a particular source of information. 94% mentioned consistent outcomes, 93% - positive patient outcomes, and 88% - durability.

Regulations in the Market

• As noted in the original research, in the US, medical devices are regulated by the Food and Drug Administration (FDA).
• The device's class determines the regulatory pathway. According to FDA, "most Class I devices are exempt from Premarket Notification 510(k); most Class II devices require Premarket Notification 510(k); and most Class III devices require Premarket Approval."
• Portable ultrasounds are considered Class II devices, which means that they require 510(k) clearance.
• After analyzing the database of 510(k) premarket notifications, we concluded that most such devices are regulated by Part 892 (Radiology Devices) of Title 21 (Food and Drugs), Chapter I (FDA Department of Health and Human Services), Subchapter H (Medical Devices) of the Code of Federal Regulations, which was last revised in April 2020.
• Specifically, portable ultrasound devices that have been approved recently, such as Butterfly IQ, Philips EPIQ, and FUJIFILM's Sonosite, have been regulated under section 892.1550 titled "Ultrasonic pulsed doppler imaging system."
• Additionally, manufacturers of such products have to comply with all relevant regulations from Title 21 of the Code of Federal Regulations (Subchapter J, Radiological Health) Parts 1000 through 1005.
• However, it is unlikely that those regulations have a big impact on purchase decisions since "there are no federal radiation safety performance standards for diagnostic ultrasound."
• At the same time, according to research by Evidera, the most important factor in new medical device purchases is a thorough analysis of existing data on the device's performance relative to price. It is influenced by declining or flat reimbursement rates.
• The above issue also makes the purchase process more structured and makes hospitals and physicians collaborate closer on making purchase decisions.

Research Strategy

Learning About New Devices

• COMPAMED and MEDICA are large trade fairs for medical suppliers and institutions. While individual practitioners are unlikely to attend these events, hospitals and large hospital groups are. In 2019, 121,000 trade visitors and more than 5,500 MEDICA exhibitors attended COMPAMED and MEDICA. In Germany, new devices for hospitals are often purchased through group purchasing organizations exterior to the hospitals, as well as through a centralized department within a hospital network.

•  Personal relationships between Medtech companies and individual buyers are essential and an often undervalued part of the buying process. This is particularly true for smaller clinics and individuals. Larger hospitals and university hospital networks form relationships with companies on a much larger scale, with one hospital often purchasing new devices on behalf of other hospitals in the network, nevertheless, forming professional relationships with suppliers is key in the purchasing of new equipment.
• It is a legal requirement for medical practitioners in Germany to undertake continued professional development annually, with 70% of this in their specialized field. This ensures that practitioners are up-to-date with the latest research and technical developments, and with the prioritization of digital healthcare in Germany, this includes the latest Medtech. Individual practitioners and smaller clinics learn about new technology as part of this development, with practitioners in larger hospitals informing and influencing decision-makers from a clinical perspective.

Online Sources for Medical Practitioners

•  The German Medical Journal has over 800,000 visitors annually. It is a peer-reviewed journal that includes news from medical research and innovations in medical diagnostics and equipment. With respected sponsorship partners including Medtech companies and medical suppliers, the German Medical Journal is a well trusted online resource for medical practitioners.
•  The Deutsches Ärzteblatt is the most widely read medical journal in Germany, offering specific editions aimed at GP's, clinicians, and other working doctors. It is the official journal of the German Medical Association and the National Association of Statutory Health Insurance Physicians, and the only publication aimed directly at doctors in Germany. The journal covers a wide range of topics including the latest developments in medical devices, diagnostic, and research tools.
•  MedtecLive runs online and in-person conferences and trade shows for medical professionals in Germany. They have partnered with respected government bodies and companies including The Bavarian Ministry of Economic Affairs, Regional Development, and Energy. The events include lectures, seminars, and networking opportunities with leading professionals and companies. A recent event in Dusseldorf was attended by 123,000 visitors and more than 5000 exhibitors.
•  Medizinio is an online portal for medical practitioners to compare devices and gain advice on purchasing new devices. They have a section dedicated to ultrasound machines and provide offers and information on top brands within the industry.
• The International Journal of Medical Device and Adjuvant Treatments publishes regular articles and papers about innovative devices and current research. The journal is peer-reviewed by experts in the field of study relating to each article, this ensures its credibility within the industry.
• The World Health Organization (WHO) publishes reviews, articles, and journal entries often highlighting the latest developments and news within the health sector. As a global organization, the WHO has become a well respected and established online resource for medical news, regulations, and developments.

What Professionals Look For in Medical Devices

• The German healthcare system is regarded as one of the best in the world, with a focus on innovation. More than 65% of German physicians see innovation as a priority in maintaining these high standards.
• In Europe, all medical devices must have the CE marking, meaning they are certified for use in Europe, however, studies have shown many practitioners prefer products that have been evaluated and reviewed by other neutral bodies. Consumers look for GS and TUV marks to show that an electronic device has been safety tested. While these marks are not legally required they will be something practitioners are looking for.
• As the third-largest market for medical devices in the world worth $37 billion, Germany imports fewer medical devices than other European countries with purchasers choosing devices manufactured in Germany instead.

Other Relevant Legislation

• The context for this research in Germany is that there have been two legislative amendments put in place in recent years that highlight priorities within the medical profession. There is a focus on digital transformation with the introduction of The Special Care Contract in 2015 and the Digital Care Act (DVG) in 2019.

• With the EU Medical Device Regulation coming into effect on May 26th, 2021 the regulatory requirements for medical devices will increase, causing practitioners to seek clarification on the compliance of new technology. Manufacturers with approved devices on the market have three years to demonstrate compliance with the new legislation.

Regulatory Framework /Government Requirements

• As outlined in the earlier research findings, Canada demands compliance with ISO 13485:2003 from the manufacturers of Class II, III, and IV medical devices, including portable ultrasound devices.
• Other sources are providing additional information regarding the regulatory framework for innovations and products in ultrasound technology.
• Health Canada has the regulatory authority of ensuring access to safe and effective medical products by the Canadians.
• The Food and Drugs Act (FDA) regulates imported and Canada-manufactured medical products, including medical devices sold in Canada.
• Non-regulated health professionals in Canada can be involved in portable ultrasound devices, but they are not under provincial or federal law.
• Canada’s non-regulated health professionals depend on professional associations such as Sonography Canada for regulation.
•  Health Canada’s Special Access Program approves the use of unlicensed medical devices in Canada.
• Sonographers, the greatest users of ultrasound devices, are bound by the guidelines for professional ultrasound practice as advanced by the Society and College of Radiographers and British Medical Ultrasound Society.
• The Canadian Association of Radiologists works with recognized experts and selected professional bodies to establish national standards and guidelines to promote safety, efficiency, and quality regarding ultrasound devices in healthcare.

Additional Helpful Findings

• There are now various high-quality options for portable ultrasound devices in Canada. The specific clinical needs inform which device is the best option for a healthcare practitioner.
• Health Canada has issued Butterfly Network a medical device licensing for its point-of-care ultrasound device called the Butterfly iQ.
• The Canadian healthcare practitioners and health systems can now access the Butterfly iQ, the world’s first whole-body portable ultrasound, to enhance the fight against the COVID-19 pandemic.
• The Canadian healthcare practitioners fighting the COVID-19 pandemic can now use the Butterfly iQ to perform lung ultrasound at the point of care. This portable ultrasound device has been effective in sensing pulmonary involvement in supposed COVID-19 patients.
• Sonosite lends portable ultrasound machines to Canada-based physicians and ultrasound-trained healthcare practitioners involved in humanitarian work.

Research Strategy

Regulatory Framework

• As outlined in the previous research, the NHS is the primary distributor of medical equipment in the UK.
• However, there are other websites that provide information specific to innovations, new product launches, and advancement in ultrasound technology.
• The British Medical Ultrasound Society is a non-profit organization that provides education and information regarding ultrasound to healthcare professionals in the UK.
• The society was founded in 1969 and has over 1,000 members. 
• The Society of Radiographers is the primary "trade union and professional body for the diagnostic imaging and radiotherapy workforce in the UK."
•  The College of Radiographers is the charitable subsidiary of the Society. Its aims to support radiographers through education and research in the field.
•  The British Society of Echocardiography is a charity organization that represents and supports clinical echocardiography professionals through education and accreditation.
• The organization holds an annual event that features multiple leading guest speakers in the field of echocardiography that discuss the latest advancements and newest products available on the market.
• The British Society of Echocardiography has more than 4,000 members. 
• The Society for Vascular Technology aims to "advance non-invasive vascular diagnostic services by promoting training and research in vascular technology."
• The organization posts quarterly newsletter to its members, featuring topical articles and updates on professional issues, and hosts joint study sessions with the Venous Forum and BMUS. 

Other helpful findings

• A medical device needs to conform to the requirements outlined in the UK MDR 2002. 
• The regulation states that any manufacturer that plans to sell a medical device in the UK needs to first verify that it is correctly classified. 
• The device must have passed a clinical evaluation procedure through an Approved Body that meets the requirements outlined in the UK MDR 2002 amendment.
• Moreover, the manufacturer needs to notify the MHRA of any safety and performance investigations and register the device with the organization.
• The UKCA mark is placed on devices as a way to indicate that they conform with the regulations outlined in the UK MDR 2002.
• There were no additional requirements needed for ultrasound devices, according to the Society of Radiographers, as the only outlined requirements relate to quality assurance and imaging practices.

Research Strategy

How medical professionals learn about new developments — general trends not specific to France

• In terms of preference, a 2015 study sheds some valuable insight on how healthcare practitioners learn about new developments in medicine.
• The study showed that online search ranks beneath ‘colleagues’ and ‘print medical journals’ when it comes to learning about new developments in medicine. The 2015 infographic study showed that 70 percent of medical professionals learned about new developments in medicine from their colleagues while 69 percent preferred print medical journals.

 

Source

 

• Further, the study indicated the rising relevance of digital sources with 70 percent of medical practitioners relying on mobile apps and 58 percent on online medical journals as their preferred online sources.
•  Another study conducted in 2016 showed more or less similar trends among medical professionals albeit with slight differences. It compared information search habits between junior and senior doctors and established that the former were likely to rely on online sources (70.4%). They also regarded peer-reviewed sources as the most reliable.
• Preference for online resources was mostly guided by speed, quality of information, and ease of access.  
• The results of these two studies reinforce the observations of a practicing doctor and associate director of the internal medicine program at Cambridge Health Alliance, who stated that for doctors and other frontline medical practitioners, ‘curiosity’ was the key to remaining updated in a rapidly changing state of medical knowledge.
•  Dr. Stark identified social media (Facebook and Twitter) as a crucial place for knowing what “experts and non-experts are talking about.”
• The reliance on social media is also highlighted by Dr. Hooman Kamel of Manhattan Hospital who relied on Twitter to follow up on the emerging critical-care practices by physicians in the wake of the Coronavirus pandemic.

France

Online Search

• Online search is one of the preferred methods by medical professionals in France to learn about, research, and purchase medical equipment including ultrasounds.
• In France, the go-to website for medical professionals seeking to learn about new ultrasound devices [and purchase] seems to be europages — a B2B sourcing platform that connects healthcare facilities to various manufacturers of ultrasound devices across France.

Medical equipment tradeshows

• Our preliminary search shows that medical equipment tradeshows are another source of information on ultrasound devices in France.
• These events take place every year and attract sizeable crowds of medical practitioners. For example, Health-It Expo is a bi-annual event held every May. It focuses on hygiene healthcare, medical devices, and biomedical technical units.
• Previous events attracted between 5,000 and 20,000 participants and 100 – 500 exhibitors.
•  SantExpo is another event that showcases recent technological developments in healthcare, management, information systems, and other healthcare facilities. Based on previous events, the attendance is 5,000 – 20,000 visitors and close to 500 exhibitors.

Advertisements

• Ads form part of the information platform from which medical professionals in France learn about new ultrasound innovations.
• All ads must get prior authorization from the National Safety Agency of Medicines and Health Products. Medical equipment advertised in France fall into two main categories — reimbursable Medical Devices (MD) for which only classes I and IIa are advertised to the public. The other is the non-reimbursable MD.

Best practices

• Medical devices in France must meet the following requirements:

• Ultrasound devices are regulated by Directive 93/42/EEC on medical devices (EU MDD). For the most part, the regulations seem to apply more on the part of manufacturers, distributors, and importers. These entities are required to comply with several annexes of the MDR and IVDR (Annex I, VIII, XIV, and Articles 13, 14, and 15)

Market distribution

 

Source

 

Research strategy

• Specific habits and trends on how medical practitioners in France learn about, research, and purchase new medical devices were not immediately identifiable using conventional search techniques.
• Therefore, to develop insights on these trends, we triangulated information using several academic studies that investigated the learning habits of medical professionals. We limited the studies to less than six years old to capture the most recent trends.
• We corroborated these study findings with real-life scenarios using case studies of medical practitioners from the U.S. The similarities were undeniable. We extrapolated these habits to the medical fraternity in general holding that similar trends are likely to characterize learning and purchase habits of French medical personnel of ultrasound devices.

How medical doctors and clinics learn about new medical devices in Australia

• The Royal Australian College of General Practitioners (RACGP)produces a magazine called Good Practice. They ran an article which talks about GPs using portable ultrasound devices in the field to assess and treat patients. This type of article would prove useful to medical professionals considering purchasing a portable ultrasound device.
• The RACGP also run workshops for GPs. One such workshop on their website, unfortunately, currently postponed due to the pandemic, is entitled Introduction to point-of-care ultrasound for rural GPs. The workshop aims to inform GPs how to use portable ultrasound equipment using five ultrasound workstation. The course is delivered by sonographers.
• The Consumers health forum of Australia produces blog entries which, medical professionals may refer to for information about medical devices.
• The TGA website has a list of its alerts involving medical devices and it indicates 14 items, ranging from thermometers to ventilators, that have been the subject of alerts to clinicians and consumers this year. This information would be relevant for medical practitioners considering purchasing new equipment.
•  Digitalhealth.gov.au produce blogs produce posts from healthcare subject matter experts, which would prove useful to licensed practitioners.
•  Australasian Society for Ultrasound in Medicine (ASUM) run workshops and events which may provide relevant information for those looking to keep their knowledge up to date with ultrasound developments with a view to purchasing equipment.

Process for licensed practitioners to purchase portable ultrasound devices

• In the article in Good Practice referred to above a GP explains how useful she finds her backpack ultrasound and how she made a business case to the RFDS (Royal Flying Doctor Service) to purchase more. The article confirms that this was successful and more devices were purchased for the bases in Western Australia and another for the Rural Women's GP Program.

Medical devices/equipment market

•  Goldstein Market Intelligence analysts forecast the Australian medical device market size to be growing at a CAGR of 10% for the period of 2017-2030. The report notes that intelligent medical equipment is officially endorsed by many hospitals and medical institutions, and by consumers, both of which are adding confidence to the Australian medical device market
• According to IBISWorld key buyers in Australia of medical equipment include General Practice Medical Services and Diagnostic Imaging Services.

• A report entitled the Medical Device Industry in 2020-2021: Key Trends & Outlook notes that in Australia, medical and surgical equipment accounts for more than half the industry’s revenue.
•  Industry revenue is anticipated to increase by nearly 4% over the next five years to AUS$5.5 billion, despite the pandemic and weak demand from the country’s mining sector.

• According to IBISWorld, medical practitioners and hospitals depend wholly on federal and state government funding to staff and equip clinics. The above report notes that Australia’s technological progression, however, is constrained by the likes of governments and public hospitals, as they are incentivized to keep a lid on capital expenditure.

Regulations

• The main regulations relating to medical devices in Australia are the Australian Code of Good Wholesaling Practice for Medicines and the Therapeutic Goods Act 1989 administered by the Therapeutic Goods Administration (TGA).
•  Advertising is covered by the above as well — under the Therapeutic Goods Act 1989, it is prohibited and is an offense to advertise to any person a medical device that is not included on the ARTG, which is a register of therapeutic goods that can be lawfully supplied in Australia.
•  TGA's website gives details of studies and a record of goods on the above register — doctors and other medical professionals would likely need to refer to this to ensure that any product they were considering purchasing met the required standards.
• Example of an entry on the register — Phillips Electronics Australia — handheld ultrasound equipment.
• The TGA take a risk-based approach to regulation which depends on the purpose of the device; the risk it poses to the patient; the user, those within the vicinity of it when it is in use; whether the device is for internal or external use and the length of time it is used for.
• The TGA operates a tender process and details of all open tenders can be found on their website.
• The Australian Government Department for Health sets out guidelines for the use of ultrasound in obstetric conditions. These were last updated in 2007 and do not make specific reference to portable ultrasounds, although they are likely to be relevant to portable devices as well.

Research strategy

How Licensed Practitioners Learn About New Medical Devices

•  Manufacturer sites: Licensed practitioners learn about new medical devices, including portable ultrasounds, from device manufacturer sites. For example, Philips provides information on new ultrasound products and its portfolio, like the Philips Epiq Elite ultrasound.
•  Exhibitions and conferences: Licensed practitioners also learn about new ultrasounds from exhibitions and conferences, such as the Australasian Society for Ultrasound in Medicine conference held in October 2020.
•  Advertisements: Practitioners learn about new ultrasounds through ads. For example, manufacturers and companies use the Australasian Sonographers Association (ASA) publications to advertise ultrasounds to ASA's members, including nearly 7,000 ultrasound professionals.

Sources That Practitioners Trust for New Device Purchases

Medsafe

• Practitioners trust Medsafe (the New Zealand Medicines and Medical Devices Safety Authority) for information on new device purchases in the portable ultrasound market. Medsafe conducts pre-marketing approval for all new devices, including ultrasounds. Practitioners trust Medsafe to tell them which devices have been approved for quality, safety, and efficacy before buying the products.
• Medsafe also conducts post-marketing surveillance to monitor the safety of medical devices in use. Unsafe devices are removed, and prescribing practitioners are advised about new safety information for products.

Ministry of Health

• Practitioners trust the Ministry of Health to provide them with information on new medical devices, including portable ultrasounds, that it has approved for marketing and use in New Zealand.
•  The Director-General of Health must approve any devices for the market.

The Health Navigator

• Practitioners trust and use the Health Navigator website to assist them when considering buying portable ultrasounds as the site provides information for health providers on ultrasounds.
• The website offers New Zealanders a single platform to find trustworthy and reliable health information and self-care resources.

MedTech Core

•  MedTech is another source trusted by practitioners for new ultrasound purchases. The site provides information for practitioners on ultrasound devices, including newly manufactured ultrasound devices and innovations like the Uri-Go.

The Medical Technology Association of New Zealand

• The Medical Technology Association of New Zealand (MTANZ) is a national industry body that represents medical technology companies in the country. It produces the New Zealand MedTech in Action digital publication.

• Practitioners trust MTANZ for new device purchases as the organization is a "leading medical exhibition management specialist for 30 years."
• MTANZ has offered exhibition management services for various conferences, including the Australasian Society for Ultrasound Medicine. This experience makes it an excellent source for new ultrasound device purchases.

Regulatory/Government Requirements That Physicians and Clinics Look for

• When considering buying portable ultrasound devices, physicians and clinics ensure that the device complies with the Medicines Act 1981, including ensuring that the device is safe to use. Physicians and clinics also ensure that the ultrasound devices they are considering buying follow the standard prescribed.
• Physicians and clinics look for portable ultrasounds that conform to the listed description as required by the Medicines Regulations 1984. The Medicines Regulations 1984 was created by the Governor-General after consulting bodies and organizations representing those substantially affected and on the advice of the Minister of Health.
• Some clinics and physicians consult the New Zealand Obstetric Ultrasound Guidelines when considering buying ultrasounds. The Guideline was created by a group of expert clinicians with help from the Ministry of Health and are used by health professionals like general practitioners, obstetric doctors, radiographers/sonographers, midwives, and radiologists. The Guideline provides "quality and detailed guidelines for maternity ultrasound, to ensure that diagnostic ultrasound usage in New Zealand is clinically appropriate and uniformly of high quality."

Research Strategy

Purchase Journey Insights

• Spain's imports of Ultrasound machines were $73,015,820 in 2019. The country imported Ultrasound machines worth $16,994,520 from Netherlands, $12,267,900 from the United States, $10,047,870 from Austria, $7,016,510 from China, and $5,166,070 from the Republic of Korea.
• Some compiled lists of physical sites to buy ultrasound machines disclosed a total of 10,235 stores that sell the equipment.
• Some of these locations have e-commerce capabilities, including:
•  www.maquinas-maquinas.com 
•  www.ftl-maquinas.es 
•  www.atu-ultrasonidos.com 
•  www.ultrasonidosgala.com 

• Comprehensive information on the portable ultrasound market with geographical distribution is available behind the paywall.

Regulation Insights

• Experts believe "Spain is far from meeting the Golden Rules standards regarding equipment renewal, and 1 out of every 3 ultrasound scanners is obsolete, with age exceeding 10 years."
• The European regulatory framework (applicable in Spain) ensures the safety and effectiveness of medical devices.
• Ultrasound devices from various manufacturers worldwide are welcome in Spain, provided they are approved by the European Union FDA. Spain follows the European Community Regulation 2017/745/EU on medical devices. This FDA authorizes portable ultrasound devices that are suitable for use in Spain.
• The main body responsible for all technical and quality aspects of medical products in Spain, the Spanish Agency of Medicines and Medical Devices (AEMPS) disclosed no specific regulations controlling the purchase of ultrasound equipment in Spain.

Research Strategy

How Medical Doctors and Professionals Learn about New Medical Devices/Equipment

• Italian medical doctors and professionals like radiologists leverage educational "videos on clinical topics," ePosters, white papers, YouTube, and online libraries to educate themselves on new ultrasound imaging devices. The most successful companies marketing ultrasound devices in Italy (such as Esaote) are keying into these preferences and utilizing Youtube videos, "online ultrasound webinars," posters, clinical eBooks, and iOS/Android APPs to educate medical professionals about their new devices.
• Medical doctors and professionals also leverage the website and other social media pages of manufacturing companies like their Facebook and Instagram pages to learn about new medical devices. One company keying into this preference is Esaote. The company provides general information about its "products, technologies and activities" to professionals through its ultrasound web page and related social media profiles.
• Esaote's YouTube page has 1,380 subscribers. The company has more than 20 training videos used by professionals to learn about ultrasound devices. Collectively, these videos have over 200,000 views.
• Medical professionals also use LinkedIn pages to learn about new devices. Esaote's LinkedIn profile has 28,890 followers. Most professionals following Esaote on LinkedIn also view pages belonging to other medical organizations such as Althea, ab medica spa, and GE Healthcare.
• Esaote has 34 followers on Vimeo. It has 1,798 likes and 2,116 followers on Facebook.
• A graphical representation of the resultant use of various online channels to learn about the solutions provided by one of Italy's top portable ultrasound providers (based on the number of subscribers and engagement or the number of content-related views) reveals that YouTube is the channel most utilized by professionals to learn about ultrasound devices.
•  
  Source
   

• The engagement statistics for various platforms belonging to Esaote is as follows:
•  
  Source
   

How Clinics, Medical Doctors and Professionals Buy Medical Devices/Equipment

• Public hospitals in Italy buy medical devices through public tenders. They leverage public tenders to research companies with products that qualify or meet their requirements. Interested companies willing to sell to these hospitals often submit adequate evidence that indicates their professional expertise and business experience before the hospital board makes a purchase decision.
• Tenders related to public procurements are published on the website of the National Procurement Center (CONSIP). Through tenders, public hospitals purchase about 75% of medical devices (including diagnostic imaging devices) meant for the Italian market, while the remaining devices (25%) are marketed to the private sector.
• One of the most successful companies marketing portable ultrasound devices in Italy, Esaote, recently sold 103 portable ultrasound scanners across four Italian regions.

What Professionals Look for When Buying Medical Devices/Equipment

• The first thing professionals do to consider if they can purchase a new medical device is to find out if the device has a CE mark. Professionals then try to figure out if they can associate the new medical device with an established diagnosis or procedural DRG code before purchasing the device.
• Professionals often check the National Formulary List (the NTPA or Nomenclature Tariffario delle Prestazioni Ambulatoriali). They also go through the NTPO (Nomenclatore Tariffario delle Prestazioni Ospedaliere) or the DRG in-patient list to verify if a new medical device is used for a listed hospital activity before purchasing a new device.
• A graphical expression of the decision-making process associated with purchasing new devices in Italy is as follows.
•  
  Source
   
• The process professionals used to determine whether to buy a device for diagnosing illness among in-patients across Italy is here.
•  
  Source
   
• A diagrammatic representation of the process professionals used to decide whether to buy a medical device for diagnosing illness among out-patients across Italy is as follows:
•  
  Source
   
• Apart from the factors highlighted in our previous research, some vital details professionals consider when buying medical equipment or devices in Italy include the details of devices flagged by regulating bodies often referred to as purchase "decision[-]makers" or influencers. The regulating bodies whose regulations these professionals watch out for include the Ministry of Health/Direttorato Generale Farmaci e Dispositivi Medici (DGFDM, or General Directorate of Medicines and Medical Devices), Commisione Unica Dispositivi Medici (CUD, or Commission for Medical Devices), Agenzia Nazionale per i Servizi Sanitari Regionali (AGENAS, or National Agency for Regional Healthcare Services). These regulating bodies often highlight issues associated with the use of some medical devices.
• Agenzia Nazionale per i Servizi Sanitari Regionali (AGENAS, or National Agency for Regional Healthcare Services) regulates the types of medical devices medical institutions can purchase to the cost-effectiveness of the services they provide to patients. The Ministry of Health/Direttorato Generale Farmaci e Dispositivi Medici (DGFDM, or General Directorate of Medicines and Medical Devices) develops policies to monitor the quality of purchased devices.
• Medical professionals or institutions that are interested in reimbursement relative to the price of purchased medical devices lookup guidelines provided by the Agenzie Sanitarie Regionali (or Regional Health Agencies), Commissioni Regionali Dispositivi Medici, and the Commissione Prontuario Terapeutico Ospedaliero (CPTO, or Commission for the Hospital Therapeutic Handbook) for device-specific information and guidelines.

Research Strategy