Preamble!

So, here is part 6 and the final of the promised portable device review series.

This is the Lumify from Philips, and we have been looking forward to this for a long while. Due to no hitch from the company, more from my side, I took delivery of the system 2 weeks ago.

So, what did we reckon to it?

Reviewer 1 – ED physician

My good friend Cian McDermott (@cianmcdermott) is an ED physician and fellow Ultrascoundrel. He travels the country and Europe with us teaching and promoting Ultrasound in all its guises. I was delighted when he said he would come on board with this review. So again, we have 2 takes on things!

 

What the company say

The Lumify is Philips’ solution to the handheld US device industry. It comes with all the mystery of the next Harry Potter movie and the impressive backing of Philips – a giant in the digital health & technology industry. The device has built a reputation and a half over the years and we always hear about it within our circles….at least 3 times a week (arbitrary nonsense statement really!). Check out the site below…

• “Philips has an established heritage in creating high-performance transducers. For Lumify, we were very deliberate about our selection of the right sensor technology that would deliver the absolute best image quality for each of our Lumify transducers without compromise. Parameters such as resolution, sensitivity and low power performance were key considerations in order to achieve the highest IQ and reliability possible in a Philips handheld ultrasound solution.”

Then there’s the augmented reality side! Now this is a huge area of development within medicine and we are still arguing till the cows come home as to which platform is safe enough within the often ridiculous constraints of GDPR etc. Obviously, as clinicians, patient safety and confidentiality is paramount…so let’s not moan anymore about this. So…REACTS…what is it? Take a look at the slideshow below…(courtesy off the Philips site).

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My Unboxing day!

A delivery came up to the unit addressed to me. I knew what it was! But, what I did not expect was a full unit, completely sealed in all of it’s ‘from the factory’, boxes!! Included was a Galaxy Tablet to run things from. Could this be complicated?? My colleagues were looking at me as if to say, ‘where have you got all of the cash from for this?!’

Off I went, breaking the seals!

As mentioned, all beautifully packaged with each probe in its own individual box. The Galaxy Tab had to be unwrapped as well.

So what’s it like – hands on?

Cian is in blue

Jonny is in Orange

I got the Lumify delivered to our hospital in a metal suitcase that was very impressive as I walked to the car park!

Display device

The display device is Android OS. In our case it was a Samsung tablet or you can connect it to a compatible smartphone. This will be a problem for many Apple users.

The probe is wired to the display device and plugs directly into the port on the base of the tablet.

The next step is to download the Android app on Google Play – I am Android user but this will not suit the majority of doctors.

My initial problem was the need to bolt the tablet onto my iphone in order to download and connect to the Play store. The 4G connection in our place is rather suboptimal! SO I had to turn off the software updates for the Tablet as it also tried to do this. I got there eventually, then you have to let it know your google account details before you can get any further on. Slight faff really.

No satchel but given a carry bag by our local rep in Dublin.

I also received a rather nice satchel with my device (brags!)

There is a nice firm plastic connection to the probe, but the one to the screen is less snug no problem after scanning

I found the connection to the device to be solid, but the phased array probe often became disconnected at the probe end whilst scanning. 

The App

Download it from the free Google Play store – Android only.

It is very intuitive…there is no faffing about at all. Once the probe is connected, you are essentially off!

The controls are a cinch to use. There is clear gain, depth, save, freeze image, save loop etc etc. You can pre-select different structures to scan (vascular / lung / heart / abdomen etc) via nice side images, as per which probe you connect. When you save a loop, there is a lovely reassuring beep too. Images are all stored in the local cache, from which you can export them to a destination of your choice. Files save as MP4, another feature I like. You can customise your clip length, we set ours to 4s. 

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So..all in all, a nice, user friendly app with no brainer functionality. Plug in and scan!! Well done Philips!

 

The Probes

As shown above, there are 3 probes – linear, curvilinear and phased array.

They have a very ergonomic feel to them, the right weight, all wired to whichever device you choose (Android smartphone or tablet). There is generally a good fit to the probe from the tablet. There is also a reinforcing plastic hub to protect the rather precarious small micro usb connector. As I mentioned, with the phased array, I got some disconnections at the probe end off and on. 

There are various screen gestures including patient info, zoom in and out by pinch, pan , annotations type and move. The system offers colour flow fast 60 for cardiac/ slow (38 for cardiac) as well as move and resize for the colour box. There is also M-mode.

 

The Scans

So, my only gripe and this could be me however, was that in order to get your scans exported, you can choose various destinations. Great right? Well, unless you have a separate drive / plugin USB converter, this is a little taxing. The other option is to export them out to email. Simple…seemed so, but I found you were limited to 4 scans of 4s only. This means sub-dividing the rest into separate emails and you can imagine what a pain this is for a full scan series. As a result, some got to me, others just didn’t send? Perhaps this was teething issues from my side. But, this could be easier with export to a cloud / google drive or dropbox. I think Google drive option is available, I just didn’t use it.

Nevertheless, the scans were fabulous!!! People around the bed spaces with me on my rounds were gobsmacked!

Lung

Pleural effusion in a patient with liver mets

Same patient, with effusion on the other side

Scans post ICD insertion and drainage showing almost complete lung re-expansion

Pleural effusion contralateral

Abdominal

Left upper quadrant

RUQ and enlarged gallbladder

Heart

L PLAPS view demonstrating complex located pleural effusion and almost perfect A4c!

Lines and Vessels

Brachial artery view

Arterial line wire in situ after longitudinal needling and vessel puncture

The Verdict!

Extra points from Cian:

• REACTS technology = Remote Education, Augmented Communication, Training and Supervision. See website
• There are a vast wealth of educational opportunities. It is possible to link the transducer to your Android phone and use Google Chromecast to link out to a central display device (essentially screen casting). This offers huge benefits for medical education and medical school curriculum integration. I used the Lumify to teach bedside sono-anatomy to our pre-clinical anatomy students. Fabulous!

General:

Portability

Number of probes

• 3…but you have to keep changing them over and you have to carry them all. Not overly cumbersome to be honest, but there are grounds they could be lost, become misplaced and changing them is a little faffy if we are pushed!
• Generally, ergonomically brilliant!
• Great weighting and flawless on most fronts.

Screen – dedicated or linked to tablet/phone

• Linked to Android based devices. Annoying for Apple fans, but the tablets offer really nice screen sizes.
• The Android based devices offer HD quality images.

Battery life

• Legendary on the tablets. Essentially, the battery time is the time on the tablet / smartphone battery.
• I don’t know what a phone based connection offers?

Interface, logistics and ergonomics – Touchscreen, user-friendly software?

• Fabulous app
• Fabulous integration and easy plug in and scan interface!
• My 9 year old could get this off the ground. It is simplicity at its best.
• Scans are easy to store and Lumify offer the usage of a range of cloud services (such as Tricefy, DropBox, TomTec Zero, Qpath, etc) or to any DICOM system free of charge.
• Customers get the opportunity to choose a device which suits their needs. The devices approved by Philips range from 5.5 inch phones to 18 inch tablets, both Wi-Fi and cellular. They update the list of approved devices regularly, ensuring Lumify remains future-proof.
• A detachable transducer cable, allows the potential for compatibility with new devices, platforms or operating systems in the future. As an example, they now offer a USB-C cable, allowing the use of Lumify with approved USB-C Android devices.

Cost

 Warranty

• 2 years standard warranty on the tablet provided by the manufacturer
• 5 years standard warranty on the transducers

 Probes

• Now…here is the caveat to the whole game!
• Each costs around £4999 plus VAT. 
• They will supply a free tablet too!
• When you add this up, for the full system, you are looking at £17k total! This and this alone is the major disadvantage
• Philips also offer a financing option for those customers unable to cover the cost of the system up front (T&Cs apply). In addition, discount is available for multi-transducer upfront purchases.

There are no other hidden subscription costs luckily!

Score and Conclusion

Cian

For me, Lumify is the best handheld device out there at the moment in terms of image quality, portability and remote broadcast technology.

The cardiac imaging in particular is fantastic

The user interface and user experience is excellent. Lumify comes close to the Philips cart based systems. We have been using this system at SMACC for a number of years with excellent results.

The price is steep, especially considering you may need to purchase more than 1 probe

Lumify uses Android OS which may be a disadvantage for some and an advantage to others.

My overall score is 9/10.

I have docked a point because of the high price and because 3 separate probes may be required

Right now, Lumify is the best in show….

Jonny

This device is one I was very excited to receive. I echo everything Cian says above and my score, like Cian’s, reflects pricing and the fact you really need 3 probes to get full benefit from this system. I realise that a tri-probe version would be nigh on impossible to produce. The closest we have at the moment it the dual probe technology GE offer in the Vscan.

Philips have produced a really nice system here and when compared side by side with the iVIZ from Sonosite, this pips it for me, as these two can be compared due to very similar concept set. A really lovely user interface, sharp images with beautiful probes and a great concept in REACTS.

As I have said before, I am much more a fan of wired devices over wireless. The wireless devices, for me, are trying to be too clever at the expense of good images and bad dropout when fast scanning. What I want though, is a device I can pull right out of my pocket and go, without the need to change probes. My bias unfortunately is reflected in my score from this angle.

My mark… 8.5/10