CrowdMed is a crowdsourced medical diagnosis platform. The company participated in the most recent Y Combinator class and launched publicly today at the TEDMED event in Washington, D.C.

“The premise of the wisdom of crowds is that a large group of nonexperts can be very wise once you have the right mechanisms in place to aggregate their collective intelligence,” said founder Jared Heyman in an interview with VentureBeat. “Many people operate under the assumption that crowds are unwieldy, but they can be smarter than expert individuals. If I had to choose between one doctor and one random person on the street for a diagnosis, I would choose the doctor. But if I have to pick between one doctor and hundreds of people with relevant information to share, I would pick the crowd.”

Heyman previously founded an online market research firm called Infosurv, where he experienced the power and accuracy of collective wisdom, and its capability to predict potential outcomes. In 2003, his sister got sick with an undiagnosed medical condition. She spent years going to specialist after specialist, but none of them could figure out what was wrong. By the time she was diagnosed with a rare disease that affects one in 15,000 women, she had seen 16 different doctors and racked up over $100,000 in medical bills.

“This illness almost killed her — she lost three years of her life,”  he said. “Many physicians are hyper-specialized these days and have a hard time seeing things outside of their speciality. This is a problem with the medical system, which meant my sister couldn’t get an accurate diagnosis. I thought there has to be an alternative between Google searches and WebMD and bouncing from doctor to doctor.”

Heyman said that while individuals can only hold so much knowledge in their heads, a crowd can hold an infinite amount. On CrowdMed, people anonymously submit a case into the system, providing information about symptoms, medicine history, demographics, family history, and case reports. Then the community of “medical detectives” (MDs)  suggest likely diagnoses and place bets on which outcomes they think are correct. CrowdMed’s patented prediction market technology aggregates feedback from the crowd and distills it down to a probability that can be assigned to different diagnostic suggestions for each patient. There is a leaderboard, so MDs only offer suggestions or place bets when they have something valuable to contribute.

“Our philosophy is that medicine is an individual sport right now, with doctors working in isolation to solve a patients’ case,” Heyman said. “We believe it should be a team sport, with lots of people collaborating to provide accurate diagnoses more quickly at a lower cost. This goes against the grain of how medicine is viewed today, based on the knowledge of experts who go to school for a lot of years and have a prefix before their name.”

The founders have been developing CrowdMed for four years. During the beta period, they built up a community of more than 700 people through word-of-mouth and through partnerships with organizations like Stanford medical school. So far, about 25 cases have gone through the system, and Heyman said they have a “high hit rate.” He gave the example of a child with a rare disease called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, or PANDAS for short. The patient had previously visited over 20 doctors and generated $250,000 in medical bills. Heyman said on CrowdMed, he got the correct diagnosis in a few hours because one of the detectives was familiar with his symptoms. The technology amplified this insight, the community agreed with it, and the solution was assigned the highest probability.

The service costs $199 per case with a full money-back guarantee if the diagnostic suggestions are not satisfying. CrowdMed also collects a $20 refundable deposit when users tell them the final correct diagnosis, to reward the MD community. Heyman said that they are working on a partnership with a major medical journal, and hope that instead of competing with physicians, CrowdMed becomes a tool they themselves use to achieve greater diagnostic success.

Along with its launch, CrowdMed also revealed that it has closed an initial seed round of $1.1 million led by New Enterprsise Associates and including Y Combinator, SV Angel, Andresseen Horowitz, and Greylock Partners.

Photo Credit: CrowdMed

The ability of technology to impact healthcare is one of the topics discussed at HealthBeat, VentureBeat’s upcoming health conference.

Of all the noble causes out there, the prevention of infectious disease is high on the list. This is certainly part of the mission for biotech company Visterra, which has completed a $26 million round of funding to support technology that discovers and develops antibodies used in the prevention and treatment of major diseases. The company’s lead product, VIS410, targets multiple types of influenza, and the investment will contribute to widening the scope of the platform.

The Bill & Melinda Gates Foundation and Omega Funds contributed $13 million, in addition to a $13 million previously raises from Polaris Venture Partners, Flagship Ventures, and Lux Capital. Visterra is based in Cambridge, Mass. Read the press release.

ZocDoc is making a huge step forward in its mission to simplify connecting patients with doctors. The company today announced ZocDoc Check-In, a feature that lets you complete medical forms before an appointment, and prepopulates that information for future doctor visits.

ZocDoc, one of New York City’s hottest startups, boasts that this is the first major product it’s added since launching in 2007. The company’s core service lets patients quickly find doctors (who pay $300 a month to list on the service) and book appointments online or through its mobile apps. ZocDoc now serves more than 1.8 million patients per month.

“It’s something [the check-in product] we’ve been developing and testing for some time now, but we wanted to perfect it before rolling it out more broadly,” ZocDoc founder and CEO Cyrus Massoumi told VentureBeat over e-mail today, when asked how long the company was working on the new feature. “Not only is there a highly complex engineering and data entry effort involved in uploading or converting each practice’s forms and tagging each field. There’s also a tremendous human engineering piece to this. We needed to extensively test this with some of our practices prior to launch, to ensure that the training we provided led to good adoption among practices and offered a stellar experience for patients.”

ZocDoc Check-In is free for both patients and doctors, and the company says around 10 percent of patients will have access to the feature today. Being able to fill out paperwork early was the most requested feature from patients, ZocDoc says. Not surprisingly, medical officers testing ZocDoc Check-In have reported more efficient workflows and increased accuracy for paperwork.

“Our goal has always been to build products that empower patients and address problems in healthcare that haven’t yet been solved,” Massoumi said. “In launching ZocDoc, we learned that in order to meaningfully shift behavior on both ends of the healthcare system, it’s crucial to pursue mutually beneficial solutions that can address pain points for patients as well as doctors.”

Currently the feature is only available for desktop use, Massoumi tells me the company isn’t looking into a mobile version yet.

ZocDoc’s service now covers doctor appointments in 31 major metropolitan areas, and the company says it covers more than one-third of people in the U.S.

The company has raised around $95 million so far, including a large $50 million round last year from DST Global.

When I started in the healthcare field more than 25 years ago, the only thing that a healthcare IT startup needed was a good idea — a new technology, maybe, or a new scientific pathway. “If you build it, [they] will come.”

But 25 years later, a lot has changed, and startups need more than just a good idea if they want to secure growth capital to expand their business.

So, when I talk to prospective Safeguard partner companies, one of the first questions I typically ask tells me everything I need to know: “Who’s your customer?”

In a competitive funding environment, early- and growth-stage companies need to know who will buy their product; whether or not that customer is going to pay for their product; and why that customer would be willing to pay for it.

The paradigm shift

“Build it and [they] will come” is no longer an effective business strategy, especially in healthcare IT, where the complicated web of payment and reimbursement has blurred this formerly simple equation. Innovation and the “next big idea” have shifted from a push model to a pull model, andstartups need to adapt to that.

Some companies — like Apple — aren’t affected by this paradigm shift, as they effectively control their market. An example that’s closer to home is Avid Radiopharmaceuticals. Avid creates diagnostic molecular imaging tests for neurodegenerative diseases like Alzheimer’s disease. Avid developed its imaging tests with no specific customer in mind, believing that the ability to rule out an Alzheimer’s diagnosis was valuable. Eli Lilly confirmed that value when it acquired Avid in late 2010 for $300 million upfront, plus an additional $500 million in contingent consideration (payable upon the achievement of future regulatory and commercial milestones).

But the push model in healthcare IT is risky and expensive. Entrepreneurs improve their chances of success if they work to understand unmet market needs, not just what they think the market wants. Unless there is a “pull” from customers, patients, providers, or payers, an entrepreneur inhealthcare IT won’t be able to capitalize on just a good idea.

Identify your customer and what you can do for them

Who are these so-called customers? Big picture, they might include patients (consumers), providers (doctors, hospitals, etc.), and payers (employers, insurance companies, and government entities, including Medicaid and Medicare). The customer mix will vary for each company depending upon the specifics of the business.

A lot of IT ideas make sense, they aim to make healthcare faster, better, or cheaper. But startups need to determine who benefits economically and when. When startups seek venture capital financing, they should gear their pitch toward ROI as it relates to their customer.

Think about the following questions:

• What is it worth for employers to have a healthier workforce in terms of productivity, for example?
• What is the value of decreasing compliance with therapy or keeping patients out of the hospital?
• Is that ROI calculation backed by data or does it have to be proven to a benefits administrator or payer?
• What problem are you solving for the customer?

For example, Medivo implemented a pull model around patient health management. It enables patients to order lab tests online and better understand the test results so they can be diagnosed early, appropriately treated, and monitored. Physicians and patients both benefit from this service, but neither is an ideal customer.

Instead, Medivo targets payers and biopharmaceutical and medical technology companies, all of which benefit from successful interactions between patient and physician. Those interactions help doctors correctly diagnose ailments and encourage patients show up for appointments and adhere to appropriate therapy. As a result, Medivo has had customers virtually from the start, one of the reasons why Safeguard was attracted to the company.

Understand your customer and the industry

Even after identifying the customer, healthcare IT startups face another challenge: no one really truly wants to pay. Consumers certainly don’t want to pay out of pocket. Providers are dealing with shrinking reimbursements, which limit the dollars they want to part with. Private payers strive to remain financially competitive. Medicare is dealing with growing entitlements. Sales cycles are long. Customers can be monolithic, and it’s important to identify an advocate within some of these large organizations.

Another issue is that technology, reimbursement, and policy change over the protracted timelines for biopharmaceutical development. And most of the solutions being proposed are incremental at best. Traditional biopharmaceutical development typically follows a push strategy. But no matter how much startups understand the problem and how good the solution, the time to market is relatively long, and the market will most likely change by the time these companies get there.

In this space, the pull model generates technologies that enable more accurate use of biopharmaceuticals or medical technology. These are potentially shorter term solutions that improve outcomes, decrease suffering, and save money. A lot of diagnostic testing as well as faster and cheaper DNA sequencing fall into this category.

Looking forward

In spite of the obvious economic and societal benefits, general adoption of health and wellness is slow. But in the not-too-distant future, much of this will truly matter. Healthcare reform and increasing costs will demand solutions. ROI will become more apparent. We will be not only personally rewarded for staying healthy, but economically rewarded as well. Physicians and other providers will also benefit by keeping us well or managing our illnesses in a more cost-effective manner. It’s just a matter of time until the ability of the tools at our disposal intersects with serious demand for better outcomes.

So bottom line for all you entrepreneurs out there in healthcare IT: Create a target product profile, and then figure out who your customer is. Identify the customer very early on in the process. If you want to improve your business’s chances of success and funding from angel investors and venture capitalists, keep asking yourself, “Who’s our customer?”

Dr. Gary Kurtzman is the managing director of Life Sciences at Safeguard. He has more than 25 years of experience in operations and investments, leveraging his medical expertise to enable businesses to enhance their products and grow their services, as well as to discover new partnering potential in developing entrepreneurial companies. Check out more posts like this at the Safeguard blog.

Health tech image via Shutterstock

These days, particularly in the wake of Facebook’s $5 billion S-1 filing, few will argue the explosive impact that social media is having on the way we live.

We see it in the way relationships build, the way messages spread, and the tremendous amount of data that’s been assembled about who we are and what we do.

The potential is huge; but until very recently, physicians have been largely unable to take full advantage of what these connections have to offer. Specifically, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 prevents doctors from using email or text messaging, much less open platforms like Facebook or Twitter, to communicate about patient care without risk of being fined or fired.

Still, the potential for physician-focused, web-based networks is huge, and HIPAA-compliant tools and sites have indeed started to take shape and populate.

Healthcare itself has been (often rightly) criticized as slow to change. In fact, Dr. Leslie Saxon recently published an insightful article on why the Internet hasn’t yet had any real impact on how medicine is practiced.

But research has shown that as far as technology goes, doctors themselves have proven to be early adopters. Having seen the kinds of conversations that have already begun to take place, I strongly believe that the future of digital medicine will be anchored in these kinds of connections.

Think, for example, of the impact of having a rural doctor in Alaska be able to send pictures of a complicated emergency case to a former classmate now working at a stroke center in Boston — and getting real-time feedback. This is where, in my mind, social networking truly goes from entertaining to life-changing.

With physicians connecting in real time across specialties and beyond the traditional bounds of hospital walls, patients may soon be able to stop worrying about getting access to the right specialist.

Medicine’s brightest minds will be accessible from the remotest spots — on an airplane, at an underserved clinic, or in the thick of a disaster zone. Soon, any doctor with a mobile device will have the resources and reach to pull together a personalized, patient-specific team of experts for any given case. Sometimes, it will take as little as a question to the right expert in a sub-specialty to change the course of treatment for the better. In other instances, more lasting and meaningful collaborations might take shape.

Information itself is poised to travel differently, too. Facebook and Twitter are already showing us how effectively networked communities can transmit important data, and even bring obscure new ideas to the forefront of cultural debate.

For doctors, who have historically relied heavily on sifting through a surfeit of medical journals, this kind of hive-minding can help ensure that the most promising and thought-provoking research or techniques rise to the surface and reach a wider audience. Moreover, by posting, sharing, and commenting on articles and cases within their professional networks, physicians will become more active and engaged participants in the future of medical research and learning.

The existence of these large and overlapping communities of doctors promises to tap a goldmine of public health data. Using discussion threads about symptoms and outbreaks, the spread of infectious disease can be tracked automatically, as can the efficacy and speed of treatment plans. Complications of new therapies, previously unknown risk factors for common diseases, even entirely new disease entities may be identified from increased sharing of data that has until now lived in the filing cabinets and memories of individual physicians.

The social power of networks like Facebook and Twitter to connect, entertain, and enrich our lives is undeniable. It’s time to extend the networking paradigm to healthcare and reap an even more substantive set of rewards.

Alex Blau, MD, Medical Director at Doximity, is a graduate of the University of California San Francisco School of Medicine and trained in emergency medicine at Stanford Hospital and Clinics. He has been working in the emerging mobile health space since he was a senior medical student, when he founded MediBabble, an iPhone-based medical language interpretation tool now in use by more than 15,000 health care professionals. In addition, Dr. Blau has worked as a healthcare journalist, has been published in multiple journals and textbooks on emergency medicine, and has been an invited speaker at national conferences on early stage startups and innovation in healthcare.

Image courtesy of lightpoet, Shutterstock

Every single person in the world has a health story. As a doctor, my job is to help people edit the story that your health is telling and to treat your story as unique to make you healthier. It’s our signature challenge to become more efficient and accurate editors as digital healthcare begins to scale worldwide, which can create 8 billion health stories.

My own story as an MD — and my interest in Big (Health) Data — started when I was an intern in my hometown at St. Louis City Hospital in 1985. I thought I could make a contribution treating people in the inner city.

I spent many on call nights in the ER. The ER itself was like a war zone: violent, dirty, full of law enforcement officials, and in the middle of this chaos, families bringing in their sick kids for elective things. There wasn’t and still isn’t an evening option for working parents, and the system fails the indigent poor most dramatically.

After three years in the inner city hospital system, I realized that neither patients nor providers had the tools to deliver effective care and that the solutions to health problems there were largely political and out of my control.

I left St. Louis and moved on to training as a cardiologist and then as an interventional electrophysiologist. Seven years later, I became a high-tech specialist working at a major university in San Francisco, implanting sophisticated devices that treat and actually prevent sudden cardiac death.

It was lucky timing: 1995 was the beginning of an incredible 10-year high-tech wave in heart disease innovation. When I was in San Francisco during the 1990s dotcom boom, I watched as Silicon Valley introduced us to the Information Age. It has changed my world, but it hasn’t much changed how I practice medicine. Back then, we doctors and dotcomers were sitting in the same restaurants, but we weren’t drinking the same Kool-Aid.

It took a decade but the digital revolution finally started coming to medicine. I found myself sitting in meetings on Sand Hill Road with venture capitalists and technologists talking about the big opportunity in health: scaleable health care that could help hundreds of millions of people. But technology companies were too afraid to assail — or too timid to tame — the beast of healthcare.

Mostly, they still are. Today, we have thousands of health and fitness apps connecting us to digital “coaches” and helping us socialize with our friends, but we don’t have a medical platform. We don’t have a medical Google, or an Amazon, or a Facebook. We don’t even have an AOL of medicine. What we mostly have is a Wikipedia for medicine, which I and my fellow clinicians and colleagues quote daily. (That’s a good thing.)

We have had some big successes with digital medicine. In my field about six years ago, device companies started putting antennas into implanted devices. We now analyze data from those devices in more than 200,000 patients. We’ve collected information on 20 million device downloads, recorded 150,000 life-saving interventions, and collected millions of pieces of valuable additional data. The numbers were clear. Here is what we’ve learned:

If you open up this implanted device to the network, people live longer.

We live longer and healthier lives when our health is continuously monitored by a device and exceptions to normal health are reported by the device to our caregivers. The technology exists and is often very inexpensive. It keeps people out of hospitals; saving money and lives. We’ve proven that.

So why aren’t we doing more monitoring? It’s not a regulatory problem or a lack-of-vision problem in the medical and technology companies; it’s that there’s too much perceived risk in changing the medical structure.

These technologies could profoundly improve the basics of how we practice medicine. Being connected fundamentally changes the doctor-patient relationship.

We get continuous data, review exceptional events daily, and can alert patients when they need help. We can catch disease patterns as they are happening. We have the potential to act within minutes or hours versus months in the traditional follow-up clinic. Patients can learn to partner in their care. They can be meaningfully engaged and empowered. We live in the so-called Information Age. A time when you can look up anything: bank records, flight information, and the price of tea in china. Just about anything.

But how many of us have a copy and control of our own health records or that of our family members? How many of us interact with our own health data as fluently and seamlessly as we do with our finances or sports scores?

A common view in the medical community is that people don’t know how to handle their own health information. That it takes a professional to interpret it. How would we feel if we were told we couldn’t handle our own banking information or our kids’ report cards? Meaningful access to our personal health information is a right, and encouraging that access will become one of the most important civil rights issues of our era.

Over the next two years mobile phones and inexpensive sensors will better connect us, if we choose this path. We will see individualized care on a scale that would have been unimaginable just a few years ago.

Imagine your doctor calling you to schedule an appointment because she knows the condition of your body, rather than vice versa. We see products at the University of Southern California Center for Body Computing before they hit the market: sensors are becoming more powerful and much smaller.

At the USC Center for Body Computing, we conducted a study using the AliveCor ECG case. (We presented the results a couple weeks ago at the American College of Cardiology.) We gave it to 50 people with iPhones who attend our yearly Body Computing Conference. We found people transmitted an average of 36 30-second tracings a week.

I personally reviewed all the tracings. In one situation, I was able to diagnose acute cardiac ischemia in a Nigerian gentleman in Mumbai from my home in Los Angeles by reviewing a 30-second ECG collected on the iPhone. Helping this person was personally gratifying and represents a brilliant example of leveraging our experts across the globe.

We have a global wireless network that is ruthlessly efficient, more mobile phones than people, and global carriers that can deliver medical data continuously. We have tablets with medical grade image and video quality capability. We have diverse digital storage capabilities. We have vast social networks. The most successful companies in the world right now make or enable most of these products. That means there is a lot of interest. That means there is a lot of investment.

Sensors are becoming ubiquitous and advanced. They are in phones, in shoes, in your teeth, in small patches. At the CBC we’re testing them in cars, in athletes, and in kids games.

This is an important advance for several reasons. One night a few months ago, I was playing tennis with a 19 year-old who plays for a local junior college. On our last point, at the end of the 90-minute game, I was at the net and she missed a ball. She stumbled to the back fence and collapsed against it.

I ran over and felt her pulse and it was going extremely fast. I used the AliveCor case to diagnosis her arrhythmia and was able to terminate it with a physical maneuver before she passed out. Turns out that she’d already played several hours of tennis that day, hadn’t really eaten or hydrated and hadn’t gotten enough sleep the night before.

I had been thinking about, doing research on, and implanting devices in patients (including athletes) at risk for sudden cardiac death for 20 years, and yet I never considered that some of those sudden deaths occur because of the type of rhythm I witnessed first hand in the tennis player that night. What is generally considered a more pedestrian nonfatal rhythm in others can be deadly in an elite athlete.

This is the kind of on-demand medical information I was looking for my entire professional life.

By simply collecting basic vital signs we can help a kid in Ecuador with a heart arrhythmia, and a kid in Washington DC with diabetes. We can create ways to eventually help billions of people. The 21st Century version of the house call will be as far away as a smartphone.

So how do we start to deliver on the outrageously great and transformational potential that personalized digital medicine holds? We think it starts with that first point of contact. We need to get everyone connected—at least once—to the digital health ecosystem

To encourage wide adoption, we are building a platform to bridge the digital divide and connect the more than 5 billion mobile phones in the world to the health ecosystem. We want to use every day mobile phones to collect one piece of the world’s health data stream to increase the health information flow and to create “Big Data” life analytics. Our initiative is called http://www.everyheartbeat.org. By 2013 we hope to create a system in which anyone can log-in and start recording their health narrative through their wireless phone. We estimate that recording 6 billion people’s heart rates will consume 1 terabyte of information a day; that is 1000 less than the movie Avatar. (As part of an ongoing study we have already recorded heart rates from 20 million device downloads.)

I think about the world in a few years and imagine owning and sharing health data just like we can share our life on social networks.

What will billions of heart beats show us?

It’s like the Human Genome Project.

We can use Big Health Data to study life patterns, identify disease, solve endemic health problems, and give us more control over our health.

It’s the beginning of an evolution toward knowing oneself and accepting the commonality of health needs and awareness across humanity. We are trying to tell the story of eight billon heart beats because we know it will help that sick kid in the ER at 3 a.m. in Mumbai, in Bangladesh, in Sao Paulo, in the Bronx, in East Los Angeles, in St. Louis. Everyone in the world can participate, and push medicine toward a health information revolution. This is the Internet of You. That helps 8 billion people. That helps all of us. One heartbeat at a time.

Leslie A. Saxon, MD, is the Founder and Executive Director of the University of Southern California Center for Body Computing, and the Chief of Cardiovascular Medicine at the University of Southern California Keck School of Medicine. This essay was adapted from Dr. Saxon’s 2012 TEDMED talk.

Image courtesy of Monika Wisniewska, Shutterstock

A digital doctor's office

There is no cure for the headache induced by excessive paperwork every time you visit the doctor’s office. So its no surprise that as tablet computer come to replace clipboards and smartphones become ubiquitous among patients, the medical app DrChrono is gaining some traction.

The service, which claims to have signed up 50,000 doctors and 400,000 patients, has raised a $2.8 million round of seed funding, reports the NY Times, from Russian billionaire Yuri Milner and Google’s anti-spam czar Matt Cutts.

The app, which is free for physicians, helps both the doctor and patient to monitor prescriptions, remember the details of previous visits, and engage with one another in between trips to the office. Doctors can use it to take photo and video for comparison between visits. There is also a freehand drawing tool for things like marking up X-rays.

The startup makes money offering premium services like integrated billing and storage for medical records. It even promises an end to the wild scrawl doctors have made famous on their prescription pads, with its own dictation software.

The company began life in New York, but moved west for Y Combinator and has settled in the Valley ever since.

July 9-10, 2013
San Francisco, CA

Early Bird Tickets on Sale

In February 2011, Mobisante got the green light from the U.S. Food and Drug Administration for its mobile, smartphone-powered ultrasound device. It took the medical device startup another eight months to meet the various FDA guidelines, but now its MobiUS SP1 Ultrasound System is finally available for commercial sales starting this month.

The medical device industry is itching to go mobile, but first it has to get the Food and Drug Administration to pick up the pace. For Mobisante, the process has dragged on for so long that its $7,495 ultrasound system ships with a Toshiba TG01 touchscreen phone running Windows Mobile 6.5 — a device that was originally released in 2009. Businessweek magazine reports the FDA is overhauling its policies on mobile device regulation sometime next year, but until then mobile medical device makers must continue to jump through hoops, slowly.

These types of small medical scanning devices with Wi-Fi and cellular connectivity can be taken into the field, are more affordable and easier to operation than full-sized machines, and images can quickly be shared with other medical professionals at far away locations. Captured images are small, a maximum of 480-by-480 pixels — enough for mobile usage but not a replacement for traditional ultrasound machines. The smartphone can store up to 8GB of images and they files be uploaded over a Wi-Fi or cellular connection, or offloaded via USB.

Because the imaging device connects over USB, the company has not been able to work on a compatible version for iPhones, iPads or Android devices, though Mobisante does hope to expand to medical tablet devices such as Panasonic’s ToughBook in the future, according to MobileHealthNews.

The Redmond, Wash. based startup is going up against much larger manufacturers. GE makes the VScan mobile, a $7,900 portable ultrasound device that looks like a large Motorola Razr flip phone. Siemens sells its Acuson P10 ultrasound system for $8,499.