Philips EPIQ 7c User Review
©Walter Rasmussen, R.D.C.S.
Our medical center has purchased many Philips EPIQ 7c ultrasound machines and I have worked with it over the past three years. Philips is one of the major competitors for ultrasound internationally and has a reputation of high quality imaging and sturdy design. Throughout the history of ultrasound manufacturing, there have always been good points and bad points about every ultrasound machine and that rule holds true with the EPIQ 7c.
At first glance, the EPIQ has quite an impressive, sleek, modern design, reminiscent of a high quality sports car or an apple product. It is quite light weight compared to earlier ultrasound machine designs and very easy to push. The main control section and monitor can be turned, elevated and angled to certainly any position that a sonographer would ever need while working in a crowded hospital room or ICU unit.
But while the EPIQ excels in its form, maneuverability and flexibility, the low height of the main body shelf, drawers and cubbyhole, forces the sonographer to squat, stoop and reach for supplies, which is not good ergonomic design.
The EPIQ cart body is too low, requiring the operator to stoop, squat and reach for stored items. Pushing the ultrasound machine from the front is a dream, while pushing it from the rear is quite awkward because the sonographer must bend at the waist and extend arms over the lower body of the machine in an unnatural and unbalanced way in order to reach the middle hand-holds. It is therefore extremely cumbersome to drag this machine through a doorway that closes on its own.
The power and network cables on the EPIQ are not provided with adequate stowage. The power cord holder is small, and requires that the sonographer bend over or squat and wind it tightly around a post whenever the machine needs to be transported. The power cord barely fits upon its post and It would be better if there were a bar fixture that allowed it to be more quickly and easily draped. Perhaps this bar could also allow the sonographer to more easily push the machine from the rear.
The network plug is placed on the side of the machine with nowhere to stow a network cable while attached. Instead, the cable must be completely unplugged,wound-up on the power cord post, or just stuffed in the compartment while attached, which is awkward and messy. While it is true that the EPIQ has a built in wireless capability, it is however, not compatible with all wireless systems and so a network cable is necessary at our medical center.
By comparison, the rear of the GE Vivid Body (left) has a rail that facilitates both pushing from the rear and storing the power cable.
Securing the wires more time-consuming and the lightweight loops of wire slip, droop and dangle while transporting the machine. Unless the wires are meticulously attached to the hooks, they become messy and easily catch on objects in patient rooms because they are unprotected and hanging on the outer edges of the control panel.
Above: On a machine with multiple transducers attached, the dangling wires are even more of a problem.
Above: Audio Sound with only two cheap tiny speakers!
Good spectral Doppler sound provides higher audio resolution than the spectral Doppler display itself and for this reason, the ultrasound machine should provide high quality amplification and good frequency response but for a machine that is advertised as, a “premium” ultrasound system, the spectral Doppler sound quality on the EPIQ is thoroughly disappointing and more akin to one of those portable Doppler units that nurses use to check for pulses. One look at the small, monitor mounted speakers and it is easy to see why the sound quality is so low. When compared with earlier recent Philips products such as the HD-15 and the iE33, and the GE E-95, the spectral Doppler sound quality on the EPIQ is a downgrade.
Touchscreen Control Panel:
The control panel of the EPIQ is as sleek and beautiful as the body and at first glance conveys the image of an easy to use human interface and in many ways it is. A futuristic feature of the touchscreen is the ability to move through menus by swiping the surface of the touchscreen horizontally. But there is is a lot of unused space between menu items and the operator has to constantly slide back and forth from one page to the other which is kind of cool to do at first, but quickly becomes bothersome.
It would have been better to group all of the related buttons closer together on one page and eliminate the second page so that there is less time and effort spent sliding back and forth, looking for the sought-after adjustment. An alternative to swiping the screen is to firmly touch the small dots that indicate the page you are on. These dots should have been made larger for easier activation.
The measurement and analysis page is well-organized, uncluttered, customizable but at times active measurements close and need to be reopened again to be complete. The first page and second page of the CW and PW Doppler Mode are very sparse. They could have been combined into one screen to increase user efficiency.
One of the more frustrating adjustments to make on the EPIQ is the audio volume level. This consists of a narrow, sliding soft key. It is very difficult to adjust the volume because the slider is small, clumsy to operate and glass surface lacks sensitivity. It would have been better if the EPIQ had been given a traditional rotating volume knob.
Main Control Panel: The EPIQ has a very clean-looking analog control panel. The trackball and surrounding switches look very efficient however they are made of a lighter/more fragile plastic than traditional ultrasound machines such as the iE33 and Siemens’ Sequoia. The button action is stiff and repeated pressing is sometimes necessary to perform a function. Some of the buttons seem to grate against other buttons and at times the confirmation beep repeats multiple times, indicating that the button is activating the function (such as image capture) multiple times. The buttons also have limited play which makes it sometimes necessary to strike them very hard and quickly in order to get precisely what you want. These characteristics cause uncertainty about the status of the recording and the operator has to double-check the clip. If the operator is wearing gloves, there is even more likelihood that the buttons will be difficult to operate due to decreased tactile feedback and less sensitivity of the touch screen.
Above: The plastic buttons of the trackball cluster feel too delicate. When pressed, the buttons are crunchy and do not provide good tactile feedback for how far it is necessary to push them.
Even though the layout of the trackball cluster looks good, most are flush with and in too close proximity to each other, resulting in more errors when choosing and pressing them. In particular, the Acquire 1 button is too close to the Freeze button. If the buttons were separated from each other (as they are with previous Philips ultrasound machines), there would be less chance of errors.
As with the iE33, there is a lag time between pressing the Acquire button and the initiation of recording. This has been an issue with all the Philips machines and makes getting the exact cycle or event desired much more difficult to time and obtain.
Imaging and Image Quality User Experience:
While Philips advertisements and reference and training materials tout advancements in imaging technology for the EPIQ, the user experience hints at how little has changed since the machines that it has replaced, (the HD-15 and the iE33), have been discontinued . The monitor has excellent image quality. For those who have used previous Philips machines, the layout is largely unchanged and this makes transition to the new machine easier. As with previous Philips ultrasound units, the thumbnail images appear on the right side with a scroll bar that is too narrow. If the scroll bar were made just twice the width, it would be much easier to pinpoint with the cursor and use.
It seems that it is no easier to scan a difficult to image patient with the EPIQ than it was with the iE33, and it is only through experimentation with all of the available imaging modes that a sonographer will obtain high quality results.
1. The lag-time between pressing the Acquire button and initiation of acquisition is still there (much slower than competitors).
2. The use and appearance of Color Doppler has a slight improvement over the iE33.
3. There is very little post-processing available on the EPIQ and in this way, it is not competitive with GE and even its own HD-15. In fact, only the overall Gain of the 2-D image can be increased and only upon recall of a stored image. The GE allows increase in Gain in all modes even while in the buffer before storage. The Philips HD-15 allows all the Gain manipulations that the GE and EPIQ do, plus you can change TGC and LGC gains and all Doppler gains!
5. The Write Zoom functionality on the EPIQ has not been improved over the iE33. Once Write Zoom position and size are set, it cannot be panned through the transducer imaging plane as can be done with the GE and the HD-15. Instead, the operator is required to go out of Write Zoom, re-position the box and re-initiate Zoom.
6. Recalled images cannot be magnified and re-acquired, thus impacting workflow.
8. The touch screen lacks sensitivity. It can often require quite forceful repeated taps on the screen to activate a function.
The EPIQ 7c has excellent image quality that is comparable to the iE33. The new and quieter body design however, is not ergonomic. Faster technology is a plus but many annoying quirks of the iE33 software have not been improved. The EPIQ is missing some great features that have been available from other manufacturers years-ago.